ECG’s radio show and podcast, Healthcare Upside/Down, offers unfiltered perspectives on what’s working in US healthcare and what’s not. Hosted by Dr. Nick van Terheyden, each episode features guest panelists who explore the upsides and downsides of healthcare in the US—and how to make the system work for everyone.
Years ago I worked for a charitable organization called the Children’s Holiday Foundation, based in the United Kingdom. Our mission was to provide memorable experiences and trips of a lifetime to terminally ill children. The concept was similar to that of the Give Kids the World or the Make a Wish Foundation.
For many of the children, this meant a trip to Disney (and this was back when there were only two—in California and Florida—so delivering on that wish meant international travel).
This was a big operation, with a large swath of sponsors and a group of volunteers made up of qualified professionals like myself, nurses, and physiotherapists, as well as police officers, who gave up their time to provide these kids with a great experience.
The make-up of children and the conditions they had varied, but at that time cystic fibrosis was a terminal illness, and survival rates did not extend much past late teens at best.
Things have changed dramatically thanks to some amazing work and advances by a number of groups. But what really changed the trajectory of the disease was teamwork, learning, and cooperation.
In fact, there were some centers of excellence that demonstrated in their data a significantly better survival rate than other institutions, even though the basic approach and medical treatments were similar. In the true spirit of medicine and patient focus, these teams worked together, raising the outcomes for everyone.
Dr. Alan Lassiter, a principal at ECG, understands this spirit of cooperation, especially as it concerns children’s health. On episode 84 of Healthcare Upside/Down, he talks about breaking down the barriers of competition in healthcare and sharing data, insights, and experience to build a truly inclusive healthcare service that moves everyone one step closer to personalized and economically viable care. Below are a few excerpts.
Reimbursement challenges in pediatric care.
“First of all, you have to recognize the impact of the reimbursement situation—Medicaid does not reimburse well. It does not cover the cost of delivering healthcare, period. And if you have 50% of your population served by children’s hospitals and covered by Medicaid, then the only way that you can solve that problem is to look at it from a system-wide view. You bring every player, every provider into this marketplace so that we can work together as a team.”
A systematic approach to care.
“You have to look at pediatric care in the full spectrum. You have to move from primary care to secondary care to tertiary care to quaternary care, because it works as a system, and care must be delivered in that way. If you can do that, then you can begin to develop efficiencies in care delivery through care model redesign, through handoffs, through things that really help you to be more efficient, and to minimize cost and maximize clinical outcomes in a positive way.”
The need for philanthropy.
“Pediatrics is heavily dependent on philanthropy. You have to have people stepping in—in addition to what the government or the commercial payers pay—and augmenting the deficit with philanthropy. The important thing to understand is that this is a ‘we’ problem. It’s not a physician problem. It’s not a hospital problem. It’s not a healthcare system problem, in the classic sense. It’s a global problem, a community problem. And it can be solved if we work from that perspective.”
Edited by: Matt Maslin
