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Dec
12
2006

There is an old folk tale about the peasant wife and how she solved a problem. Every night, she and her husband found that their feet were cold while they slept, because their blanket was not long enough to tuck in.

To solve the problem, she cut off a wide strip from the top of the blanket and sewed it on the bottom. That way, she reasoned, there should be enough blanket at the bottom to tuck it in at night.

This kind of thinking seems to be what is going on in "health care reform."

Solving the whole health-care conundrum all at once would be too much to ask, but what about starting with one significant change?

How about a system of facilities, smallish buildings somewhat like our public library system (free, and offering many services), but specifically related to health-wellness-medical matters. Offering a resource and assistance for information-gathering, test-taking (of basic types like glucose monitoring, basic blood tests, amino acids panel, thyroid, etc. - basics).

How about having this system offer books, magazines, assistance with formulating an internet search or literature search -- but no medical advice -- and in addition, offer basic tests, and providing the answers direct to the patient.

(And while we're at it, let's not call them 'patients' any more. At these facilities, let's call them "patrons.")

All services would be basic, but all services would be free.  No actual health care provided.

Doctors might be quite alarmed at the idea of patients have direct access to tests . . . their own tests . . . on the grounds that 'they won't know what the test means.'  Perhaps the patient won't, but on the other hand, it would be a step up from (1) no information whatsoever, and (2) no health care whatsoever -- which seems to be the case now.

And patients can be roughly divided into two groups:  those who want to know everything; and those who want the Person in Chage to take care of everything.  So doctors would still have plenty of patients coming to them, even for very basic information.  Those would  be the ones who like having some other Person in Charge, and not being in charge themselves.

However, it does seem that facilities such as these Health-and-Wellness-Information-Centers could take a great deal of burden off of the bottom layer of the existing 'system'.

As one model of free care to get health and wellness started in the right direction, we could think about the Regional Centers in California which do 'assessments' of special-needs children.  Very coordinated approach, and free.  Those  Centers might be something to explore, as one model.

Some reasons why the world may be ready for this kind of idea:

  • people are already taking on more and more of the burden of their own care, because so many are under- or un-insured.
  • people are already doing research on the internet, educating themselves, talking on line -- about all sorts of things; travel, investments, real estate -- and oh yes, health, because the current 'system' is not meeting their needs
  • providing basic, fundamental sources of detailed information to a large number of people, currently called 'patients,' could save very large amounts of money.

A COSTLY EXAMPLE OF THE CURRENT NON-SYSTEM

Elsewhere in this website there is a story about a woman who had already developed diabetes but had no access to health care (including good sources of information earlier in life, apparently).

Over one 18-month period, she was "rushed almost monthly to the emergency room, spent weeks in the intensive care unit and accumulated more than $191,000 in unpaid bills."

The article talks about saving money -- by having provided her with free care, but not through the Emergency Room and not in an emergency fashion -- "Her care in the last 18 months has cost . . . $104,697, far below the $191,277 for the previous period."

Apparently they're quite proud of saving money with health care that costs around $70,000 a year? No wonder the system is in trouble! That's about $5,800 a month. How many ordinary Americans make that money each month? And of those who do, how many should have to pay over their entire salary -- leaving nothing to live on -- in order to have medical care for diabetes?

SOME OTHER EXAMPLES

There are a multitude of other examples where very high costs could have been avoided:

For example - a young woman gets pregnant, she has epilepsy, and no one has told her that anti-epilepsy drugs and pregnancy can spell Disaster. Or they haven't told her forcefully enough . . . because time, at patient visits, is so short.

If she had had some real education when she first began taking medication, everything could have been different. Information could have been delivered by way of live lectures, video lectures, group meetings with peers, or handouts specific to her situation, or all of the above. Her high-risk, and very high-cost pregnancy might have been more like a bump in the road than the car wreck that it could turn into.

Another example. A teenage boy begins drinking. Every time he goes out drinking, he comes back home nearly out of control No one educates him, or his parents, on the importance of basic vitamins and minerals for metabolizing alcohol. The rage that can be associated with alcohol (not to mention all of the other symptoms). The parents, and perhaps teachers, wrongly conclude that he is psychotic . . . and once again, the situation degenerates to a disaster, but one that could have been avoided.

Another example. A middle-aged man begins taking a statin drug. His doctor fails to tell him that the statins deplete ubiquinone, also known as Coenzyme Q, also known as CoQ10. (Certainly some doctors do provide this information, but by no means do all of them provide it.) After taking the drug for a few months, the man develops muscle pain, and eventually neuropathy. His doctor tells him there is no connection. The man's on-line research and on-line "bulletin board" buddies tell him otherwise.

If all sorts of information were available right at the start -- handouts, videos, lectures, whatever -- there might be many fewer expensive problems, down the line.

THE PUBLIC IS ALREADY ACQUIRING INFORMATION

Today, people go on line to `bulletin board' discussion groups and ask their questions. The questions frequently begin with "I saw the doctor today, and he told me I have X, Y or Z Disease or Syndrome -- but he didn't tell me much about it."

Or they go on line and read and study. Health-and-medicine searches are one of the most popular searches on the internet...

The medical community frequently complains that information on the internet is not reliable. Well then, why not accumulate a lot of knowledge in one place (or more than one place, in large cities), instead of the massive wasteful duplication that now exists?

There are hundreds of websites. How would an individual know what is reliable and what is not?

THIS MOVEMENT IS ALREADY UNDER WAY

It just doesn't have a building in ever town; but it's 'out there' and already happening -- on television and on the internet, as well as in books and magazines.

For instance, on cable or satellite television, The Research Channel shows academic speeches, including medical and biochemistry events.

Over the internet, so-called 'distance learning' is available.  Johns Hopkins has what they call "OpenCourseWare". And other institutions have also made a commitment to "the open publication of their materials in OpenCourseWare initiatives, and are devoting resources to support these projects." Currently, within the U.S. those are MIT OpenCourseWare, CarnegieMellon's Open Learning Initiative, Tufts University, and Utah State University. And there are others outside the U.S.

So let's begin another, new, "free library-and-basic-testing system."  When do we start?

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Join the dialogue here

Sep 27, 2007 1:55:51 PM
Brenda Turner says

Thank you for blogging about Health Care Reform! The growing number of uninsured, now at over 47 million, the high cost of insurance and the release of the 2008 presidential candidates’ health care plans have brought the topic of health care reform to national headlines and prime time news.

But what about the individual stories of American citizens facing a health care crises today? How do they navigate the broken health care system? At Outrageous Times.org we talk about the issues concerning individuals and small businesses. In addition to reporting on pending legislation and the record profits of pharmaceutical and insurance companies, we address the real life stories -- emergency room care, mental health issues, drug abuse, obesity, preexisting conditions and children's health. By letting our voices be heard-together we can find common sense solutions to reduce health care costs and increase access to quality health care for all.

Outrageous Times is our monthly grass roots newspaper, dedicated to health care reform now and is distributed to over 20.0000 readers in Mercer County, WV and Tazewell County, VA. The web site www.OutrageousTimes.org is a both a local and national health care resource. We would like to invite you and your readers to submit your stories, experiences, observations and opinions to OutrageousTimes.org. Comments posted on OutrageousTimes.org are often reprinted in the Outrageous Times.

Thanks in advance for your contributing your knowledge to OutrageousTimes.org.

Sincerely,
Brenda Turner
Publisher
Outrageous Times

Apr 10, 2008 5:39:39 PM
ediamacated person says

I see patients and listen to their understanding of healthcare problems and see the cost of the very very stupid things they buy. The cost of healthcare I mean real healthcare is not the crazy numbers people quote. A Dr. and hospital are instructed to bill UCR fees. These are not the fees negotiated with the insurance company and more often than not the insurance company does not pay the negotiated fee 30% of what the patient thinks the doctor or hospital is getting paid. In other words Dr.s do not get paid as much as teachers you stupid assholes. No retirement worth over 1 million is paid for Dr.s but is paid by teachers. Doctors do not get healthcare during their career and definitely on retirement like teachers. Doctors do not start their careers at 22 like teachers. Doctors do not have low SATs lowest 1/3 of all that go to college like teachers. Many of my friends are quitting medicine and teaching bio in high school. So don't give out bad info about mediicine people do not close profitable hospitals or medical practices.

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