North Coast Journal

PUBLISHER - April 1996

It isn't coming; it's here

by Judy Hodgson, Editor and Publisher

People now receive 75 percent of their daily news from television. I was reminded of this fact last month by a colleague of mine from a North Coast television station.

By watching only television news this last year, however, one might mistakenly conclude that health care reform has slipped off the national agenda. Especially since Hillary Clinton changed her hairstyle to a flip.

But in fact, changes in health care are proceeding rather rapidly. Insurance companies, government and nonprofit agencies, doctors, hospitals, HMOs and drug companies are all jockeying for position in the new national order of medical care. (For what's happening in the local medical community, see this month's "HMO update")

What drives this flurry of activity?

I heard a talk recently by St. Joseph Hospital's CEO Paul Chodkowski. Statistics clearly show that although the U.S. spends by far the most money per person per year among the industrialized nations, we are the least satisfied as consumers.

Are we just a nation of complainers?

Well, people living in the United States often receive less service for their dollar. For example, the number of hospital days per person in the United States averages 1.2 per year, versus 4 in Japan and 3.3 in Germany. The physician visits per person per year here are 5.6, versus 12.9 in Japan and 11.5 in Germany. (Japanese actually see their physicians once a month?) We have the highest infant mortality rate, in part because of drug abuse but also due to inadequate prenatal care and ignorance.

Are you bored with statistics yet? The employer cost of medical benefits is nearing $4,000 per employee. The number of uninsured in this country continues to rise (34,000 million). Medical care now consumes 14 percent of our gross national product - twice the rate of other countries.

No wonder pressure for reform is continuing to build. But what type of reform?

Like it or not, we are moving away from a free-choice system where patients choose their physician and revenue is dependent on the volume of services and episodes of care.

We are moving toward a system where revenue depends on the number of covered lives. In this system, physicians are partners with hospitals, specialists and other providers. In all likelihood, you are - or will be - a member of a large group that will contract with a large group of providers whose goal it is to keep you healthy. In this system, the incentives are in preventative care and efficient use of resources within the system.

Managed health care isn't coming. It's here.


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