Health care forum Dr. Kevin Sand says 'It's value not volume'
By Lissa Greiner
If America is going to reform its health care system, it's going to have to change its priorities.
"We're going to have to start rewarding physicians for value, not volume," Decorah's Dr. Kevin Sand told about 20 people during a health care forum sponsored by the Upper Iowa League of Women Voters last week.
Sand added he believes there are a number of solutions to moving the state of health care in a positive direction.
"We need to create value, coordinate care, reform our payment system so providers are rewarded for value over volume, and provide health insurance for all," said Sand.
"We need to make sure everyone is included and has the basics," he said.
"We also need to focus on prevention. (Healthy) lifestyles should be rewarded."
Sand, who has been a family practice physician in Decorah for 30 years, said the issue is near and dear to his heart.
"They've been trying to reform health care in this country for about 60 years ... It sounds like we're going to get something done this time," he said, referring to President Barack Obama's health care reform proposal.
A moral issue
Sand said he is troubled by the statistic that about 16 percent of the U .S. population has no health care or insurance.
"It's a moral issue. I believe everyone should be covered. Who would look at someone out there and say, 'I don't think you need to be covered'? The question is: how to get there," said Sand.
A better job
Sand added he believes the U.S. could increase its efforts in administering health care to its citizens.
"I think we can do a lot better job. We spend a lot more (on health care) than other countries, yet we're rated about 30th (for delivery)," he said.
"Our biggest problem is the expense of health care ... it's been going up much faster than everything else in our economy for many years," he said.
Audience input
Sand asked attendees what their biggest concerns regarding their own health care were.
Decorah's Barb Kellogg addressed the issue of portability of insurance.
"If you are self-employed and live in one state and you want to move to another state, your insurance is dropped. It becomes difficult to get insurance in the next state due to your age or pre-existing conditions," said Kellogg.
Mark Goulson, Decorah, added he would like to see the elimination of pre-existing conditions and lifetime caps (limits).
"And I think it's absolutely critical that we have some form of public option," he said.
The League's Carol Hagen said, "I would like to see more energy and resources go toward prevention and healthy living than pathology and problems."
Decorah's Joann Hagen added, "I don't think your insurance should be attached to your jobs."
Taking ownership
Sand said he strongly supports the concept of a "medical home," a single provider through which all of a patient's medical information is funneled.
"No matter where a person is seen, that medical information comes back to your medical home and you have one person who is kind of in charge of your care," he said.
He added in a country with 47 million people without health insurance coverage, everyone needs insurance options that are "guaranteed, portable and that can't be denied, cancelled or priced too high."
"We need to own our own insurance. So if I move or lose my job, it goes with me," said Sand.
In addition, Sand said he feels there should be subsidies available for those unable to afford insurance.
"Insurers should be required to accept all patients. Health care debt is one of the leading problems in bankruptcy," said Sand.
Ponying up
Sand said while he supports the public option, it won't come without a cost.
"People must be willing to participate. Everyone must be willing to pony up and pay into the system ... and be fined for not participating," he said.
Fear mongering
Sand said he feels one of the problems with achieving true reform is the amount of fear being stirred up by the plan's opponents on Capitol Hill.
In reference to a comment made recently by Senator Chuck Grassley, Sand said, "Everyone is worried they're going to pull grandma's plug. That comes from a conversation about paid providers talking to people about what their wishes are. It's an inexcusable way of bringing out negativity toward the plan."
For more information about health care reform, visit www.mayoclinic.org/healthpolicycenter.
