The two stories that really got under my skin was the young girl with lupis and the young man that had to choose his job to get appropriate health care. These two young people are the future of America and their medical situation is impeding their advancement. The fact that some Americans have to deny health care and careers just to survive because of unfortunate medical conditions is a tragedy! Relative to other developed and industrialized nations, there is no excuse for America to be suffering from a failing health care system. The irony is that America masters quality, specialty care yet has one of the highest rates of infant mortality and bankruptcy cases due to medical expenses because of a lack of primary care resources and affordable health care. Health care has become a business, not a human right.
The question remains, how can the health system improve? As the video outlined, every American should be required to have health care insurance. However, more importantly (and more upstream) the health care system’s stake holders’ finances need to legally contained. Pharmaceutical companies, health insurance companies, doctors, hospitals, employers and consumers all need to be financially regulated to avoid the high administrative and technology costs and salaries.
The way the health care system depends on employer or private insurance and Medicare/Medicaid (if the person actually qualifies) is not sustainable, efficient or moral. Health care is one of those components of society that needs to be government regulated and not left to the open economy.
I agree with Kelly's posting about how much health care has become such a business and not a human right. Its incredible that coverage is extended to a limited pool of citizens: white-collared employees, the wealthy, and the healthy.
ReplyDeleteI think the videos bring up very real and astonishing points about how 47 million are uninsured, many with "junk" health insurance, those that unhappily stay in jobs or marriages for coverage, and a majority that feel unsatisfied with their current plan. Its really quite odd that the U.S., such an advanced nation in other policies and technology can be so held back by basic health care. New college grads settle for any job that will pay for health insurance, middle-aged workers that go bankrupt from medical bills, etc.
I know from experience volunteering in a clinic that provides health care to the uninsured that many hard-working people who have jobs, usually in a labor-intensive field like construction, are left without insurance. I find it interesting that many people do not qualify for Medicaid based on income and Medicare based on age. As a pharmacy technician, I find it sad that at times the elderly are forced to pay what their plans do not cover. Working with insurance companies is no easy task either. Pharmacies are frequently hit with prior authorizations or other excuses to not cover medications.
I really liked how the one video emphasized that if all Americans were enrolled into healthcare and not just the sick, then the system could work. The healthy majority would offset the costs of those that need medical care. In time, the young healthy citizens would need more health care due to aging. If only that system could be made into a reality.
Some of the points made by Dr. Delbanco hit home for me. He discussed the idea of a national personality that won't accept medical rationing and how we need the financial crisis to force us to accept a changed system. There is a concept about implementing changes in policy where the response is J shaped, which is to say, it gets worse before it gets better. That is where we are headed, and the critics aren't going to be patient to wait for us to turn the corner.
ReplyDeleteThe interview with Sam Nussbaum brings up this idea of medicine-as-business and how for-profit medicine might "deliver slightly higher quality services" becuase they have invested in higher quality machines/doctors/support staff/etc though we have seen in class that access to MRI or CT or Specialists doesn't translate into better health by conventional measures.
Atul Gawande has a great article in the New Yorker (http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande) which talks about how the focus of health care reform really needs to include a shift in medical thought/training/incentives to promote health for hte patient and to disincentivize the business of medicine for the doctor. Obviously this is in addition to providing health insurance for all, encouraging oversight of insurance companies, discouraging defensive medicine and implementing Tort reform.