Stories From the Heart

By Stephanie Schneiderman

I’ve spent this summer with Costs of Care looking for stories about the heart – literally and metaphorically. I read through essay submissions from Costs of Care’s annual contest over the last three years and chose some of the most relevant, poignant patient and provider stories to draw lessons from. Although I drew on academic sources to elaborate on my key points, I found the individual experiences in various essays provided the clearest picture of where cardiology should focus in the future. Focusing on cardiology is a great way to illustrate problems within our healthcare system. Few problems are unique to cardiology alone.

Here is what I learned:

1. Cutting costs in cardiology follow the same rules as most of health care: get people out of the emergency rooms and into primary care offices and urgent care centers; try to use the most effective procedure to get the most valuable care; be upfront with patients and work with them to make health care any more affordable.

2. The health care system is interconnected. Unfortunately the challenges in the health care system are all connected as well. It’s hard to send everyone to primary care offices if there aren’t enough doctors; over-utilization of testing is inevitable without an electronic medical record to refer to during emergencies.  It may seem that change is impossible, or at least improbable. Yet, every change makes a huge difference. Every provider has the potential to cut costs for their patients and for society. Convince one patient with high risk of type 2 diabetes to exercise more and eat healthier and you save them the costs of insulin management and related complications. Prevent one woman with heart disease from going to the emergency room and treat her for $100 versus thousands.

3. Yes, systematic changes are needed. We need more doctors, more cost effectiveness research, more help for people who can’t afford health care. These are coming, albeit slowly. In the meantime, we do the best we can to cut costs where we can. That doesn’t always mean reduce care. It’s more about keeping people where they will receive the best care for their needs. Too many people with chronic diseases slip through the cracks because they only can afford care in an emergency. If these people were given more care, chances are it would cut costs. Waste is defined as something we don’t need. Health is something we need, to face poverty due to health care bills is something we don’t. While providers and patients alike face extremely difficult decisions, conversations about whether we need less treatments, or more, will help offset those times when there isn’t room for debate.

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Stephanie Schneiderman is a Junior studying Health Science, Society, and Policy at Brandeis University. She recently finished an internship at Costs of Care.