An Open Letter to President Obama & the Democrat & Republic Parties on Improving U.S. Health Care

Re: An Improved Health Care System: Goal No. 1--Keep Americans Well & Out of the Hospital

Evelyn Smith, MS in Library Science, University of North Texas, 2012

Yesterday, I received a notice from Blue Cross/Blue Shield of Texas that my health insurance rates are increasing by 20 percent.  Since I only had a mammogram this year (that BCBS of Texas didn't remimburse me for), I can only make an educated guess that I am now paying for other Americans whom the Patient Protection and Affordable Healthcare Act is supposed to serve. While I don’t begrudge helping out those who truly need it, this increase will be difficult for me. Even so, the Blue Cross/Blue Shield rates coupled with my deductible of $2,500 are still a better bargain for me than what the Healthcare.gov monthly payments would be. This increase along with the final assignment of the American Library Association's Reference and User Services Association Continuing Education class I'm just now completing, however, have prompted this take on how to improve American health and health services.  Please work together across the aisle to solve this crisis:

1. The main goal of this improved health-care system is to keep would-be patients out of the hospital.  Hence, it will specialize in preventive care by giving incentives—in the form of lower premiums—for improved life-style habits:  For example, the Internal Revenue Service could award health care subscribers a “cash-back” incentive if they live a healthy lifestyle, maintaining a healthy weight for their age and gender, according to actuary tables, exercising for at least 30 minutes a day five days a week (something I need to work on), as documented by checking in at fitness clubs, and not smoking.  Medicaid recipients might also receive a small reward if they achieved these goals as well. This is similar to an idea found in the Reader’s Digest article “18 Big Ideas for Health Care Now” as are many of the other ideas in this letter (2008, November, para. 16).
2. Apply the principle of triage to the health-care system, concentrating on fighting “the big five” chronic conditions—chronic artery disease, digestive heart failure, asthma, and depression (18 big ideas, 2008, para. 2).  This also means accepting the fact that obesity is now a chronic disease. 
3. Expand literacy programs in the states with the lowest functional literacy rates to ensure a well-educated citizenry.  In most instances, this would mean increasing adult ESL educational opportunities.
4. Let consumers shop across state lines for the best insurance plans (18 big ideas, 2008, para. 67-68). 
5. Recognize that the “one-size fits all” model for health care might not work.  Different regions of the United States and different populations have different health care needs depending on their education, income, life style, and (dare I say it) ethnic origin.  For example, New England is the healthiest region of the United States, and it is also  the most highly educated part of the country (America’s health rankings, 2012, chart; Education statistics, 2013, StateMaster.com). Conversely, most Southerners would need to re-evaluate their love of fatty and fried foods.
6. Stop unnecessary treatments by instituting tort reform (18 big ideas, 2008, para. 31-32).
7. Since more medical expenses usually occur in the last two years of life than any other time, educate families of patients eligible for hospice care that this is often the more humane alternative than opting for heroic care; for example, families of Alzheimer’s patients need to be informed about the advantages of hospice care (Alzheimer’s disease, 2003, para. 5 & 6).
8. Send prescriptions to pharmacies electronically, avoiding medical errors (18 big ideas, 2008, para. 18).
9. Reward patients for using retail clinics for routine health care and minor medical emergencies instead of the hospital emergency room (18 big ideas, 2008, para, 21).
10. Reduce infant mortality through better prenatal care and education of potential mothers-to-be before they become pregnant.  Public high schools, focusing on teenage mothers, and community centers and public libraries would be awarded grants to implement these programs (18 big ideas, 2008, para. 36).
11. Reward and promote healthy eating and exercise through school lunch programs featuring healthy foods and after-school physical fitness activities (18 big ideas, 2008, para. 39-41).  For instance, public schools can already receive grants from the federal government if they make salad bars a part of their food service.  As a substitute teacher, I also know that this will only truly succeed if children and teens will actually eat their vegetables.  I’ve seen more than a few middle school students turn their noses up at the thought of eating the few healthy entrees on their cafeteria’s menu, instead opting for pizza, hamburger, and fries.
12. Provide incentives for pharmaceutical companies to create and provide affordable drugs (18 big ideas, 2008, para. 55-56).
13. Publicize virtual medical Websites (18 Big ideas, 2008, para. 59-60).  Accordingly, public library Websites as well as outreach programs need to publicize appropriate lifestyle and wellness choices as well as to acquaint uninsured patrons with their insurance options under the Patient Protection and Affordable Healthcare Act (“Obama Care”).  To ensure that public library Websites provide both safe and relevant medical information, M. H. Oermann argues that they should ask medical professionals to evaluate any medical information that they post (2005, Abstract). 
14. Publicize the Food and Drug’s Administration  recent decision that the FDA no longer considers trans fats safe since it increases cholesterol (Haynes, 2013, November 8, para. 1-2). 

P. S. You might want to take a look at the virtual reference library that I have created for a small town in Texas that doesn’t have an accredited librarian or any subscription-based Online services: 

http://evelynelainesmith.blogspot.com/

References

Alzheimer’s disease and end-of-life issues. (2003, Aug. 1).  Alzheimer’s Disease Education and Referral Center. http://www.nia.nih.gov/alzheimers/features/alzheimers-disease-and-end-life-issues

America’s health rankings. (2012).  United Health Foundation.  Retrieved from http://www.americashealthrankings.org/Rankings

Education statistics > best educated index (most recent) by state. (2013).  StateMaster.com.  [Statistics are from 2005].  Retrieved from http://www.statemaster.com/graph/edu_bes_edu_ind-education-best-educated-index

18 big ideas to fix health care now. (2008, November).  Reader’s Digest.  Retrieved from http://www.rd.com/health/healthcare/18-ideas-to-reform-health-care-now/

Hayes, Ashley. (2013, November 13).  Put down that doughnut: FDA takes on trans fats. CNN.  Retrieved from http://www.cnn.com/2013/11/07/health/fda-trans-fats/

Oermann, M. H., et al.  (2005, September 14).  Using Websites on quality health care for teaching consumers in public libraries.  Quality Management in health care. 114(3), 488-95.  [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16027597