Op-ed: Health care reform must continue – in Utah and across America


Even with these advancements, we know there is still room to improve health care delivery in Utah and across America, so that all citizens have access to the best care whenever they need it.

Recently, the U.S. House of Representatives passed the American Health Care Act, which will trigger even more debate as Congress takes its next steps in health care reform. As these discussions occur, everyone involved must remember the main objective is to create meaningful and sustainable improvements that produce high-quality, affordable care and reduce inefficiencies for Utahans and for all Americans – and improve health outcomes. Without comprehensive changes, the burden on taxpayers will further escalate, while the health of Americans will continue to lag behind many industrialized nations.

Eighteen months ago, the National Academy of Medicine (NAM) launched its policy initiative, Vital Directions for Health and Health Care, to identify the most pressing health challenges facing Americans, and to present the most promising, evidence-based solutions. The NAM assembled a nonpartisan steering committee of 18 prominent health care experts to lead the initiative, and commissioned policy papers authored by over 150 leading health-policy specialists, scientists and researchers.

Across the papers, it is evident that achieving progress will require a far broader effort that engages everyone — from patients and families to local communities to elected officials — to develop innovative and equitable solutions. And importantly, progress necessitates independent, nonpartisan and strong evidence-based research, and sound real-world advice to move our nation forward.

Published recently in the Journal of the American Medical Association, the steering committee’s framework provides evidence-based, actionable insights and recommendations for advancing health, health care and scientific progress, and provides the foundation of what we believe would be an optimal health system.

Among the Vital Directions priorities: Policies should encourage initiatives that activate local communities, because good health begins where people live, work, and play. Health care should also meet the demands of an ever-engaged consumer by ensuring that care is linked to each individual’s goals, promoting telehealth where appropriate and giving patients greater access and ownership of their health data, while safeguarding privacy. Health care delivery in the future will need skilled clinicians working as integrated teams to deal with a more medically complex population.

The work at the University of Utah Health Care (UUHC) aligns with these priorities. Using big data and analytics, the UUHC team determined how much it actually costs to provide patient care, including, for example, the cost of an hour in the emergency department. They’ve also modified various medical practices and procedures to deliver more efficient and effective care.

Michael Porter, an economist and professor at Harvard Business School, called UUHC’s accomplishments “epic progress” because few health systems are doing this properly. By knowing the precise cost of care and improving their processes, UUHC is able to make better decisions that result in better patient care.

A key message that resonates from the Vital Directions initiative is that we must cut through the nation’s deeply polarized politics if we are to address the vexing long-term problems of achieving better health and delivering higher-value and quality health care. The Vital Directions framework and accompanying set of issue papers can serve as a blueprint for lawmakers seeking to build bipartisan policies.

The contributors to the Vital Directions framework are sharing it with government officials, policymakers, private-sector leaders, and the broader public in the hope that we can help guide an informed discussion to make us a healthier nation. This shared goal can bring us together to work toward better health of all Americans.

Victor Dzau, M.D., is president of the National Academy of Medicine (formerly the Institute of Medicine). Michael Leavitt is a former governor of Utah and former Secretary of Health and Human Services. They are two of the co-authors on “Vital Directions for Health and Health Care: Priorities from a National Academy of Medicine Initiative,” which was published online in March, 2017 in the Journal of the American Medical Association.

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Op-ed: Health care reform must continue – in Utah and across America

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