Once again, quality takes a back seat to cost

All this silly debate about whether or not the Obama administration wants to set up "death panels," as former Alaska Gov. Sarah Palin claimed on her Facebook page, isn't necessarily just the rantings of a politician with ambitions for higher office. It seems to be symptomatic of the inability of so many people at all points on the political spectrum to understand the real issues.

I don't like Palin, I don't like what she stands for and I especially don't like her trying to rile up the lowest common denominator with incendiary statements based on falsehoods and half-truths, but I have to give her credit for at least talking about something other than cost or access in healthcare reform. OK, I guess these alleged "death panels" would deny access to care, but she's also talking about quality of life.

That's more than I can say for a story from the Kansas Health Institute's KHI News Service about a Medicaid telehealth and remote monitoring project in Kansas. The article focuses on how the pilot program has saved the state $1.5 million on Medicaid expenditures from an investment of $290,000. It also quotes an official from a participating technology vendor, who says that Medicare likely is saving money from the two-year program that ends in October, even though CMS doesn't cover telehealth monitoring. "When we keep Wilma from going to the hospital, we're saving Medicare money," Monte Coffman said about one 76-year-old patient. "When we keep her out of the nursing home, we're saving Medicaid money."

If the state could come up with $2.2 million to expand the program to another 1,000 frail elderly and disabled patients, the savings could reach $20 million a year. That's all great, but let's look at the human side of the equation: Wilma Young, the patient Coffman referred to, has been kept out of a nursing home thanks to the pilot program, which has provided her with health monitors and a modem to send vital signs to nurses that are three and a half hours away.

The feisty Young said in the article that she has fought efforts to move her to a nursing home. "My doctor's tried to put in me twice, but I beat him both times. I'd rather be right here," in her own apartment.

How about we stop listening to the actuaries, bean counters, politicians, activists, talking heads, angry mobs and others who are quarreling over cost, access to care and the role of government in healthcare reform? We could solve a lot more problems, help people live better lives, and likely save money and make care more accessible for more people by looking at the improvements in quality of care and quality of life that new technologies afford. - Neil