How does “Land of the free and home of the brave” translate into health care accountability. I am puzzled and troubled by this enigma.
Freedom of choice is one of my highest values for all people. I support citizens’ rights to make decisions. However what if their choices cost me money and inconvenience? What then?
Along comes “population management” as a public health priority. What then is the solution to obesity as it relates to “population management” in healthcare? While there are some “actionable” items being completed, aside from the constant data analytics being formulated and the “preaching” and ‘pontificating” of health and wellness achieved via medical homes…where is the beef…so to speak?
Where are the actual statistics that “obese populations” are being truly managed at this point for better public health and at less costs?
There is currently a big contradiction between population management and real life. Having literally sat in the emergency room of a local hospital for 6 hours on the July 4th holiday, I was again reminded that the amount of morbid obesity is unfathomable. Patients-in-waiting who were obese but that did not deter them from trotting back and forth to the vending machines to consume more junk and sodas. Equally appalling was the obesity of the healthcare staff positioned behind the desks and in nursing roles.
Honestly, it is an oddity to see doctors and nurses who are overweight themselves providing redundant emergency room care for people who literally do not care about their weight or health and wellness. Look no further than the hospital gift shop to see what items are flying off the shelves in the category of “munchies” and you will soon realize that the healthcare providers are part of the obesity epidemic and not part of the solution in most cases. “Do as I say…not as I do” really doesn’t work very well.
Short of mandating that people who eat junk and gain weight are likely to be penalized monetarily, where does the rubber meet the road here? Truth is that many of the “offenders” have little or zero accountability at this time because of their “non paying” status or because their employer hasn’t decided to become “self insured” and clamp down on the costs.
In other words, there is no accountability or incentive to actually do better in diet and health management in most cases. Also, healthcare reform now allows anyone to be treated in a hospital regardless of their status to pay. Relative to the privately insured or self insured hospitals who employee healthcare workers, there are some “bright spots” and examples of hospitals who have taken giant steps and dramatically reduced their outlay of dollars spent on problems with obesity among other issues. New Hanover Hospital or www.nhrmc.org is an example of a healthcare provider organization who has made a considerable change via deciding to “self insure”. Considerable focus on health and wellness within a healthcare setting can garner benefits in a “self insured” scenario. There is a direct link with accountability of the insured participants in this type of setting.
One can argue that “education” is the key. The jury is still out on this. Children have more diabetes than ever and fast food business is off the charts successful most anywhere one goes.
So…..where then is the fiscal accountability when one doesn’t have to “step up to the plate of accountability” and pay for the healthcare that they are receiving.
Perhaps the notion of “population management” should be broadcast to the public at large so that they too will know what exactly is being talked about, what actions are being taken and where they as citizens of the USA can make a difference in their own communities.
At this point, I do not see a bright spot in this equation although I am cautiously optimistic. Americans, regardless of their socioeconomics, are possibly the fattest people on earth and getting fatter by the minute. Large populations are in addiction and will continue down that path. Smokers do not wish to quit and “big food and fat” eaters will continue to mainline fatty foods as long as they can do so without major consequences to their health or to their pocketbooks. Supersize clothing has even become a great business that does nothing to discourage weight loss because 2x, 3x and 4x are just now mainstream fashion.
Make no mistake, I like to eat with the best of them but know that my choices equal the quality of my life and there are consequences.
While I appreciate Bob Atlas’ take on merging ACOs with Medicaid Management, I still say “good luck” on the subject of doctor’s getting patients to comply in the “land of the free and home of the brave” where fierce independence to eat, smoke and not exercise remains the choice healthcare participants can make each and every day…………..and they do…all the way to the doughnut shop, the processed foods aisles, the soft drink vending machines and the super weekend deals for snack foods at every grocery store that are mega advertised in all print media. This population of people is not shopping at Whole Foods or even coops.
To your health,
The health industry advisor