Improving health care

Tuesday, Feb. 1, 2011 | 2:01 a.m.

Much of the health care debate in the United States over the past few years has been focused on insurance and cost. The country spends an inordinate amount of money on health care — in 2009 it was $2.5 trillion or one-sixth of the gross domestic product — and the much-needed reform law was aimed at getting people coverage and containing costs.

The fight over the law since it passed has largely been about the insurance mandate. Several federal lawsuits are making their way through the courts challenging the legality of the federal government penalizing people for not having coverage. On Monday a judge in Florida ruled the law to be unconstitutional, leaving the federal courts that have heard the case split 2-2 on the law’s legality.

Although the lawsuits are on a path to the Supreme Court, there is another important matter that hasn’t received enough attention — the quality of health care. The United States spends more than any other industrialized nation on health care, yet Americans can’t expect any better outcomes than they would in other countries.

Dr. Michael Rozien, chief wellness officer of the renowned Cleveland Clinic, said when it comes to health care the United States spends “twice as much as Europe and three times as much as Asia. That’s because we have twice the chronic disease of Europe and three times as much as Asia.”

In a recent interview with the Las Vegas Sun’s Marshall Allen, Rozien said there are “four things driving the problem: physical inactivity, food portions and choices, tobacco use and stress.”

Through years of bad choices, people can end up with chronic — and costly — medical problems. That adds to the cost of medical care in the United States, not to mention the toll of human suffering. Wellness and preventive care are cheaper than treating illness and disease and are better. A healthy lifestyle can prevent, minimize or reverse many illnesses.

Rozien, also the chief medical consultant to “The Dr. Oz Show,” encourages people to make changes, from walking more to making better choices — less fat, lower sugar, whole grains and no smoking, for example.

The key is that people have to be involved and take an active role in their health. They have to be informed about their health. People should be carefully considering what they’re eating, and they should work with their doctors to improve their health before they get sick.

As well, the health care system in this country could, and should, do better. As the Las Vegas Sun’s “Do No Harm” series about hospital care has detailed, medical mistakes and injuries have happened because of a culture that often puts profits above safety and has opposed transparency. Many problems are swept under the rug in a culture that refuses to talk about medical errors. Mistakes and poor care can add to the overall cost of medicine and add to human suffering.

To improve, hospitals and physicians should be discussing mistakes so others can learn from them. There should be a strong culture of safety, where doctors, nurses and medical staff are working together to prevent errors.

Many other things can be done to improve the quality of care in the United States, but the bottom line is that individuals, physicians and hospitals could contribute quite a bit by accepting their share of responsibility for improving it.