The Nielsen Revolution
Is 2009 the time for a health care revolution? This is the question AMA President Nancy Nielsen answered for WPBA on the evening of April 7th. Dr. Nielsen’s response: “Oh yes, we are!” Nancy Nielsen is arguably more qualified than any other individual to make such an assertive statement. Nancy Nielsen, the 163rd president of the American Medical Association, has previously served as speaker of the AMA House of Delegates. She also served two terms on the AMA Council of Scientific Affairs, where she helped formulate policy positions from medication safety to alcoholism among women. In short, she knows what she is talking about.
Dr. Nielsen, cheerful and energetic, took the floor in front of room full of eager spectators. Early in her presentation, Nielsen stressed the willingness of the AMA, under her leadership, to collaborate with private and public leaders to produce a health care system more responsive to the needs of American citizens. The AMA has been a frequent consultant for federal and state governments as well as other medical associations. These relationships have been built with great care to reach for expanded coverage and choice, improved quality and safety, and greater economic efficiency.
These are quite lofty goals, especially considering the situation Dr. Nielsen described to the audience. Currently, there are 46 million Americans uninsured and with the costs of health care provisions rising, that estimate looks to increase. In 2008, total health care costs totaled about $2.4 trillion, a figure that is projected to be $4.4 trillion by 2018. In Dr. Nielsen’s eyes (and certainly those of the uninsured), this trend is simply unacceptable.
Dr. Nielsen, though, was very hopeful a solution could be found. While she did not belittle the significant influence of politics in the formation of that solution, she did emphasize the first place to begin reform was not in the Congress, but the home. Lifestyle choices account for 50% of health care determinants, thus our personal choices, not surprisingly, are the largest influences on our health. Due to this, Nielsen asserts that greater emphasis on wellness must be included in any policy changes.
Investment in wellness programs was just one major point Dr. Nielsen sought to make to the crowd before her. Nielsen also called for stronger support of comparative effectiveness research, elimination of excessive administrative costs, more value-based decision making in all areas of health care delivery, and dissemination of information regarding the best health practices to the public. Grouped together, these will help alleviate the health care crisis under the analysis of Dr. Nielsen. Nielsen was quick to affirm all of this can be accomplished without the need for a single payer system. Only time will tell if Dr. Nielsen’s words will come to fruition. Until then, we wait with anticipation for the revolution.
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