Andrea Hackathorn

Intro to HIT

Module 2, Assignment 3

September 2, 2017

US Healthcare System

Healthcare reform has been a hot topic for several years. It was a very big talking point in past

presidential elections. I have read articles which cite research that show the U.S. healthcare system is

one of the most inefficient and expensive in the world. According to Litchenstein, 1993, The U.S.

spends more per capita on health services than any other country in the world, but lags behind many

other countries on such health indicators as life expectancy and infant mortality. The debates that swirl

around the media and within the discussions in our homes and among our leaders all seem to have the

efficiency and cost of our healthcare system specifically as their concern. How to address these issues

spins a lot of debate and brings up a lot of controversial solutions.

When I look at the healthcare systems and its problems, I think back to what I can personally

observe. My family is no stranger to health problems. My husband has Crohns disease and three of our

six children have a rare type of dwarfism called Brachyolmia. When we started our family years ago, we

could not have imagined our countrys system would have a great impact on our life. I know what it is

like to have financial burden as a result of the costs of healthcare. I dont just hear complaints about the

rising costs of healthcare on the news or see them on social media, I feel them.

When I sat down to pen my thoughts for this paper, I thought back to 2009. My husband had

been laid off work as many people were during that time. The money we made until he got back to a job

in his field was not much. We had to take what was available. At that point, our income became so low,
we qualified for Medicaid. For a few months, my husband got to go the doctor and get his Remicade

infusions without us worrying how to pay for them. For once, they were completely covered by

insurance. When he finally got a good job again (with health insurance), I was so relieved, but I could see

in his eyes the worry of if he was going to get sick again from having to go through the red tape and

waiting periods to get his infusions covered by the new insurance and possibly a program to help with

the copays. No one should have to feel that way. A hardworking man with health insurance should not

have to worry if he can pay for his healthcare. We have a problem in our country with the cost of care,

especially the cost of prescriptions.

In reflection, the efficiency of our system also came to mind. I frequently connect with other

people who have or their child has a spondylodysplasia, meaning short trunk dwarfism. Brachyolmia is a

spondylodysplasia. It seems that the quality and efficiency of our care is not the same across the U.S.

Some people have much better access to care than we do in Cincinnati. There are also people who wish

they had access to the level of care here because they have no one in their area experienced to give

them the care they need. While there are people who come to the U.S. from other countries to receive

our care, I have noticed that there are things that other countries do that could make our system a little

more efficient. For example, my children with dwarfism are seen every 6 months to a year by a

geneticist and orthopedic doctor. My oldest daughter also has to see a spine surgeon who monitors her

spinal stenosis who is separate from her orthopedic doctor. This is not counting all of the appointments

we schedule for physical therapy or for other related problems that arise. Yet, when one of them gets an

ear infection or other illness, we get lectured by our family practitioner for not making our yearly well

check-ups and have to schedule a new patient appointment just to be seen for an illness. I have

explained that we have so many appointments and my children are seen so often that I cannot afford to

take them to the doctor when they are not sick for a well-check. They have plenty of eyes on them. This

topic came up in our group on Facebook and a lady from Australia was astonished that our geneticist
didnt also function as the primary care doctor for our children. In her healthcare system, since her child

had a genetic condition that was followed regularly, the geneticist became the primary care doctor. I

thought that was one of the most practical things I have ever heard in terms of making the care of my

children more efficient.

Now those are just small ways that the bigger picture of the efficiency and cost of the U.S.

Healthcare system has impacted me and helped form my opinion that our system could work harder to

improve efficiency and lower costs. While I feel like our family has received good care, there are ways

we could improve upon our system. One such suggestion that has come up a lot in recent years is the

single payer system. I have thought a lot about what it would mean for our country, but I think we have

a bigger issue than that to address in terms of solutions to the cost our healthcare system and rising

insurance premiums.

It is alarming that the rate of diseases is skyrocketing. When we look at the overall cost of the

care in the U.S., I feel we must address the fact that more and more people are becoming chronically ill

and our treatments are often palliative rather than curative. I think the best thing we could do to drive

down healthcare costs is to work to cure and prevent disease. Chronically ill patients are the biggest

consumers of our healthcare. For example, 75% of our countrys healthcare spending in 2005 went to

treat chronic disease. While some of these conditions are not preventable, many of them are. The CDC

has estimated that if people eliminated risk factors such as poor diet, inactivity, and smoking; we would

prevent 80% of heart disease, stroke, and type 2 diabetes, and 40% of cancer. The amount of chronic

disease impacts the amount that we pay for our healthcare. This especially raises the cost of our

insurance premiums (The Growing Crisis of Chronic Disease in the United States, n.d.). Perhaps instead

of debating on whether or not we should go to a single payer system, we should be working on reducing

the risk factors involved in creating those diseases and rising costs.
 While we could pour more funding into research and campaigns to eliminate the risk factors

that cause many diseases, it would be difficult to sway the minds of everyone in the country. Many

people are happy with their unhealthy diets, and do not wish to change them. To massively reduce the

consumption and cost of healthcare this way, we would need massive cooperation. That is difficult to

achieve. Also, focusing on research to providing cures rather than making patients lifetime consumers of

medications is costly.

Education programs could help to change the lifestyles of individuals to help prevent disease. It

is vital to reach our younger generations before they form habits of poor health choices. Also, incentive

based programs could help get more people on board with changing over to a healthier lifestyle. If they

wont change for the sake of their health, perhaps they will change if they get discounts on certain care

or premiums for losing weight or quitting smoking.

Another way to drive down costs in the U.S. is to lower the cost of our medications.

Pharmaceutical companies make a lot of money off of ill patients. Caps could be placed on how much

profit these companies can make selling their treatments. The cost of manufacturing certain

medications verses what the patient is charged is at times astounding. Deangelis, 2016, states, In 2013

the profit margin for pharmaceutical companies ranged from 10% to 42%, with an average of 18%.

Deangelis also notes, The United States, unlike other developed countries, allows pharmaceutical

companies to charge whatever they want as long as they do not collude with one another in setting the

prices. In other words, these companies can charge whatever the market will bear. Making matters

worse, the US Congress, influenced by pharmaceutical lobbyists, has not allowed Medicare to negotiate

drug prices, as do most health care systems, HMOs, and some insurance companies. In those countries

that negotiate the prices of their national insurance plans with Big Pharma, most drugs sell for much

less.
 Again, while addressing the costs put in place by pharmaceutical companies would help lower

healthcare costs, it would be a difficult process. Many of our politicians are influenced by lobbyists to big

pharmaceutical companies.

Fortunately, many states are already taking a look at legislation to help change the ways

pharmaceutical companies conduct business in order to drive down costs (Big Pharma Profits and the

Public Loses, 2016).

In terms of efficiency, I think that we are on the right track in focusing on the continuum of care

of patients and their records. Increasing communication efforts among doctors could also be a great

asset in reducing waste. Not only would this increase efficiency, but it would also help to reduce costs.

The increased use of Integrated Healthcare Delivery systems can enhance this effort (Sales and Gordon,

2016). While many providers have been slow to adopt electronic health records and move over to

integrated systems, many initiatives have been put into place to help providers with the costs.

As our country works together to reduce costs and increase efficiency, it is my hope that we can

look at the bigger picture of how to reduce the occurrence of preventable chronic disease, focus on

curative rather than palatable treatments, regulate the cost of medications, and increase efficiency

through integrating providers.

Works Cited:

Deangelis, C. D. (2016). Big Pharma Profits and the Public Loses. The Milbank Quarterly, 94(1), 30-33.

Retrieved September 3, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4941970/.

Litchenstein, R. (1993, Nov. & dec.). The United States' Health Care System: Problems and Solutions.
 Survey of Ophthalmology. Retrieved September 3, 2017, from

https://www.ncbi.nlm.nih.gov/pubmed/8310399

Partnership to Fight Disease. (n.d.). The Growing Crisis of Chronic Disease in the United States. Retrieved

September 3, 2017, from

http://www.fightchronicdisease.org/sites/default/files/docs/GrowingCrisisofChronicDiseaseinth

eUSfactsheet_81009.pdf

Sayles, N. B., & Gordon, L. L. (2016). Health Information Management Technology. Chicago, IL: American

Health Information Management Association.