Transforming Healthcare 1: Aims

This post is inspired by #FutureMed

In the words of David Sayen, Regional Administrator at the Centers for Medicare and Medicaid, there are three aims for improving any health system. One - better health for the population. Two - better care for individuals. Three - lower cost through improvements.

Most developed health systems around the globe are struggling to maintain costs while providing quality care. In Australia, health costs are expected to balloon out to the entire State Budget by 2050.  Standard & Poor have warned that healthcare costs could go from an average 6.3% GDP in 2010 to 11.1% in 2050 in developing countries due in part to ageing.  Increasing costs have the potential to stifle innovation as governments and private corporations struggle to make ends meet. The dollars have to come from somewhere and, quickly, we are drifting towards a system that favours keeping up with growing demand rather than trying to reduce the number of cases presenting to our emergency wards.

Individual care begins prior to birth and stops only when we do. The responsibility of accessing this care sits both with the individual and with the health system. We need to have a system that encourages frequent check ups - something that hardly adds to healthcare costs, especially when simple measures suggested at the GP can lead to prevention and early detection, both of which can, when applied appropriately, decrease further health costs and increase quality of life.  Seeing the doctor periodically needs to become a part of our culture.

The sociocultural framework around healthcare needs to change. It may be called the Healthcare system but it is often perceived as the sickness system. Aside from vaccinations, we often only visit the doctor when things go wrong. We wait until we're in pain, vomiting uncontrollably, bleeding profusely or unable to function as well as usual to drive ourselves (often dangerously) to the doctor or hospital. Suggestions of a check up are all to often met with 'but I'll catch a cold from someone in the clinic!' or 'but I'm too busy for that' rather than an understanding that an hour in the GP's office could save days or months of hassle down the track. Glaucoma, which can cause irreversible blindness, is preventable but has no symptoms until some vision is lost. Forever.  High blood pressure can present with stroke or heart attack.  While human nature (and Australian culture) may convince us that 'if it ain't broke, don't bother fixing it' that shouldn't mean we neglect check ups.

So what can we do as a community change the perception of health and reduce costs?

Step 1:
Somewhat counter-intuitively, we need to reduce the 'medicalization' of health and 'pathologizing' conditions.  One of my friends, Dr Steven Tucker, says that no-one knows how to lose weight but everyone knows how to put it on. In order to reduce our waistlines, we simply need to avoid doing the things that increase our girth. There's no magical solution, it's (for the most part), healthy eating and exercise with indulgences in moderation should maintain healthy body sizes. Quitting smoking needn't be medically managed - it is possible to quit on your own. Numerous health conditions can be managed simply with some guidance from your GP.

Step 2:
Visit your doctor frequently - you should be able to spare an hour once a year to say hello. Even if you are a healthcare professional yourself.

Step 3:
Innovate, innovate, innovate. Global collaborations can introduce new ideas from across the seas, reducing device costs and providing out-of-the-square solutions to problems facing clinics in other parts of the world. Combining our expertise and data, we can all be a part of the solution.

Step 4:
Educate. Take an active role in your health, teach your children about basic health and give them ownership of their future. Take ahold of your own. Make sure it's holistic. Listen to health messages and make sure that the health messages going to the community are understandable.

Aim high for lower costs in a better healthcare world.

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