Neighborhood care

December 12, 1991

Johns Hopkins Hospital's plan to match health services with community needs is exactly the kind of innovative thinking that is necessary if we are to come to grips with runaway health-care inflation in the United States. It is a sad fact that America is now spending a far larger amount of its gross national product -- around 12 percent -- on health care than other developed countries, and not delivering medical services very efficiently at that.

A leading factor in this disproportionate expenditure is that large numbers of uninsured people have in effect made the emergency room their "family physician." Lacking the resources to seek care when serious illness might be prevented or treated inexpensively, these people -- numbering 34 million nationwide -- often put off seeking medical care until their condition requires hospitalization. At any given moment half the beds in Hopkins Hospital are occupied by people suffering from conditions which could have been prevented.

Since Hopkins is seeking community input into establishing more accessible health care, allow us to put in our recommendation. Norway has established a nationwide system of community-based "health stations" to which every citizen is assigned. These stations are operated by nurses and paramedics who can administer inoculations and even treat minor illnesses like colds; if serious illness is detected, the patients can be referred to hospitals. The stations have gained the confidence of citizens to the point that even the royal family uses them.

We urge consideration for some variation on the Norwegian model. The cost of such clinics ultimately would be more than offset by keeping people out of hospitals through preventive care.

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