An Overview of Health for Life

 
A National Framework for Change Brochure (Spring 2011)
Health for Life: Better Health Better Health Care Brochure


A Window of Opportunity Is Opening …

Health and health care are the domestic issues of most urgent concern to most people.  This is not surprising—the health of our families and our communities affects virtually every aspect of our national life—social, economic, and moral.

Good health all of one’s life and the availability of health care that is safe, reliable, affordable, and as good as it can be when it is needed is a universal aspiration that cuts across all American economic, political, ideological, race, age, and gender demographics. 

It is often said that the U.S. has the best health care in the world—and there is much of which we can be proud. We have millions of able and inspired people who have devoted their professional lives to the care of others.  We have thousands of well-equipped facilities and a relentless spirit of innovation in the private sector and in our universities and colleges that continually bring us new ways to help and heal. As we evolved as a nation, we found ways to ensure that millions of Americans had access to affordable medical care through the workplace or government sponsored programs.   As a generous people, we have established charities and countless organizations dedicated to health and health care causes in support of the ill and injured.  And for much of our history, the nature of America in the eyes of the rest of the world has been that of a people of boundless energy and vigor.

But as we look out to the future in the first decade of the 21st century, we find a darkening picture—our nation faces daunting challenges in health and health care.  Our population is aging; the health of Americans of all ages is not improving and is, by some measures, deteriorating. Obesity, high blood pressure, diabetes, and other chronic illnesses are draining the health and productivity of our communities.

Today, tens of millions of Americans have no health insurance from any source.  Insured Americans find the cost of their insurance climbing beyond their means and the cost of the care itself is rising at an unsustainable rate, straining government, business, and family budgets to the breaking point.

Dozens of polls and studies have documented the public’s anger with the “system” that isn’t a system, the rising costs and fear of loss of coverage—if they are fortunate enough to have it.  They know firsthand that the delivery of care is fragmented, the potential for error is high, and that caregivers are frustrated. They want and expect better.

For all its strengths, the system of delivering and paying for care that has evolved over the decades is today in need of deep and lasting change so that it will be ready to respond to a nation facing a changing economic, physical, and social environment. The movement for health reform is not new. But it has long been clear that the solutions are economically and politically difficult. We’ve tried, but progress has been slow, small, and piecemeal.  The lack of strong national leadership and no national health policy to guide us has resulted in little action since the last major health care debate some 15 years ago.

The choices we must make in the near-term will set a course for America’s health and health care that will take us deep into this century.  As we come together to plot our course, our vision must be clear, our leadership strong. When it comes to health care, the only interest that is special is the public interest.

The opportunity for change is before us.  It is time to come together and succeed.

Another Plan from a Special Interest Group?

Many candidates for office, consumer, health care, business and other groups are offering their “plans” for health care reform.  Nearly all of them center on their preferences for dealing with the most serious of the problems facing our nation: the millions of Americans who lack health coverage. 

The women and men of America’s hospitals are keenly aware that simply finding a way to bring health insurance to everyone will not solve the myriad problems that plague health care today. Every issue and constituency tied to health and health care will need to be refocused and retooled to build a genuine system.  Federal, state, and even local laws and policies must change.  The patchwork mechanism of public and private insurance and payment must change.  The tools and incentives available to individuals and families to better manage their health and health care must change. And the way care is delivered to and experienced by patients and families must change.

Some of theses changes can be helped and spurred by public action, but many require the will and perseverance of the individuals and institutions that make up the health care field. Many of the changes are underway, but the pace and the progress must be quicker.  The nation’s hospitals are committed to an agenda for change that embraces the goals of the Institute of Medicine’s Six Aims for Improvement:  care that is safe, timely, effective, efficient, equitable, and patient-focused.

On the public policy front, making the needed changes happen will require assembling perhaps the broadest coalition of individuals and organizations in the nation’s history to tackle a domestic policy challenge.

The nation’s hospitals offer Health for Life – Better Health, Better Health Care—not a hospital plan for health reform—but a roadmap for change and for building relationships and coalitions that could guide us on what will be, under any set of economic and political circumstances, a long and difficult journey.

An Evolving Framework for a Healthier America?

In 2005, the leaders of the American Hospital Association were deeply concerned over the lack of the nation’s progress on health reform since the early 1990s.  It was time, they believed, for the hospital field to reassess its own vision for better health and health care in America and to take a greater leadership role in advocating for change.

Health for Life is the product of more than two years of discussions with individuals and organizations in and outside of health care. In addition to their own 5000 member hospitals in rural, suburban, and urban communities, AHA leaders listened to community and faith-based leaders, elected officials and policymakers at every level, consumer and health advocacy groups, educators, the business community, and many others.

We took a hard look at what’s good—and what’s not-so-good—about health and health care in our communities and tried to understand why recent approaches to health system reform have failed and how best to remove the many obstacles to progress.

The ideas and actions that emerged have been debated and discussed by the women and men on the frontlines of health care in multiple forums across the nation.  In July 2007, the American Hospital Association Board of Trustees voted to make the organization’s work public. 

In subsequent weeks, Board members shared the framework with dozens of organizations and individuals: consumer groups; physicians and nurses; health advocacy organizations; and business, labor, and insurance groups.  And they launched an initiative to seek their reactions, advice, and support.  The goal: bring together the building blocks of the national coalition that will be needed to make the changes to achieve better health and better health care—and let the work begin.

A coalition of that magnitude could influence the outcome of elections by committing those who serve in public office to working for the public policy changes we must have.  The coalition could serve as a powerful catalyst for improving community health and making health care work better for both the people who need care and the people who deliver it. That is the power Health for Life hopes to unleash.

The specifics of Health for Life will grow and change as others add to its strengths and details. What must be preserved is a realistic, common sense approach to change that eliminates the old barriers to progress and rewards cooperation and collaboration.

What will not change is the goal of making America a nation of healthy people, leading more balanced lives and managing chronic disease whenever possible.  And when they need health care, they will enter a genuine system that is efficient, affordable, and accessible to all, of high quality, with coverage for everyone, and provides a care experience that exceeds their expectations. 


How It Works

NATIONAL FRAMEWORK FOR CHANGE


Health for Life identifies five essential elements of reform upon which we must build if our nation wants to achieve better health and better health care.

  • A Focus on Wellness - Some but not all illness is preventable.  Good primary care, health education and a healthy lifestyle are essential to improving individual and community health status.  As health improves, costs of health insurance and health care can be better controlled.

  • The Most Efficient, Affordable Care - Americans will not be satisfied unless and until the cost of insurance and the cost of health care are affordable.

  • The Highest Quality Care - Motivate doctors, nurses, hospitals, nursing homes, and others to work together and team up with patients and families to make sure the right care is given at the right time and in the right setting.

  • The Best Information - Good information is the gateway to good care.

  • Health Coverage for All - Paid For By All -- Health coverage for all is a shared responsibility.  Everyone -- individuals, business, insurers and governments -- must play a role in both expanding coverage and paying for it.

What follows is an overview of each element and some of the goals and federal policy actions that will help put them in place as the foundation for a better way of achieving good health and good health care. What you’ll see is only a part of what each element contains.  The full picture can be found at aha.org.  But this overview will give you a sense of the breadth and depth of the journey we must begin as a nation.


FOCUS ON WELLNESS

 

Goals

Actions

Healthier lifestyles.

Better compliance recommended care.

Fewer preventable diseases

Support personal health goals

Financial incentives to reward healthy behaviors and compliance with care plans

Provide support and coaching needed to change behaviors

An objective, trusted source of consumer health information and education.

Guarantee access to primary care

 

 

Financially reward doctors and others who provide primary care

Require insurers to guarantee plan access to 24/7 primary care

Focus on children at an early age

 

A national investment in school-based health: nutrition, fitness, immunization, and school nurses.

 

 

 

MOST EFFICIENT AFFORDABLE CARE

 

Goals

Actions

People are better informeddecision makers

Require sharing by all providers, payers, and suppliers of quality and pricing information with the public

 

Better manage chronic disease

Explicitly fund chronic care management

Evaluate the efficacy and useof new technologies and drugs

Create “technology assessment centers” to analyze the comparative effectiveness, costs, and benefits of new technologies and drugs

 

Spend our limited resources on care,not paperwork and lawyers

 

Simplify the working of publicand private insurance

Create a better alternativeto today’s liability system

 

Well-trained workforce in sufficient numbers and with needed mix of skills

 

Expand educational capacity, resource, and early math and science learning to meet current and future health care workforce needs.

Design new roles for workersto meet future care needs

 

 

 

 

HIGHEST QUALITY CARE

 

Goals

Actions

Development and greater use of evidence-based care

 

Create a national investment to research the best evidence in patient care and develop practice guidelines

 

Motivate doctors, hospitals and others to work together on behalf of patients and their care

 

Redesign payment to give provider groups a single amount to manage the entire episode of a patient’s care and better coordinate care

Modernize laws and regulations to allow doctors, hospitals, and others to work together in teams or networks.

 

Coordinate treatment of physicaland behavioral health needs

Redesign coverage and payment to guarantee parity

Integrate physical and mental health care delivery

Increase the availability and use of compassionate end-of-life care

 

Expand options for end-of-life care at home and require everyone to complete an advance care plan.

 

Reward outcomes, not volume

 

Redesign payment to reward quality providers who follow recommended “best practices”

 

 

 

 

BEST INFORMATION

 

Goals

Actions

Increase patient safety

Reduce duplicative testing,unnecessary costs, and patient hassle

Ensure open communicationbetween patients and providers

Speed the creation of electronic health records and personal health recordsby selecting “interoperable” standards

Create a unique, confidentialhealth information number to accurately link patients to their health records

Speed the adoption of healthinformation technology

Ensure easy access for patients to their medical records and health information

Enable better care coordination

 

Allow providers and community collaboratives to share information technology

National investment in IT for doctorsand hospitals most in financial need

Require health care suppliersand insurers to enable the use of IT

Require specific IT adoptionby doctors and hospitals

 

 

 

HEALTH COVERAGE FOR ALL –  PAID FOR BY ALL

 

Goals

Actions

Health coverage for all

Increase access to care for all

Increase insurance efficiency

Protect against high-cost health events

Reduce differences in careby race, ethnicity, and other characteristics

 

Every individual must be responsiblefor having health insurance coverageand contribute to the cost

Every employer must take responsibilityfor providing health insurance coveragefor their employees and contribute to the cost

Every insurer must guarantee accessto coverage that is affordable, gives consumers the protection they need,and delivers value

Governments must maintain their current responsibility for coverage for seniors,the disabled, and certain low income people

Additional collective financing will be needed

 

 

Better Health...Better Health Care...What Will it Take?

The answer is deceptively simple, yet extremely complex: all of us, together.

Individuals and families must have the information and help to improve their health and direct their own health care.  The American story is full of examples of an inspired and energetic people changing lives and changing communities for the better.  It can be done again.

The forces that shape and affect health and health care must commit to action and change.  That must include government at every level; the private sector; civic, community and religious groups; the providers, payers and industries of health care; and advocates for consumers, patients, minorities, and others.

Are the five elements of Health for Life the right foundations for the health and health care we need and deserve?  Will the concepts embedded in them move us closer to the goals?  Can you help us build and strengthen them?

Health for Life will be a work in progress for as long as our nation believes it can be healthier and better able to care for those who are not.

We welcome you to be part of the journey.

For more detail see: "Ideas for Change "

 

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