A recent Quote of the Day (May 19) discussed Intermountain Healthcare as an example of how an integrated health care system can help to control costs by emphasizing quality improvement. A co-author of the Health Affairs article cited, Dr. Brent C. James of Intermountain Healthcare, has discussed this topic with Dr. Joe Jarvis of the Utah Healthcare Initiative. Although their views on single payer differ, their discussion is a welcome addition to this dialogue.

Utah Health Care Initiative

IHC: A Quality Story
By Dr. Joe Jarvis
May 21, 2011
http://www.utahhealthcareinitiative.com/blog/2011/05/21/ihc-quality-story/

Dr. Brent James Responds
By Dr. Joe Jarvis
May 23, 2011
http://www.utahhealthcareinitiative.com/blog/2011/05/23/dr-brent-james-responds/

Brent James: Senate Testimony on quality
April 29, 2009
http://www.utahhealthcareinitiative.com/blog/2009/04/29/brent-james-md-senate-testimony/

Although Brent James has demonstrated that quality is attainable independently of the financing system for health care, his approach requires a degree of altruism which he posses but which has not permeated the entire health care delivery system.

Quality and financing are two different considerations, but there is a tremendous amount of overlap. A well designed single payer system provides tools and incentives for quality enhancement, just as a high quality system provides efficiencies for the financing system.

Dialogues such as this between Dr. Jarvis and Dr. James move the process forward bringing us closer to the day that we can experience a high quality health care system for all that is truly affordable – a financing system that is universal and equitable, and a high quality delivery system that makes it work.