Health Care Reform: What YOU Can Do ....

Yesterday on facebook, we had quite an interesting interaction because I used the words 'health care reform'.  Wow!  What a button!  It's GREAT to see people focused on the subject, and historically you will find that when a controversial subject is close to 50/50 in opinion, people get very 'active'.  And 'active patients' is what many progressive thinkers in the medical industry want.  Including Lumigrate!

Last weekend, President Obama came here to Grand Junction, Colorado  to hold a town hall meeting about health care reform.  It happened to be the weekend of the Palisade Peach Festival here, and 'the girls' went and picked peaches while he worked to bring his message to our community and hear our input.  There were follow up meetings for him to personally get to know why Grand Junction, Colorado has significantly better health care than most places in the United States.  Both of our hospitals reported some of the lowest Medicare reimbursement rates in the country in 2006 and at the top nationally was our Hospice and Palliative Care of Western Colorado.   There obviously are a number of reasons for this and since Lumigrate is fortunate to be located here, I thought I'd include a piece about it for your information.

When I was in Berkeley last month speaking at the chronic pain conference, a woman came up to me afterwards and said she already knew about my home town because of an article she saw in The New Yorker in June about communities and systems where health care was improved (see link below, FYI; it is an outstanding article). There are a handfull or two of areas in the country or health care systems which have significantly lower costs and higher outcomes.  The article refers to research by sociologists who have studied why certain regions became leaders in biotechnology while others did not.  Just as an anchor store will 'define' a mall, a university or company can define a community and set the norms.  This anchor will work with competitors to encourage free flow of ideas and cooperation, producing particularly successful communities, while others that don't collaborate or try to dominate will not have this favorable environment surrounding them. 

Grand Junction's enriched medical environment is largely credited to Rocky Mountain Health Plans (link below, FYI) and collaborating physicians.  Established in 1974 by community leaders, including physicians, Rocky Mountain Health Maintenance Organization, as it was originally named, was formed as a not-for-profit health plan to coordinate the delivery of health care for the entire community.  They have done many innovative things, including having a home health department to provide in-home care to people and keep them out of the more expensive hospital when appropriate -- they are the only organization in the country doing this.   "Rocky" and the Mesa County Physicians Independent Physician Association (MCPIPA) worked together to ensure citizens got the care they need.  They have a special emphasis on chronic conditions, which are the most costly to a health insurance company.  

The guidelines for these two cooperating organizations that came together so many years ago were to be collaborative (not adversarial), to have the physicians and patients making the medical decisions, and realize "health care professionals and organizations have an obligation to improve the health of the community, not just to provide and pay for sick care."  The physicians agreed to receive a similar fee for patients with the varying types of insurances, which reimburse higher and lower, instead of whatever the insurances paid to keep from 'cherry picking' the type of patients they accepted.  This resulted in some physicians making less so that others could make more.  They also peer-reviewed their processes and procedures and interfaced with many other organizations to make sure people had access to the best health care possible. 

One of the physicians who speaks about this, and contributed an article to one of the local papers, is Michael Pramenko, MD.  He is a family physician at Primary Care Partners, is president of the Mesa County Medical Society, and serves on health care committees related to health reform.  A link to his article is provided below and we encourage you to read it because it's really helpful for consumers to have a perspective of what doctors are experiencing and participating in related to their piece of the health care puzzle. 

There are many exceptionally good hospitals, programs, medical centers and clinics in Grand Junction and surrounding area because of this enriched environment that was created through collaboration.  Much can be applied to other communities or the larger national level.  One example is the community-wide electronic records started in 2005 which streamlines information costs and improves patient quality of care.  

I moved here from the Denver area five years ago and had to adjust when driving because when you're merging into traffic, cars slow down to let you in front of them, not speed up to get ahead of you.   On a return trip "home" once, I realized I had more negative interactions on the road in ten minutes than I had in a whole year in Grand Junction driving.  Who knows if these things are related, but it serves as an example of an important concept: what each person does has an effect on the whole. 

What you do about health care has an effect on the whole.  As for 'health care reform', please take a minute if you haven't already to familiarize yourself with the model on our home page about 'You' being in the center of a team of people collaborating about your health care.  If we start thinking about improving each patient/provider interaction as "health care reform", we can definitely be doing something today that reforms health care ... starting in that moment and having more influence in the future when more and more people shift to that way of thinking.  People want to know what they can do as individuals, and becoming more educated and involved about health care is something that would add up to a lot if everyone did it.  The most important person to a patient's health care is the patient, so the medical consumers are in a very powerful position and mostly don't recognize it. 

Then help others interested in health care reform by talking about this concept with them -- refer them to the website if you think it is helpful.  Talk with your family, friends, medical providers and other community members.  Just as we see health care having YOU at the center when it comes to each consumer, I think health care reform in the country will benefit if enough people will shift to this kind of thinking.  And keep in mind consumers can be wonderful messengers to the providers who are scrambling around every day trying to keep up with everything in a system which has grown increasingly difficult.  The industry and government are struggling with our input to make changes, so we can each do our part to strengthen what we do in our roles as the patient/consumer at the center of things.   

I suggest whether you're talking about your own personal 'health care reform' (whether that has to do with stress management, nutrition, exercise, etc.) or that of the nation, do what our home page suggests.  Be educated -- get good information from reliable sources and remember there is a difference between facts and opinions.  Dig down on subjects that are important to you and be sure you have the facts -- look for the source of the information.  Take the lead in thinking of yourself in the center of your health care team and work with your providers and communities to adopt this type of thinking as a part of health care reform if YOU think it makes sense. 

Please email us here at the website and let us know what YOU think!

Resources:

Link to The New Yorker, June 1 story, "The Cost Conundrum"  www.newyorker.com [1]

Link to Dr. Pramenko's article in the GJ Free Press: www.gjfreepress.com/article/20090626/COLUMNISTS/906259980&parentprofile=search [2] (interviewed by PBS' News Hour with Jim Lehrer and many others) and to his clinic, Primary Care Partners pcpgj.com [3]

Link to coverage by the Grand Junction Sentinel: www.gjsentinel.com/ [4]

Link to Rocky Mountain Health Plans: www.rmhp.org [5]

AND get a glimpse of our amazing scenery, peaches, wine and more and find out why Grand Junction considers itself the recreation hub of the United States (there are more types of recreation in a 100 mile radius) - www.visitgrandjunction.com/ [6]