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Fix This Mess

Fix This Mess

More Health Care Fixes

By Mary Beth Regan

Empower the Patient. Consider the pills that are thrown away, or the test results that are ignored. By prescribing treatments and screenings that patients don't want, providers waste medical resources. John F. P. Bridges, PhD, an HPM assistant professor, says we need to curb paternalism and increase efficiency. The founding editor of a new medical journal called The Patient—Patient Centered Outcomes Research, Bridges recommends adopting a patient-centered approach in which empowered patients collaborate with providers to make informed decisions about their health care.

Invest in Preventive Care Strategies. Tobacco-related illnesses claim 438,000 lives each year, including tens of thousands who did not smoke but became ill from secondhand smoke. Beefing up preventive policies to tackle smoking and other lifestyle issues could save billions of dollars and countless lives, notes Stephen Teret, JD, MPH '79, an HPM professor.

Improve Primary Care. Countries with weak primary care systems (including Belgium, France, Germany, and the United States) show higher costs but poorer performance on major health indicators such as life expectancy and child survival, according to recent work at the School led by Barbara Starfield, MD, MPH '63, an HPM professor. As countries like the U.S. undertake health care reform, "mostly directed at conserving costs," Starfield notes, policymakers should consider "that a strong primary-care orientation within health service systems continues to exert a positive effect," particularly for children.

Restructure the Health Care Workforce. Rather than increase medical education funding to train more doctors, as advocated by the American Association of Medical Colleges, the money would better be spent on providing health care for millions of uninsured Americans. That's according to a recent study by Jonathan Weiner, published in the August 4, 2007, issue of the British Medical Journal.

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