I recently heard a criticism that all health care matters, and therefore naming the nonprofit Health Care That Matters, Inc. implies that some health care does not matter.  The criticism misses the point of the mission of Health Care That Matters, which is to recognize the work being done by numerous people and organizations to move the dial on health outcomes and population health.  Unfortunately, there are instances in our health system, which generally pays for volume, where providers deliver health care services that do not matter to a person's overall health.

Take for example the alleged overdiagnosis of ADHD in children.  A New York Times article from 2013 explored this issue:  http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html?pagewanted=all&_r=0.  One aspect of the article suggests that pharmaceutical companies and some groups with ties to those companies financially benefit as more people are diagnosed with ADHD.  This makes perfect economic sense because as the number of consumers increase, the higher the demand in the products that will satisfy the consumers' needs.  In this case, the products are drugs to regulate ADHD symptoms.  This issue of creating demand in health care so that revenues can increase occurs in many other facets of the health system, including long-term care, surgical care, and laboratory tests to name a few.  Overutilization in health care is one of the areas that the government seeks to combat through its auditing and enforcement mechanisms.

Health Care That Matters, Inc. seeks to remind people that really good, meaningful health care programs exist.  These programs exist for the primary purpose of improving the health of a population.  The programs may often be underfunded, but they try to address underlying issues that may be causing or exacerbating the health problem, such as the social and physical environment.  The programs may be looking at disparities in care between racial or ethnic groups, or just trying to create a bridge of understanding between provider and patient.  Health Care That Matters, Inc. aims to highlight these programs and encourage others to learn from them and perhaps implement similar programs in their own community.  If you know of any programs that deserve such recognition, please let us know at www.healthcarethatmatters.org.  

 

Exemplars in Integrative Medicine

As I was creating content for my new nonprofit organization, Health Care That Matters, Inc. (check it out at www.healthcarethatmatters.com), I stumbled across the Bravewell Collaborative, a community of leading philanthropists who work together to transform our health care system and improve the health of the American public through the advancement of integrative medicine.

What is integrative medicine?  According to the Bravewell Collaborative website, www.bravewell.org:

"Integrative medicine is an approach to care that seeks to integrate the best of Western scientific medicine with a broader understanding of the nature of illness, healing and wellness."

As noted by Bravewell, integrated medicine can be incorporated by all health care professions and systems, and it not only improves care for patients, but also enhances the cost-effectiveness of health care delivery for providers and payors.

That last point about enhancing the cost-effectiveness of health care delivery for "payors" is important.  Right now, insurance reimbursement for wellness is sparse to nonexistent.  Insurance pays for curing an ailment, but it does not pay for maintaining health.  Thus, for many, access to wellness services such as fitness and nutrition classes or consultations, massage or relaxation techniques, meditation or yoga therapy, or numerous other activities that help create a sense of well-being, is out of reach.

Interestingly, the Arizona Center for Integrative Medicine at the University of Arizona is experimenting with a payment scheme for wellness services:  the Center seeks insurance reimbursement for services covered by insurance, but charges patients a separate membership fee that covers access to preventive and wellness services.  See http://www.everydayhealth.com/healthy-living/integrative-care-promises-to-be-more-effective-cost-efficient-4004.aspx.

The concept is admirable, but I hope to one day see insurers covering preventive and wellness services in parity with curative care.

Valuing Prevention

The Ebola outbreak draws to mind the importance of prevention, an often overlooked, under-funded part of health care.  When I attended the University of Michigan School of Public Health, we learned that over 90% of our health care resources are spent on acute care and the rest on prevention.  Yet, the greatest strides in human longevity and quality of life have been made in the realm of public health and prevention.  Things like basic sanitation, vaccinations and healthy lifestyles add more quality life years than most expensive equipment or invasive procedures.  Right now, there is no cure for Ebola, so prevention is absolutely key.  Yet, for prevention to work, the public must "buy-in" to the measures that must occur.  These measures, such as quarantine or mandatory vaccinations, often limit our individual freedoms, but as a society we weigh the loss in freedom to do whatever we want against a greater cause, such as a prosperous future.  Sometimes, when research and evidence support the loss in freedom for individuals, an entire society can benefit.

"Health Care That Matters" is born!

Welcome to the first blog post for Health Care That Matters, a website dedicated to recognizing and discussing efforts at improving individual and population health and wellness.  The idea of Health Care That Matters was born out of research I have been conducting for my book with the same title.  I stumbled across stories of people doing amazing things to help move the dial on population health.  The Health Care That Matters website, at www.healthcarethatmatters.com, provides links to some of those stories.  I invite you to share similar efforts that are happening in your community.  It is my belief that we should celebrate those people who are devoting their time and talents to help make a difference in a person’s health.  This usually requires large investments of unpaid time, as our current health care system is not set up to reward for good health care outcomes (although there is movement in that direction – a subject of a future blog post).  Health Care That Matters may help accelerate the system in the direction of paying for value by showcasing what is possible by a few dedicated people. 

A recent article by Consumer Reports, http://www.consumerreports.org/cro/magazine/2014/11/it-is-time-to-get-mad-about-the-outrageous-cost-of-health-care/index.htm, tries to ignite a flame in health care consumers by exhibiting three outrageous practices common in the health industry.   Those practices are just the tip of the iceberg.  I believe that raising consumer and provider awareness of how our current health system is structured and how it could be improved through more of the initiatives highlighted on Health Care That Matters is the key to creating a health system worth bragging about.