Five Failures of the American Healthcare System

First part in a series.

We started practicing direct care because we knew there were major problems with American Healthcare. So what’s wrong with our profit-maximizing system. For starters, here’s five startling realities of our healthcare model:

1. We Spend the Most Money on Healthcare, But Get the Least in Return
The US spends more on healthcare than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain, and Australia. But the problem is that the US ranks last in health and mortality when compared with 17 other developed nations.

And then there’s the red tape: 30 cents of every dollar spent on medical care in America is wasted, which amounts to $750 billion annually. That’s the amount the Department of Defense estimates we spent on the ENTIRE Iraq War! This $750 billion of waste is made up of inefficient delivery of care and excessive administrative costs, unnecessary services, inflated prices, prevention failures, and outright fraud.

Thirty-five percent of Americans have difficulty paying their medical bills, and nearly two-thirds of all bankruptcies are linked to inability to pay medical bills due to being uninsured or underinsured. Medical impoverishment is nearly unheard of in wealthy nations, other than the US, because all have some form of national health insurance.

In comparison, there’s direct care — where patients and doctors know what they’re paying for and what they’re offering. It’s billed and charged the same way you would a cable or phone bill. There’s the transparency that’s taken for granted with almost everything else that we buy and sell.

2. Our Chronic Disease Rates Are Extraordinarily High
Americans have the second highest rate of chronic disease of the seven countries examined, with Australia being number one. With all of the money we’re spending, what are we missing? This statistic reflects poor preventative care and lack of attention to lifestyle habits, such as diet, exercise, stress, and sleep.

Once again, more direct care would be in opposition to these negative factors. Instead of what we have, we’d have more access to doctors, more care given by these doctors, and all of it at a more affordable price. Doctors and patients could find time to build a relationship, so docs can make better prognoses, and patients can make better lifestyle choices.

3. Poor Coordination of Care
This issue is tied to the problem of waste. Our  fee-for-service medical system drops the ball when it comes to managing patient care, especially if patients have a complicated illness requiring multiple providers. We have poor access to medical records, duplicate testing, gaps in communication, confidentiality violations, and rushed and fragmented health care. According to data from multiple sources:

  • 3 out of 10 lab tests are reordered because the results can’t be found.
  • 68 percent of specialists receive no information from the primary care provider prior to the referral visit.
  • 60 to 70 percent of referrals go unscheduled.
  • 25 percent of appointments are missed.
  • 7,000 people die every year from sloppy physician handwriting.

We’re glad to know we’ve successfully opened a practice where we don’t have to see 40 patients a day just to keep our doors open. We can take the time to properly document our interactions, using the technology of today, and correctly prescribe and fill prescriptions for our patients.

4. Most Americans Do Not Have a Primary Care Provider
One of the reasons Americans’ healthcare is so poorly managed is that they are least likely to have primary care providers. There are 0.5 general physicians per 1,000 people in the US, but the average among OECD nations is 1.23. Americans are also the most likely to say that their physician doesn’t know important information about their medical history, which has dire implications for quality of care and increases the likelihood of medical errors.

But with direct care, where quality of care is rewarded, we can motivate doctors to join our ranks, and increase the patient to doctor ratio. We can also make healthcare more affordable meaning that as a business owner, these doctors can find more customers. It’s about creating a place where instead of paying mostly for insurance and fear, we can pay for a doctor and care — and trust that we as patients aren’t being rushed through the system, at the risk of mistakes, for the sake of profits.

Oh, and, speaking of errors…

5. Americans Are the Most Frequent Victims of Medical Errors
It can be argued that medical errors are leading cause of death in the US—higher than heart disease, higher than cancer. The latest review shows that about 1,000 people die EVERY DAY from hospital mistakes alone. This equates to four jumbo jets’ worth of passengers every week, but the death toll is largely ignored.

Types of errors include inappropriate medical treatments, hospital-acquired infections, unnecessary surgeries, adverse drug reactions, operating on the wrong body part—or even on the wrong patient! One in four hospital patients are harmed by preventable medical mistakes in this country, and 800,000 people die every year as a result. Of those 800,000, 250,000 die as a result of medication errors.

Affordable Health Care Act: Getting MORE of What Isn’t Working
The U.S. does not have a healthcare system; we have a disease-management system dependent on expensive drugs and invasive surgeries. Our system is on a mission to maximize profits, not to help people maintain or regain their health. The Affordable Care Act is likely to make matters worse rather than better, as the Act does not include any illness prevention strategies. Nor does it contain any measures to rein in out-of-control health care costs related to overcharges. Instead it expands an already flawed model of “care” that is one of the leading causes of both death and bankruptcy for Americans.