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Expert touts integration as essential to health care reform

Apr. 19, 2013 @ 12:00 AM

HUNTINGTON -- Calling the American health care system "our own personal Vietnam," author and physician Dr. Ted Epperly said its problems are the biggest risk the country faces today.

"It's not Iran or North Korea." said Epperly, author of "Fractured -- America's Broken Health Care System and What We Must Do To Heal It."

"The biggest risk our country faces is the health care system."

Citing numbers that showed health care spending rising to 50 percent of all spending over the next six decades, Epperly offered a sobering warning.

"If a dollar of every two dollars spent in this country is being pumped into health care, how do you make a country run with that kind of equation?" Epperly asked.

Epperly was the keynote speaker at Thursday's second annual Paul W. Ambrose Health Policy Forum, an extension of the medical school's three-year health policy fellowship within the family medicine residency program. Thursday's crowd was a mixture of physicians, medical professionals and the general public. Epperly said it was going to take all segments to fix a fractured health care system.

"We have the 37th-ranked health care system in the world, behind Costa Rica," Epperly said. "All the systems outside the U.S. -- none are perfect, mind you -- all have one thing in common: integration and cooperation at the primary care level.

"I'm convinced we have the best players in the game," said Epperly, likening the health care system to a basketball game. "But, we're getting beaten because we don't work together as a team. We get paid to shoot the ball. We're ensconced in a fee-for-service world. It's a free-for-all system where folks are shooting baskets as fast as they can."

Epperly advocated for patient-centered, community-facing medical homes, to get people through the right door of the health care system.

"It's about relationships and engagement over time, shifting the equation from the ERs and hospitals to the time people first report systems. We need to keep people as healthy as possible, as functional as possible and decrease the load of downstream care," Epperly said. "We don't want people to continue being the pinball in a broken system."

He cited needed changes in the system, some of which he said are addressed in the Affordable Care Act, such as rising costs and payment structure, including Medicare and Medicaid, as well as the lack of a quality strategy and wellness/prevention strategies in the way the system has always run.

"Our system is more known for making money than helping people, and I'm not trying to be critical, but until we're all engaged, things will not change," he said. "Imagine a symphony all playing from a different sheet of music. That's our health care system. We're not on the same sheet of music."

Epperly said true health care reform will never come until all facets of medical care -- emergency rooms, patient-centered medical homes, affordable care organizations and hospitals -- are aligned.

"It's all about integration so people are entering the right doors at the right times," he said. "We're all different victims of the same system, but we're in it together, and we have to work through it together to help align things where they need to be."

Follow H-D reporter Beth Hendricks on Facebook or Twitter @BethHendricksHD.



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