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Monday, June 12, 2006

People treated like . . . people

By Michael Waddoups
Utah State Senator, District 6

One of my strong impressions after visiting the Riverwoods Surgery Center was that patients should be aware of the wealth of healthcare options available - and have more freedom to choose the best fit for the procedures that impact their lives.

The Riverwoods Surgery Center is an alternative to the typical hospital surgery room. It seemed cleaner, more personal, and much less expensive.

In fact, Riverwoods Surgery Center was more like a hotel than a hospital. People were treated like . . . people. The atmosphere was respectful and personable. This probably doesn’t happen every time, but I saw one doctor walking a patient out to his car after a treatment. That kind of care is refreshing.

ASCs (Ambulatory Surgery Centers) are also less expensive. One surgery that costs $3100 at a local hospital, costs $2100 at an ASC. In addition, ASCs boast a strikingly low infection rate, when compared with traditional health care providers.

I was impressed.

I believe doctors and their patients can and should have enhanced alternatives, more transparency, and more information. Insurance companies and the health care industry should encourage, not impede, this process.

We would serve our constituents well to promote a healthcare system where more choices are made by the patients who's lives and health are at stake - rather than the insurance company, hospitals, and employers.

I believe government can help in two specific ways:
1 - Encourage insurance companies to be more cooperative. They should be less restrictive with those who do the work and pay their premiums. People should have a full spectrum of options available to them in their time of need.

2 - The State should require health care providers to identify their infection rates and make that information available to the public. Perhaps the Health Department could post and publicize those rates on their website.
Watch for upcoming legislation on choice and transparency.


Anonymous Robin Riggs said...

Sen. Waddoups:

Please be advised that the Salt Lake Chamber has led an effort to create an Employers Healthcare Coalition to study the rising costs of healthcare for businesses, large and small. The Coalition has hired the Utah Foundation to conduct the study. The study will feature a series of focus groups to identify key issues from each of the various health care sectors. The first focus group was held last week and featured human resource directors from nearly 30 companies in the state. The next focus groups will feature insurance companies, doctors, hospitals, and insurance brokers.

Robin Riggs
VP & General Counsel
Salt Lake Chamber

6/13/2006 8:54 AM  
Anonymous Steve Catmull said...

In principle we should have choice and transparency.

As a consumer of healthcare, I'm equally concerned not only about cost, but about finding good healthcare.

If we want to increase the competition within healthcare, we need to continue to make outcomes digestable for consumers. Senator Waddoups only talked about surgical infection rates. I want to know about bedside manner and other service outcomes.

When I want to find a good specialist or doctor it's really who you know who might know a good doctor versus what is known about historical performance.

If we want to make choice easier, we need to provide significantly more outcomes data and far more than just SIP (surgical infection prevention.) Free markets dictate require perfect knowledge and low barriers to entry in order to make choices. Let's not forget all three principles.

6/13/2006 9:06 AM  
Anonymous Demosthenes said...

It would be interesting to see how many patients actually take the time to research who their doctors are before they go in to see them. It would also be interesting to know how many patients actually take the time to find out how good their hospitals are before they head to the ER.

Choices are good, but people should be able to expect quality health care wherever they go. This should be the goal of private and public entities in the state – to be able to provide affordable and quality healthcare to anybody, anywhere in the state.

Transparency is only useful when the people who need it know where to look. Let's be honest. The truth is very few people would utilize this information even if it were hand-delivered to them.

Legislators need to spend less time generating reports on the current status of Utah’s health care system and more time making it into what it should be.

6/13/2006 12:54 PM  
Anonymous Anonymous said...

I can vouch for the use of ambulatory surgery centers, they are more personal, less costly and as a matter of fact the infection rate IS lower. ASC's should be a matter of choice not dictated by insurance. You should be allowed to choose by a number of factors. Competition keeps us all at our best. Without it you can expect substandard care across the board. If we lose choice why would any of us strive to continue to be the best? Let us be honest. If an ASC is reputable, then you can expect the surgeons who use that facility to be reputable as well. It is up to us to educate ourselves about our insurance and the premiums we pay for the service we receive. Most people know very little about who their physicians are let alone what kind of facility they are headed to for their surgery. Let's get educated people! Then we can fight the battles. We don't buy anything else without firsthand knowledge, why do we "buy" health insurance without knowing firsthand where we can and cannot go, and who the doctors or facilities are? Know any good hand surgeons in the Ogden area on the most popular plan in that area???

6/14/2006 7:22 AM  
Anonymous Steve Catmull said...


Most people do not use the information that is available to them. How many constituents read this blog? How many check agendas and minutes for their city meetings?

Very few as a proportiion of the population, but the transparency of information is essential to drive choice.

As in any profession there are those who are good, better and best. It is altruistic and noble to think that we could have consistently good healthcare. Unfortunately, it's just not a nearterm reality.

In fact, if you listen to the Taskforce recording, you will see that one of the reasons that ASCs are cheaper is because they don't do all procedures that even hospital outpatient departments do. Under testimony, one of the ASC docs mentioned that because of profitability and medical supplies issues, they route some patients to outpatient departments.

So it is nice that Senator Waddups quotes a single price comparison, but what never gets talked about is the statistical effort to normalize the populations to see if you really are treating patients with similar age, sickness, and other key factors.

Statics are often abused to serve a political purpose and I think they are on this case. Let's get more information out there and let other enterprizing individuals use it to drive lasting and meaningful change in healthcare.

6/14/2006 10:20 AM  
Anonymous Anonymous said...

I love the fact that Senator Waddoups cares about what is happening in healthcare today, and is willing to spend the time to sort out fact from fiction! The fact that there are options in the delivery system, such as ambulatory centers is a good thing. The fact that access to those options is restricted by insurance payers is a bad thing. I understand the arguement by insurance companies, which state that "if 'they' direct patient access" it will save money. My answer to that position, is "who says so?" How can that broad statement represent the absolute truth?
Saves money for whom? I doubt that premiums have gone down for employers or patients with patient restricted access. Has it contained costs of service? Not hardly!
Is the money "saved" going back to decrease premiums? Improve coverage?
There is a lot of work to do to improve the system. One of the biggest improvments occurring in the past decade was the entry of physician owned facility, which an example is the ambulatory surgical center. Doctors are now having the opportunites to participate with the "cost" side of the business. As Senator Waddoups noted in his observation of doctor/patient experience in River Woods, the doctors care about doing the right thing for the patients, including the safety of getting them to the car without fall or injury. I am appalled when insurance companies report that they will not contract for services in an ambulatory center where doctors have ownership. They would rather contract with corporate healthcare systems who report extrodinary profit earnings! Consumer education is a BIG piece of the pie, but is not the only consideration for a redesign of the system.

6/14/2006 1:55 PM  
Anonymous Clark Newhall said...

Sen. Waddoups' comment on the customer-friendly nature of privately-owned surgical centers is not surprising and his remark that the state government has a role in making the medical industry "treat people like people" instead of "patients" is a refreshing recoognition. The need for a change in attitude in the medical industry goes much deeper than the cosmetic features of a pleasant, hotel-like atmosphere, as I am sure the Senator recognizes. Indeed, the paternalistic approach to "patients" so familiar to us all is not only corrosive to the spirit, it is dangerous to helath and life. It is the cultural attitude that has allowed the medical industry to refuse to makes its prices clear to the consumer; to refuse to address the hundred thousand deaths caused each year by mistakes in hospital; to refuse to acknowledge and be open to people who are injured by mistakes; to bully legislators into passing laws that allow hospitals to shield bad mistakes and bad doctors from public scrutiny---all these are the result of the arrogant attitude that "we know what is best for you." I urge you, Senator, to consider legislation this coming term that will open up the industry and force it to be accountable to its customers, your constituents.
Clark Newhall MD JD

6/14/2006 3:43 PM  
Anonymous Anonymous said...

Clark Newhall would have us believe that this enigma of rising costs and hidden fees is the conspiracy of the medical profession. To the contrary. Now as physicians who have been subjected to hospital corporate management and insurance provider pressure with little control of the premiums they or their patients pay, and little if any control of what the insurance providers pay them, some clear-sighted physicians have forrayed into the business world where they are learning that there is a better way. This is happening despite the contrary attempts of the threatended corporate entities to supress legitimate competition of their near monopolistic powers.

Clark, you need to pick this apart and address concern where it is warranted, not just at the whole "medical industry".

6/15/2006 2:57 PM  
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