Getting what you pay for

“Throw out the rules and start from scratch…,” that’s what Dr. Rashika Fernandopulle told Connecticut radio listeners last week in a provocative interview about the cost and quality crisis we’re facing in health care today.

On their weekly radio show “Conversations on Health Care,” Community Health Center Inc. leaders Mark Masselli and Margaret Flinter interview and spotlight innovators in the field. On March 24, they interviewed Fernandopulle, who runs Cambridge-based Iora Health, an organization focused on transforming the delivery of health care. He doesn’t mince words about our current broken system:

“We spend an obscene amount of money on health care…. It’s bankrupting individuals, it’s bankrupting companies who can’t compete internationally and it’s bankrupting the country….. We are spending so much yet the quality we get is awful. Anyone who is trying to get health care knows it’s depersonalized, it’s fragmented, it’s reactive and the outcomes are embarrassingly poor”

In health care, it’s clear that there is a huge gap between what we pay for and what we get. Universal Health Care Foundation of Connecticut is working to ensure state residents understand what they should expect from the changing health care system and how they can help create a better system of care. In a few weeks, we’ll be unveiling a large public education campaign to provide residents with the information they need to make informed decisions for their families and communities. Efforts like Dr. Fernandopulle’s are worth noting.

He is pioneering a new model of primary care that relies on team-based care with strong community supports. This new approach has been shown to achieve improvement in key measures of health status and patient satisfaction as well as net spending reductions of 20 percent. If you’re interested in seeing how he’s doing it check out this Atul Gawande 2011 New Yorker “Hot Spotters” article.

The Affordable Care Act expands access to care, and bans the worst insurance practices. Federal health reform is now in full implementation mode, with tens of thousands of uninsured residents expected to get coverage starting in January. But these gains could become nearly irrelevant if we can’t halt out-of-control cost increases and make great leaps forward in improving quality. The status quo is simply not acceptable; as Fernadopulle says, we really need to “start from scratch.”

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