Follow The Money
Most of what is being done in the name of healthcare reform and end-of-life preparation is determined by the availability of money to support the efforts. No funds, no effort. It doesn’t matter what the cause or need is. That’s life, most of us have learned. Follow the money.
It is discouraging though to be sick and reminded of this fact of life, but it is only wishful that it could be otherwise.
Instead of reform this process produces more of the same rather than the change that is typically ballyhooed. The shame of the system is that we are all misled. Okay, I’m misled.
When I take a close look at healthcare reform I see only more of the same. I have identified 32 existing layers of care composing what I describe as a sinister maze of healthcare that is impossible to navigate. It is pictured on this blog’s home page.
Because the Affordable Care Act (ACA) makes funds available for its implementation numerous organizations are behind it, but as a caregiver or patient, it is just adding another layer (layer 33, if you are keeping score) to the broken and dysfunctional system. I back ACA, but to see it as anything other than a make-do patch on a crumbling foundation is to delude yourself.
Or take the Palliative Care Initiative. Palliative care is a wonderful alternative and should be available to everyone. But like ACA it is a well-funded patch on the system (layer 34).
Even the healthcare establishment recognizes the system is unnavigable. An increasingly common feature of care is the addition of “care navigators” to navigate patients through the system of care and treatment. These providers, usually RNs, have become necessary because patients can’t find their own way through treatment. In one case, lung cancer patients were taking so long to be processed into the cancer treatment system that they were missing out on timely and urgent treatment caused by so much friction in the system.
If we keep approaching reform of the healthcare system the way we are currently, there will be no reform. Caregivers will be impeded and patients will be harmed by more of the same.
Instead of working from the top down we need to be working from the bottom up. A new foundation is needed rather than piling on more of the same.