Patients have a duty to help reduce health care costs

By Dr. Michale J. Pramenko

“I do not believe in a fate that will befall us no matter what we do; I do believe in a fate that will fall on us if we do nothing.” — President Ronald Reagan

Twenty-five years have passed since President Reagan signed a law that required emergency rooms to treat anyone that entered (the 1986 law is known by its acronym, EMTALA). Fast forward several decades and witness President Barack Obama signing Obamacare into law — partially in an effort to fund Reagan’s unfunded mandate.

No doubt, both men wanted accessible health care for all Americans.

Reagan signed a law that would likely be defined as socialism on Fox News these days.

Obama, recognizing the high cost of emergency room care, signed a law that would encourage greater chronic-disease management and would strive to reduce the use and need for emergency care.

Indeed, two presidents sharing one goal. Only modern politics could make their perceived intentions appear oceans apart.

Now, more than ever, the idea that a great country can provide needed health benefits for its citizens rests with the citizens themselves. With respect to uncontrolled health care costs — we have seen the enemy and it is us.

We expect the best health care in the world in America. And, if you are fortunate to have insurance, we have access to some world- class technology. It comes at a world-class price. Remarkably, at the same time, Americans continue to illustrate how to foster an even greater need for medical intervention.

Why? Due to our habits, lifestyles and expectations, our needs have outpaced our budgets. Americans’ eating, smoking and drinking habits tend to cause some fairly expensive ailments. Our outlandish expectations for what Medicare can spend on us after age 65 belongs in “Ripley’s Believe It or Not.”

But let us not place all the blame on the citizens of this country. After all, as patients, are we not merely buying what the industrial medical complex is selling?

As a physician, I am keenly aware that this massive health care system we have created requires regular “fuel” to satiate its appetite for further growth. New pills, potions, procedures and promises of potency provide an ever-expanding menu of possibilities. But something is missing. No, some things are missing: value and patient responsibility.

As patients, we need better information about the value of the medical interventions that we receive. Then, we must use that information.

Here are just a few questions needing better answers: Are there less expensive alternatives that provide similar or even better outcomes? Is there good, non-biased literature that supports the screening and treatment of certain diseases? As a patient, am I getting an opportunity to share in the decision-making process by having better access to information and more communication with my medical providers? Where is the most cost-effective location to have a procedure performed?

At the same time, we should support more financial incentives to keep and stay healthy with a proper diet and exercise.

Certainly, we should not expect a limitless supply of health care for a lifestyle based on a limitless approach to calories, alcohol or cigarettes.

With rights come responsibilities, and health care should be no different.

So, whether you agree with Reagan or Obama, true success in managing our health system rests with the citizens. A reasonable solution to rising health care costs rests upon our behaviors and expectations, our choices and our habits.

We all need to become savvy consumers of health care, more involved with wellness, and more informed regarding price and value.

Ask more questions. Seek more answers. You deserve them.

Quite frankly, the fate of our health system depends on it.

Michael J. Pramenko M.D. is the executive director of Primary Care Partners. He serves on the Club 20 Health Care Reform Committee and is a past president of the Colorado Medical Society.


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