Re: OK, here's what I sent to change.gov

[Guest guest]

Gordonso glad you sent this to themsince they are being inundated with suggestions I sure hope you listed your credentials (IHI work, etc.) but having met you and having read your posts, it is notlike you at all, to toot your own hornthe rest of us could send a jointly "signed" statement (with names and state listed) endorsing your suggestions, below, and referring the healthcare change team to idealmedicalpractices.org, as you have done, plus we could send a list of links toarticles that have been published about primary docs in this listservejust a thoughtforgive me if this idea has already been posted in a threada Mintekoffice managerfor Rian Mintek, MDThere is a growing sense of dismay among health care improvement experts and health care providers interested in reforming the US health care system. The current trajectory of the US health care system is unsustainable and reform is urgently needed, but reports in the media strongly suggest that the Obama/Biden health agenda plans are as likely to exacerbate as they are to help the current situation. Without fundamental reform of payment policies and the delivery system we expect the current proposals to lead to the accelerated crash of the UShealth system. A high performing health system achieves better health outcomes, experience of care, and lower per capita cost of care. Effective primary care is the core of a high performing health system. The US is not a high performing health system and has worse population heath outcomes, worse experience of care, and higher per capita health care costs than other developed countries. The basic work of primary care (WHO 1978 Conference) includes: Point of first contact (I can get care when and where I need it)Relationship over time (I have a provider who knows me)Broad array of services (My primary care provider takes care of the bulk of my health care needs)Coordination of care (My primary provider guides me through the health care system) Low reimbursed fee for service results in rapid visits with early referral or lack of engagement on the complex issue of lifestyle change (still the most powerful intervention available), and no ability to engage in a wide array of services or care coordination Primary care is a dying breed in the US due to the combination of inadequate funding to do the basic work of primary care and the crushing yoke of administrative work. The primary care providers in the US are ready and willing to redesign their practices if they could practice in a favorable policy and payment environment (we have been demonstrating this in a grant funded initiative with volunteer practices from across the US –www.Idealmedicalpractices.org) “Insurance for all” and “An EMR in every office” fail to address the fundamental flaws in the US system and are as likely to exacerbate as help. At the VERY LEAST we urge funding for some demonstrations of truly transformational health payment and delivery. The models deserving funding should include participant outside the usual and customary players to help break the insularity of “group think” evident in current policy proposals.

[Guest guest]

so what's been the response?

LL

At the VERY LEAST we urge funding for some demonstrations of truly

> transformational health payment and delivery. The models deserving

> funding should include participant outside the usual and customary

players

> to help break the insularity of " group think " evident in current policy

> proposals.

>

[Guest guest]

Beautiful!

Subject: OK, here's what I sent to change.govTo: Date: Sunday, December 21, 2008, 10:17 AM

There is a growing sense of dismay among health care improvement experts and health care providers interested in reforming the US health care system. The current trajectory of the US health care system is unsustainable and reform is urgently needed, but reports in the media strongly suggest that the Obama/Biden health agenda plans are as likely to exacerbate as they are to help the current situation.

Without fundamental reform of payment policies and the delivery system we expect the current proposals to lead to the accelerated crash of the US health system.

A high performing health system achieves better health outcomes, experience of care, and lower per capita cost of care.

Effective primary care is the core of a high performing health system.

The US is not a high performing health system and has worse population heath outcomes, worse experience of care, and higher per capita health care costs than other developed countries.

The basic work of primary care (WHO 1978 Conference) includes:

Point of first contact (I can get care when and where I need it)

Relationship over time (I have a provider who knows me)

Broad array of services (My primary care provider takes care of the bulk of my health care needs)

Coordination of care (My primary provider guides me through the health care system)

Low reimbursed fee for service results in rapid visits with early referral or lack of engagement on the complex issue of lifestyle change (still the most powerful intervention available), and no ability to engage in a wide array of services or care coordination

Primary care is a dying breed in the US due to the combination of inadequate funding to do the basic work of primary care and the crushing yoke of administrative work.

The primary care providers in the US are ready and willing to redesign their practices if they could practice in a favorable policy and payment environment (we have been demonstrating this in a grant funded initiative with volunteer practices from across the US – www.Idealmedicalpra ctices.org)

“Insurance for all” and “An EMR in every office” fail to address the fundamental flaws in the US system and are as likely to exacerbate as help.

At the VERY LEAST we urge funding for some demonstrations of truly transformational health payment and delivery. The models deserving funding should include participant outside the usual and customary players to help break the insularity of “group think” evident in current policy proposals.

[Guest guest]

Time will tell.

G

From: [mailto: ] On Behalf Of llyonmd

Sent: Monday, December 22, 2008

3:52 PM

To:

Subject:

Re: OK, here's what I sent to change.gov

so what's been the response?

LL

At the VERY LEAST we urge funding for some demonstrations of truly

> transformational health payment and delivery. The models deserving

> funding should include participant outside the usual and customary

players

> to help break the insularity of " group think " evident in current

policy

> proposals.

>

[Guest guest]

Gordon,

I copied your post and sent it to my Senator Wyden and my representative DeFazio. I have been sending quoted documents with all interesting posts from the list serve about the health care system problems: off went 's note about the insurance companies with bouncy checks, the medicare administration problem discussions, your good quotes. I have been hoping I would catch the interest of one of their health care specialist email readers, given my famous big city name, and that they would recognise the excellent information they are getting. Hope you don't mind.

Joanne

Subject: RE: Re: OK, here's what I sent to change.govTo: Date: Monday, December 22, 2008, 4:56 PM

Time will tell.

G

From: Practiceimprovement 1yahoogroups (DOT) com [mailto: Practiceimprovement 1yahoogroups (DOT) com ] On Behalf Of llyonmdSent: Monday, December 22, 2008 3:52 PMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: [Practiceimprovemen t1] Re: OK, here's what I sent to change.gov

so what's been the response?LLAt the VERY LEAST we urge funding for some demonstrations of truly> transformational health payment and delivery. The models deserving> funding should include participant outside the usual and customaryplayers> to help break the insularity of "group think" evident in current policy> proposals.>

[Guest guest]

Well, the CBO says that the only change that will save money is for

somebody (wonder who?) to buy more IT:

http://www.ihealthbeat.org/Articles/2008/12/19/Budget-Office-Highlights-Health-I\

T-as-Promising-Health-Proposal.aspx

" According to the CBO report, a requirement for physicians and

hospitals to use health IT as a condition of participating in Medicare

could save the federal government $7 billion in the first five years "

>

> so what's been the response?

> LL

>

> At the VERY LEAST we urge funding for some demonstrations of truly

> > transformational health payment and delivery. The models deserving

> > funding should include participant outside the usual and customary

> players

> > to help break the insularity of " group think " evident in current

policy

> > proposals.

> >

>

[Guest guest]

I don’t mind at all, the more of us

hammering away the sooner the walls come tumbling down.

G

From: [mailto: ] On Behalf Of joanne holland

Sent: Monday, December 22, 2008

6:45 PM

To:

Subject: RE:

Re: OK, here's what I sent to change.gov

Gordon,

I copied your post and sent it to

my Senator Wyden and my representative DeFazio. I have been sending

quoted documents with all interesting posts from the list serve about the

health care system problems: off went 's note about the

insurance companies with bouncy checks, the medicare administration

problem discussions, your good quotes. I have been hoping I would

catch the interest of one of their health care specialist email readers,

given my famous big city name, and that they would recognise the excellent

information they are getting. Hope you don't mind.

Joanne

From: L. Gordon

<gmooreidealhealthnetwork>

Subject: RE: Re: OK, here's what I sent to

change.gov

To:

Date: Monday, December 22, 2008, 4:56 PM

Time will tell.

G

From: Practiceimprovement

1yahoogroups (DOT) com [mailto: Practiceimprovement 1yahoogroups (DOT) com ] On Behalf Of llyonmd

Sent: Monday, December 22, 2008

3:52 PM

To: Practiceimprovement

1yahoogroups (DOT) com

Subject: [Practiceimprovemen t1]

Re: OK, here's what I sent to change.gov

so what's been the response?

LL

At the VERY LEAST we urge funding for some demonstrations of truly

> transformational health payment and delivery. The models deserving

> funding should include participant outside the usual and customary

players

> to help break the insularity of " group think " evident in

current policy

> proposals.

>

[Guest guest]

Bravo! You say it so well. Add in there equal pay for equal work regardless of zip code, based by each state

There is a growing sense of dismay among health care improvement experts and health care providers interested in reforming the US health care system. The current trajectory of the US health care system is unsustainable and reform is urgently needed, but reports in the media strongly suggest that the Obama/Biden health agenda plans are as likely to exacerbate as they are to help the current situation.

Without fundamental reform of payment policies and the delivery system we expect the current proposals to lead to the accelerated crash of the US health system.

A high performing health system achieves better health outcomes, experience of care, and lower per capita cost of care.

Effective primary care is the core of a high performing health system.

The US is not a high performing health system and has worse population heath outcomes, worse experience of care, and higher per capita health care costs than other developed countries.

The basic work of primary care (WHO 1978 Conference) includes:

Point of first contact (I can get care when and where I need it)

Relationship over time (I have a provider who knows me)

Broad array of services (My primary care provider takes care of the bulk of my health care needs)

Coordination of care (My primary provider guides me through the health care system)

Low reimbursed fee for service results in rapid visits with early referral or lack of engagement on the complex issue of lifestyle change (still the most powerful intervention available), and no ability to engage in a wide array of services or care coordination

Primary care is a dying breed in the US due to the combination of inadequate funding to do the basic work of primary care and the crushing yoke of administrative work.

The primary care providers in the US are ready and willing to redesign their practices if they could practice in a favorable policy and payment environment (we have been demonstrating this in a grant funded initiative with volunteer practices from across the US – www.Idealmedicalpractices.org)

"Insurance for all" and "An EMR in every office" fail to address the fundamental flaws in the US system and are as likely to exacerbate as help.

At the VERY LEAST we urge funding for some demonstrations of truly transformational health payment and delivery. The models deserving funding should include participant outside the usual and customary players to help break the insularity of "group think" evident in current policy proposals.

-- M.D.www.elainemd.com

Office: Go in the directions of your dreams and live the life you've imagined.This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

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[Guest guest]

I have been working on getting information about primary care and the IMP movement (and sending them your way Gordon ;-) since before the primaries. Since we get so much attention from the candidates here, I took the opportunity to put a lot of literature into the hands of his Iowa coordinator, as well as meeting him in my office to show him how it can work. I agree, we just need to keep hammering. Everytime a situation arises in my office of money poorly spent because of no primary care, I send a general summary to change.gov. It is therapeutic for me even if my emals are starting to end up inthe 'oh, her again' pile. There is hope, Obama actually wants the superintendant of Chicago schools to head the Department of Education. While I may not agree with all the ideas, at least there seems to be some appreciation for real life experience over ' beltway conventional wisdom.'

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.