One thing is certain

The recent ruling by the United States Supreme Court upholding the Patient Protection and Affordable Care Act no doubt will result in continued debate regarding how best to provide consistent, high-quality and affordable health care services. No matter what your personal opinion may be, one thing is certain. The time is now for everyone to work together to further enhance services and make care more available for all Americans.

Caregivers and insurers must do their part by continuing their unwavering commitment to quality, innovation and doing what is right and best for patients. In addition to ongoing efforts directed at patient safety, such as eliminating health care-associated infections, this effort must focus on working with patients to ensure they are receiving the right care at the right place and time from convenient and primary care practices to advanced hospital settings. It is time to eliminate unnecessary services that are not helping patients and may, in fact, be detrimental to them. And it is time to implement a best-practice, consistent approach not only to caring for patients' illnesses and medical conditions, but also to doing all we can to stay healthy in the first place.

In addition, the time is past due for caregivers to be compensated for the quality of their care not simply the volume of care provided. For our country to be able to afford health care moving forward, we must fully develop and embrace paying for performance quality rather than quantity.

Patients must do their part, too. Much of the money spent on health care services can be attributed to the unhealthy lifestyle choices we often make. It's time for patients to partner with their doctors to reduce the risk factors associated with poor choices, such as smoking, excessive drinking, not getting enough exercise, not getting enough sleep and eating a high-fat, high-sodium diet.

]Increasing the number of people with health insurance and access to care long has been a priority for health care professionals and organizations across the United States. After the Supreme Court's ruling, we need to continue our efforts to attain that goal and make the promise of coverage and access a reality.

Glenn Steele Jr., M.D., president, CEO
Geisinger Health System, Danville, Pa.
Care support, not life support

Re: "The Perils of Palliative Care" by David Ollier Weber in H&HN Daily, June 26

I spent too many years watching terminally ill children suffer and die in pediatric intensive care units [and] fully know the long way we caregivers have yet to go regarding palliative care. Advanced technologies have been focused to provide "life" support rather than "care" support. We need to redirect our focus as caregivers rather than as medical practitioners. The difference allows for death with dignity and comfort for the living.

Laura Daly, R.N., LHRM

The truth about Medicare

Re: "Medicare and Meatballs" by Bill Santamour in H&HN Daily, June 20

The unfortunate truth is: There is no such thing as a free lunch. The only way to assure adequate resources is to plan ahead with required contributions or be willing to take the cost out of current resources. Both choices mean determining what is needed and paying for it (see taxes). That doesn't mean health care isn't too expensive now. A lot needs to be done to reduce costs, streamline care and improve prevention as in lifestyle changes. Even with all that savings, the share of total GDP going to health care is going to rise and no amount of wishful "I'm planning to" will eliminate it until some miraculous changes such as elimination of obesity are achieved.
Medicare and Medicaid are in place because we decided a long time ago that we didn't want seniors to be left to die in bad circumstances. If Bob feels otherwise, it may be because he hasn't seen the alternative.


A strategy on disparities

Re: "Health Care Facing a Disparities Tsunami," a video interview with Fred Hobby, H&HN Daily, July 2

Hospitals are complex organizations. I hope that leaders understand that intentionality and thoughtful consideration to strategy are needed and not just training programs.

Tim Findley