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How are the Doctors affected by Reform

Quick Summary of pertinent points in a Kaiser conference video

Some health care organizations have combined thoughtful use of technology and better use of personnel to improve preventive care and treatment of chronic disease, obtain better outcomes, and offer additional job satisfaction to their health care workforce. For example, the Colorado unit of Kaiser Permanente reduced the mortality associated by cardiac care by 76 percent, in part through a coordinated and multi-disciplinary team using electronic medical records.

Sweeney a giant in HC reform:  in favor of universal coverage (meaning HC for all)

Commonwealth fund:  studied claims of 5M people, studied over care:  $1/2T out of $2T total wasted

Another study:  extend best practices, could save $1/2T of the $2T

Another study:  care done all over as is done in areas of best cost/quality areas:  again 25% savings

Not by rationing, or other means of restrictions

Who is spending now:  chronic conditions, not cancer or broken bones, 80% having multiple conditions,

            Care right about ½ of the time

            Diabetics consume 32% of Medicare and it is done right about 8% of the time

Massive opportunities in delivering care right

            Cost distribution:  1% of population is 30% of the cost of care, and if brought in line with rest, then the costs would be comparable to that of Canada f we could intervene earlier        

            10% of folks who are consuming 80% of costs

            Could cut the number of heart failures, kidney failures in ½

How to achieve:  focus in on half dozen conditions that drives 60% of costs

            Set goals, reduce kids who have asthma attacks

            Must focus:  toolkit including electronic medical record

            Track to see how the care goes, and intervene

            Asthma:  number one cause of death in kids, and can reduce admissions by 50-90%

            African American kids:  much worse

Need a national culture of health:  can reduce diabetes by ½

            Loose 15 lbs, diabetes goes down by 50%

            Get rid of transfat, diet improvement

            Walking ½ hour a day: cuts diabetes by ½

Not rocket science but cannot succeed by small quality improvements          

25% cost improvements through care improvements

Do not need a rationing model