SMART Health Care Reform; that is Specific, Measurable, Realistic and Time Sensitive for all!

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Thank you for sharing your story and sending in ideas about why we need health reform this year.
The following is the content of your comment:
Name:
Belai Habte-Jesus, MD, MPH
Email:
Globalbelai7@gmail.com
Address:
837 Allison Street, NW
City:
Washington, DC
State:
DC
Zipcode:
20011
Share your questions and ideas for changing Health Care for all Americans:

Dear President Obama:
I am a public health physician and scientist currently working in the health field as the Corporate Director for over 12 home health care agencies in the Metropolitan Washington, DC; Denver, Colorado Springs, Grand Junction and Delta region of Colorado, Los Angeles, California and Allentown, Pennsylvania. We provide skilled and non skilled health care to patients in their own homes at the direction and guidance of their attending physician.

This makes care available to patients in their own home environment as well as reduces cost to care due to hospitalization and institutionalization. Our service is considered as Boutique Medicine by some circles but we refer to it as back to the future when the Attending physician used to visit patients in their own homes some 50 years ago, before the advent of modern gigantic hospitals and their accessories.

As such, we take modern health care to people's homes and their environment where they heal and recover faster. Prior to coming to the USA in 1993.

I was working with the British National Health Service and when I discovered President William Clinton was proposing a health care reform, I wrote to the then health care reform team and was invited to come to the USA and present my own paper to First Lady Hilary Clinton team entitled : Cradle to Grave- Health Care Reform, An Idea Whose Time Has Come.

I reviewed the global health care system, by focusing on Scandinavian, British, German, Canadian and Japanese Health Care Systems and comparing them with the US Health Care System. My focus was on making Preventative Medical Care Universal and mandatory to all according to their age and sex and current health status. Just like the Car Industry, the Insurance System should be made to work for people to keep them healthy and not wait until they are too sick to benefit from preventative health care.

As such, I proposed that at each Birthday, every citizen should get a letter from his attending physician, summarizing his or health risk factors, current status and future prospective and invite them for annual Birth Day health Check. Obviously the content of the screening will vary according to the age, sex and predisposing factor of each individual.

I also suggested A Portable Medical Record System that each patient is given at the end of each visit and can take with him or her to any future visit. The Medical System will be portable, electronic and will be available to each patient, attending physician and national data base.
As a Public Health Physician and Medical Scientists who have worked in Africa, Europe, Asia and North America, the most critical deficit in all health systems is that there is viable data about prospective patient needs, based on lifestyle, behavior, and current disease spectrum. All the CDC and NIH data bases are using out of date mortality data that does not reflect morbidity and risk factors for each age group, as such they are planning for the dead people and not for living populations.

The Patient Communication Log or Portable Medical Record will change this frustrating situation by providing up-to-date Evidence based medicine and preventative care that is tailored to the specific needs of each patient, reviewed at least once a year at their birth day. I wrote a proposal to the NIH Research Team about making such Portable Data Base available to patients, physicians and the public health system but unfortunately failed to implement it due to like of sponsorship and resources.

I believe the current health care reform, should address both the Management Information System i.e the Medical Record System as well as making health care available based on evidence that is collected at annual basis for each citizen. Then the health care reform will be guided by the notion of making every citizen healthy with the advanced medical technology and not wait until the patient had all the symptoms and signs of death.

Yes, Health Care Reform is needed to ensure that we pay for staying healthy and productive and not for healing after we get sick. This is a big paradigm shift and the Medical profession and interest groups such as Insurance Agencies who make money out of the misery of people will not like it. Yet, it is in their interest too, if we pay for insurance by staying healthy, as we will pay them for a longer period than when we become too sick and die too soon in the current system.

Health Care Reform and SMART Change that is specific, measurable, appropriate, realistic and time sensitive is a a truly win-win proposal. However, any change always frighten those who think they are benefiting from the status quo, even though the evidence does not support. Yes, we can do better and we can change is the message to all of us that resonated though out the 2008 election and needs to be implemented smartly.

The truth is life is changing all the time. Our own body is shading billions of cells a day and replacing them with new ones. The question is... What is the replacement? Is it with good smart cells or with aging, cancerous or rather pathologic cells. None of us know this on a second by second or minute by minute basis. However, if we do regular tests, scans will know at least the trend and can reverse it. That is what the health care reform should support. The normal positive changes taking place in our body, society and in the health care science, technology and practice.

But it is already happening for all our technologies such as cars, houses and electronic gadgets, that we pay to have the best utility and function and not wait until they broke down. Fortunately, current up-to-date knowledge about our physiology and immune system supports this idea. We are designed to live up to 120 years with fairly good health if we know how to look after our emotional, behavioral, physical and psychological health.

We need to practice evidence based health care and that can only happen if every body is given at least annual Birthday health screening and relevant evidence based care while they are still healthy and able to enjoy life. When we get sick as we all do, we need to get modern first class medicine in our own home setting and not wait to get into the health institutions which are filled with iatrogenic infections which are more difficult to treat.

I trust it is clear that the Cradle to Grave Health Care System is medically and fiscally sound idea and most importantly creates a healthy thriving community that continues to be productive until 120 years of life span. So, I say, let us modify both the health information system, annual birthday health screening and care for people in their own homes.

It is fiscally, medically and culturally appropriate to do so. I will be happy to furnish you with additional information at your convenience. Thank you and wish you all the best.
Learn from President Clinton and involve every one in all your deliberations and report to us on a regular basis and ask for our participation as you are doing now.

Bless you.

Belai Habte-Jesus, MD, MPH Global Strategic Enterprises www.Globalbelai4u.blogspot.com Globalbelai7@gmail.com voice: 703.933.8737 and 571.225.5736