Our View - Some lessons Iowa can teach on health care

Published Dec 1, 2009. By Press-Citizen Editorial Board.

Iowa must be doing something right in terms of health care.The Common Wealth Fund just ranked the state as No. 2 in terms of overall care on its State Scorecard on Health System Performance. Given that Iowa scored lower in all the individual categories -- access, 4; prevention and treatment, 6; avoidable hospital use and costs, 14; equity, 8; and healthy lives , 7 -- the overall score reflects just how skewed and imbalanced the systems can be in other states.The high overall ranking is all the more impressive because Iowa also is one of the states that pay out the least amount of money for health care.And it's that combination of high quality and low cost that caught the attention of the non-partisan Concord Coalition, who began a partnership with the University of Iowa College of Public Health and the Iowa Healthcare Collaborative to study how Iowa's successes may be relevant to the online national debate.Back in July, the committee formed through these partnerships -- the Iowa Committee for Value in Health Care -- put out five principles for value-based health reform. The list includes:• Achieve fiscal sustainability through high-value health care.• Innovation through collaboration.• Expand the role of primary care.• Increase wellness and prevention.• Promote individual involvement in obtaining high-value health care.Although the principles are broad enough to be endorsed by nearly everyone along the reform spectrum, the committee is scheduled to release a report Monday that will flesh out those principles using specific Iowa examples. Hopefully this collaborative approach will prove to be infectious within the broader debate.On today's Opinion pages, three of the active participants in the committee provide a sneak peek at some of the information in the report. Each presents his or her individual perspective, and not that of the committee.Sara Imhof, Midwest regional director for the Concord Coalition, stresses, "More needs to be done to ensure that reform is fiscally responsible -- not just over the next 10 years but far into the future."UI professor Brian Kaskie focuses on how reform needs to include programs that improve the nation's "health literacy" so that patients can take a more active role in their own health care.Christopher Atchison, director of the UI Hygienic Lab and associate dean for Public Health Practice, takes a more personal route as he describes the anticipation and hope that initially accompanied President Bill Clinton's failed attempts at systematic health care reform 16 years ago."Most of us were disappointed with the outcome of those reform debates because we saw then many of the same needs for improvement that we see now," Atchison writes. "The cost of health care is consuming more and more of our nation's gross domestic product (more than 16 percent). It is draining state budgets and causing businesses to reduce coverage and limiting individual access to care."We thank the committee members for working hard to inject some Iowa commonsense into the national debate.And we hope they help persuade all the stakeholders that the nation can't wait another year -- let alone another 16 -- to reform its health care system.