While Idaho lawmakers wrangle over implementation of the Affordable Care Act, health care industry officials say they're ready to move past politics and onto revamping systems of care.
In a March 15 forum at St. Luke's Boise Medical Center, members of Leadership Boise--a subset of the Boise Metro Chamber of Commerce that includes local nonprofit, government and business professionals--weighed in with a group of industry experts about the future of healing America.
"It's long overdue that we have this dialogue in our nation. What we've created is the most expensive 'wealth care' system, not health care system," said Dr. Ted Epperly, program director and CEO of the Family Medicine Residency of Idaho.
With more than 30 years as a health care provider, Epperly counseled President Barack Obama's administration in the days leading up to congressional approval of the ACA. He described the nation's current model as unsustainable: Both the health industry and patients themselves need to get used to the idea of accessing care early and often, not delaying a visit to the doctor's office until something is seriously wrong.
"The future doctor's office is going to be empty, not full, and the reason is that people are proactively being helped to stay healthy in the community, not reactively coming into my office," Epperly said. "We're already behind the eight ball if that happens."
Steven Weeg, retired executive director of Health West and executive member of Gov. C.L. "Butch" Otter's Idaho Health Care Council, agreed with Epperly that the trend toward preventative health measures will require the industry to change how it provides care.
"I think the role of the medical community may be to help guide you and your health, and how to live, and how to make those decisions intelligently," said Weeg.
That could mean fewer cheeseburgers and more exercise to avoid higher insurance premiums. More employers, regular purchasers of big and small coverage plans for their colleagues, may ask employees for health evaluations, according to Doug Hetherington, employee benefits consultant with Leavitt Group Benefit Services of Boise.
"It could be a biometric screening, it could be a health-risk assessment," he said. "It's basically a report card on your life. It's not just your life today, it's your lifestyle as well."
In the future, Hetherington added, patients may be automatically reminded with a phone call if they fail to refill a prescription of, for example, blood pressure medication.
"You may not like that, but that's the reality of things," he said.
Part of making Obamacare work might require patients to visit the doctor before they have a problem. Most important, the panel members agreed, was that most Americans have some level of coverage--a central tenet of the Affordable Care Act. As a result, they said, fewer uninsured Americans may end up being treated for trauma in the nation's emergency rooms, often leading to massive hospital bills and the possibility of bankruptcy.
"Every one of us at some point in our lives, before we die, will have a health care cost greater than we could ever afford individually," said Weeg. "The sooner we're all in it together, the better. Let's cover everybody."
Epperly concluded his remarks with a quote from Michael Pollan's book The Omnivore's Dilemma:
"Eat food. Not too much. Mostly plants," wrote Pollan.
Epperly took some liberties by offering his own directive:
"Get health care. Not too much. Mostly primary care."