Opinion | Susan Knopf: Health care escape fire
For the Record
“We don’t have a health care system in this country; we have a disease management system,” University of Arizona medicine and public health professor Dr. Andrew Weil said in “Escape Fire: The Fight to Rescue American Healthcare.” The film will screen at 6:30 p.m. Sunday at Colorado Mountain College as part of the Summit Colorado Interfaith Council’s Summer Sundays Film Series.
The scariest part of this film is that it’s true, and very little is being done about it.
For the record, if you watched the last round of Democratic presidential candidate debates, there was a lot of controversy about who had the best health care plan and who was going to let you keep your insurance. Turns out, they were talking about the wrong stuff. The only one who got it right was Marianne Williamson. In the June 27 debate she said, “We have a sickness care system.”
“What we need to talk about,” she said, “is why so many Americans have unnecessary chronic illnesses, so many more, compared to other countries.” She said we should be looking at Big Pharma and insurance companies. “It has to do with chemical policies. It has to do with environmental policies. It has to do with food. It has to do with drug policies.”
“Escape Fire” takes the viewer on a journey: The sick care system treats illness and is not always effective. Republican and former Safeway chairman Steven Burd is featured in the film. He figured out how to slash health care expenses. He saw human behavior accounted for 70% of Safeway’s medical costs. So he created broad incentives to encourage employees to change diet, increase exercise and improve general health.
Burd said something very interesting. We all accept the premise that our driving record dictates our auto insurance premium. Why not apply that model to our health insurance rates and coverage? Burd offered employees discounts for exercising, losing weight, quitting smoking and other proactive health choices.
That preventative, whole-body approach is exactly what Dr. Dean Ornish, president and founder of the nonprofit Preventive Medical Research Institute and clinical professor at University of California San Francisco advocates. After 16 years, he persuaded Medicare and Medicaid to reimburse for intensive cardiac rehabilitation treatment, which focuses on comprehensive lifestyle changes, like diet and exercise.
More systemic changes are needed to move toward a patient-centered health care system and away from a sickness management system. In “Escape Fire,” Dr. Leslie Cho, of the Cleveland Clinic, said she can get paid $1,500 for a five-minute exam that results in cardiac surgery, but if she spends 45 minutes working with the patient to manage health, she’s paid just $15.
That’s why the Cleveland Clinic works differently from other medical practices. Doctors reportedly are paid salary rather than a “fee for service.” The Cleveland Clinic developed “Value Care,” which looks to improve the “quality (of care) and outcomes for patients.” The clinic seeks to “make health care proactive instead of reactive, preventing problems before they start.” It’s not about the number of tests or the number of specialists you see.
An interesting study co-written by Dr. Elliott Fisher found that patients in Miami cost more than twice as much to treat as patients suffering similar ailments in Minneapolis. The outcomes weren’t different. The study found the Miami patients simply got more tests and saw the doctor more often. In a phone interview this week, Fisher said medical costs differ most based on “where, how and how often” the patient is treated. Again these increased costs don’t improve patient outcomes.
Of course the battle to promote health care and move from a disease-management system is controlled not so much by our politicians as it is corporate America, which has a vested interest in the current broken system.
“We’re in the grip of a very big industry, and it doesn’t want to stop making money,” medical journalist Shannon Brownlee said in the film. “We spend $300 billion on pharmaceuticals, almost as much as the entire world,” she said.
In the film, Wendell Potter, former head of communications for Cigna, said, “… the power lies with corporations.”
Find out how to seize your power and take control of your health on Sunday, and get a chance to discuss these issues with local physician Dr. Christine Ebert-Santos, Peak Health Alliance CEO Tamara Drangstveit and Summit County Public Health nurse Lauren Gilbert. It’s our money and our health.
Susan Knopf’s column “For The Record” publishes Fridays in the Summit Daily News. Knopf has worn many hats in her career, including working as an award-winning journalist and certified ski instructor. She moved to Silverthorne in 2013 after vacationing in Summit County since the 1970s. Contact her at email@example.com.
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