Aligning Forces for Quality South Central PA’s Annual Meeting Asks, “Are you Reiding?”

It’s a pivotal time in our country’s history, as our health care system begins a massive reconstruction. No matter where you land when political lines are drawn, you can’t turn on your computer, television or radio, without hearing that our system is broken. What you may not realize, however, is that other countries are producing better outcomes.

In fact, as highlighted in Aligning Forces for Quality – South Central PA’s (AF4Q-SCPA) collaborative program, A Summer Reid, when it comes to curing people who can be cured, among 19 wealthy countries, America ranks last. In the U.S., approximately 20,000 people die from lack of access to care each year, and Americans with diabetes die younger than diabetics in any of the other wealthy countries. These people are in our communities, our neighborhoods and our families. In this context, it’s difficult to overlook.

To spark a community dialogue for change, AF4Q-SCPA, WITF and 75 libraries throughout central Pennsylvania collaborated to encourage people to “Reid,” this summer. To participate, residents checked out New York Times bestselling author and PBS correspondent T.R. Reid’s book, “The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care,” and then shared responses to discussion questions for the chance to meet Reid at AF4Q-SCPA’s annual meeting on September 11. By the time the author arrived in central Pennsylvania, a full banquet hall greeted him to hear his stories about traveling around the world to discover best practices in medicine. 

As he shared that evening, during his family’s travels, they began to notice that the medical care they received, particularly in wealthy countries, was extremely high quality or an “American level” of care with reasonable waiting periods. The prices, however, were strikingly minute in comparison.  He began to ask, how do they provide high-quality care at such a low cost and still provide care for everyone? Why do they do it? And, perhaps most importantly, why doesn’t the world’s richest country provide health care for everyone?

To answer the how, Reid walked the audience through the four models of health care used around the globe – Beveridge, Bismarck, Douglas and “Out-of-Pocket” – and explained how the American system borrows many of its ideas from the models. He even asked attendees to reconsider what they’d been told about “socialized medicine,” as it is currently practiced via Medicare/Medicaid and veteran care.

Why should a country provide health coverage to all of its citizens? From Reid’s perspective, one key factor is that it’s practical and it saves money.

“If a person can come in and get treated when she first feels a tinge of pain on the right side of her abdomen, she can go to the doctor and he can say, ‘I’m worried about your appendix.  I think we ought to do something about that.’ That can become a fairly inexpensive and quick procedure.  If she can’t afford to see a doctor, and she’s one of 48.6 million people who don’t have insurance, she just kind of hopes the pain will go away. Then, three months later she has a burst appendix. She’s in the emergency room in a life-or-death situation…” And, it’s expensive.

But other countries also provide health coverage to everyone because they simply think it is fair. “They would say that all of their residents have a right to health care – it’s a human right,” said Reid.

From his perspective, Americans would be less likely to agree that it is a “right” or “entitlement,” but they do believe that their friends, neighbors, colleagues and families should be able to see a doctor if they are sick and need treatment. Americans do sense the moral imperative, and in his mind, this led to the recent health care reform with the Affordable Care Act. While it still won’t cover everyone, it will make major inroads.

In summary, Reid concluded that designing any country’s health care system is a moral decision. It’s a question of ethics and justice and decency. If you decide that it’s a moral imperative, then you will design a system where everybody gets coverage.  What happens if you don’t?

As Reid shared, “You’ll end up with a system where some people get the finest care, the world’s finest facilities with no waiting, and 48.6 million people barely get in the door until they’re sick enough to get to the emergency room… You end up with the American health care system.”

In the months to come, AF4Q-SCPA has continued to facilitate discussions about Reid’s findings and need for change. It’s been estimated that his book was read by approximately 2,500 people as a result of A Summer Reid through all of its various channels including libraries, local book stores and the WellSpan Health System, which chose the book as its 2013 Leadership Read.

Thanks to everyone for continuing the momentum!

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