Thursday, February 21, 2013

Blog Assignment 4 - US Health Care

Health care is one of the most popular topics in the United States today. For this week’s blog assignment, we watched the documentary “US Health Care: The Good News”. This documentary examines an array of health care systems around the world and reports the their positives, negatives and differences between each system.

The Dartmouth Atlas Project started in 1973. At that time, researchers studied different towns in Vermont in order to track differences in treatment and cost. In Vermont, the researcher wanted to study the places that were not getting enough medical care. Instead of under service, they found extreme variation. In more recent studies with this project, researchers studied Medicare billing records. This resulting in the same findings in Vermont in 1973, which were huge variations in treatment and spending.

Access to health care is a very important concept in the world. Is it a right or a privilege to have this access? Personally, I believe that access to health care is more of a right than a privilege. There are many different factors that prevent Americans from getting health care and insurance, however, many Americans cannot help these factors. For example, a person does not usually choose to get cancer, but unfortunately it can happen. This person might or might not get the adequate health care for various operations to fight the cancer. This person could not receive the health care due to a preexisting condition or some other cause. One of the biggest reasons why I think everyone should have access to health care is the fact that the healthier a population is, the more productive a society will be. If every American had access to quality, affordable health care coverage, the whole nation would benefit from it. Another basic reason is that a nation could save a lot of money in the long run if every citizen had access to its health care. There will always be the problem of people abusing their right to health care, but it would be worse to have everyone earn it when there are many outlying factors that could prevent someone from getting the same access to health care.

This documentary visited various places in the United States and reviewed their health care systems. The first stop was Grand Junction, Colorado. This spot is thought to be the best medical system of them all, being a model for health care delivery. Here, doctors decided to take care of everyone in the town and get paid the same fee for the same treatment regardless of if the patient was rich or poor. In addition, a small portion of each doctor’s payment is withheld until the end of the year and then gets distributed based on the doctor’s overall performance. This system is interesting because there was little objection. The next stop, Seattle, Washington, had an innovation called coops, which was businesses being owned by their customers. In Seattle, the medical system that was examined was a corporation that was big on using technology to communicate with their patients. Doctors would use emails to treat their patients, and would increase face-to-face time with the patient when the latter would physically come into the office for a visit. I thought this was interesting because many medical systems today use technology for records, communication and more, but this corporation was astounded at how well the technology worked for them. The third place, Everett, Washington, had a system where the doctors owned the clinic. This stop was big on controlling the costs of health care and trying to reduce or even eliminate unneeded tests. This, in turn, would lower the cost of care for patients. I thought this place was intriguing because it was able to eliminate pharmaceutical representatives and samples, and actually lower the costs for patients overtime. Finally, the documentary stops near Dartmouth College to examine Hitchcock Medical Center. This center emphasizes patient involvement in treatment choices. By giving the patients more of a say in their treatments, this system was more successful because there were less surgeries and less unnecessary tests that saved a lot of money.

I believe that the way medical care is delivered in the places visited in this documentary can certainly be duplicated in the area I am from. One of the main reasons why I think this is because using modern technology in a medical system was proven to be more efficient, as shown in the documentary. This is an easy innovation to implement in modern medical systems and a good way to improve efficiency and reduce costs. However, it is essential to have strong leadership and commitment within the community for these programs to be effective, and these are some things that not every city has. There could be multiple reasons why the area that I am from has not implemented these elements into the medical system yet. Everyone, doctors, hospitals, physicians and insurance companies, must all be on board and cooperate together for the system to be successful.


  1. Nice blog post!

    I also think that the medical systems shown in the documentary could be replicated throughout the country. As you said, the physicians participating in these systems have no objections. Everyone has to be on board for these systems to work. In an ideal world implementing these systems would be easy. But in the harsh real world, people are greedy, selfish and unorganized; these vices are the main obstacles of implementing systems. Having convincing and powerful initiative and leadership would also be important in doing this. And from the capitalist medical care market, the system we have is not broken. So why fix it?

    I think there has to be some sort of government intervention, if we want this to go national, or even state-wide.

    Thanks for the post!


  2. Thanks for your post Leslie.

    When I watched this documentary last year I was struck by the fact that there are many vested interests that would be opposed to providing better preventive care. Physicians and hospital are primarily paid to treat disease rather than prevent it. The partial solution, thus far, has been to try and make insurance companies (who want to reduce medical expenditures) fight against these interests through managed care. Clearly these two competing forces have been unsuccessful at controlling costs.

    Thanks again.