'No Child Left Behind' Meets 'No Patient Left Behind'

| 7/1/2008 11:06:04 AM

Tags: healthcare, pharmaceuticals, holistic medicine, U.S. politics,

My mother is brilliant. We were comparing recent frustrating experiences with doctors one evening when Mom, a 4th grade teacher, had an idea: The United States should do away with our current healthcare system and replace it with one similar to No Child Left Behind (called No Patient Left Behind), in which physicians are held personally accountable for the continued well-being of their patients. 

Think about it: the industry’s focus would immediately be yanked away from the myriad pharmaceuticals (and their accompanying unethical incentives), and redirected to the task at hand, which is finding the most effective solution to whatever is ailing the patient. Doctors would reduce their list of patients to a number that allows them to give each the time and attention their condition warrants. 

Was she serious? Of course not, and she dismissed my insistent requests that she put the idea into words and send it to newspapers and magazines. Neither of us would suggest that if a patient is diagnosed with cancer and ultimately loses the battle, his or her oncologist should receive a pink slip (even if that is how we treat our teachers when a student can’t or won’t obtain a passing grade). We’re just saying that a doctor should be able to show that every effort was made to heal their patients, and no stone was left unturned in the process. 

“That’s all fine and dandy,” you say, “until it occurs to you that there are way too many sick people and not enough doctors to provide that kind of care.” I agree, though I’d like to point out that a similar scenario has existed in our schools for some time now. Too many children require extra time and attention to achieve the goals mandated, and not enough educators exist to provide it. 

Where are we going to find the money to do this? Where do the uninsured fit in this scenario? Those are tough questions. When educators asked how to fund No Child Left Behind without additional federal assistance, they were essentially told to figure it out for themselves. You see, we don’t actually need to have a plan in place to revamp healthcare, we just have to do it. 

No, my mother’s offhand (and mildly sarcastic) idea is not perfect. But neither are the solutions that were proposed during the primaries. Our broken healthcare system has been and will be a hot topic in the next few months as we near the presidential election, and I’d like to see some real brainstorming. Get creative. Suggest another outrageous overhaul. Get people to think. 

elizabeth hensley_1
7/8/2008 8:06:50 PM

I went without medical care from Jr High to the age of 32 with sleep apnea. I knew I had it. But could not get any doctor to believe me. Undiagnosed Asperger's syndrome was a factor. I can not read or respond to facial expressions and have trouble making eye contact so I came across as weird. I was in agony most of the time for 24/7 sleep deprivation migraines. I know something must be done! Too many people are suffering. Maybe we need to turn more of the diagnostic tasks over to computer flow charts and hold doctors accountable for checking for everything checkable. They can't be expected to remember to check for everything or what the symptoms are, or what tests to run, but they could be taught better where to find the answers to those questions if the information were available in a more organized manner than just being stuck in medical text books. That would help.

carmen ortiz
7/8/2008 2:59:07 PM

The problem with the health system here is that it is a for profit system and gready corporations want more and more money. Who makes the most? The middle man. The hospitals and doctors can cut cost all they want but it never makes it to the patients who pay for their own care. If you have health insurance and think you have it bad just try to pay for medical care without it. Little known fact: the only way big companies can negotiate to keep their health spending down is because the uninsured are forced to make up for the discounts big companies get. Did you think the doctors and hospital were just being nice? I worked for one of the largest middle man companies in the USA (can't name them: non-disclosure clause) and I know how it works. People blame the uninsured for the high costs when they should be thanking them.

roger nixon_1
7/8/2008 11:25:04 AM

I live in Canada and healthwise consider myself lucky to do so. I've seen far too many tv shows of the consequences of not having medical insurance in the States. (loosing homes, savings, etc.) Remember the full quotation is: "Love of money is the root of all evil". While the Canadian Healthcare system has its problems... funding, wait-times, etc. no citizen is refused medical help simply because they lack money. I do however like the "no patient left behind" approach. I have peripheral neuropathy, cause unknown, which has left me on disability. The costs of my medical treatment are incalculable (not to me, it was all covered) but to no avail. The doctors say: "you have peripheral neuropathy, we don't know the cause. Have a nice day." I need a Dr. House, who won't quit until the cause and cure are found. Please understand, my disquiet is with the medical establishment as a whole. Even in Canada, where payment is not a problem to the patient, many doctors seem to have lost any feeling of responsibility to find the answers. For many, if it can't be fixed with an at-hand prescription; well too bad, have a nice day. If I'd continued to live in the U.S. (went to High School there.. Dad worked with U.N.) i would now be at least broke and on the streets, or simply dead. How can any country consider itself "great" in any sense of the word when its citizens can loose everything over a health problem and whether they live or die is measured soley by their ability to make/have money. No wonder citizens resort to any method possible, ethics, morals, right and wrong are irrelevant, inconvenient and downright encumbering... and can you blame them? As I said, our Canadian system isn't perfect, but the man responsible for starting it, Tommy Doublas, was voted the "Greatest Canadian" for his contribution to making this country the safe, caring place it is today. Sorry this is so long.. I'm a journa

pc mcb
7/8/2008 12:37:05 AM

I am one of the people in the USA with minimal health insurance. The problem as I see it is money. Everybody wants more money, and if they don't get money, they won't consider treating patients. The pharmaceutical companies push pills and want more profits to pass on to stock holders. The insurance companies push HMO's, which don't work, and want more profits for stock holders. Hospitals want more money for bigger and more modern hospitals, without regard for the patients. If we all accept just a little bit less, prices would start to come down and more people would be able to afford more health care.

7/7/2008 2:15:02 PM

My wife is a physician and I consult within the healthcare and health insurance industry; so let me share our perspectives on the subject. All parties (hospitals, docs, patients, insurance companies and pharmaceutical companies) seem to desire lower healthcare costs. And in fact, if you compare apples to apples and you look at the costs of specific procedures or treatments over the past decade...in almost all cases that came claim item in 2008 is cheaper than in 1998 (often, even without inflation adjustment). However, the overall cost of healthcare has indeed risen. The main reasons appear to be the overall decrease in health of our population (even a 10yr old today is more obese and less healthy than the previous generation), increased longevity (whereupon we also consume exponentially more health services in our last years), a smaller healthy "payer pool" (as insurance companies really do need healthy customers to share costs with unhealthy customers), the increased administrative costs of regulatory compliance and lastly the increased complexity and sophistication of medical treatments. While the same-level MRI as 1998 will be cheaper today. Today we also utilize a newer MRI which is much more sophisticated, complex and costly. Not to mention the sophistication-level of treatment. How do you compare the costs of gene-therapy today for diseases (immune disorders, cell disorders) in which only the symptoms (anemia, joint pain, etc) were minimally treated previously? In my mind, the issue is not the cost of healthcare...we easily can provide affordable subsistence-level healthcare to all our citizens. However, today we have the option of healthcare far beyond that subsistence level...leaving us with the unique decision of "how much healthcare is enough and at what price?"

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