Lower Costs and Better Care for Neediest Patients

The author, Atul Gawande, gets an A in writing/journalism and an F in economics/politics (Obamacare) and an F in racial profiling for referring to a Sri Lankan as having "cute rabbit teeth, but it's an excellent article about innovation and research. Jeffrey Brenner is an innovator--he knows how to lower medical costs by looking at the big picture. By analyzing block by block the hospital visits of Camden's residents "He found that between January of 2002 and June of 2008 some nine hundred people in the two buildings accounted for more than four thousand hospital visits and about two hundred million dollars in health-care bills. One patient had three hundred and twenty-four admissions in five years. The most expensive patient cost insurers $3.5 million. . . His calculations revealed that just one per cent of the hundred thousand people who made use of Camden’s medical facilities accounted for thirty per cent of its costs."Lower Costs and Better Care for Neediest Patients : The New Yorker
(If I'm not mistaken, there are similar studies on crime families and city maps.) I'm not sure I'd call Brenner's program "revolutionary," except in the sense it's how most healthy people live as a matter of routine--don't smoke, don't drink to excess, don't use drugs, aren't 300 pounds overweight; we know how to cook, take medication; we have stable relationships, we attend church, we socialize; in short, we're smart enough to take care of ourselves.

When offered a free clinic in their building which included a social worker assisting them with things most of us (reading this blog) know how to do, resulted in some worry and objections. . ."This doctor’s office, people were slowly realizing, would be involved in their lives—a medical professional would be after them about their smoking, drinking, diet, medications. That was O.K. if the person were Dr. Brenner. They knew him. They believed that he cared about them. Acceptance, however, would clearly depend upon execution; it wasn’t guaranteed. There was similar ambivalence in the neighborhoods that Compstat strategists targeted for additional—and potentially intrusive—policing."

Yes, how do you get people to give up personal freedom and bad habits in exchange for good health?