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By Mallen Kear
| Even though our teen population is showing an alarming increase in the rates of asthma, obesity, diabetes, and beginning stages of hypertension and cardiac disease, we spend very little health care resources addressing these rising problems. |
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The Archimedes Movement enters the health care reform debate by asking the question, “What do we want a reformed health care system to look like?” By finding a consensus about the health system that we want, the Archimedes Movement hopes to create a health care system that has health as its goal.
Everyone knows that our health care system is broken. It is not truly working for anyone, whether someone has health care coverage or not. The Archimedes Movement focuses on the elements necessary in a system to ensure that the goal of creating a healthy population remains primary.
Why, even though we are spending more health care dollars per person than any other country, do we have such poor health outcomes? Is it the cost of our uninsured population? Is it the enormous administration costs claimed by our private insurance industry?
If we look at how our health care dollars are being spent, we can see the misguided priorities of our current system. Even the dollars spent on actual health care, excluding administration costs, are not serving to keep us healthy.
There are two ways to look at this. First, we can look at where, over the course of our lifetimes, these health care dollars are spent. An overwhelming percentage are spent at the beginning of life — think of the low birth weight newborn beginning life with weeks spent in the neonatal intensive care unit — and at the end of life, when medical technologies often prove to be so futile.
Contrast this expenditure with the health care dollars spent on the typical teenager. Even though our teen population is showing an alarming increase in the rates of asthma, obesity, diabetes, and beginning stages of hypertension and cardiac disease, we spend very little health care resources addressing these rising problems. Yet if we would, future health care problems and costs might be avoided.
The second way to look at our current system is to consider how we do address illness and health. Take cardiac disease as an example. Instead of addressing the root causes of cardiac disease — this would take an increase in primary care providers, in health education, and in prevention — we instead wait until cardiac disease is serious enough to cause a “heart event,” often then leading to a surgical intervention such as a stent placement.
In describing a reformed health care system, the Archimedes Movement borrows from Don Berwick and The Institute for Healthcare Improvement. Specifically, the IHI’s “Triple Aim” addresses three elements necessary for health care improvement. These are: Population Health (Does the health care change serve to increase the overall population health?), Quality and Cost (Does the health care change increase quality while also reducing cost?), and Individual Experience (Does the health care change improve the individual’s experience as measured by patient satisfaction, patient safety, and patient outcomes?)
The versatility of the “Triple Aim” has been proven; it has already effectively been used across the world, in the smallest clinic settings to large-scale health systems. These systems include those like Sweden, that although “single payer,” still need to include the “Triple Aim” to keep their health care system focused on serving the needs of their population.
Whatever the outcome of the political debate over health care reform, the Archimedes Movement is ready to speak up about the health care system we deserve to have. Our health, and the health of our families, friends and neighbors, depends on it.
Mallen Kear, a retired RN, joined the Archimedes Movement in 2006, shortly after it was founded by former Oregon Governor John Kitzhaber.
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