The Heart Beat

Among the current headlines at WebMD is space dedicated to the US Presidential candidates and their positions on health care. Please read this and anything else that you can find about this topic. Then please, vote – vote with you mind, heart, and information! Health care is a critical issue to this election and although I won’t try to unduly influence you, here a few thoughts from someone who lives in the system every day, trying to do my absolute best to take care of you and your loved ones.

The US health care system is a bit broken, but it’s not a total disaster. There are lots of really great health care providers – docs, NP’s (nurse practitioners) and PA’s (physician’s assistants) – out there working really hard, but there aren’t enough of us. Putting restrictions on the reimbursement and ability to practice of advanced practitioners such as NP’s and PA’s just further handicaps the system, especially in rural areas.

There are great, good, not-so-good, and really bad health care providers in all walks, be it MD, NP, or PA. People should be scrutinized on an individual basis for poor outcomes, not on the basis of their degrees and initials. There is enough work for all of us, and given the declining enrollment in schools for all primary care professions (but especially medical doctors) and the increasing numbers of “boomers” in the system, the country is going to need all of us that it can get!

An emphasis on prevention and wellness promotion is a very good thing. Many candidates SAY they endorse this. My apologies in advance to all of you who are struggling with your weight, or smoking cessation, or addiction, but the system has to stop coddling these behaviors. We need an insurance system that provides people with the support, tools, educational resources, and incentives to improve their health.

We need a system that helps people to find someone to take care of them as a primary care provider and discourages use of the ER for every little sniffle and sprain. By discourage I really mean penalize for misuse and abuse. But first we need to make options for them to do otherwise readily available. In my opinion we have to stop paying for visits to the ER like I see every day, in which an individual says to me, “I have an appointment with my doctor later today/tomorrow/2 days from now, but I just couldn’t wait any longer for this stubbed toe/sore neck/ankle sprain/cough I’ve already had for 2 weeks” (or insert your favorite simple problem here).

We need to give incentives to companies to pay for employee wellness programs and to include adequate breaks in their day for exercise. There are any number of research studies that demonstrate increased worker productivity on the job and improved overall health when they are given the opportunity for a 20-30 minute exercise break or organized stretching session during the work day. So what if companies lose an additional 1/2 hour of work time if the time that is actually spent working is more effective?

Insurers need to provide adequate incomes through reimbursement to health care providers for both sick care and “well” visits in which people are taught to control their diabetes, cholesterol, or diet, or make a quit smoking plan. Health care providers who make the effort to become certified as specialty educators, (certified diabetes educators are one example) and maintain that certification through continuing education, should not have to fight to be reimbursed for providing diabetes education to patients. When a person with diabetes learns enough strategies and effectively applies them to reduce their overall blood sugar readings to a certain degree they decrease their risk of developing heart disease by 25-35% Tell me that doesn’t save money!

Finally, we need to find a way to control malpractice claims. There is a role for personal responsibility in health care, and I shouldn’t have to look over my shoulder every minute worrying about whether or not an individual is going to follow my instructions and return to see me in the office or the ER if something in their condition changes.

Your vote is an opportunity to influence the country’s progress for the next four years. The ability of our country’s health care system to improve health outcomes and controlling costs is critical to the health of hundreds of thousands of baby boomers who are coming of age. Please consider your vote thoughtfully.

Take care,

Laurie

Related Topics:

• Health Care Reform
• Universal Health Care Coverage

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