How can we make health care better?

[eliza61]

I saw a very interesting program last night on PBS called "sick around america" and got to wondering how can we improve our health care system.
http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/

I am not trying to start an argument about who did what, socialism or any other hot button topic.

Simply start a "wish list" so to speak. If you could design a new system or improve on the one we have what would you include.

I have 2 things that would effect health but are not really part of the health care industry.

1) I would love if we could bring back "gym" classes. My kids school have gym only once a week. I guess I'm pretty old fashion, I think maybe getting kids to run around every day would help with our child obesity problem.

2) Portion size I'm guilty of this. my portion sizes are probably more appropriate for a small elephant. How did we get so use to a pound of pasta being normal?

 

[RNMOM]

Eliza, both your suggestions are very good!

Having worked in several different hospitals over the past 33 years, I think the concept of electronic records is really reasonable. We have many hospitals in Cleveland and the 3 biggest, Cleveland Clinic, University Hospitals and Metrohealth all have been using electronic records for quite a while. When you go to your appointment the doctor and nurses use a computer terminal to enter data and pull up records, xray results, past tests. It makes the appointment faster and more accurate. Any changes are made by the nurse or tech who does your vital signs. One group of offices, the doctors bring in their laptop, the others have desktops. Each time they enter their password at the beginning of the visit and lock it off at the end.

I wish there were not so many people against this method. You might be surprised at how many hospitals and offices use these methods.

I also would like to see everyone under the same system. Medicare, government employees, everyone. It would reduce the cost due to paperwork and billing to a large degree.

 

[eliza61]

Hey RN,
I think the biggest fear is the possibility of stolen information. I did see a tv report (on Oprah) saying that hospitals that started this decreased the number of medical mistakes by quite a lot especially medication errors. Dennis Quaids son almost died due to inaccurate dosage of a blood thinner so he also champions electronic records. The hospital where his son was at instituted the system and decreased their mistakes by almost 30%.

 

[raysnkaysmom]

I just wish there was a way everyone could have insurance.... that's it...

 

[Buckalew11]

I


1) I would love if we could bring back "gym" classes. My kids school have gym only once a week. I guess I'm pretty old fashion, I think maybe getting kids to run around every day would help with our child obesity problem.

I know exactly what you are saying. I had "real" PE classes growing up and loved them but by HS, kids hated PE and would do anything to get out of participating in the actual class. My sister is now a HS PE teacher and trying to get the kids to do PE is almost a lost cause. She used to do elementary school and they loved it 9for the most part) but the HS kids, ugh. Let's just say she hates her job now. Plus, there is so much paperwork it is hard to conduct a class! Sad state of things.

 

[minniecarousel]

I just wish there was a way everyone could have insurance.... that's it...

Amen!

I wish that health insurance weren't tied up with one's employment.

 

[The Mystery Machine]

I saw that TOO!!!! That was a very good special and very depressing and real I am afraid.

Worth watching imo.

 

[wall*e2008]

The person receiving treatment needs to have some vested interest in the cost. This will prevent someone from going to the ER for an runny nose. If you have to pay x% of the initial visit you will go to the GP for a runny nose, since the cost is less.

If you chose not to do preventative treatment, prenatal care, etc and then you get a huge bill that could have been diagnosed or prevented and not gotten the expensive treatment, you pay way more than the person who did the preventative care and needed that treatment.

 

[Golf4food]

Stop making insurance dependent upon employment and pay for it just like you do auto or homeowners insurance and mandate that rates not be higher for non-employee group plans.

Get the government out of it as much as possible.

Keep decisions in the hands of the doctors and not an insurance administrator behind a desk 1,000 miles away deciding what treatment can and cannot be used.

Overhaul the justice system to better deal with frivolous lawsuits that drive up costs for everyone. Legitimate lawsuits are one thing, but so many just seem out of hand these days. If we stop thinking that a billion dollars is no big deal then we'll stop throwing cash around like we have unlimited funds and perhaps start trimming a little fat!

Stronger focus on preventative care rather than accute care, like with dentistry. There is a reason insurance usually covers 100% of two cleanings/check-ups each year - it saves a lot more money in the long run.

 

[rparmfamily]

I watched it too, great show!

I was a little scared about the woman w/cataracts driving though!!

 

[rparmfamily]

The person receiving treatment needs to have some vested interest in the cost. This will prevent someone from going to the ER for an runny nose. If you have to pay x% of the initial visit you will go to the GP for a runny nose, since the cost is less.

If you chose not to do preventative treatment, prenatal care, etc and then you get a huge bill that could have been diagnosed or prevented and not gotten the expensive treatment, you pay way more than the person who did the preventative care and needed that treatment.

I think they did made a good point last night about this--the man who never had insurance, never went to the doctor, then BAM at 51 has a heart attack,etc and THEN gets insurance--how he was an insurance companies worst nightmare and why individual policies can be so high. He never paid into the system...but got huge amounts out.

 

[Free4Life11]

Make HSA's available to everyone. Expand and promote high deductible health plans.

 

[wvjules]

Amen!

I wish that health insurance weren't tied up with one's employment.

Mine isn't tied to my employment.

Make HSA's available to everyone. Expand and promote high deductible health plans.

Here is a website with such plans....

www.ehealthinsurance.com They even have HSA's.

 

[rabx5]

People who use the ER for stuff they can be treated for at a physicians office. I guess what I am saying is people wait too long to see a doc and then go to the ER, raising the cost of everything.Not only the cost is an issue, but they are taking important time away from people who really have an emergency situation. They get antibiotics so often these days, that antibiotics are no longer working anymore.


Edited to add this story that was on Yahoo. I rest my case
http://news.yahoo.com/s/ap/20090401/ap_on_re_us/frequent_er_patients

AUSTIN, Texas – Just nine people accounted for nearly 2,700 of the emergency room visits in the Austin area during the past six years at a cost of $3 million to taxpayers and others, according to a report. The patients went to hospital emergency rooms 2,678 times from 2003 through 2008, said the report from the nonprofit Integrated Care Collaboration, a group of health care providers who care for low-income and uninsured patients.

"What we're really trying to do is find out who's using our emergency rooms ... and find solutions," said Ann Kitchen, executive director of the group, which presented the report last week to the Travis County Healthcare District board.

The average emergency room visit costs $1,000. Hospitals and taxpayers paid the bill through government programs such as Medicare and Medicaid, Kitchen said.

Eight of the nine patients have drug abuse problems, seven were diagnosed with mental health issues and three were homeless. Five are women whose average age is 40, and four are men whose average age is 50, the report said, the Austin American-Statesman reported Wednesday.

"It's a pretty significant issue," said Dr. Christopher Ziebell, chief of the emergency department at University Medical Center at Brackenridge, which has the busiest ERs in the area.

Solutions include referring some frequent users to mental health programs or primary care doctors for future care, Ziebell said.

"They have a variety of complaints," he said. With mental illness, "a lot of anxiety manifests as chest pain."

 

[The Mystery Machine]

Mine isn't tied to my employment.



Here is a website with such plans....

www.ehealthinsurance.com They even have HSA's.

FYI....

My 17yodd has had open heart surgery. She is not insurable in the private market.

She cannot get private life insurance.

The only place she is going to be able to get insurance is through an employer.

 

[Disney Doll]

Stop making insurance dependent upon employment and pay for it just like you do auto or homeowners insurance and mandate that rates not be higher for non-employee group plans.

Get the government out of it as much as possible.

Keep decisions in the hands of the doctors and not an insurance administrator behind a desk 1,000 miles away deciding what treatment can and cannot be used.

Overhaul the justice system to better deal with frivolous lawsuits that drive up costs for everyone. Legitimate lawsuits are one thing, but so many just seem out of hand these days. If we stop thinking that a billion dollars is no big deal then we'll stop throwing cash around like we have unlimited funds and perhaps start trimming a little fat!

Stronger focus on preventative care rather than accute care, like with dentistry. There is a reason insurance usually covers 100% of two cleanings/check-ups each year - it saves a lot more money in the long run.

You should run for Presdient next time!

 

[Disney Doll]

FYI....

My 17yodd has had open heart surgery. She is not insurable in the private market.

She cannot get private life insurance.

The only place she is going to be able to get insurance is through an employer.

Many employer-offered insurances are now also looking at "pre-existing conditions" & coverage or non-coverage of them. Scares me too, since I had open heart surgery as a child and may be looking at another one!

 

[The Mystery Machine]

Many employer-offered insurances are now also looking at "pre-existing conditions" & coverage or non-coverage of them. Scares me too, since I had open heart surgery as a child and may be looking at another one!

Ugh....Something has to change here.

 

[bbangel]

I watched this program and agree it was very interesting (and incredibly sad)
Made me very glad I live here and not there!

I hope that all the groups come together and as the one man said - agree that everyone deserves access to health care and work from there. It won't be easy (and the majority will think it sucks at first) but it can be done. No system is perfect, but losing your house because you have cancer or have a heart attack should just be unacceptable.

 

[Robbi]

The person receiving treatment needs to have some vested interest in the cost. This will prevent someone from going to the ER for an runny nose. If you have to pay x% of the initial visit you will go to the GP for a runny nose, since the cost is less.

If you chose not to do preventative treatment, prenatal care, etc and then you get a huge bill that could have been diagnosed or prevented and not gotten the expensive treatment, you pay way more than the person who did the preventative care and needed that treatment.

This I agree with 100%. A few months ago I took my mom into the er on a Sunday afternoon with chest pains. It was like a party. There were people cutting up and laughing. The people they were there with-the patients were acting up too. They could have waited until the next day to see the GP. The patients had a runny nose.
People use the er as a primary doctor visit.

Stop making insurance dependent upon employment and pay for it just like you do auto or homeowners insurance and mandate that rates not be higher for non-employee group plans.

Get the government out of it as much as possible.

Keep decisions in the hands of the doctors and not an insurance administrator behind a desk 1,000 miles away deciding what treatment can and cannot be used.

Overhaul the justice system to better deal with frivolous lawsuits that drive up costs for everyone. Legitimate lawsuits are one thing, but so many just seem out of hand these days. If we stop thinking that a billion dollars is no big deal then we'll stop throwing cash around like we have unlimited funds and perhaps start trimming a little fat!

Stronger focus on preventative care rather than acute care, like with dentistry. There is a reason insurance usually covers 100% of two cleanings/check-ups each year - it saves a lot more money in the long run.

In our state if a lawyer brings a frivolous suit, they're reprimanded and fined.

I agree with everything in your post.