Most people die prematurely
from diseases that are preventable. More
than half of us are living with a chronic
condition, not always treated properly. But
a poll by ABC, USA Today and the Kaiser Family
Foundation asking Americans what the main
reasons are for the high cost of health care
found only 29 percent attributing it to unhealthy
lifestyles and only 23 percent to an aging
population.
H
I T S
Center President Jessie Gruman
was quoted in separate articles in the Washington
Post, one about racial gaps in preventive
screening and one about the difficulty in
having patients comply with prescribed treatments.
The first story also appeared in the Charlotte
Observer, the Bradenton Herald and the Myrtle
Beach Sun News.
M
I S S E S
News media stories
about people waking up from comas and recovering
their faculties
are the stuff of human interest and, in the
case of television, ratings. The Mayo Clinic
decided to examine just how well major newspapers
reflect reality and, not surprisingly, the
coverage is misleading. They don't report that
most comatose patients are not trauma victims
and thus do not have as good a chance of recovery
as the heralded cases. Many comas are induced
by physicians, which leads to a better chance
of recovery. Most people in comas do not suddenly
awaken and are often permanently disabled. http://www.mayoclinicproceedings.com.
The fact that USA Today recently ran a week-long series on
reforming the health care system reflects the concerns of most
Americans and places them high on the policy agenda facing
the new Congress.
Conventional wisdom within the health industry is that
costs will be driven down and quality of care boosted
if only patients behave more responsibly by practicing
prevention and getting screened properly at the right
time.
Jessie
Gruman President
and Executive Director
Center for the
Advancement of Health
However,
it is not happening and cannot happen so long as patients
are in the dark about what they are expected to do to
participate – not only in preventing illness – but
also in their care when they are ill.
For preparation of my new book, "AfterShock – What
to Do When the Doctor Gives You – or Someone You
Love – a Devastating Diagnosis," I interviewed
hundreds of people about their experiences with health
care immediately after getting the bad news.
One recurring theme was that they were constantly surprised,
not only by the emerging details of a new and serious
disease, but also by the tasks they and their families
were expected to take on in order to get good care.
Some people were surprised that they were expected to
find and evaluate the qualifications of specialists to
give them second opinions. Others were shocked when they
realized that they needed to police the surgical team
to make sure every member accepted their insurance if
they were to avoid costly fees.
Some were taken aback by the need
to maintain their own medical record as a back-up to
ensure that information
was not lost among doctors and hospitals. And others
believed – until disastrously proven wrong – there
was no need to ask questions because the doctor would
tell them everything they needed to know.
Whatever the level of discourse,
health care now uses the language of "personal responsibility" and
the notion of individuals as "consumers" as
shorthand to describe people who exert “choice” and
who are “empowered” patients.
Unless you have a personal need
to know about these advances, however – and what it means to negotiate
them as a patient – it’s likely that you
really don’t have a clue about what is expected
of you.
Doctors, labs and hospitals have
clear expectations about what patients must do; sometimes
so obvious no
one thinks to mention them (“make an appointment,
arrive on time and plan to stay until your appointment
is over”). Sometimes expectations have changed,
but the person hasn’t gotten the message about
the change (“always check about getting physician
pre-authorization for procedures and tests”). And
sometimes the expectations come about through default
as a result of gaps in communication among doctors and
hospitals ("obtain test results and send them to
all relevant physicians”).
But the most critical element in
the system – the
public – has yet to be let in on what it must actually
do in order to get good care. Before we can reform the
system, we will have to inform its consumers.
FROM THE CENTER
CMS
APPOINTMENT Center President Jessie
Gruman has been appointed to the
Advisory Panel on Medicare
Education for a two-year term. This panel reports to the
Centers for Medicare and Medicaid Services and advises
the government
on strategies concerning education about Medicare choices,
expanding outreach to vulnerable and underserved communities
and assembling “best practices” to help consumers
evaluate plan options.
APHA CONFERENCE Dr. Gruman attended the annual
American Public Health Association conference in Boston to
promote her book, "AfterShock – What
to Do When the Doctor Gives You – or Someone You Love – a
Devastating Diagnosis." The book is available for pre-order
at http://tinyurl.com/yfstnw
POSTER
SESSION The Kellogg Fellows in Health
Policy Research program cohosted a poster
session and networking reception
at the Oct. 23 NIH Health Disparities Conference. Two 2006-08
Kellogg Health Scholars -- Phoenix Do from the University
of Michigan site and Anita Wells from
the Morgan State University
site – were among 60 researchers selected from more than
300 applicants for the poster session. The Center hosted a
dinner afterward for Kellogg Scholars and Fellows and Friends
of this Community of Scholars.
BLOG The Center's HealthBehaviorBlog is now
one year old and gaining notice in the
online health community. It offers
provocative
discussion and links to news about research and policy
affecting, naturally, health and behavior.
HEALTH AND BEHAVIOR INFORMATION TRANSFER
The
Environmental Protection Agency, is developing a national
pilot program to recognize communities that factor into community
planning, environmental considerations and the need for older
adults to be physically active. For more information: http://www.epa.gov/aging/resources/factsheets/build_healthy-factsheet.htm
The application process for the NIH 2007 Pioneer Award
is now open. Scientists at all career levels and engaged
in any field of research may apply, so long as they are
interested in exploring biomedically relevant topics. Application
instructions are at http://grants.nih.gov/grants/guide/rfa-files/RFA-RM-07-005.html
Dr. Raynard Kington, principal deputy director of the
National Institutes of Health and its former director of
its Office of Behavioral and Social Science Research, has
been elected to membership in the Institute of Medicine.
