Doctor’s Tip: Why our health care doesn’t get better faster
Two recent health tip columns discussed our broken health-care system and one of its related problems: medical errors, the third most common cause of death in the U.S.
For anyone interested in improving the health care system in our country (and that should be all of us), a new must-read book is “Mistreated, Why We Think We’re Getting Good Health Care — And Why We’re Usually Wrong.” The author is Robert Pearl, M.D., who is executive director and CEO of the nonprofit Permanente Medical Group, the largest health care group in the U.S. He is on the faculty at the Stanford Medical and Business schools, is a prominent physician-leader in health care, and has studied the health care systems in several other developed countries in addition to our own.
Some of the observations Dr. Pearl makes in his book are:
• “Seventy-six percent of patients describe the quality of care they personally receive as good or excellent,” but the majority are dissatisfied with the system in general.
• “Among developed countries, the United States has the highest infant mortality rate, the lowest life expectancy, and the most preventable deaths per capita.”
• “As a nation, we spend 50 percent more on medical care than any other country, and yet we rank 70th globally in overall health and wellness.”
• “We have the best-trained doctors on the planet, and yet their avoidable mistakes kill nearly 200,000 Americans each year.”
• “We pay doctors and hospitals based on the number of services they provide rather than the quality of care they deliver to their patients. Consequently, American patients undergo a very high volume of unnecessary tests and procedures.”
• “As consumers, we demand the latest technologies from our banks, telecom providers and retailers, but we passively accept last century’s technology in our hospitals and medical offices.” An example of this is that 50 percent of physicians still use paper records, and for those who have electronic records the various brands often can’t “talk to each other,” so that when you see a different physician they often lack important data.
• “We have excellent physicians who are burned out, unfulfilled and in some cases terribly depressed.”
• “We have already unaffordable health care costs that continue to rise at twice the rate of our nation’s ability to pay.”
• “The quality of a patient’s care and his or her access to it varies dramatically based on such characteristics as race, ethnicity and socioeconomics.”
• To improve our health-care system we need more primary care providers such as family doctors and internists, but instead we have too many specialists.
• Obamacare provided insurance for millions of people who previously couldn’t afford it, or because of pre-existing conditions couldn’t get insurance at all, but “there are still millions of Americans who are uninsured.”
• “Meaningful change in health care often takes years, even decades. The Institute of Medicine estimates that a new, proven treatment takes an average of 17 years to make its way into routine patient care.”
A logical question is: Why don’t we fix this dysfunctional and expensive system? In order to understand the answer, it’s important to know about what Dr. Pearl calls the legacy players. These are players in the health care system that wield undue influence over us and over members of Congress.
They are deriving tremendous financial benefit from the current system, and therefore do everything they can to block change. The legacy players are: major insurers; hospitals; physician specialty societies; and drug and device companies.
In the next four columns, each of the legacy players will be discussed, based on Dr. Pearl’s insights.
Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at firstname.lastname@example.org.
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