Our Broken Healthcare System

Our Broken Healthcare System: How Scared Should We Be? | Medpage Today – by David Nash, MD, MBA, FACP – Oct 2018

I see so many current problems in so many aspects of our society arising from the supreme focus on profits when capitalism is allowed to run amok without any social constraints.

Our healthcare industry values patients only as consumers and manipulates us to “need” moneymaking services like surgeries, or lucrative products like the latest medications.

In An American Sickness: How Healthcare Became Big Business and How You Can Take It Back, author Elisabeth Rosenthal, MD, argues that our health care system focuses less on health and more on profitability — and supports the premise with compelling anecdotal illustrations of what is wrong.  

Although they exaggerate for emphasis, her “economic rules of the dysfunctional market” target the issues with remarkable precision; for example:

  • More treatment is always better, and a lifetime of treatment is preferable to a cure.
  • Amenities and marketing matter more than good care.
  • There is no free choice; patients are stuck buying American.
  • Economies of scale don’t translate into lower prices; more powerful providers can simply demand more.
  • There is no such thing as a fixed price for a procedure or test; prices will rise to whatever the market will bear and the uninsured will pay the highest prices.

In the second book,Mistreated: Why We Think We’re Getting Good Health Care — and Why We’re Usually Wrong, Robert M. Pearl, MD, calls attention to disturbing realities, e.g.:

  • Medical error still accounts for close to 10% of all American deaths.
  • The lack of universal use of interoperable electronic records still leads to duplication of effort and errors.
  • Physicians continue to be paid on volume rather than the value of the services they provide.
  • There is inadequate focus on prevention.
  • There is an opioid addiction crisis that stems, in part, from deliberate actions by pharmaceutical companies.

In the latest of his incisive books,Prescription for the Future: The 12 Transformational Practices of Highly Effective Medical Organizations, Ezekiel J. Emanuel, MD, refutes the notion that reforming the health system goes well beyond skirmishes over the Affordable Care Act.

He suggests that it is about resolving two fundamentals problems —

  1. underperformance of the system on practically every metric and
  2. unaffordability of health care for individuals, businesses, healthcare professionals, and the government.

My fear is that everyone — individuals, businesses, the healthcare industry, governmental leaders, and policy makers — is ignoring the symptoms of a chronically ill system because of the sheer exhaustion that comes with a toxic political environment and a deeply entrenched status quo.

Author: David Nash, MD, MBA, is founding dean of the College of Population Health at Thomas Jefferson University in Philadelphia, and a board-certified internist renowned for his work in public accountability for outcomes, physician leadership development, and quality-of-care improvement.

4 thoughts on “Our Broken Healthcare System

  1. canarensis

    Is itr now a law that anyone writing anything about any aspect of medical care in the US MUST insert something about how opioids are destroying the fabric of society & that the “epidemic” is caused by prescription meds? It seems especially hypocritical that the author puts that bit of BS right after the true fact that medical errors cause a huge number of deaths –tho they fail to mention that they cause FAR MORE deaths than all opioid deaths combined –illegal & legal. AAARRRRGGGGHHH.

    Liked by 1 person

    1. Janie Anderson

      thanks for stating, what to me is the obvious, no matter how great the content why must they always thro that jab at doctors and pain patients I for one am so sick of the twisted ignorant narrative of so many, I also find so interesting the idea that we must concentrate all of our energies on the “opioid crisis” when so many other things are responsible for death rates so much higher, ie: cigarettes, alcohol, sugar, doctor errors,ect. can we not talk about some of these, not the least of which is illegal fentanyl

      Liked by 2 people

  2. taylo138

    I agree 100% with this statement by David Nash, MD, MBA, FACP.
    “Our healthcare industry values patients only as consumers and manipulates us to “need” moneymaking services like surgeries, or lucrative products like the latest medications.”
    Our healthcare system is a failure!
    Due to greed and major medical system failures, I’m an example of doctors being too busy to CARE about outcomes over money.
    I was a practicing RN & now, short of a miracle,
    I’ll never work again.
    Now, I have a full-time job meeting with the doctors caring for me.
    The government is terrifying doctors who provide pain control to seriously ill people; yet, doctors perform extremely risky and potentially damaging procedures everyday without oversight are creating chronic conditions.
    (I wasn’t in a horrible car accident. I was seriously disabled by two ‘TOP’ doctors.)
    Outcomes should be the #1 priority in healthcare!
    Patients should be told the success rate of surgeries and by surgeons.
    Informed Consent is not happening. If it was I wouldn’t be living with chronic pain and disabled at 51 years old.
    Yes! Healthcare is very scary and something has to change!

    Liked by 1 person

    1. Zyp Czyk Post author

      When the pain was directly caused by “medical care”, it’s even more outrageous that they won’t treat it. But I think the opioid denial is starting to crack and crumble as more doctors are speaking up.

      Let’s just hope it doesn’t get too much worse before it gets better.

      Liked by 1 person


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