WILLMAR -- At the very least, it's hard work.
But if it's done right, creating a health care system that is sustainable for the future can accomplish the triple goal of providing better care and improving community health at a lower cost, Dr. Sanne Magnan told a local audience Tuesday.
It's "a huge issue in front of us," she acknowledged. "But let's think about this as citizens and let's talk about this for our children."
Magnan, chief executive of the Bloomington-based nonprofit Institute for Clinical Systems Improvement and a former Minnesota Commissioner of Health, spoke to a Willmar-area group that has been exploring ways to deliver value in health care while holding down costs.
The group, a cross-section of local health providers and business leaders, began meeting this past May.
Their efforts are taking place against a complicated backdrop.
According to a 2010 analysis by the Commonwealth Fund, the U.S. spends the most on health care but has worse outcomes than any other leading industrialized nation.
Although spending on health care in Minnesota is growing at a slower rate than the rest of the U.S., it's still rising steadily, threatening to outstrip state revenue growth and reducing the amount of money available for education, roads and other vital infrastructure.
Turning this around will take nothing less than redefining the system, Magnan told the 30-some people who attended the Tuesday morning forum.
"What we often do is we keep tinkering at the edges and putting new layers on what we already have. That's not going to work," she said.
Among the elements Magnan recommended:
n Greater emphasis on community health as a whole.
n More focus on the social determinants of health -- socioeconomics, health-related behavior, the physical environment and so on.
n Improvement of the patient experience, centered on what patients themselves say is important to them.
n Team-based care that uses the best of each health care professional's skills.
n A sustainable business model that rewards health and wellness.
n A recognition that cost must be addressed.
"We've got to find the right, appropriate way to bring cost into the discussion without having accusations of death panels or accusations of denying care or accusations of rationing," Magnan said. "Communities like you can lead the way and think about responsible ways to talk about cost."
There's no single solution, Magnan said. Furthermore, what works in one community won't necessarily work in another.
"Honestly, if we do it right, it's probably going to make us uncomfortable," she said. "We're going to be pushed out of our normal environment."
But once the process is under way, it will help lead to health care that's more responsive to patients' needs, more effective at sustaining overall community health, and less costly, she said.
Resources that are freed up from an expensive, cumbersome system can then be reinvested in social health that continues to stimulate better outcomes and lower cost, Magnan said. "You're going to essentially create a reinforcing loop."
For members of the audience, one of the most pressing questions was how to engage the public.
"How do we talk together about how this is a mutual problem?" wondered Dr. Rick Lee, director of Woodland Centers.
Others wanted to know how to counteract negative messages and a culture that's often at odds with healthy lifestyles.
Finding common ground is crucial, Magnan said. "People need to use the resources and the creativity and the bright minds that they have in their community. What will happen is you will develop a shared perspective that is richer than anything you've had before. Out of that common purpose and creativity, you will get new thinking and ways to do things you never thought of before. It's going to be hard work but it's worth it."
Organizers of the meeting said they're sending out a followup survey to the participants and are looking for more involvement.
The city of Willmar is tackling the development of a 20-year vision that includes community health, said Ken Warner, president of the Willmar Lakes Area Chamber of Commerce.
"That's where we can make a difference and have a healthier community," he said. "We have to do it together and sit down at the table together."