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Commentary: All Americans need health safety net

Dr. Dan Bell (right), founder of Eureka Christian Health Outreach clinic in Eureka Springs, Ark., visits with clinic staff in the full service pharmacy.
UMNS photos by Suzie Bell.

A UMNS Commentary
By Dr. Dan Bell*

June 17, 2009 | EUREKA SPRINGS, Ark.

Bell examines a patient. The clinic serves uninsured,
low-income individuals.

“Fixing” the American health care system will require multiple steps, some of which are relatively inexpensive.

Here are 10 suggestions:

  1. Improve access to dental care at all age groups. Multiple medical problems are spawned by bad teeth, and dental care is harder to get than medical care. A Federal Dental Corps using paraprofessionals for extractions will likely be needed.
  2. Encourage preventive care by eliminating “copays” for proven strategies such as mammograms, pap smears, cigarette-smoking cessation, treatment of childhood obesity and an annual preventive health planning visit for those age 50 and older.
  3. Reward primary providers who manage patients with less expensive testing, less expensive treatment and fewer referrals to specialists for common problems like back pain, headaches, bellyaches and acid reflux. Encourage clinical judgment on the front end.
  4. Enact tort reform in concert with this effort to “detechno” common problems. This would cut the heavy utilization of expensive tests such as MRIs and CT scans.
  5. Provide rapid assessment for disabled patients, and grant them medical coverage quickly when appropriate. Currently, patients linger in a limbo-like system and deteriorate further before coverage ensues.
  6. Work out a system of universal access to health care. Uninsured, low-income people between 18 and 64 particularly need a safety net, possibly from a “public” health corporation. If the government would provide capital for basic health facilities, faith-based organizations could provide basic charity care in these facilities and thereby provide a safety net that would keep many of these individuals out of the emergency room. This would prevent their chronic conditions from causing serious morbidity.

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  7. Help Americans make a serious attitude adjustment in how they deal with health issues. They must first take appropriate natural or lifestyle steps for conditions before they receive expensive treatments for problems. For example, the patient who won’t quit smoking should not be allowed to have cardiac bypass surgery, carotid endartectomy or peripheral artery procedures.
  8. Provide people with mental illness better access to mental health facilities. This group falls in the cracks readily, since people who are mentally ill often won’t seek psychiatric or medical care. Many of these patients will not leave the home, so home visits by providers who can prescribe and provide medications would have a significant effect on initiating much-needed therapy.
  9. Simplify end-of-life care to provide more comfort care to the dying elderly, rather than aggressive hospital care that consumes tremendous resources in the last days of life. Maximize home care via hospice.
  10. Give families incentives to care for their elderly at home through publicly funded stipends. This would be much less expensive than nursing home care and provide enhanced quality of life for the elderly.

*Bell, a member of Eureka Springs United Methodist Church, co-founded a free medical clinic in his community.

News media contact: Kathy L. Gilbert, Nashville, Tenn., (615) 742-5470 or newsdesk@umcom.org.

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