Patient First By Marimar McNaughton Photography by Allison Potter Fifteen minutes with Reid revealed the journalist’s passion for equitable health-care for all Americans and how to achieve it. Reid, who was a special guest of the University of North Carolina Wilmington in November 2013, granted two inter-views and delivered a lecture. “I’m American, I like to think we’re the biggest, strongest, richest, most innovative country in the world; we should be No. 1 in this really crucial area,” says New York Times bestselling author T.R. Reid. This sentiment forms the bedrock of Reid’s research, published in nine books about global healthcare, and outlined in his 2010 book, “The Healing of America: A Global Quest for Better, Cheaper, Fairer Health Care.” If you missed the lecture, watch his PBS documentary. Fifty minutes into “US Health Care: The Good News,” he poses the question to a doctor who advocates for improving the quality of healthcare for everyone to lower the cost of medical care across the board. It’s really not so much a question but a statement that any taxpayer who looks at healthcare as a business might echo. “As a taxpayer who funds Medicare and Medicaid I should like you because you’re lowering the cost of healthcare,” Reid says to the camera. The doctor replies, “You should like me because I’m taking good care of my patients.” The exchange between Reid and his subject begs the question. “All the other countries in the world like us — I mean advanced, high tech, free market capitalist democracies — provide healthcare for everyone,” Reid says. “On average they spend half as much as we do. They often have better outcomes; they cover everybody. We leave 50 million people uninsured and spend twice as much. We’re spending more and getting less than all the other countries like us.” Leadership is key to effecting the kind of change Reid writes about and reports on. In the model of Grand Junction, Colorado, leadership came from the medical community. “In Grand Junction it was the doctors who did it. It was the doctors who decided, doggone it, we should cover everyone in our town. Medicaid is the lowest payer, it’s the poorest organized. If your 8-year-old has an earache, the average cost in Colorado is $98. Some insurance companies pay $120. Medicaid pays $28. So here’s what happens: You call up and say, ‘I think my son has an earache.’ The “I don’t think it’s the most important issue but it’s the biggest industry, health-care. It touches every single American. It’s a $2.6 trillion industry. One in every $6 is spent on healthcare. We’re paying way too much and getting way too little compared to all of our big economic competitors. The reason I care about this is doctor says, ‘I think I can fit him in at in February 2019,’ like that. They can’t see them.’ “The doctors in Grand Junction were particularly bothered by this — especially the obstetrician — seeing women come into the emergency room ready to give birth, and they hadn’t ever seen a doctor. Those are the babies we lose in America. We have a really high rate of neonatal death, that is death before the first birthday.” “It’s these people who never get care, and their babies die, because we don’t cover them. The doctors didn’t want to live in a community where people were not getting medical care so they set up that system where the money from all the payers is pooled, and it doesn’t matter whether the patient is covered by Medicaid or the world’s best insurance company. The doctors set it up and that’s what’s really striking about Grand Junction and that was 30 years ago and it’s still in place. There’s a local insurance company that administers it for them.” Leadership can also come from the business community. “In Everett, Washington, the Everett Clinic turns out to be one of the five cheapest places in America to get healthcare. Very good care and very low prices,” Reid says. “They have all these mechanisms. They never prescribe a brand name drug, they sharply limited the tests they do. That came from the customer, that came from Boeing. Boeing said, ‘We’re spending too much on healthcare and you’re our major provider; if you want to keep our business, get costs down.’” 48 WBM january 2014
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