Talks and debates regarding American healthcare seem to be endless and reach little to no consensus. With pros, cons, and its fair share of chaos, American healthcare seems to be on the verge of a breakdown, especially if we analyze the reports issued by people with clearer heads than of those of American politicians. According to such reports, the American healthcare system is so broken, it would need an “erase and rewind” type of upgrade. However, things are not all dark. Today we will focus on the things that do not work, work well, and could work better.
1. Increasing the Quality of Care, not only the Costs
The American healthcare system is the most expensive one of all developed countries, but the quality of care falls short in comparison to other countries. The U.S. underperforms in fields such as better health outcomes for patients, but also access to proper medical care, efficiency of medical services, and equity between groups with above-average and below-average incomes.
One of the most staggering issues is that even if the U.S. is an international leader in medical research and technological advancements, it is still very inefficient when it comes to the adoption of modern health information systems.
One solution to assess the quality of the medical act would require more than asking patients for feedback, as imposed by Medicare. The short surveys patients fill out after discharge can’t teach us much. Allowing doctors to access patient data in a short time or perform follow-ups on the success of certain medical procedures would be a necessary first step.
According to the reports, the U.S. medical system would become more successful and the care would become more efficient with the continued adoption of health information technology. An easy system of identification, monitoring, and coordination would help physicians offer efficient and safe care for their patients.
2. Recognizing Medical Errors with Honesty and Working towards their Prevention
Some studies show that medical errors are the third most common cause of death of patients in the United States. Such results become even more frightening when you translate it into numbers: almost a quarter of million people die every year because of medical errors. According to Robert Pearl, Executive Director and CEO of the Permanente Medical Group, infections in the hospital environment are responsible for killing tens of thousands of people.
Doctors and nurses fail to wash their hands between patient visits or fail to decontaminate properly hands, rooms and hospital surfaces/instruments. Such mistakes, together with diagnosis errors, drug mishaps, unnecessary surgery, under-evaluation of life-threatening conditions, and lack of access to real-time patient records across multiple care units make medical errors become as serious as heart disease and cancer.
However, such problems reflect more of a system failure and not “bad doctors”. Therefore, one solution to the problem would be to update the national health statistics to recognize and track down medical errors as a cause of death. While the human error is inevitable to some degree, poorly coordinated care and inconsistencies in insurance coverage, inadequate measures for tracking and preventing medical errors are all part of a problem that can find its solution.
3. Learning from Other Countries and Adopting Models of Good Practices
While all other countries have plenty to learn from the Unites States in terms of medical research, development of technologies, and medical education for aspiring doctors, the U.S., in its turn, should also take a few notes on healthcare management.
America is still the only country with the most expensive healthcare, which does not feature universal coverage. The discussion about healthcare insurance in the U.S. is endless and able to stir conflicts on all levels, so we will only present you with other examples of countries that handle things differently (and are also top performers in healthcare):
- The United Kingdom: universal healthcare, single payer system;
- Germany: universal healthcare, insurance mandate system;
- The Netherlands: universal healthcare, two-tier system;
The single-payer socialized medicine is not a new idea – not even in the Unites States – but it works in most developed and in course of development countries. The two-tier approach means that the government uses the taxes collected from the citizens to pay for basic healthcare for everybody, while the citizens can also opt for supplemental private medical insurance for better services or more advanced tests and procedures.
We could argue for or against universal healthcare in the Unites States for many years and not reach a solid conclusion. However, learning from others’ example and success stories cannot hurt.
4. Training and Hiring More Doctors
The Association of American Medical Colleges commissioned a study back in 2017 to assess the problem of physicians’ shortage in the immediate future. The results came back positive – the United States will face a shortage of doctors of up to 100,000 professionals by 2030.
Moreover, doctors are facing retirement, their average age today being 51-52 years old. While authorities, hospitals, and medical associations make sustained efforts to keep the balance, the truth is there are not enough young and well-trained doctors to replace the ones who will retire during the next few years.
One incentive to keep doctors doing their job and even relocating to rural areas or poor communities is the salary. Experienced doctors make a lot of money and they receive rewards if they choose to relocate. the job outlook for doctors and nurses is higher than in comparison to other professions as well. Salaries are getting higher too. For instance, a nurse anesthetist salary is the highest in all English-speaking countries.
However, this does not mean that generous paychecks will keep doctors in the system if they do not want to be here anymore. Burnout, bureaucracy, little time to dedicate to patients and healthcare policies deter doctors even from young ages. Even residents have to deal with burnout and they did not even became full-time specialists.
Medical associations are asking for more funds to train more doctors in med schools and residency programs, but so far the U.S. registered little to no progress in this direction. If you end up waiting for hours to see your doctor or if you do not receive the proper hospital care that you pay for because there is only one doctor to 2000 – 3000 patients, you should start writing letters to your congressional representative.
5. Making Good Things Even Better
As we said, the reports on the American healthcare system also emphasize on the good parts of this system. Even if America distinguishes itself as a country with poor but expensive healthcare costs, out-of-control drug prices, a new opioid crisis, and millions of citizens not getting any healthcare at all, it still ranks decently on other aspects.
One such aspect is effective care – a field that includes preventative care and prevention medicine. The doctor-patient relationship (when the doctor has time to develop one) is laudable, together with doctors’ efforts to help patients stay healthy, prevent diseases, and lead satisfactory lifestyles.
Prevention medicine helps the entire system, reducing visits to the doctor and health insurance costs, while cutting doctors some slack and giving them time to deal with life-and-death situations (especially in hospital environments).
Our doctors show concern for patients’ diet, lifestyle choices, physical exercise, and psychological problems. The American healthcare system is not the fairest of them all and not even close to becoming the best. However, doctors are still the most important mechanism in the entire system and we should all help them make things (and the system) healthier.