A 2015 Commonwealth Fund brief showed that — before the major provisions of the Affordable Care Act were introduced — the United States had worse outcomes and spent more on health care, primarily because of greater use of medical technology and higher prices, compared to other high-income countries. The United States ranks last overall, despite spending far more of its gross domestic product on health care. The U.S. ranks last on access to care, administrative efficiency, equity, and health care outcomes but second on care process measures.
American healthcare is screwed up and meant to enrich the providers. Four features distinguish top-performing countries from the United States:
1) they provide for universal coverage and remove cost barriers;
2) they invest in primary care systems to ensure that high-value services are equitably available in all communities to all people;
3) they reduce administrative burdens that divert time, efforts, and spending from health improvement efforts; and
4) they invest in social services, especially for children and working-age adults.
The United States trails far behind other high-income countries on measures of health care affordability, administrative efficiency, equity, and outcomes.Commonwealth Fund
I experienced the inadequacy of our healthcare system firsthand. Two weeks I crashed while cycling after trying to avoid some roadkill in the bike lane. I hit the curb and fell over onto the sidewalk. After a few days of pain and discomfort in my shoulder, I emailed my doctor to get an MRI. Before I could get an MRI, however, I needed an x-ray. That appointment took a week. After the x-ray was negative, I could go for an MRI, which took another week to schedule.
At present, I can’t make an appointment with an orthopedist until I get the MRI results, and by the way, the ortho has a waitlist of at least three weeks. So I continue to live on ibuprofen and heat packs. This is today’s American healthcare.
I understand that the changes needed for our healthcare are not easy, but money prevents change. Lobbying and profits take a front seat to patients’ needs. Better to have a patient go through 3-5 weeks of pain and follow a process than to address the problem as soon as possible.
When I lived in California, there was an Immediate Care facility that I often used when I had health problems. They had onsite x-rays, cat scans, and MRIs which could be used immediately if necessary. They even had cardiologists on staff with diagnostic equipment. This IS the future of healthcare.
CVS knows where the future of healthcare is going, but setting up stores with doctors, and diagnostic equipment is a heavy expense. In the meantime, PBMs, pharma, and insurers will continue to make money at patients’ costs.
Welcome to American healthcare, the most inefficient in the world.