Healthcare Reform - Letter to President Elect Barack Obama

The President Elect is welcoming comments fromsolution already exists and can deliver on this
the public via his website at Change.gov. I'm surepromise. Research has shown that the vertically
he and his transitional team have had plenty ofintegrated healthcare organization Kaiser
ideas, hopefully constructive and helpful, since hisPermanente consistently outperformed university
historical win.and community hospitals in decreasing risk of
When it comes to healthcare, I personally believeheart disease by 30 percent. Other studies have
that the public doesn't want to do all the researchshown that the VA healthcare system with its
in uncovering the best doctors, hospitals, or healthsalaried doctors provided better care to its
insurance plans anymore than they want todiabetics than doctors in the fee for service
research the most financially solvent bank orcommunity. Other organized healthcare
safest restaurant to eat in. Nevertheless I wroteorganizations like Geisinger Health Plan and Harvard
my book Stay Healthy, Live Longer, Spend WiselyPilgrim Health have also shown superior outcomes
- Making Intelligent Choices in America's Healthcarethan the fragmented uncoordinated doctors and
System precisely because that is how thehospitals around them.
healthcare industry and employers, who purchaseHealthcare will never be cheap, but we can get
the insurance, feel that the system as a whole willmore for our dollars. The Dartmouth Atlas of
improve. At least if that is the expectation,Care found that even though there was not a
provide the public the skills and knowledge tolarge difference in health outcomes, the cost of
make the right decision.caring for Medicare recipients in the last two
My comments to the President Elect highlight ayears of life varied widely from $93,000 per
very different system of reform, which alreadypatient at UCLA, $85,000 at John Hopkins, and
exists and is a uniquely American solution to the$78,000 at Massachusetts General, to the lowest
healthcare crisis.at $53,000 at Mayo Clinic. The "savings" from the
To President Elect Obama:most expensive programs could be moved to
Healthcare is currently provided by hospitals andprovide better access or quality care to those
doctors each working separately in little fiefdomswho need it, but it won't change the total medical
which worked well two centuries ago whencost expenditures.
patients died of acute illnesses and infections.Our healthcare crisis will only be solved if the
Today patients are busier than ever, caring forentire industry reorganizes into systems which are
aging parents, and dealing with chronic illnesses,aligned to focus on the end product, great
that were never faced by generations ago. Thehealthcare delivery, rather than the piecemeal
public already gets a variety of choices in financialmom and pop cottage industry which currently
services, consumer electronics, air transportation,exist. This is far harder than it sounds and will
and dining, which are often provided by well-run,require leadership from within healthcare to get it
highly regarded, focused organizations. Why notdone as well as federal leadership on changing the
healthcare? Americans don't want the level ofpayment structure to encourage quality rather
responsibility of researching doctors, hospitals, orthan volume.
health plans anymore than they wish to reviewIf as a country we fail to solve this crisis, our
the safety records of airlines, DUI reports ofeconomy will simply worsen as the workforce will
pilots, or the maintenance records orbecome increasingly unhealthy as more people
airworthiness of the aircraft they are about tofind healthcare unaffordable and consequently will
get on. Similarly with healthcare what they expectbe unable to work or be competitive in a global
and want is a patient friendly healthcare systemmarketplace. This is a competition we cannot
to care for them when they get ill.afford to lose.
The good news is that a uniquely American