Lonesome Tree in Sandhills

Wednesday, April 8, 2009

Health Care Reform - Discussions & Results

First Step: Health Care Community Discussions In December, the President's Transition Team launched an engagement of the public in health care reform that was extensive, intense and unprecedented. Over 9,000 citizens in all 50 states/DC signed up to host community discussions. Patients, doctors, business owners, and advocacy groups - people from all walks of life and various viewpoints gathered, discussed and submitted reports. The Health Policy Transition Team conducted 30,603 Participant Surveys and with help from dedicated volunteers read and analyzed 3,276 group reports submitted and survey results. Details of Report

Video: Results and Remarks of Firefighter and EMT Discussion host, Travis Ulerick, rose to his mother's challenge to stop complaining and do something about the health care problems he saw first-hand as a firefighter and EMT in Dublin, Indiana. A video of Travis' remarks and discussion results are in the sidebar.

Results and Conclusions:
Americans have a cohesive view of what is wrong and the general direction to fixing our health system. Interest in continuing to stay involved was very strong. A group in Green Acres, WA wrote: "We are extremely encouraged that President-elect Obama is reaching out to all Americans rather than special interest groups to come up with a solution. More than ever, we are optimistic that this solution will be reached."

Top Concerns - System Not Focused on Health or Prevention:
75% - costs (55%) and lack of emphasis on prevention (20%)
25% - preexisting conditions limit insurance (13%) and quality of care (12%)

Solutions Wanted:
55% want a fair (36%), patient centered and choice-oriented system (19%)
32% want a simple, efficient and comprehensive system

Second Step: Five Regional Forum in MI, VT, IA, NC, CA.
Democratic and Republican Governors Regional Forums bringing together citizens, key health care stakeholders, and elected officials to discuss what must be done to change our health care system. There was consensus that lack of health care and costs have adversely affected business competition with detrimental effects beyond political partisanship. With community organization and participation comes commitment to reforming the system because it simply is too important to our nation.

Final Step: Discussion of 30 Health Care Stakeholders on April 8
Leaders from hospitals, physicians, nurses, public health, educators, business, insurance and IT participant comments summarized in Health Reform Blog. (Big issues listed below)
C-Span (2 hr) Airtime at 3:50 pm on April 8

Major Stakeholders Ready for Reform:
Leader of America’s Health Insurance Plans (AHIP ran "Harry and Louise" ads early 90's) stated to President Obama: "We want to work with you, we want to work with the members of Congress on a bipartisan basis here. We hear the American people about what’s not working. You have our commitment to play, to contribute, and to help pass health care reform this year. American Medical Assoc. (AMA), Physician-Hospital Organization (PHO) also committed to reforming the health care system.

Action Needed Now - Big Gorilla Issues:
Patient-Centered - focus system based on patient-centered and individual care.
Insurance Plans - insureds do not understand policies affecting care and costs.
Insurance Costs - not sustainable for small businesses (employ 70% of workers).
EMR 'Wiring' - focus on patient & operability for information and reimbursement.
End-of-Life - options affect economic and human costs (hospice vs intervention).
Prevention - focus must on prevention of chronic diseases at home and school.
Education - provide health care literacy programs for prevention and options.
Provider Shortage - need to train more doctors and nurses to meet demand.
Primary Care - clinics, not doctors, needed in rural and low-income areas.
Disabilities - train providers in care of disabled with more home care options.
Home Care - align costs and care w/facts - most care is provided at home.
Responsibility - engage employers and insurers in system designs.
Children Care - system must include schools, chronic disease and disabilities.
System Design - simplify, seamless access, technology and education.
Risk Barriers - patient risk-taking and align incentives among providers.
Social Connections - strategic investment w/health impact in communities.
Pharmaceutical - FDA approval delays requires funding more staff.
Dental Health - integrate prevention into health care system structure.
Public Health - healthy work/military force relies on care at front end.
Patient Choice - patients want choice of providers not insurers.
Individual Responsibility - health incentives work (nutrition and activity).


  1. It's simple economics; we're in a global economy...we can't compete with the rest of the so-called "first-world" countries that provide health care benefits to their citizens. That doesn't even begin to address the moral concerns.

  2. It's a good list. I happen to think a single payer system is inevitable, and would restore to patient care dollars that are currently being sucked out by the billions and going to insurers for non-health related expenses.

    Meanwhile, thanks for visiting Surgeonsblog: what a circuitous path to get there! I agree with your husband about "will to live" and have written about it in various ways on my blog. I also believe in the importance of providing confidence in and connection to one's surgeon. Which is complicated in the context of legalities, informed consent, time constraints, etc etc etc


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