Tuesday, August 4, 2009

Jarvis on Health Care at City Club

Posted By on Tue, Aug 4, 2009 at 5:12 PM

1630/1249425521-jarvis.jpgDr. Joe Jarvis, head of the Utah Healthcare Initiative, spoke at City Club of Boise this afternoon and citydesk showed up, took a spot in the back and diligently took notes in our trusty reporter's notebook. Had we had the forethought to check Jarvis' blog this morning rather than late yesterday afternoon, we'd have seen his City Club comments posted in full bright and early at 5:42 a.m. this morning.

Idaho Health Care for All picked up the tab for Jarvis' Boise travel expenses, and for those who caught the talk but were disappointed not to have Jarvis' usual slideshow (which he ditched in deference to the Boise State Radio crowd listening in), Idaho Health Care for All will post the slides.

Jarvis, who's run unsuccessfully for office in Utah twice, has a simple message when it comes to health-care reform: Health care is not a commodity that is efficiently distributed by a marketplace and therefore it's not a question of if the system needs to change, but how.

In his City Club remarks, Jarvis hammered a few key points more than once, specifically that health-care spending is on an unsustainable trajectory, and in order to effect change, a new system must reign in waste. Seems simple enough, right?

The only caveat is that what Jarvis considers waste is what health corporations consider profit. And to keep status quo, those corporations spend, according to Jarvis, $1 million a year courting every member of Congress—and that figure does not include campaign contributions.

Jarvis, not surprisingly, is not impressed by what he sees being debated in Congress. He flat out says both Congress and President Obama are wrong to throw tax money into massive reform. The issue is not a lack of money to provide coverage, according to Jarvis, it's that too much money is spent.
"Per-capita health spending is twice as high as it is in any other nation, and rising faster, because we waste up to half our health spending on inefficiency and poor quality."

So what's the solution according to Jarvis? Well, he opposes socialized medicine for starters, but he said, market forces have no place in medicine. He does, however, argue that as members of a society, we have a shared social responsibility to care for the sick. We also have agreed that we have a shared social responsibility to build a functioning transportation system and we tax ourselves to create and upkeep that infrastructure, he said. No one has a Constitutional right to pavement, but we work together to make it happen, Jarvis said.

In conclusion, he did offer six health-care practices he says should be eliminated in order for a new system to be successful:
1. Health underwriting, or cost shifting
2. Unsafe hospitable practices, which is the fifth leading cause of death in the country (behind HIV, auto accidents and breast cancer)
3. Inappropriate, or superfluous care, especially when less expensive and equally successful options are available.
4. Perverse incentives (Jarvis cites a Wall Street Journal article that states: "Hospitals and doctors can make more money providing inefficient, mediocre care.")
5. Market-based health policy ("Shopping is perhaps the quintessential American experience, but patients are not shoppers.")
6. Benefit denial, or rescission, which is essentially the practice of dumping the sick.

After his speech, Jarvis also fielded a number of questions, in which touched on the importance of electronic medical records (very important, says Jarvis), the Canadian health-care system (flawed) and the Wyden-Bennett Bill (against it, because it will create Swiss-cheese coverage due to a lack of quality improvement and cost control measures).

Final words: the health-care change we need cannot be mandated entirely from the big boys in Washington, D.C. Quality improvement will come from those who are at patients' bedsides. Patients must take responsibility to consider all options. And most importantly, the profiteering must end.

Wendell Potter former Cigna exec tells Bill Moyers how health insurance companies have hijacked American's health-care system. See the full interview here.

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