Thoughts and Observations on Health Care and Preventative Medicine

While traveling in Florida during spring break, I stopped at a 7-11 store to put gas in my car. What was surprising to me was that each gasoline pump had a bright blue sticker with a message to perform proper hand hygiene…you see, the Florida Department of Health is trying to get the message about H1N1 flu prevention to everyone, using every available opportunity. Maybe their example should be food for thought.

Last night the House of Representatives finally cleared the health care reform bill. I’m in the majority of those who desire health care reform. I’m not certain, however, that the bill that was passed is, in any way, “reform.” It seems to be a way to add insurance coverage without actually “reforming” our delivery model. If we continue to focus on acute care and episodic medicine, then we will simply drive costs higher. At some point, we need to realize that the best approach is prevention. Anything that keeps a patient out of the hospital, or supports a patient who has been discharged, so that patient is not readmitted, should be our ultimate goal. While some pundits suggest that prevention efforts do not reduce costs, I would argue that we haven’t really made a effort expansive enough to even measure the benefits. Labels on cigarette packages, labels on alcoholic beverages, labels on cereal boxes…is that prevention? Exercise? Weight control? Stress management? Are these initiatives getting enough attention? Sadly, the reimbursement model currently applied to health care values high tech procedures, and minimizes non-procedural components. Maybe our model at least partly explains why the United States ranks so poorly when compared to other countries in the arena of health care outcomes. We need true reform. Not just some version of expansion, but truly a sea change that impacts us on all levels. Health reform must include components that touch and affect society at all levels, including education, family life. habits, activity, and personal responsibility.

A final thought:
Where is the willpower to confront the reality in our society which super sizes everything, makes being a couch potato an art, requires elevators to go even one floor, and considers exercise nothing more than bending a elbow as food is moved from plate to mouth? Failure to actively address these and other issues will keep any hope for improved health in our country stalled.

- Dr. Joe Prosser, MD
Chief Quality Officer