More Thoughts on Vermont Discussion

As promised, below are some further thoughts on the four areas outlined in my initial post from the Vermont forum. These are areas that, to me, seem to be clear and critical components of health reform at the national level.

  • We have got to do a better job of preventing disease in the first place. About 30 percent of the growth in health care spending seen over the past twenty years is linked to a doubling in obesity rates. We need population-based and public health initiatives that will help to promote health in places where Americans spend their time: schools, workplaces, and communities.
  • Unless we find better models to manage the chronically ill, we will not be able to bend the health care cost curve. About 75% of health care costs in the U.S. are associated with patients with one or more chronic conditions. We need a more holistic system that is truly focused on the patient. To make this work, we must extend care beyond the traditional doctor’s office. The community health teams in Vermont are a tremendous model for the rest of the country on how to make this work.
  • We need universal coverage. When it comes to coverage, everyone has a first choice for how to do it; but everyone’s second choice is the status quo. If we want to improve health, and spend our health care resources more wisely, it doesn’t make any sense to have a group of Americans who don’t have regular access to care to help them stay healthy. We need to be willing to work together to find compromise, as Vermonters were able to do.
  • The health care system must be made simpler. We spend way too much on administrative costs. We need to find ways to make things simpler, and more effective, for patients, providers, and others coming in contact with the system. Interoperable, affordable health IT systems must be a priority.