Waiting for Reform

When I discuss the ideas of creating a proactive patient with others, I often sense a bit of hesitation and skepticism in their voices.  "Is our current health care system ready for a patient participating in their own care", they'll ask.  The optimist in me wants to say "of course", but realistically, I know there are many challenges we'll face in trying to change the status quo.

Despite the bumps in the road ahead, I simply don't believe we can wait for the health care infrastructure to come up to speed.  I was recently reminded of this when reading The New York Times feature on the fact that health care and insurance companies are not accepting new cancer therapies.  Rather than traditional intravenous (i.v.) drugs, some chemotherapeutic medicines are now available in pill format.  The patient no longer has to visit the clinic to receive treatment -- they can just pop the pills at home.  Although it seems like a logical step in medical treatment, the pill therapy has not been well received by health providers and insurance companies.  Doctors may be reluctant to prescribe the cancer pills for a number of reasons, such as wondering whether patients will remember to take the pills on their own, or loss of revenue, since doctors can charge for the clinic time required to administer the i.v. drugs, but cannot do so for pills taken at home.  But most damaging to the pill therapy is the fact that insurance companies are not reimbursing this treatment at the same level as i.v. treatment, which means high out-of-pocket expenses for patients.

While this case describes a very drastic change in the health care status quo, it's essence highlights the common lag between progress and acceptance.  Change is occurring, the health care infrastructure is resisting, and, most importantly, patients are losing.  That's why I think it's important to address the issues involved in making the next generation patient now, before they create such a large divide between the traditionalists and the progressives.  Incremental changes are easier to digest than large ones.  Perhaps if just a small number of us start arming ourselves with genetic information, personal biometrics, and an increased knowledge of medical and scientific information, we can help smooth the road ahead.