|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
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,
“Fixing” the American health care system will require multiple steps, some of which are relatively inexpensive.
Here are 10 suggestions:
- 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.
- 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.
- 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.
- 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.
- 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
- 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.
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.
- 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.
- 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.
- 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 firstname.lastname@example.org.
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