The General Chronic Health Problems of the American Health system and the hidden danger awaiting it.
When he saw the crowds, he had compassion on them, because they were harassed and helpless, like sheep without a shepherd
Matthew 9:36-38
On the surface, America’s Health System appears to be a formidable, well polished multi-billion dollar enterprise headed by well dressed, highly paid CEOs whose main mission is society’s well being. A powerful system that’s forcefully marching forward even as slowing down is the prudent path many of society’s wise are calling for.
It runs tall state of the art hospital buildings that look like fancy hotels, and utilizes multi million dollar electronic medical records (EMR) system that helped transform doctors to data gatherers, clerks and technicians as many doctors complain. Physicians and medical providers lament how the EMR, that has not shown clear patient care benefits to justify its cost, has forever altered the close relationships with their patients.
It commands expensive top of the line advanced diagnostic and surgical equipment, an array of highly priced medications, treatments, and health care premiums that most people can’t afford.
It’s a competitive industry where nonprofit hospitals’ CEOs map their cities’ demographics, and compete fiercely with each other for insured patients in continuous multi million dollar advertising campaigns that promise better technology, better services and better care.
And so this is what you and I hear and see:
Great architectural hospital buildings, sophisticated, well dressed and highly paid CEOs who remind us how vital to society their medical enterprises are.
Unmatched technological advances, and expensive medications that work.
Slick advertisements that show excellent, caring, and compassionate hospital systems.
And that’s what we begin to believe based on what’s seen and heard: America’s health system is kind, healthy and well. A perfect model for other nations to follow.
But then we run into facts, figures and numbers about America’s health System that begin to question what we hear and see on the surface.
What appears to be is different than what the facts are as the following words show.
“Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. A growing body of research is calling attention to this problem, with a 2011 report by the National Research Council confirming a large and rising international “mortality gap” among adults age 50 and older. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people, because recent studies suggest that even highly advantaged Americans may be in worse health than their counterparts in other countries.”
Excerpts from: U.S. Health in International Perspective
Shorter Lives, Poorer Health
National Research Council (US); Institute of Medicine (US). Edited by Steven H Woolf and Laudan Aron.
Other highlights of the above report according to Richard Know in an online article titled “U.S Ranks Below 16 Other Rich Countries In Health Report,” the following are other important highlights of this nearly 378 pages report:
“Strikingly, even Americans who are white, insured, college-educated and upper-income are worse off than their counterparts around the world — a finding that no one quite understands.
“The report also finds that the U.S. fares worse in nine health domains: birth outcomes, injuries and homicides, teen pregnancies and sexually transmitted infections, HIV/AIDS, drug-related mortality, obesity and diabetes, heart disease, chronic lung disease, and disability.”
The above report provides clear data that despite the astronomical expense 
and the great advances of medicine in America specifically in areas such as “cancer screening and mortality, control of high blood pressure and cholesterol, smoking rates, and suicides”, society’s physical and emotional health is worsening instead of improving.
But why?
On the surface everything looks and sounds good: Magnificent buildings, billions of dollars in profits, and media ads depicting peaceful, happy and healthy people feeling and getting better.
But as I read the report, I begin to reflect.
All looks so well, so calm. But much like the Titanic sailing amidst a star laden skies in its seemingly peaceful transatlantic voyage, our American Health System might very well be heading towards a giant, unseen iceberg. America is losing its primary care physicians at alarming speeds due to burnout, stress, and frustration with rushed, and the increasingly shorter, one-on-one patients’ visits. This rising tide of discontent can be seen with physicians curtailing their practice, quitting the practice of medicine, and early retirements
Our health system is bound to collide sooner or later with this massive iceberg of: Burnt out primary care physicians leaving patient care by the droves and not having enough experienced providers to replace them fast enough. Fewer medical students choosing primary care, and many of the newly hired primary care physicians eventually following the same predictable path of burning out and leaving.
And a deteriorating quality of medical care which is the expected outcome of rushed visits that lead to unsatisfied patients, unaddressed physical and emotional issues, and a rise in medical errors.
According to an article by the Washington Post: Health & Sciences (washingtonpost.com/Kaiser Health News)
” Patients of satisfied doctors are more likely to show up for their appointments and adhere to treatment for diabetes and high blood pressure, studies show. Another survey found dissatisfied physicians reporting more difficulty than other doctors in caring for patients.”
“The lack of an adequate primary-care infrastructure in the U.S. is a huge obstacle to creating a high-performing health-care system,” said David Blumenthal, president of the Commonwealth Fund, a health-care research foundation.”
Is the VA system facing similar challenges and is the same iceberg awaiting in its course?
Advice and recommendations offered here are not meant to replace your medical provider’s individual evaluation, diagnosis and treatment. Please see your medical provider for any physical or emotional concerns.
Views expressed here are only of the author, and do not represent the views of any other organization or entity.
Adel G Hanna, M.D.
Author: Soldier To Soldier, A Doctor’s stories from a Military Camp
www.adelhanna.com
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