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Real Healthcare Reform

September 13, 2013

Dear readers, real healthcare reform exists.

Every weekday I spend an hour in the car dropping my kids off at various schools.  I get to listen to an hour of NPR without having to fulfill a thousand small demands: “I can’t help you right now, Mommy’s driving!”  This morning NPRs Innovation Hub host Kara Miller talked about a program called Health Leads, started in Boston in 1996 by Rebecca Onie.  It’s fantastic.

Her premise is the same as the Jets in West Side Story; “The trouble is he’s lazy, the trouble is he stinks, gee Officer Krupke!”.  It’s the same as Dr. Paul Farmers, who says “Yes he’s got malaria but the problem is he’s starving”.  Onie saw that doctors prescribed drugs to treat illness, but didn’t know how to prescribe the things that prevent the illness.  For example, a child gets a prescription for an inhaler for an asthma attack, but the real problem is there’s no heat in the house.  The doctor is not even going to ask a question about something like heat or food because he/she wouldn’t know what to do with the answer.  What if you could write a prescription for heat?  What if you could write a prescription for a ride to the clinic, or more sleep for a mother, or vegetables?  With Health Leads you can.  Staffed with hundreds of college volunteers, Health Leads staff take these prescriptions for staying healthy and connect the patient with the resources to fill them.  Right there at the doctor’s office.  Patients don’t need to go to anywhere, fill out any forms, pay anything, or wait.  If the child with asthma had heat in her home, maybe she wouldn’t have had an asthma attack.  Health promoted, not illness treated.

This is astounding.  Not only that it’s so great an idea but that it’s so simple and so obvious.  It’s not even a new idea.  Various doctors in isolation have tried it with local arrangements with grocery stores and pharmacies.  These attempts have been met with varying levels of discouragement in the form of officials who insist that health care dollars be used on sick care.  Health Leads doesn’t deal with insurance at all, except to get patients medicaid if they need it and qualify.  They’re not billing for anything.  It doesn’t cost any more than the programs already in place that patients can be connected with.  And there are two things about Health Leads that I particularly like:  it’s low-tech and high-communication.  Because in order for this idea to work someone, a nurse, a doctor, a social worker, has to be asking the questions.  Which means someone is looking at the whole patient, which means that someone is communicating with the whole patient.  The only technology you need is a computer, a phone, and a college student who knows how to work them.  Real healthcare reform.

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