Does American Health Care Need Reform?

There is extraordinary medical care being practiced in the United States.  While medical breakthroughs do not occur linearly, there is a clear forward trend of progress.  Naturally, there are setbacks and failures which are learning opportunities in medicine as they are in life.  My own medical journals are increasingly populated with studies examining the use of artificial intelligence.  Endoscopic scope journals present examples of technical wizardry which only years ago would have been thought to be science fiction.   Sooner than we imagine, medicine will be offering widespread personalized or precision medicine when treatments will be customized according to a patient’s genetic profile.   Up to now, most of our treatments follow a one-size-fits-all model which is already recognized as a clumsy tool.  Ten patients might both have rheumatoid arthritis, for example, but these genetically unique individuals would likely benefit from tailored therapies.

But despite the monumental progress, there remain flaws and failures in our health care system that have yet to be solved. Here are a few challenges to consider.

Medical Care in America

Is the Glass Half Full or Half Empty?

• Health care is a right.  Why are there still folks without medical insurance or adequate insurance?
• Why should a medicine prescribed by a medical professional for a sick patient not be covered?
• Why does access for patients to medical professionals remain so limited?  I personally know many physicians who are booked out for months.  Sick patients seeking appointments will be advised to seek care in an urgent care or an emergency room, both of which are inferior to a visit with one’s primary care physician.
• Physician burnout has become an epidemic within the profession which demoralizes practitioners, strains doctor-patient relationships and results in doctors retiring prematurely.  We are not doing enough to deliver relief to caregivers.
• There is a national nursing shortage.  This is a direct attack on patient care. The solution?  How about improving their working conditions and compensation?
• Why can’t there be a universal electronic medical record (EMR)?  Does it make sense that one EMR cannot communicate with another?
• The inequities in medical care fall disproportionately on underserved and minority communities.
• Overdiagnosis and overtreatment, a frequent target of this blog, is rampant.  This burns up resources and harms patients.

The great challenge is to continue to forge ahead on the wings of science and innovation while also committing to correct the persistent flaws and failures in the system, which should be solvable.  For this to happen requires that all of us including the public be willing to give up something in order to serve the greater good.  Can I count on you?