Patient-centered model offered as road to reform

From Seattle, the call went out for proposals: Come up with an idea to fix the U.S. health care system and win $10,000. Contest judges cast their votes, selecting Vaughan Glover, DDS, a dentist in Arnprior, Ontario, as the winner.

Judges didn't think it strange that they picked a Canadian's idea to cure what's plaguing America's health system. They liked his patient-centered model, believing it uses the best of the American and Canadian systems.

Now contest organizers hope to turn the best ideas into reality.

"The contest is not an end. It's a beginning. We want to effect a positive change in health care," said Kathleen O'Connor, a Seattle health care consultant and writer who ran the contest.

O'Connor put together the contest to spark ideas about health system reform. Proposals could be up to 50 pages in length and had to address issues such as regulatory challenges, financing and management structure.

O'Connor received more than 100 entries from 33 states and Canada. Making their pitches for reform were physicians, dentists, teachers, students and others from many professions. There were ideas about medical liability insurance, employee-decided medical coverage and other reforms. "It hit a nerve with people," she said.

Nine judges with health care backgrounds convened in Oregon and listened to the top 10 finalists' proposals.

In late October, the panel picked Dr. Glover's plan for the $10,000 prize. Second place got $5,000, while third collected $1,000.

O'Connor used her own money to cover much of the prize money, while a foundation and some judges also contributed funds.

"We just loved the proposals. Even the ones that didn't make the finalists had good nuggets in there," O'Connor said.

Winning proposal focus of book

Across the border came Dr. Glover's idea, which he has been working on for years and is the focus of a book he wants to publish. His patient-centered model promotes giving the patient information to foster good health over a lifetime.

The patient would have a primary coach, such as a doctor or nurse, to help guide care. Personal savings accounts for health would provide a financial support system.

"People can't deny that the health system should be patient-centered. I really believe what I'm proposing can fix health care," said Dr. Glover, who wants to use his prize money to publish his book. "The patient is the center, the coach is next and support people are the third tier."

Joan L. Richardson, MD, a family doctor in Miami, was the only physician among the 10 finalists. Her plan called for the government and private sector to work together to provide health care to everyone and would feature a national patient database accessible to physicians and hospitals.

"I feel the system needs to be updated, not necessarily changed," she said.

Dr. Glover and Dr. Richardson plan to push lawmakers to hear their and others' ideas by playing active roles in Code Blue Now, a national, nonprofit advocacy group launched by O'Connor and supporters in conjunction with the contest.

The group is reviewing the top contest entries and formulating proposals to take to congressional leaders, O'Connor said. Its goal is to build a national dialogue and prompt action to improve the U.S. health care system.

"We all have an opportunity here to reform health care. It's incredible what grassroots can do," Dr. Glover said.

Some said the contest did a good job of generating ideas for debate.

"The whole point of the exercise was not to say here's the answer, but to get more people involved in discussing problems and possible solutions," said Andrew Holtz, MPH, a contest judge and a freelance health journalist. "It was a step toward public involvement."