Sick to Death and Not Going to Take It Anymore!

Published in: Promises to keep: Changing the way we provide care at the end of life. Accelerating Change Today (A.C.T.) October 2000 / The National Coalition on Health Care and The Insitute for Healthcare Improvement. (Washington, D.C. : The Coalition, 2000), p. 2-3

Posted on RAND.org on January 01, 2000

by Joanne Lynn

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We have designed and built a health care system around the priorities of a past era - not around the needs of the chronically ill. Many of the current care systems and financial incentives do not yield what we need when we are old, sick, and frail. We can do better, but changing the status quo requires a few major shifts in how we view the end of life. There are many ways to envision a better health care system. One way is picturing a single health care provider talking with a single sick and frightened patient and trying to imagine what that provider could promise, in a care system that really worked the way it should. We face problems that our grandparents would envy - the problems that come from growing quite old and dying rather slowly. From the perspective of a century ago, our problems must look attractive. This is not the biggest problem to confront mankind, but it is among the most tractable. All it takes is innovation, learning, reorganization, and commitment. We don't have to wait to develop a new drug, or to find a major scientific breakthrough. To make excellent care routine, we must learn to do routinely what we already know must be done. People should not expect the end of life to be miserable and meaningless. We already spend a great deal of money on care for that time; we should get good care for that expense - without having to hope for good luck.

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