Medical Change That You Can Believe In

The past presidential election has brought the slogan “Change You Can Believe In” into every household in America. This column will discuss health care changes, and whether or not you can believe in.

Both Democratic and Republican candidates have addressed the need for change in the American health care system. The media would have you believe that health care in America is terrible because our infant mortality rate is higher than many other developed countries around the world, and our health care expenditures are greater than many other developed countries despite no differences in perceptions of the quality of care. Do we need to change our entire system or not?

We should first realize that patients from around the world come to the United States because our health care system is generally regarded as one of the best in the world for handling serious illnesses, diagnosing difficult conditions, and performing complicated operations. Assuming you have insurance, and assuming you can make decisions about your health care without inappropriate denials of coverage (sometimes denials occur in heavily managed health care plans like some HMOs), then you can receive the best care in the world.

Is this American health care expensive? Yes! Does this health care sometimes result in tests designed to detect diseases that you ultimately do not have? Yes! Do you sometimes have to go to multiple different specialists to get the best treatment? Yes! Do you sometimes have to repeat tests because the first ones have been misplaced or were not as accurately done as possible? Of course, you do! Do you always get all of the information that you want from your physician or the staff in the doctor’s office? No! What can be done to improve our current situation?

First, everyone should agree that more people should be able to access the basic elements of our health care system. Currently uninsured individuals should have access to health care that treats acute illness, results in good decisions about preventive treatments and screenings. People without insurance should be able to get urgent care rather than inefficiently monopolize physician and staff time in emergency rooms (which should instead be focused on true emergencies and have shorter waiting times).

Further, there is no doubt that unnecessary tests and treatments do take place (although this is less common than under-treatment) and the system needs to be more efficient. Even insured patients still receive too little preventive care, and too few screenings for serious conditions. Although unhealthy lifestyles need to be improved, many clinics and doctor’s offices spend too little time helping patients to lead healthier lives.

One of the great accomplishments of 2008 was passage of the Genetic Protection Act sponsored in part by Senator Edward Kennedy. This Act protected your information about your genes which can help you to understand your risk of illness and the changes you need to make to prevent serious chronic diseases.

In 2009, health care reform will be on the agenda of congress, and this will affect not only Medicare and Medicaid programs, but also private insurers who tend to follow the changes in the Medicare program. What changes should we be seeing in the health care system?

We know that care improves when patients follow clinical care guidelines. Therefore, changes in reimbursement that promote the compliance with nationally accepted health care guidelines will be most important additions to our system. But you can help make this a reality for your own care now! You can check with your doctor’s office to be certain that your physician actually knows the health care guidelines, follows them, and tracks whether or not your care is compliant with those national standards.

Secondly, it is likely that Electronic Health Records will be mandated by federally funded insurance as well as your private insurance because Electronic Health Records can eliminate duplication of tests and treatments, and can make certain that there are no unhealthy interactions between your medications that can result in poor outcomes. You can check to see that your physician has and uses Electronic Health Records.

No matter whether your doctor has an Electronic Health Record or not, you can already help eliminate duplication and begin to check on your treatments, by having your personal health record either online as digital information, and/or at home as paper copies. By so doing, you will know your diseases, your medications with their side effects, your risks of serious medical conditions, preventions, best lifestyle habits, your doctor’s treatment plans for you, and your schedule of future tests and exams. You’ll have to decide if you like the idea of having your most intimate information on a computer server “online”, since many patients do not want accidental disclosure or hacking to risk their privacy of these records. Your computer or paper files can work just fine.

A most important healthcare change will be more emphasis on prevention and screening, which implies better use of genetic evaluations to determine individual patient risks. It is hoped that in time, every clinic will have a computerized program of all the preventive and screening interventions to be certain each patient has received them. Until then, you should be certain that you have asked your physician about the risks of all the usual serious illnesses, what you can do to screen for them, and what you can do to prevent them.

Change is coming, as in all aspects of our lives. We hope the health care changes which take place under the leadership of President Obama, Secretary of Health and Human Services Tom Dashel, and your own individual legislators will result in better care for all of us.

And you can play your part in making sure the new laws and regulations are “Healthcare Change You Can Believe In” by communicating with your congressman, your senator, and the president’s office in order to mke your feelings known. Although it is unlikely that you will personally speak with your congressman, your senator, or the president, let the staff know your opinions and your opinion will be heard! The email, fax, and phone numbers can be obtained in your phone book, or on line. If there is any question about who they are, contact your primary care physician’s office or go to your local library.