Values-Based Transformation of Health Care

January 12th 2009

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Posted by Gil Friedell, M.D.
Friedell Committee for Health System Transformation
 
Some 50 years ago as a young pathologist and a new Lieutenant in the Navy Medical Corps I was in charge of the laboratory in a 600 bed Naval Hospital on the Marine base at Camp Lejeune, North Carolina.  Having been on active duty for all of two months I leaned heavily for guidance on my Chief Petty Officer who had some 18 years of service.  One day, after having—with some difficulty—instituted a new procedure in the lab, I looked at him and said, “I guess this isn’t like the “old navy” is it Chief?”  He replied, “Doc, the “old navy” never was!” After 60 years of medical practice in a variety of job settings in different parts of the country I’ve come to the same conclusion about our supposed, often referred-to health system in this country.  I don’t think it ever was. 
 
At least not a system in which people everywhere receive comprehensive, coordinated health care from physicians and other health professionals.  Doctors and other providers, including hospitals, clinics and departments of public health—especially in rural and other underserved areas—seem mostly to be in separate silos, without meaningful communication links concerning their patients. And leadership of what is now referred to as the “health industry” is fragmented, with many services, eg., mental health, not available to many, and with insurance companies rather than health professionals making decisions about patient care.  Moreover, in spite of spending significantly more than other countries  on health, the health outcomes in this country—and in this state—are no better than in many of those countries.
 
The 50 members of the statewide, independent, non-partisan Friedell Committee for Health System Transformation believe it’s time for concerned citizens across the Commonwealth to assert ourselves, to become “health system change agents”, and to adopt and promulgate the set of values stated repeatedly by Kentuckians as the basis for the health system we want.  These values, incorporated in the Principles put forward by the Committee include: 1) access for all; 2) quality care; 3) affordable care; 4) efficient care; 5) respect for patients and families; 6) patients’ rights honored; 7) individuals must share responsibility for care and cost; 8) health professionals responsibilities and rights; 9) health systems must promote health of individuals and populations; and 10) health systems are accountable to the public. 
 
It’s time for the public to take charge!

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