Trusted local news leader for Prescott area communities since 1882
Sat, April 20

Editorial: Series examines serious problems in health care access

For the past seven days, the Courier has published a series of articles on "Who Will Care for Us?" by T.M. Shultz.

This examination of the issue of access to health care locally established at least three key points, to wit:

• We have serious, complex problems in the health care system that don't fit the commonly accepted stereotypes that come to mind when people have trouble finding a doctor who takes their insurance - or finding one at all.

• The picture is sobering but one we can change with concerted effort by Congress and key institutions.

• We face a static or even declining number of doctors, especially in primary care, and a rapidly increasing number of older patients with multiple health problems whom fewer doctors are willing to treat.

It's possible to turn this situation around, and a number of local agencies and institutions are hard at work on the problems now.

First and foremost, we must boost the number of primary care doctors in the area and change the insurance system to pay them what they're worth for doing the kind of treatment and preventive medicine that makes for healthier people and less stress on the entire system. Insurers should pay primary care doctors to spend proper time with patients to understand their conditions and to educate patients to take better care of themselves.

One of the best ways to accomplish this is the advanced medical home concept the American College of Physicians proposed in a 2006 policy paper.

Once a doctor's practice gained certification and agreed to be accountable for quality, efficiency and patient outcomes, the primary care physician will lead a team of health professionals looking after the patient and will track the patient's overall health status.

Next, we need to accelerate efforts to bring good doctors here - especially primary care doctors - and keep them here. That means not only making the area attractive to the doctor, but also setting up methods of finding good jobs for doctors' spouses.

Finally, we need a complete overhaul of managed care and Medicare. It's a great concept to try to monitor doctors' billings more closely, but once things reach a point where doctors refuse to deal with all the hassle and second-guessing and refuse to accept Medicare patients and patients with certain insurances, it's time to rethink it. The system doesn't work. One doctor said he resents a 24-year-old clerk hundreds of miles away dictating how he cares for his patients.

All of us need to help out as well by taking greater responsibility for our own health by eating properly and getting at least minimal exercise.

Some of that exercise should take place with a pen and pencil or at a keyboard to make it clear to Congress that we need an overhaul of Medicare and insurance programs, as well as legislation and appropriations to promote more medical school and residency programs for primary care doctors.

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