April 24, 2018
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Journalist finds good news in U.S. health care system

By Daniel Hartill, Sun Journal

LEWISTON, Maine — There’s good news buried in the U.S. health care system’s web of unfairness and inefficiency, argues best-selling health care writer T.R. Reid.

Some medical communities are trying hard to cut the cost of health care. And it’s working, Reid told a Bates College audience Wednesday.
“In many places in America, the doctors actively work to get prices down,” said Reid, who is hosting a PBS documentary in February on what he and his colleagues found. “A lot of doctors said to us, ‘I have a mission to care for the physical health of my population. But I also have a mission to care about the fiscal health of my community.’ That was really striking to me.”
It happens too little, said Reid, who has traveled around the world comparing health care systems.
“Every other (wealthy) country in the world pays a lot less than we do and the quality is just about as good,” he said.
In 2008, Reid made the case on PBS’ “Frontline” with a show titled “Sick Around the World.” A year later, his book, “The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care” became a New York Times bestseller.
He profiled systems in France, Germany, Japan and elsewhere. Systems in those countries have problems, but they cover everyone.
In the United States, more than 49 million people have no health insurance, Reid said, citing recent census numbers.
Reid has been giving talks across Maine this week. He is speaking about his experiences with other health care systems — including years spent living in Japan as the Washington Post’s Tokyo correspondent — and talking about his new documentary, scheduled to air on PBS on Feb. 16.
“We called it ‘U.S. Health Care: the Good News,'” Reid said. “I thought that was kind of an ironic title because most of what you hear about health care is the bad news.”
He found the lower-costing communities by using research conducted by the Dartmouth Atlas Project, which analyzes health costs nationwide. The group looked at Medicare averages in communities across the country.
Reid and his team followed, traveling to the lowest-cost areas and talking with health care workers.
“On average, Medicare spends $8,700 per person, per year to keep people healthy,” Reid said. “In some counties in the United States, the average cost per person is $17,300, twice as much. And in some counties in the United States, the cost per person is $6,400, 25 percent less than the national average … People in the low-cost counties are just as healthy as the places spending three times as much.”
Parts of Colorado, Washington and Minnesota delivered low-cost health care. (Maine is about average, Reid said.)
In many cases, the major reason for success was that people were driven to control costs.
But there were other factors, too. Among them were standardization of prices and the frequency of care for things such as follow-up examinations. Both can vary widely among doctors.
If a woman is treated for high blood pressure and has it under control, a doctor in a high-cost area such as Miami might schedule follow-ups every two weeks. In Seattle, where the costs are being held down, a follow-up might be scheduled for a year away.
“A lot of stuff doctors do really has no scientific standard,” Reid said. “We really haven’t figured out yet, after all these years, what the right amount of care is for a certain disease.”

(c)2011 the Sun Journal (Lewiston, Maine)
Distributed by MCT Information Services

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