The healthcare equation
Posted: Monday, January 26, 2009 1:57 PM by Daily Nightly Editor
By Robert Bazell, NBC News Chief science correspondent
Almost no one talks about health care reform without mentioning the need to contain costs. Tonight we begin a two-part series about a collection of experiments run by Duke University that set out to rein in the price of medicine by actually improving care for patients with private insurance, those enrolled in the state’s Medicaid program, and those with no insurance at all. You can get descriptions of the various programs here: http://communityhealth.mc.duke.edu/quicklinks.
How can you improve care AND cut costs?
As Dr. J. Lloyd Michener, Professor and Chair of the Department of Community and
Family Medicine, told me, "What's really interesting is, everything we've tried has worked. Some things work better than others, but U.S. healthcare is so complex now, we spend so much money and get such poor results that it's not hard to make things better."
In these experiments, the Duke researchers started in the emergency room. Everyone knows that the ER is the most expensive and inefficient place to provide medical care for people who do not have true emergencies. Yet many people go there even if they have access to a family physician they can afford. What's worse, by time they are in the ER, they are often very sick with a condition that could have been lessened or prevented with a visit to the doctor.
The Duke researchers interviewed people who are using the ER inappropriately and asked them what it would take to get them to doctors. As a result of those interviews, the Duke program set out to make its doctors offices more user friendly (more on that in tonight’s report), and set up satellite clinics in neighborhoods, including in high schools, and reinstituted the old fashioned home visit for those who have trouble getting to the doctor. So far the results are good.
As we continue reporting on efforts to reform health care this year, it is important to remember that no one knows what reform will look like if it ever comes, but it is fascinating to see what different experiments are underway.
Click here to see related reports:
Jan. 6: Can America afford to heal its healthcare?
Jan. 12: Massachusetts a template for healthy states
Jan. 13: Health care for all comes at high cost
