My posting is going to decrease as the time gets further and further into the semester.. pharmacy school is becoming pretty demanding and quickly, but I will do what I can.
So earlier this evening, I was on the campus trying to print out some lecture notes to try and get a head start on a few things when I bumped into two of my fraternity brothers on campus in the computer lab, sitting and chatting over some fast food. After getting my notes, I went to talk to them and catch up, since both of them are on their fourth-year rotations and are gone about 99% of the time, and I only get to say hello on rare occasions.
As we small talked, they were telling me about how their rotation was, and how they were trying to figure out a way to help the hospital they were at save $1.6 million dollars in terms of their expenditures for care of their patients. In immense frustration, they threw it down and basically said ‘this country sucks, and there really isn’t any hope. There is no possible way we can solve this problem.’
I write about this because making a change in healthcare is why I got into pharmacy in the first place. I wanted to serve as a catalyst for change and this profession is where I felt I was destined for, and every day it shows that I was guided and listened correctly. But what does my desire to change the system have to do with these two friends of mine?
Let’s face it, America’s healthcare is in a bit of a rut and it’s an extremely difficult one to solve. Some people are still unaware that the United States spends almost 20% of its Gross Domestic Product (GDP) on healthcare, ranking it #1 in the entire world for spending per household. However, the return on this is absolutely horrible.. when compared against other developed countries, we rank towards the bottom in terms of the prevention of men, women, and infant’s moralities, and even rank in the 30-40’s overall for life expectancy. To put this in real simple terms, imagine the healthcare system of this country as a car.. for the amount that the US is spending per person, we should be driving a Lamborghini Veneno (which costs about $4.5 million dollars new). Well, say we’re spending $4.5 million dollars for that particular Lambo, but all we’re getting is a 1995 Dodge Caravan with 150,000 miles… and you spent $4.5 million dollars… that’s a pretty lousy investment, right? Well.. this concept is EXACTLY what is happening to us right now, and the worst part is.. everyone (for the most part) is just letting it happen!
The healthcare system is a very difficult beast to tackle, there is no denying that. We do have a great system, but the problem is we’ve let costs and other measures get out of control, and now things are getting too outrageous. For example, the other day at work, I came in and sat down to eat my lunch before going on the clock, and overheard a conversation with one of my pharmacists and a technician about heart problems he was having. He brought up a very interesting piece of information, and this is the main take home point of the conversation:
“The last time they gave me a catheter, they found that the blockage in my artery was only at 55%, and the insurance wouldn’t pay for it till the blockage was at 75%.” (Please note these numbers are approximate of what I remember).
So yeah.. when I heard that, I could not believe my ears. You don’t have an alarm or sensor on you that says: “HEY! 75% blockage is achieved, go to the ER and let’s get that taken care of!” It would be awesome if we could, but that does not exist. How are you honestly supposed to know you’re that far gone? Sadly, most people will realize it when they’re close to 95% and have that heart attack or something worse of that nature, which will involve a lot more damage and thus extensive (and expensive) repairs.
Hopefully this illustrates the problem… now what about the solution?
There’s a lot of different routes that we can take, some more practical than others. One idea has been a topic called pay-for-performance, which started with the MMA (Medicare/Medicaid Modernization Act) around 2005, which basically told physicians that if they misdiagnose, or a patient returns to a hospital within 30 days of discharge, they’re not getting paid for their services. It gives them an incentive to make sure they’re going the correct route with all the therapy and getting things right, but there are also drawbacks. Once thing I noticed is that physicians will start to “cherry pick,” and only want to practice in an area where people are more wealthier and adherent to their policies. Under-served areas and populations that have a known trend of failing to adhere to their medications, their therapies, etc., are going to be ignored and refused to be served because the government will refuse to reimburse them for failing to serve them, which will put them out of a job. This is simply just one example of a way that has been tried, and there are many more that can be given. Ultimately, there is still a lot of work that needs to be done and roads and paths to be examined.
One thing I have always believed in is the idea of preventative care, the cheapest and most effective method. What I have seen from other countries is that they work hard to focus their attention on keeping the problems from starting, whereas the United States seems to be more focused on treating the problem once it has progressed into a full-blown disease state rather than keeping it at bay. All these heart problems, obesity, diabetes, cholesterol, etc. all interconnect and have one thing in common.. a lot of it can be prevented. Now granted, there are certain people who have these disease states while living healthy lives, due to genetics, age, or other factors; and some of these things can be avoided. But I think that you can agree with me when I say that the person who has three heart attacks and needs a triple bypass surgery because he spent his whole life sitting on the couch, smoking a cigarette, and eating McDonald’s every single day could have probably avoided it a lot easier if he had just focused on the preventative care instead of this whole “I’m young and I can handle it or stop at anytime,” or “I’ll worry about it later,” mentality. This is the kind of attitude that many people have, and it’s become a epidemic.
I know there is no easy way to fix this, otherwise it would have been done already. But whatever you do, do not sit there on the sidelines and say ‘it’s impossible,’ or ‘someone else can do it.’ Be part of the solution. You may only play a small role, but being the one to talk to your friends about doing healthier things, or just being a role model, is a simple dropping of a small stone into the pond that is our society, sending its ripple effects outward to all corners of society. If enough stones drop, it could be the start to a wave of change that our society needs.
We have to stand together as one and fight for each other, not for ourselves. That is how we win. It will be a long road, but if everyone sits down with that mentality, that is the wave we will send with our stone drop, and before long, everyone will be looking around and saying, ‘someone else can do it,’ but there will be no one left standing.