What does better, cost-effective health care look like?

It looks like the Mesquite Employee Health Center, for one. More than 7,600 city and school district employees and their dependents get inexpensive routine care and pharmaceuticals at this clinic.

Clinic staffers have detected early signs of more than 400 cases of diabetes, skin cancer and other chronic diseases.

The city of Mesquite and the Mesquite Independent School District, meanwhile, have held the line on insurance costs. After paying for the clinic and its operating charges, Mesquite officials say they've saved $6.5 million since the clinic opened in 2007 by lowering medical expenses and avoiding insurance premium increases.

"If teachers have to make an appointment to see a doctor outside the clinic, it means taking at least a half day off, perhaps a full day," said Mesquite ISD Assistant Superintendent Lanny Frasier. "This way they can set the appointment for a teacher conference period. ... They can see the doctor, fill their prescription and be in and out in less than 30 minutes."

In January, Dallas opened a similar clinic in City Hall for 13,000 municipal employees and their families. Addison-based Concentra, a health care company with more than 250 employer-supported work site clinics in 40 states, is running the Dallas facility.

"Clearly more and more employers get this now, and it's spreading, this thought about prevention and wellness is indeed spreading," said Jim Greenwood, CEO of Concentra.

Better, cost-effective health care may also be the result at a new $15 million diabetes health and wellness center in South Dallas.

This morning, Mayor Tom Leppert, council member Carolyn Davis and Baylor Health Care System CEO Joel Allison are scheduled to preside at the groundbreaking, which involves a major addition to the Juanita J. Craft Recreation Center on Spring Avenue.

Fueled by poor diet and a lack of preventive care, 13 percent of South Dallas residents have diabetes – nearly twice the national average. (The incidence among all Texans was 10.3 percent in 2007.)

Diabetics in South Dallas get much of their treatment at Baylor University Medical Center – but at a stage of their illness that is debilitating and expensive. Community preventive care would improve the quality of life among patients and prospective diabetics, and save everyone money.

"South Dallas is the poorest, sickest part of the community," said Paul Convery, chief medical officer of Baylor Health Care System. "As a health system, we spend a lot of money every year on diabetes – all of it treating the back end of the complications."

Dallas has a diabetes awareness center on Martin Luther King Jr. Boulevard that provides screening, education and a support group.

The Baylor diabetes clinic will have medical staff on hand to provide patient treatment as well as screening and education – even cooking classes.

Today, tens of thousands of people in Dallas who have diabetes don't even know it yet. Many others at risk of developing the disease – obesity is a major pathway – have not had a conversation with a health care professional about the risks (which include blindness and amputation of the legs).

"Why not meet to discuss these questions, learn to cook, hold classes? Why not bring the children and grandchildren?" Convery asked.

"Health care got expensive because of the way it's delivered. Why not ... do something innovative, do something to change the curve of health care costs?"

Why not?