US healthcare. Insufficient reform

I went to the United States of America a little more than 10 years ago, shortly after I graduated from the Catholic University of Louvain with a degree in medicine after completing my studies there.

Because my wife is an American citizen, we came to the conclusion that it was time for me to take on the role of the expatriate after we had been living together in Belgium for four years. I will also admit that during that time period, there was a lot of talk about a surplus of doctors in Belgium, and I told myself that it would be wiser to try my luck there. In addition, the practice of general medicine in the United States is more fascinating than medical practice in other countries since it encompasses both office and hospital work.

The decision I made ten years ago is one that I do not regret. Being able to practice medicine in a tiny hospital in the upstate region of New York provides me with a great deal of happiness. It is impossible to deny the fact that the healthcare system in the United States is currently experiencing a crisis.

United States of America, as always, is capable of both the finest and the worst. Compared to the hospitals of all other OECD countries combined, the top five hospitals in the United States are responsible for more high-level medical research activities. However, according to the statistics provided by the World Health Organization, the United States of America is ranked thirty-seventh in terms of the overall quality of care, which places it between Slovenia and Costa Rica. First place goes to France. The World Health Organization (WHO) conducted a research that revealed, for instance, that the United States ranks last among the nineteen most industrialized countries in terms of the number of “avoidable deaths” (which refers to deaths that can be prevented by health care). The United States’ rate is 110 deaths per 100,000 people. It has been demonstrated by researchers that the decline in the United States’ position over the course of the past ten years coincides with the rise in the number of individuals who do not have health insurance.

According to the average lifetime, the United States of America is ranked twenty-fourth, with men living an average of 67.5 years and women living an average of 72.6 years. As of right now, Japan holds the title of champion with 71.9 and 77.2 years alike. Additional instances include: In comparison to children in Portugal or Spain, children in the United States have a mortality rate that is twice as high before the age of five. Women in the United States have a mortality rate during childbirth that is three times higher than that of women in Greece and Spain.

But what about the costs of medical care? Over there, there is no question that the United States of America are the undisputed champions. The United States of America allocates a far higher portion of its economy to the provision of medical care than any other modern nation. In 2006, the percentage of gross national product that was represented by health spending was 15.3 percent in the United States, 10 percent in Canada, 11 percent in France, 10.6 percent in Germany, 8.1 percent in Japan, 8.4 percent in Great Britain, and 9.6 percent in Belgium.

When we take into consideration the fact that the gross national product (GNP) per capita in the United States is higher than the average of the nations in Europe, the consequence is that the amount of money spent by Americans is nearly twice as much (in terms of dollars per capita) as the amount spent by Europeans.

In 2009, it is anticipated that the proportion of gross national product (GNP) allocated to health care will reach 17.6%, which is equivalent to 2.4 trillion dollars ($2,400,000,000,000).

Is it even possible to do so? How is it that the United States, while spending twice as much on health care as other wealthy countries, rates barely better than third world countries in terms of the quality of care that they provide? The response is straightforward: “50 million people who do not have health insurance.”

In comparison to other nations throughout the globe, the United States of America has adopted a capitalist system of health care delivery more than any other country. When it comes to the production of consumer products and services, capitalism has unequivocally proved that it is superior to every other economic system. The question that needs to be answered is whether or not it is also the best system.

According to the words of one American observer, it is comparable to citizens paying a monthly fee of thirty dollars to private insurance in order to cover the possibility of needing to visit the hairdresser due to an emergency. When compared to going to the hairdresser directly and paying fifteen dollars, wouldn’t it be more efficient to do so? It is extremely likely that a person will require medical attention at some point in their lifetime. The probability lies close to one hundred percent. According to my point of view, the only mediator that makes sense between the patient and his doctor is insurance that does not strive to make a profit.

In the United States, the cost of health care for each individual has nearly doubled since 2006, when it was $4,271 per person, and is anticipated to reach nearly $8,000 per person in 2009. A portion of this boom can be attributed to the deregulation of the health care business that occurred during the Bush administration. The profits of private health insurance companies have soared by 600% over the course of almost the same time period (the past five years). In my opinion, this is where the problem lies: a healthcare system that is based on capitalism is, practically by definition, monstrously inefficient and a massive waste of resources!

Following the completion of my three-year fellowship in family medicine in the vicinity of New York in 2002, I began my search for employment and had the opportunity to meet a family physician in a tiny hamlet in Vermont. As a result of the expansion of his practice, he was looking to recruit a colleague in order to better satisfy the requirements of the regional community.

Upon discovering his medical practice, the first thing that struck me was the fact that he had five employees working for him. These employees included a nurse, a telephone operator, a billing employee, another individual who specialized in the task of asking insurance companies for permission to send a patient to a specialist, and a fifth individual who specialized in other problems related to the complex relationships that a medical practice has every day with the twenty or twenty-five insurance companies with which it must work.

As a consequence of the fact that this medical business paid the salaries of six individuals, the physician had never taken more than a few days of vacation at a time all throughout his ten years of professional experience.

One of the most significant challenges that medical practitioners face is that different insurance companies have varied policies on the payment of visits, different barriers to overcome in order to be sent to specialists, and different lists of medications that they are willing to pay for.

As a result, this results in a large amount of paperwork, and in order to make this system function properly, medical appointments in the United States are compensated significantly more than they are in Belgium (from the perspective of the physician). A well-managed medical practice doesn’t just bring in a lot of money; it also brings in a lot of individuals to work for it.

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