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Ellen Belcher is the Dayton Daily News opinion pages editor. She writes about state government, education, the environment, higher education and all things Dayton.
Martin Gottlieb is an editorial writer and columnist for the Dayton Daily News opinion pages. He focuses on the political process itself and does such national issues as war, the economy, taxes and Social Security, as well as a hodge-podge of local and state issues.Home > Blogs > A Matter of Opinion > Archives > 2010 > March > 15 > Entry
Editorial: Lehner move could help patients save
You’ve heard a lot about new approaches to medical care that are designed to save money for taxpayers and purchasers of insurance: paying doctors a flat salary, rather than for every procedure; getting more people to buy health insurance, so as to spread out the cost; getting all medical records onto computers.
Some ideas along these lines are in the health reform measure pending in Congress. It’s big on pilot projects. (That’s one reason the bill has more than 2,000 pages.)
One idea in the bill is the patient-centered medical home (PCMH). Don’t picture a home, though. And don’t picture a doctor making home calls.
The idea is to reorganize the family practitioner’s office to put greater emphasis on prevention and communication with patients, making access to help more immediate and using technology to follow patients more carefully. A doctor heads a team that might include the likes not only of nurses and a physician’s assistant, but a dietitian, social worker and pharmacist. Patients get plenty of consultation time aimed at prevention.
The Ohio House of Representatives has now unanimously passed a bill fostering PCMH’s in Ohio, which is behind a lot of states in developing them. Rep. Peggy Lehner, R-Kettering was one of the two early sponsors.
No law is necessary to permit patient-centered homes. And this bill has no money in it, which is a disappointment to Rep. Lehner, who wanted maybe $5 million for training people in this new approach, among other costs.
But the state legislature isn’t exactly looking around for new ways to spend money. Instead, the legislation blesses the idea, identifies universities as early participants (including Wright State University), sets up a governing board, proposes state scholarships for medical students going in this direction and lays out some rules.
One controversy was whether to allow patient-center medical homes to be headed by an advanced-practice nurse. Rep. Lehner wasn’t enthusiastic about that; she felt a doctor’s extra years of training and education are necessary at the top.
(For the record, Rep. Lehner is married to a doctor. He’s a specialist, though, not the kind of family doctor who would be involved in this effort. She points out that, theoretically, the approach would mean fewer referrals to specialists, as the prevention ethic pays off.)
The bill entails one nurse-led operation in each of four zones in the state, in cooperation with a nursing school. That pilot-project approach is a reasonable compromise.
The overarching patient-centered medical home idea has won support from organizations of family doctors, pediatricians, osteopaths and others. It has bipartisan support in Congress and has been tried by both Medicaid and Medicare. It’s an idea whose time is coming. Ohio should be involved.
When a bill passes a legislative body unanimously, outsiders might assume there was no challenge. But Rep. Lehner has done constructive work in bringing the issue to the fore, in working out conflicts and in finding something an overly polarized legislature can agree upon.
Even in the absence of a state appropriation, it’s a good accomplishment for a new lawmaker.
Permalink | Comments (4) | Post your comment | Categories: Editorials, Health Care, Martin Gottlieb, Ohio government
Comments
By David Esrati
March 16, 2010 7:03 AM | Link to this
Congrats to Representative Lehner for being a Republican that actually has an idea of how an alternative to our current failing excuse for a health care system could be improved. It’s called “outcome based medicine” and pays doctors for proactively keeping people healthy- instead of for the reactive system we have now that pays per procedure. Now if only idiots like John Boehner could understand this….
By David Esrati
March 16, 2010 9:02 AM | Link to this
Congrats to Representative Lehner for being a Republican that actually has an idea of how an alternative to our current failing excuse for a health care system could be improved. It’s called “outcome based medicine” and pays doctors for proactively keeping people healthy- instead of for the reactive system we have now that pays per procedure. Now if only idiots like John Boehner could understand this….
By Gregg Gibson
March 16, 2010 1:59 PM | Link to this
David if I were you I would not throw the IDIOT word around too much.
By joe_mamma
March 16, 2010 3:43 PM | Link to this
Wow. How courageous. They blessed an idea that was not illegal. Maybe they could quite wasting their time and our tax dollars and do something that might make a difference immediately like limiting or eliminating coverage mandates.