Health Team

Fixing the U.S. Health-Care System?

Posted September 21, 2007

Signs of problems in the United States health-care system abound, but some doctors fear attempts to improve the system might ruin what's right with it.

Around 47 million people in the U.S. don't have health insurance, and medical bills are related in some way to half of all bankruptcies. Affordable health care is a prominent part in presidential campaigns from both parties.

The number of people leaving the U.S. for medical tourism is growing, Dr. Kevin Schulman, a health economist at Duke University, said. For example, in India, a new heart hospital charges $2,000 for heart bypass surgery, he said.

"The cost in Medicare here in the United States would be 20 times that," he said.

Besides lower costs, foreign hospitals can also offer excellent care, Schulman said. "We think the quality of surgery, actually, in France or in western Europe is very high," he said.

In health systems, like those in Canada, France and the U.K., care is treated as a right, instead of commodity, but long waits for some tests and treatments can be a problem.

Cathy Wright said she was aware of the pros and cons of U.S. and foreign health-care systems when she needed a second hip surgery. For both her surgeries, she shopped around the world for the best place, in terms of cost and quality.

A French surgeon had replaced her other hip in an earlier surgery, but Wright said, "I didn't have a good recuperation, so I wouldn't recommend it there."

Wright said she chose to not buy insurance, so the costs of surgery in the U.S. might be prohibitive. "The prices in America are just excessive compared to anywhere else in the world," she said.

Wright ultimately turned to orthopedic surgeon Dr. Scott Kelly at the North Carolina Orthopedic Clinic.

"I still think the top methods are probably here," she said.

For Wright, Kelly used a muscle-sparing hip replacement, a technique perfected in the U.S. "I stopped walking with the cane after about a week," she said.

Wright's gamble that th higher price in the U.S. would buy her better results and quicker results paid off, but millions face declining health or death because modern medical advances are simply not available to them.

Kelly said access to affordable care needs fixing.

"The danger, though, is throwing the baby out with the bathwater and revamping the system, and damaging what we do well - which is the higher-end, more technical surgical aspects of medicine in America," he said.


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  • DowntownStreets Sep 23, 2007

    I read somewhere that a high percentage of health care costs involve treating self-inflicted maladies---from smoking, over-eating, under exercising, poor choice of foods, substance or alcohol abuse, etc...

    If you are being treated for self-inflicted damage, why does society and or govt need to pay for it?

  • Six String Sep 23, 2007

    Some good ideas, Steve, though I think it might take more than that. But you have to start somewhere with this mess we've made for ourselves.

  • Steve Crisp Sep 23, 2007

    Two, and I go back to my scanners here, we need several all night clinics. If you listen to the scanners, the majority of ambulance calls are not for emergencies. They are for colds, flu, nosebleeds, rather minor cuts that need stitches, earaches, normal fevers, and other completely inocuous medical problems. And that doesn't even include all the people who drive to the ER for the same things. Nor does it include things that are potentially emergencies, but can be safely handled in a clinic like many asthma attacks, simple fractures, and many diabetic imbalances. Simply by opening a couple of clinics, the hospitals can pull an enormous number of patients away from their ER facilities.

    People who are sick feel worse at night, so why aren't more hospitals and private clinics recognizing that fact?

  • Steve Crisp Sep 23, 2007

    I think we can make two changes to our health care system that will make a dramatic effect on its quality and cost.

    One. institute a system of self-triage in concert with pharmacies. For instance...right now I have an earache. So what do I do? I take an antihistamine and a decongestant. If it does not clear up in two days, I go to the doctor for antibiotics. If that doesn't work in five days or so, I go back to the doctor for more testing. The whole cost there is perhaps $200 unless I can self-prescribe antibiotics in which case the cost drops to zero for the medical car part. Or I could just go to the emergency room now and in two days and they will do the exact same thing at a cost of $2,500.

    By allowing a pharmasist to use any number of different flow charts -- a process that doctors use in diagnosis without the actual chart -- we could save a ton of money and free up a lot of doctors for real emergencies and cases that are not everyday occurances.


  • Six String Sep 23, 2007

    QT3.14 --

    If you state that healthcare is not a "right", then you should also agree that access to food and shelter is also not a right. You have to pay for those too. I assume you would complain if you were denied access to grocery stores and the housing market. You might then consider it your "right", correct? No one is saying that healthcare should be given away for free, only that access for everyone and reasonable cost be available. We are the ONLY industrialized nation on the face of the earth that does not provide universal access for everyone. Further, there are effective and efficient ways to render care with a combination of private and public resources, so it doesn't have to be all government programs.

  • alwayslovingu30 Sep 23, 2007

    Test 1-2Test 1-2 our whole medical system is screwed thanks to ur good ol USA sorry overhaul they are screwing us disabled people an elderly.for all it's worth.over haul is over screwed for us they usa cant help all they can do is screw it up.anymore overhaul means surgeuns operating in the street

  • Six String Sep 22, 2007

    Pardon, but one clarification in my last post: the 3% refers to the cost, not number of suits filed. The multi-million suits represent 3% of the total dollars, according to whatever source I was reading -- I don't remember, but probably US News & World Report or Newsweek or the Noise and Disturber.

  • Six String Sep 22, 2007

    oops, let's try that again.

    There are other things to be done, like dealing with all the legal issues in the US. It cost nearly one million dollars for medical malpractice insurance. This cost is the result of damaging lawsuits. Not all lawsuits are bad, but it has become funny the direction recently - coffee is HOT!! We have lost common sense."

    I agree about some of the lawsuits being ok, some not. But I remember about a year ago reading on the subject that the average multi-million dollar cases (the ones in the news) are only about 3% of the total suits filed. The rest are relatively minor. If that is true, then I think the problem may lie more with the insurance companies crying "wolf" than with the lawyers who represent those harmed. If anyone has more on this, sound off, I'd kind of like to know for sure.

  • Six String Sep 22, 2007

    Sonet-transport "

  • hi_i_am_wade Sep 22, 2007

    Here is the easy fix to our healthcare system:

    (1) Ban all prescription drug advertisements, promotions, etc. There should be a government regulated list of drugs which describe, in detail, the pros and cons of each and it should highlight new drugs on the market. Commercials aren't cheap, removing them will lower drug costs and people thinking they need a drug when they really don't.

    (2) Cap malpractice suits.

    These two simple things will lower healthcare costs significantly. However, drug companies and lawyers will keep bribing Congress to prevent these measures from ever seeing the light of day.