Americans deserve a health care system that embodies fundamental American values. What would such a system look like? The HealthCARE principles advocated by Healthy Memphis Common Table (HMCT), Health, Choice, Access, Responsibility and Education, point the way. HMCT was incorporated in early 2000 when a group of concerned citizens, including consumers, providers and health care leaders, began meeting monthly in their homes to discuss ways to fix the broken health care system in our region. This group saw as its first purpose to identify health care values that all Americans shared that could provide the basis for real health improvement in the greater Memphis area. In 2003 over 450 health care leaders met in Memphis and affirmed these basic HealthCARE principles. Today over 200 organizations representing consumers, doctors, hospitals, health plans, businesses, and faith-based organizations have joined this community-wide effort to help Memphis become one of America’s healthiest cities. Now we need national bipartisan action based on these shared American values:
Health: We seek to reorganize our health system to promote health as its primary goal. Health care organizations should serve health first, not profits. Although profits may be necessary, patients suffer when making money is the top priority. Who stands to gain from the health care reforms being proposed in Washington? Will the reforms promote health over profit?
Choice: We choose the best value in health care providers and treatments. Americans value choice, but most don’t care who their insurance companies are as long as they get to choose their doctors, nurses and hospitals. Americans currently pay about one in seven of their health care dollars to an insurance company. Americans spend almost one in three health care dollars on administration and billing, more than in any country in the world spends on bureaucracy. We actually pay insurance companies to limit our choice of doctors and hospitals. Will the proposed “health insurance exchanges” allow us to choose best value providers and treatments for ourselves?
Access: We provide care according to need for all people. People need access to basic primary care. People without insurance have more difficulty getting needed primary and preventive care, and as a result are more likely to die. Lack of insurance, inability to get needed health care, and premature death are shockingly common. It is unconscionable for insurance companies to drop paying customers when they become ill. This is not acceptable in the United States. We need insurance reform to prohibit insurance companies from excluding people because of pre-existing conditions or dropping people when they become sick and need care.
Responsibility: We take responsibility for our health, and are accountable for our health care resources. With freedom and choice comes personal responsibility. If we want to live healthy, abundant lives, we must take charge of our health by practicing healthy habits and maintaining insurance coverage. The proposed insurance reforms mandate that everyone have insurance. Taxpayers and people with insurance already subsidize emergency and hospital care for those without insurance. We should cover preventive care to reduce the need for expensive emergency and hospital care when people become deathly ill. Everyone should pay their fair share to the best of their ability before they get sick.
Education: We continually learn and share how to improve our health and the health care system. Health reform begins at home. We must distinguish valuable, needed health care from medicines, hospitalizations and surgeries that are excessive or dangerous. Approximately one in five procedures and surgeries are unnecessary, and some are harmful. Regional health improvement collaboratives like HMCT (www.healthymemphis.org) provide valuable information on choosing a doctor or hospital and obtaining care at an affordable price.
Americans deserve health care that truly serves health. The insurance reforms proposed in Washington would be a true Christmas present to those who lack insurance, have pre-existing conditions, or whose insurance was dropped because of sickness. But the proposed reforms are only a first step. To create an affordable health system that serves health first we must reduce the money we spend on worthless bureaucracy and frivolous lawsuits, increase personal responsibility for health, and remove the financial incentives that currently encourage doctors and hospitals to provide unnecessary care. Then we can begin to hope for a health system that offers the care we need most at a reasonable cost.
Originally published in The Memphis Flyer, December 2009