Can healthcare really be fixed?

In an article in Johns Hopkins magazine, Search for an RX, Michael Anft takes a look at the healthcare system and what issues are breaking it down and the problems facing government in trying to fix the ailing system. He gathered Hopkins administrators, economists, physicians, and researchers and asked them six questions to get an understanding of the current healthcare system and the way it could look in the future.

Can universal health care work?
Some are in favor of universal health care. They feel that universal health care would go a long way toward lowering the costs brought upon the healthcare system by the uninsured and help people avoid the catastrophe of not being able to pay for care. On the other side of the argument are those that say if health costs continue to rise, universal health care may not be possible. Their other argument is that there may not be enough primary care physicians to treat 300 million people. A study done by the National Association of Community Health Centers states that about 60,000 more primary care physicians to treat so many people.

How will we pay for it?
The Physicians for a National Health Program, an advocacy group, says that a single payer program with the government as the sole insurer could save as much as $350 billion per year. Hopkins administrators and professors say that because of the clout of drug and insurance lobbyists, this type of plan will never happen. A more likely plan is one for those without public or private insurance with the government guaranteeing a minimum of coverage to the entire U.S. population. Some states who were tired of waiting, like Massachusetts, Oregon, and Maryland, have made attempts to make health care more affordable for their residents.

Will we have to ration care to afford it?
This is a very ethical question. Americans are used to an availability of a full range of services and range to value choice. They may not like the idea of rationing care but other Westernized countries limit the number of tests and treatments they will pay for but because these countries have longer life expectancies and lower infant mortality rates because people are seen more often on a regular basis by doctors. This conversation has to be happening within the industry in order for the system to be fixed. The outcome of this conversation will determine how affordable countrywide health care will be.

How can we make health car more affordable?
There are a lot of inefficiencies within the health care system that help costs rise. Uninsured people and others who cannot pay their bills and visit emergency rooms for care cost the system almost $30 billion each year. Another problem is the fee-for-services system that favors high-cost specialists which explains the lack of low-paid primary care doctors. A possible solution would be a pay-for-performance system like the one in the United Kingdom which rewards those who treat the entire population and who practice good medicine. At the same time there should be disincentives for prescribing unnecessary or redundant tests. Another issue that if fixed could save 10% of total outlay on health care would be automation. A coordinated, nationwide system that could deliver electronic medical records to emergency rooms, hospital wards, and private physicians would make patient care more efficient. This is still a pipe dream because less than 40% of health care providers are able to use electronic medical records.

Can we improve quality while driving costs down?
A way to improve care while lowering costs is by re-emphasizing primary care. The more physicians there are, the more mortality is reduced. Rural areas currently have a shortage of primary care physicians. Another thing is for doctors to use a simple checklist that would decrease infections and deaths, especially doctors in intensive-care units. Standardizing hospital care in the entire country across hospital staff and looking at what’s working in other countries in terms of prevention methods would save millions.

How do we provide better care to the elderly and save Medicare?
Medicare faces financial deficits that threaten its future. Health providers and researchers are looking into ways to spend Medicare money more efficiently. The biggest problem is the U.S. ranks number one in the rate of people who suffer from chronic diseases which is very expensive to treat. Also, we have a medical system that is acute-care based and spends money on research for these diseases like heart attacks and strokes. We need a system that focuses on chronic-care based and looks at patients holistically instead of one body part at a time.

It’s clear that the problems are large but it’s finally time that they started being tackled. Americans deserve access to affordable health care and a system that works for them.