The Oates Journal (ISSN: 1098-1446) is a publication of the Wayne E. Oates Institute addressing issues related to spirituality, ethics, and healing from the perspective of pastoral care and counseling.

The U.S Health Care System (or lack thereof) is a mess! The severity of the health crisis has finally evoked a national readiness for significant change. Although momentum toward finding solutions has slowed as a result of the current economic crises, continuing problems in the access and quality to health care will force this nation to soon return to a search for solutions. When compared globally with health care systems in other industrialized countries, the World Health Organization (Davis, et al, 2007) ranked the U.S. health care system as 37th. Today, about 45 million Americans are without health insurance, and the number is growing. Because of expensive “co” and “no” pays, even insured persons often go without needed medications or treatments. Chronic illnesses such as obesity, diabetes, high blood pressure, lung disease and arthritis have reached epidemic proportions. Many persons living in underserved communities go lacking for basic access to any health care.

Assuming that fundamental changes can happen, it is important that the change is guided by consciously decided values. One fundamental question that we as individuals, and ultimately as a nation must answer, is whether access to quality health care is a basic human right or a financial commodity available only to persons who can afford to pay? Should all persons have the right to full access to the care they need, from the right provider, at the right time, at the right place and at the right price…or just those who can afford to pay for it? The focus on high tech care has perhaps improved the quality of care for some who can afford this, but has left the masses sadly lacking in health. Can we achieve the ideal goals of America without embracing the belief that health care is a basic human right, as is food, clean water, clean air and freedom from violence?

In reviewing several current health-related newsletters, commentaries and columns that lay upon my desk, I noted three major themes in discussions related to the health care system. One theme focused on the economic/financing issues surrounding the healthcare crisis (ultimately related to how to fund the system). Example language related to this question included: falling profits; declining return on investment; falling membership in health care plans; rising medical costs; declining payments to physicians; high cost of tests without adequate reimbursement; high cost of litigation and dominance of insurance companies and pharmaceutical companies. National health care and the Single Payer system recommended by the Physicians for a National Health Program are included in financing discussions.

Obviously, financial viability of any system is necessary for success over the long term. One’s orientation to health care as a basic right or privilege however, influences decisions about acceptable levels of profit for providers, insurance companies, medical suppliers, pharmaceuticals, and identification of universal health care services that are available, accessible and affordable to all. An unspoken, critical theme often omitted in economic discussions, is the impact upon access to health care for underserved and uninsured Americans (who will be covered).

A second major theme focused on consumer (patients) health problems (or what to fund). Example language included: growing uninsured; epidemic chronic illness (Kentucky ranks 41st in the nation in protecting kids from tobacco); cancer, respiratory illnesses are increasing. There is a growing level of recognition and agreement that the next millennium health care system must pay attention to disease prevention and high personal wellness. Most understand, albeit unwillingly, that environment makes a difference in achieving good health. Not so apparent in the discussions was how to include family, mental health, end of life care and culturally appropriate care.

A third theme related to poor utilization of qualified health providers created by barriers that restrict many health personnel from freely providing their health expertise at the right place at the right time. Health care cannot flourish when care is dominated by any one profession. Knowledge is too complex. Quality care will increasingly require multidisciplinary teams, with fluid, changing leadership that matches expertise with needs in a timely fashion. Any willing qualified provider should be able to participate freely in the delivery of quality health care.

The American Academy of Nursing’s Vision for Transforming America’s Health Care System (accessed 2/22/2009 at aannet.org/policy/briers/2007) provides one view of desired characteristics of a new health care system. The American Academy of Nursing maintains that health insurance should be made affordable and accessible to all Americans. The AAN also believes it is critical that all individuals and their families have access to safe, effective, efficient and personalized health care. A quality health care system will move away from the current hospital-based, acuity oriented system, to one that provides:

• Quality of care that is safe, effective, patient-family centered, timely, efficient, and equitable

• Recognizes that the mind, body, and spirit work together in treating illness by integrating both physical and mental health care

• Matches the needs of patients with the most qualified and cost effective practitioners who can provide those services

• Uses the best technology to improve the health of individuals and communities, reduce costs and better use the clinicians’ skills

• Supports the critical contribution made by family caregivers

• Rewards successful interdisciplinary collaboration and cooperation

• Values interdisciplinary research that will help guide the system’s response to new knowledge about patient care, treatments and services and

• Helps us die with dignity and compassion

In summary, America faces the critical need to revamp the existing health care system. Informed consumers are needed to actively engage in the dialogue to create something better, and to do so with full awareness of examined values and a vision for a new health care system. If the vision presented in this column does not resonate with your values, I urge you to identify your personal vision. There is much at stake. Individuals and companies vested in the profits of health care are wide awake and at work. No sleeping on the job, folks!

References

Davis, K., et. al, (May, 2007). Mirror, mirror on the wall: An international update on the comparative performance of American health care accessed on February 22, 2009 @ www.commonwealthfund.org/content/publications/fund-reports/2007/May/

Comments (0)

Subscribe to this comment's feed

Write comment

Email Name Website		Comment smaller | bigger
		Subscribe via email (Registered users only) I have read and agree to the Terms of Usage. Write the displayed characters Add Comment Preview