American medical care costs more than anywhere else in the world yet doesn't do enough to keep us healthy. Doctors are paid for treating illnesses, not for preventing them. Too many people are uninsured and get so sick they land in the emergency room.
What people can't seem to agree on is how to fix it.
Now, two sets of proposals -- one from a task force appointed by Gov. Tim Pawlenty and one from a legislative commission -- are before the Minnesota Legislature.
Dick Pettingill, president and chief executive of Allina Hospitals and Clinics, weighs in on what's at stake.
Q Can you assess the proposals going through the Legislature?
A The nice thing is [that] there are more similarities than substantive differences in the two proposals -- the elements of universal coverage, payment reform, medical homes and linkages to the public health sector. These are all very important.
We have the most expensive health care system in the world and we're still not producing the value we're looking for. We focus on acute, critical care within the walls of institutions and not enough on wellness and prevention, such as health-risk assessments and dealing with problems such as childhood obesity. We don't have the model wired correctly. Q You mentioned the buzzword "medical homes." How is that different from an old-fashioned primary-care provider who coordinates your care with specialists?
A It's far more complex. The current model of primary care is overly burdened. There are not enough physicians and we have one physician to one patient. With a medical home, you get connected to a pharmacist, to a nutritionist, to a behavioralist ... it extends beyond a one-to-one relationship.
