US health care still needs reform, access

There is a major crisis in the United States that deprives a large number of people of the health care they need. The most visible problem is the millions of people without health insurance and the most distressing is the number of preventable deaths, more than 100,000 people per year.

Social determinants, such as race, income and environment, strongly influence who becomes ill and who receives access to quality care. The health care crisis disproportionately affects disadvantaged groups and underresourced communities such as people living in poverty, people of color and immigrants. Yet barriers to accessing care, the burden of medical debt and the shortage of primary care providers affect all people.

Below are my proposals for improving this healthcare crisis.

The Beveridge Model defined by Sir Winston Churchill speaks of five important basic concepts including health care as a human right. One of the countries practicing the Beveridge Model is Sweden, which uses a single-payer system and spends 9.4 percent of its overall gross domestic product on health care yearly (2011) compared with the U.S. which spends approximately 18 percent.

Health care has not been designed as a right, but a privilege. Health care should be declared a human right in our country and available to all Americans.

The United States government should be charged with setting the political agenda for medical and health care with the overarching goal of providing accessible, affordable, evidence-based, high-quality care. This starts with appointing federally regulated organizations that are responsible for health care clinical guidelines, financial regulations, information management, centralized payment system and quality improvement.

Part of their goal starts with assigning each household a life coach, whose main responsibility is the lifelong health care of the family. The life coach is a nutritionist, therapist and fitness coach. Together as a team, the life coach and patient will set realistic 3-month and 6-month goals for weight loss, blood pressure control, smoking cessation or reduction in bad cholesterol.

An effective electronic health record (EHR) is essential to improving health quality and managing health care delivery, whether in a large health system, hospital or primary care clinic. This EHR should focus on clinically relevant record-keeping that improves patient care by improving clinical and administrative decision-making support and accessible by all providers across the country. Most importantly, it will decrease the amount of redundant unnecessary tests since all providers will have access to the patient’s chart in real time. This will reduce the fragmentation of care due to wait time while records are being obtained or repeating of painful invasive procedures that can be avoided.

Often overlooked in annual mortality statistics is the fact that preventable medical errors persist as the No. 3 killer in the U.S., third only to heart disease and cancer. In the Institute of Medicine’s 1999 report “To Err is Human,” the authors estimated some 100,000 Americans die each year from preventable adverse events. Medical errors from unrecognizable handwriting, misuse of abbreviations and miscommunication can be minimized. A universal EHR will allow providers the opportunity to communicate with each other for consultations and clarifications even though they are thousands of miles away.

In 2009, the U.S. spent $2.5 trillion on health care; however, only 3 percent was dedicated to government public health services designed to prevent chronic illnesses. Countries that concentrate their resources on preventive services such as lowering cholesterol, high blood pressure, and obesity save millions of health care dollars in the long run. Research found that access to a primary care provider decreases the fragmentation of care that can occur when patients seek primary care services from urgent care clinics and emergency rooms. According to the American Academy of Family Physicians, there is a need for 52,000 more primary care physicians by 2025 to meet the country’s health care utilization needs.

To ensure that Americans continue to live productive and meaningful lives, we must take care of their physical and mental health. It starts with proclaiming health care as a human right, incorporation of life coaches, a federally supported health care information communication tool and full support of primary care providers. The goal is to replace costly, wasteful care with accessible, affordable, evidence-based, high-quality care.

This story was originally published July 28, 2016 at 5:23 AM with the headline "US health care still needs reform, access."