On Saturday I went to the second annual Boulder County Senior Law Day. The keynote address by Dr. Jay Want provided some excellent insights into the subject of health care reform. United States medical costs are higher and growing faster than other developing countries, even when expressed as a percentage of Gross Domestic Product. Jay stated that we got in this mess by paying people to do more rather than paying for better results. For people under Medicare, one in five comes back to the hospital within thirty days. By monitoring a patient after hospital release and providing in home assistance, many of these return admissions can be mitigated. The key is to reward improved health outcomes. In another session I attended, a physician described how he is now providing house call services to seniors. He can treat only half the patients of a doctor in an office, but he can improve the patients outcome particularly for older patients who may become worse by going through the trauma of going to a doctor’s office, waiting and then getting back home. Under Medicare 10% of the patients account for 50% of the cost, and these are primarily the frail and elderly. By looking at creative approaches, better service can be provided for a reduced cost. I also attended sessions on dementia (I have to keep up on this since the protagonist in my mystery series, Paul Jacobson, suffers from short-term memory loss). Paul suffers from vascular dementia, which, according to the presentation, accounts for only 17% of all dementia (dominated by Alzheimer’s at 70%). I also attended a session on scams, which ties in to another mystery I’ve written titled, Death of a Scam Artist. A day of learning that has given me new ideas for my writing.