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There are great variations in costs on the medical services throughout the United States. The documentary touches upon the urgent issue on how to provide a high quality medical care at the lowest price to everybody. The main goal was to understand the possible ways to reduce costs on medical services countrywide and still provide them on an excellent level.

The inspiring examples of the doctors in several hospitals in different locations give hope that the state health system can be improved and become affordable for all the residents of the U.S.

According to the long-term studies in DartmouthCollege, which resulted in a publication of The Dartmouth Atlas of Health Care, the certain communities around the country provide high quality medical care for reasonable costs. The correspondent T.R.Reid interviewed the heads and the staff in the top ranking hospitals about how they had achieved  such results. 

Most of hospitals in the film claim that their main purpose is toprevent the disease as healthy people would not come to the hospital; that is why the doctors spend so much time with their patients. This approach is definitely useful. It does not only reduce the costs for unnecessary procedures and tests, but shows that the patients and their problems are of the prior importance for the hospital.

Grand Junction doctors’ commitment to what they do is enormous. It is an amazing example of the health system model where, regardless of income and the presence of insurance, everybody within the community gets the regular medical care.

Seattle hospital seems to have the clearest idea of what the modern hospital should be. The Internet, email, and telephone communication today is the easiest way to keep in touch with clients daily, give consultations, and make appointments. Keeping records on the computer as well as in Grand Junction helps Seattle doctors not only to reduce costs, but also to get rid of the tedious paper work and have an automated data system available for clients.

While the Dartmouth-Hitchcock medical center practices involving patients in decision-making on their treatment, I cannot agree with this approach. On the one hand, informing a client of the possible ways of treatment is a good point. However,  on the other hand, the medical treatment should be totally of the professionals’ responsibility and not the clients’, which even with education on the issue cannot estimate the possible result.

Everett hospital’s way to cut costs on drug prescriptions is another brilliant idea. Having their own pharmacy in the clinic where the cheaper versions of the medicaments chemically the same as the well-known drugs are more preferable should be practiced all over the country. However, it is almost impossible. First, not every doctor would inform his client of the existence of such alternative as he may not know about it himself. Second, in this case, big brands and retail pharmacies working with them will lose much money.

However, the mentioned systems which work in those places cannot for sure be suitable for the other communities. The message of the film is not to use the same patterns for health system everywhere, but to follow the example and find the system that will work in specific conditions and serve the population right.  

In conclusion, really great changes in medical care countrywide can occur only if there is a strong, committed leadership. There is a need of leaders who really care and attach importance to lowering costs of the hospital services even sometimes reducing the salary of the doctors, leaders who are pursuing the goal of creating a credible health system on the local level expanding it around the state as well as helping people in need, saving people’s lives, and preventing the diseases. 

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