18 Big Ideas to Fix Health Care Now (page 2 of 3)

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Steve Burd motivated his employees to practice what he preaches.

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Ken Hawkins

Yvonne Sanders-Butler stamped out obesity in her school.

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Dr. Schoenberg's new technology will allow you to see a specialist anytime without leaving home.

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Ken Hawkins

Yvonne Sanders-Butler stamped out obesity in her school.

6. Use Retail Clinics for Routine Care
"Minute" clinics in major drugstore chains can help simplify health care, says Harvard business professor Clayton Christensen, by "offloading some of the work to nurse practitioners, physician assistants, and even patients." The AMA isn't keen on the idea: It wants doctors to at least supervise these clinics. Still, they're safe for minor things like sore throats, pulled muscles, pinkeye, wart removal, and vaccines.

The payoff: They're faster and more convenient. Plus, if you're uninsured, you'll pay 30 to 80 percent less than what you'd shell out for a doctor (and much less than you'd pay by going to the ER). For those who do have coverage, major insurance is usually accepted.

The action plan: Visit the Convenient Care Association at ccaclinics.org to find a clinic in your area.

7. Share Information to Fight Cancer
Could it really be this simple? Get the FDA and the pharmaceutical industry to talk more openly so patients can get safer drugs more quickly and inexpensively. The nonprofit Critical Path Institute (C-Path) believes we can save money and lives by speeding up our nation's sluggish and costly drug-approval process.

One project under way: C-Path brought 18 drug, biotech, and diagnostic companies together (many of them fierce competitors) to collaborate on a major lung cancer trial. The 18 companies are hoping to develop mutually agreed-upon tests that would allow the FDA to get results in as little as a week rather than years, says Raymond Woosley, MD, president of C-Path.

The payoff: Speeding up the trial process could reduce the number of costly failed drugs and lower the price of prescription drugs in general.

The action plan: Visit c-path.org for more information.

8. Measure Results and Make Them Public
When doctors and patients work together to meet tangible health goals that yield proven results, great things can happen. That's the idea behind nonprofit Minnesota Community Measurement. The group sets standards of care for 14 conditions, and the onus is on doctors to counsel, motivate, and even push their patients to get with the program. The organization gathers outcome data and posts the percentage of patients at each clinic who meet all the standards for a particular condition on mnhealthcare.org.

The payoff: While it's not easy to get people to change their lifestyles, compliance in diabetes patients has risen from 4 percent in 2004 to 11 percent in 2007. Jim Chase, executive director, estimates that if these improvements were adopted nationally, we could save more than $1.6 billion a year.

The action plan: If you have a chronic condition, work with your doctor to set goals in writing.

9. Stop Unnecessary Treatments
We spend more than any other country on health care, but we're not healthier for it, partly because so much of the care delivered here is unnecessary, says Shannon Brownlee, author of Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer.

"The way to fight waste," she says, "is by reorganizing the way doctors and nurses and hospitals provide care. There are models out there of high-quality, low-cost care, and they include some of the most trusted names in medicine: the Mayo Clinic, Kaiser, and Intermountain Healthcare. These programs have a primary provider coordinate all the care. They understand that 21st-century medicine is a team sport. They also put a premium on analyzing the best available evidence and then ensuring that their doctors follow it."

The payoff: "Cutting out even half of the unnecessary health care in this country," Brownlee says, "would be enough to cover every citizen who is now uninsured."

The action plan: Go to overtreated.com to learn which questions to ask your doctor; you'll find resources and links for further information.

10. Reduce Infant Mortality
More than 2,000 infants die in the United States every month, many because they're premature. "The rate of premature births has been increasing steadily for decades," explains Joann Petrini, PhD, director of the perinatal data center for the March of Dimes. More smokers, more moms over 35, and more multiple births (due in part to more women having fertility treatments) are just some of the reasons. "You could do everything right and still end up having a preterm baby," says Petrini. "We need more research into how and why it happens."

The payoff: Preterm births cost us more than $26 billion a year, so preventing them would save billions of dollars and thousands of lives.

The action plan: Support the campaign at marchofdimes.com.

11. Make Schools Healthier

• Reward healthy eating. The nine million obese kids in this country are set to become the first generation with a shorter life expectancy than that of their parents. Schools can help by encouraging fun physical activity and rewarding healthy eating. One school's success story: When Yvonne Sanders-Butler became principal of Browns Mill Elementary School in Lithonia, Georgia, a decade ago, 20 percent of her students were overweight, and just over half were passing state academic tests. She soon discovered that a typical breakfast for many students was a doughnut, candy, soda -- or nothing at all. She also found 300 slips on file excusing students from gym. "These kids were couch potatoes," says Sanders-Butler. She approached her PTA with a drastic plan: Ban candy, soda, and sugary snacks from brown bags and cafeteria lunches. Homeroom teachers now inspect all lunches and snacks and replace contraband treats with a banana or an apple. Kids and parents sign a wellness pledge, and students who stick to the program (called Healthy Kids, Smart Kids) win homework passes and other prizes. Now Sanders-Butler is working with the Robert Wood Johnson Foundation to help spread the word (healthykidshealthycommunities.org).

  
  The payoff: Today you won't see a single obese child walking the halls, and 80 percent of students pass the state tests. As of September, 17 other schools had joined the program.

  The action plan: Make the sugar-free case to the principal and PTA at your child's school. For more information, go to healthykidssmartkids.com.




• Rescue recess. In many schools, where recess hasn’t been pushed aside for academics, many students use those precious minutes to hang out rather than burn off the cheeseburgers. But at William H. Ohrenberger Elementary School in Boston, nearly 90 percent of all students participate in recess games. Fewer than half of all kids did two years ago, before the group Sports4Kids started visiting the school, says principal Stephen Zrike.
  
  "We feel play is the single most effective way to promote physical activity," says the group’s founder, Jill Vialet. "It's not someone wagging a finger at them, telling them they need to lose weight." Through fat-busting sports like kickball and dodgeball, trained recess coordinators teach kids the fundamentals of play, including the rock-paper-scissors method of resolving conflicts.
  
  The payoff: Making daily physical activity fun can set good habits for life.
  
  The action plan: Visit sports4kids.org, or search for the group’s videos on YouTube.com.



• Expand gym class. The award-winning PE curriculum in the Hortonville, Wisconsin, school district includes non-jock activities, including golf, archery, dance, and fly-fishing. The goal is to help students find something they love so they’ll continue to do it well into adulthood. Students regularly use pedometers and heart monitors, both during gym and in the state-of-the-art cardio rooms.
  
  The payoff: This past year, 70 to 80 percent of middle and high school students were within fitness targets based on heart rate and number of laps completed in an endurance test. A decade ago the rate was less than 40 percent.
  
  The action plan: The National Association for Sport & Physical Education rewards schools across the country that have outstanding phys ed programs. See what makes the grade at aahperd.org/naspe/stars.