The last three posts here have been about the many ways our own healthcare system does not serve us. It serves the businessmen who run it and stockholders. It serves their political allies, but it does not serve the people. Anyone can see in an instant that medical care is as essential as electrical, water, and sewer services for individuals and communities. There can be no argument about that. Those other services are community owned or very tightly regulated to assure consistent availability at a reasonable price. Medical services are not community owned or tightly regulated and the pricing is extremely difficult to sort out. There is very little protection for medical consumers and predators take advantage of this situation. It is like the wild west.
Now let’s talk about answers. The best medical systems in America are governed and owned by the people they serve just like water and sewer services. A great example is the Southcentral Foundation in Alaska which is owned and run by native Alaskans. This system includes a full array of services including hospitals and medical offices in cities like Anchorage. It is primary care based. 85% of their visits are done over the internet or telephone. They are remote visits because it is so hard to get around in Alaska. Despite the challenges presented by a lack of roads and railways for transportation, this medical operation has quality scores in the 75th to 90th percentile. They provide care for Native Alaskans at half the cost experienced by other Alaskans. The CEO and board members are all Native Alaskans. They set the priorities and they understand the financial arrangements that impact their people. They are doing a great job.
We have direct experience with a system like this in Southwest Louisiana owned by the Coushatta Native American tribe. They run the Coushatta Casino Resort, and they sponsor a worksite clinic for casino employees, tribal members, and their families. Tribal leaders determine the priorities and services delivered by the worksite clinic. They control it. They have full access to de-identified data on the cost detail on all medical services. Unlike most of your employers, they know precisely what they are paying for and whom they are paying for it. The members seen in the clinic cost half as much as those seen in the broader community. They are hospitalized one fifth as often and in the emergency room one third as often because their healthcare is better, and their health is better. This is a model that can work anywhere.
Your community can copy this model very easily no matter where you are in the United States, and it can be done very inexpensively. Most cost, death, and disability come from patients with chronic conditions. With proper support, nurse practitioners treat chronic diseases with excellent results. A single nurse practitioner in a small community can make a huge difference and we are prepared to support them in their efforts. Nurse practitioners can practice completely independently in over half of our states.
You don’t have to suffer and endure bankruptcy. You can have better health at lower cost. You can live a longer healthier life, but our current system will not change itself. Talk to the leaders in your community and lets work together to get something started. Your community can decide what the priorities are.
Thank you again. I appreciate all of us coming together on the need for reform and to provide true safe, cost effective, reasonable and affordable healthcare. I have seen a concerning shift of selling and packaging up products that reap high profits without thought on how patients can afford it and how it is of benefit. Time for a new model of care. US used to have public hospitals all bought out and for profit. Health to all. There are things we can do to avoid the traps