Todd Linden, CEO at Grinnell Regional Medical Center, did a nice job this week on his blog talking about “health care” versus “sick care”: 

The health care system in this country has really been more of a “sick care” system. Too much emphasis has been on mending bodies after health has left them. We have shielded folks from the true cost of health care through the proliferation and misuse of health insurance. The personal responsibility for maintaining optimal health has not been incented in the system. Although a growing number of Americans are health conscious, it is hard to deny the obvious epidemic of poor health. 

The “sick care” issue is at the foundation of health care reform.  It is one of the reasons health care and health insurance costs have risen.  We live in a very healthy society and most of us take it for granted, even though it was only 70 or 80 years ago that thousands of Americans were killed by accidents and diseases that scarcely exist today.  Advances in medicine, safety and nutrition keep people out of the hospital.  And when they go to the hospital, advances in treatment – like minimally invasive surgery – mean procedures are safer, recovery is faster and the likelihood of complications is greatly reduced. 

Our good health also comes with our good insurance coverage.  Since World War II, we have been a well-covered society.  On the up side, this has given broad access to the health care system and increased both the quantity and quality of life.  On the down side, as Todd notes, it has shielded health care users from the real cost of care and incented providers to offer more but not always better care. 

People don’t like going to the hospital and today they almost never have to.  But when they do go unexpectedly, it can be quite serious and very expensive.  For those with insurance, there is little incentive to prevent these occasions – the relatively low out-of-pocket cost and the fact that even very sick people are healed is what most of us see and remember.  For those without insurance, the result is often even more serious illness as they delay treatment. 

Certainly, we need to make sure as many people as possible are insured.  But how our society “uses” health care must also change and hospitals are helping make that happen with a focus on prevention and wellness.  This has been going at Grinnell Regional Medical Center in many ways and for several years, as Todd mentions.  In fact, every Iowa hospital provides services and programs that support prevention and advance wellness.  But hospitals are doing more than putting out the water and waiting for the horses to come around.  They are actively working to change our health care culture, to change our society’s mindset and put a focus on wellness. 

But cultural shifts don’t happen overnight.  It will take all of us, as health care consumers and providers, to create a true “health care” system.