THE AMERICAN HEALTH CARE SYSTEM IS THE MOST EXPENSIVE IN THE WORLD

THE PANDEMIC EXPOSED MANY OF ITS INADEQUACIES

 “American Health Care System is set up to produce a lot of health care, but not necessarily a lot of health.” - Dr. A. Navathe (Healthcare Economist)

The pandemic has turned our collective attention to the inner workings of the American health care system and has changed the practice of medicine forever.

It is a known fact that the US spends 25% more per person on medical care than any other country in the world, yet gets less benefits from It. Every advanced European country provides universal health care for their citizens. The USA, in spite of having the most expensive health care in the world, does not cover all of their citizens. There are tens of millions of uninsured people. The USA also lags behind many other advanced countries in health care metrics, especially in preventative health care, maternal care, infant care and longevity.

When an unexpected disaster strikes, it always reveals the weaknesses and inadequacies of any system. The Coronavirus pandemic showed how unprepared the American Health Care System was - from the basic policies to the rules and regulations, lack of protective personal equipment (PPE), ventilators, ICU beds, trained personal, effective medications, virus specific intensive medical care. Therefore, many mistakes were made. On the job training taught doctors to learn more about this novel virus, and how to best take care of very sick Covid - 19 patients.

In the interim, over 500,000 patients and many doctors, nurses and health care workers lost their lives. These figures are the most in the world.

On the other hand, this unexpected disaster forced miracles of science and brilliant scientists to discover multiple effective vaccines against this novel virus, in an unbelievable short period of time.

The American health care system is a profit oriented corporate health care delivery system. It is run by giant health care corporations. To avoid competition, all small and independent hospitals are taken over by corporations to create big hospital chains. In this system, non-profitable practices are discouraged or given limited priorities. For example, accumulated experiences over century have shown that preventative health care’s cost saving and lifesaving benefits are far superior to just taking care and treating illnesses. However, preventative health care is not as profitable as treating illnesses with interventions, modern technology, expensive new medications and batteries of tests. That is why primary care and preventative medical care are not given that much priority in the American health care system. So much so that many preventative health care measures and practices are not even covered by health insurance. Therefore, it could be said that the American health care system is more a sickness care than health care.

When the pandemic caused fear of contracting the virus and dying from it became rampant, many patients stopped going to the hospitals and doctor’s offices. A study done and published in JAMA medical journal, on this regard, reported that 43 percent of patients have not kept their appointments for many months. Consequently, only some of these patients’ condition got worse, but the majority of them did just fine. Does this mean that majority of patients scheduled appointments and cascades of laboratory testing were not necessary?

Additionally, when the pandemic began, Covid-19 patients inundated the hospitals. Hospitals diverted their healthcare resources and elective surgeries and procedures, as well as routine hospital visits were cancelled.  For these reasons, many hospitals and doctors’ main source of income dried up. It is interesting that elective surgery patients did fine without surgery. Could it be that many elective surgeries were not needed in the first place?

The pandemic caused and left permanent changes in practice of medicine, as well as established new norms. The importance of telemedicine and its effectiveness in the practice of medicine became very clear. Telemedicine avoided many unnecessary hospital visits, doctor visits, panic and stress among patients, with just a simple phone call.

No more crowded waiting rooms in hospital and doctors’ offices are allowed. Few patients at a time, with a face mask and social distancing could sit and wait. Doctors, nurses and office assistants are also had to wear face masks and sanitize examination room after each examination. These new practice norms increased practice overhead expenses, drastically. Many doctors especially those who are close to the retirement age closed their practices permanently. According to a survey by Physician Foundation, about 8 percent of the doctors closed their offices permanently. Doctors’ and nurse’s shortage became an acute problem.

So, it appears that nothing in life stays the same, everything in life changes over time.