Where would you rather be sick?
Stanley Feld M.D.,FACP,MACE
A few days ago I wrote about USA Today article “Study: Canadians Healthier than Americans.” The take home message of the article was socialized medicine in Canada is better that the medical system in America. I pointed out that the article had many defects in study design. The data derived from the study was poor. The study did not prove anything. It did however simply add noise to the debate.
On June 15, 2006 the Wall Street Journal published and article “Where would you rather be sick?” This article was to be the answer to the Canadian study. The article pointed out some of the defects in the Canadian study. The article then went on to state the survival rates for treating illness is far superior in the U.S than in Canada. Therefore when one becomes ill it is much better to be ill in the US under our system of healthcare than it is to get ill in Canada under their system of healthcare.
For the students of my blog, the facts in the WSJ article have nothing to do with the defects in our system. These defects must be repaired. A system that has 45 million uninsured, restricts access to care, daily creates more and more economic strain on every stakeholder in the system, and has the key element of the system (patient care and the physician patient relationships) deteriorating has problems that have to be fixed immediately.
As stated previously, we, physicians, know how to fix things that are broken better than any country on the planet. The healthcare system must learn how maintain health before complications occur. Fixing the complication absorb 80% of the healthcare dollar. Our fixing the complication of disease is what is bankrupting the system. The system has not been set up to maintain health. It is trying slowly but we are not even close.
We can not get distracted by noise or “Fooled by Randomness” fooled by random data. We must state focused as we work our way to the solution. In order to do this we “the patients and potential patients” must think critically and dismiss the noise we are exposed to daily.
The Weekend
Cecelia and I came to Boulder, to celebrate our 43rd Wedding Anniversary and Father’s Day with my two boys, Brad and Daniel, their wives, Amy and Laura and our granddaughter Sabrina. It has been a fabulous weekend. Forty three years feels like yesterday and the ride gets better each year. We are tremendously proud of our kids and their families.
Cecelia rented a PT Cruiser convertible. We drove all around Boulder like two teenagers the entire weekend. Our kids were and are great to us. Thanks for the wonderful weekend!
Thanks Brad
I want to thank Brad to plugging my blog in Feld Thoughts. You can all help by sending the blog information to you email lists and asking everyone to subscribe. When I get into “what to we do to fix the system? ", I will need as many people from all walks of life as I can get to act to repair the healthcare system.
Thanks in advance for participating and helping !
alan shimel • June 18, 2006
Stanley,
Wanted to let you know that I have been reading your blog from the start, keep up the good work! On a personal note, happy 43rd to you and Mrs. Feld. Whatever your secrets to a long and happy marriage, we should try and bottle that, we could all use some. Also, Happy Father’s Day!
Alan
Thanks for the comment.
The key is mutual respect and mutual trust.
Stanley
BuddhaMouse • June 19, 2006
Could you please provide a reference that supports the 80% statistic (“Fixing the complication absorb 80% of the healthcare dollar”)? I am not questioning this number, but I would like to read more about it. Thanks!
Dear Buddamouse
Here is a link to an article where Mark McClellan CMS Director calculated that 90% of the medicare cost is for chronic disease. This is a more recent figure than the 80% figure calculated by many previously.
It is a gigantic problem and a gigantic opportunity to save the healthcare system
Stanley Feld MD,FACP,MACE
This is a good start. Search the Institute of Medicine site and you will get additional confirmation.
http://www.latimes.com/news/nationworld/nation/la-na-prevent19jun19,1,3824435.story?coll=la-headlines-nation&track=crosspromo
David Kelton • June 21, 2006
Hi Dr. Feld,
I’m in my residency in Canada and look forward to see where this blog takes you and your ideas!
I will try and comment when I have time in between on-call duties. I thought I’d add two early comments in this note.
The first is that I agree with your philosophy about personal empowerment in healthcare. Many years ago the providers were about 6-degrees of kevin bacon away from the patient. New concepts such as ‘patient-centered care’ are shifting that toward 2- or 3-degrees from true informed consumers of healthcare. I think the huge reforms will be seen as we get in the 1- or 2- degrees of separation between patient and healthcare – ie they make the informed decision to balance insurance costs/interventions/lifestyle etc.
The second point that all these academic articles (and newspapers like USA Today) fail to consider the question, Who drives health innovation? The answer is clearly the US. Canada and other single payer systems operate on a stall and defer investment until public outcry/tragedy. The US churns through various models pretty quickly (with many ill side effects), but does select for true innovations in delivery of care which is so different than the areas of biotech, devices, etc.
As much as Canada dislikes admitting it, we import all our health models after years of watching American experimentation in open delivery.
I would argue without an open model, the world would be decades behind in health innovations (public school comparison here?).
Just some early thoughts. Good luck!
David
ps – i also write some of my thoughts about health care IT on http://www.opennorthvc.com (i love learning about healthcare startups)