Cynicism or a Healthcare System That Needs Help

This story is about a patient with no real experience in the healthcare system.

A patient was having some sinus issues in December of 2012. Basically, mucus had settled into his sinus cavities. It was like talking in a tunnel and difficult for him to hear.

To get relief, he started with his family doctor in December. The family doctor prescribed some antibiotics-a fast, powerful dose. After a month, experiencing no relief, he went back. The doctor prescribed more medication. No relief. He sent the patient to an Ear, Nose and Throat (ENT) specialist.

The ENT prescribed steroids. He claimed that cured 80% of the individuals with this problem. The patient had high hopes but the steroids did not work, either.

The ENT recommended a CT scan at the hospital. After much searching and aggravation, the patient found out it would be about $2,500 (Note: the patient did have insurance but had a $2,500 deductible and 20% co-insurance). He shopped around (an arduous process) for a clinic to get a price. He found one that would do the sinus CT scan for $400.

The CT scan confirmed everything. The sinuses should have been black (denoting air) but they were gray (denoting mucus).

The doctor recommended a sinusplasty. This is a procedure where the sinus passageways are stretched to allow for draining. A balloon is inflated to allow this to happen. The mucus present would be sucked out through a kind of straw. It was an outpatient surgery, taking about 1.5 hours. It was scheduled for May 31st. The patient said ok.

Of course, prior to the surgery tests had to be done (really?). A blood test, chest x-ray and an EKG. The EKG was because the procedure included a general anesthetic.

The nurse called him two days prior to surgery. The tests were fine. But the EKG indicated a Myocardial infarction (MI)-age undetermined. That meant the patient had experienced a heart attack sometime in his past.

What???

The patient was stunned. Other than being overweight, he had no health issues. If he had a heart attack, he was not aware of it. It didn’t matter. The surgery was cancelled until the patient could obtain cardiac clearance. He had to see a cardiologist to get that.

After an exam, the doctor told the patient, he probably didn’t have a heart attack. The EKG was faulty. The machines were sensitive and could give a false reading pretty easily (the patient was of course, still charged for it).

After another EKG and a heart echo sound, the doctor confirmed there was no attack and that, in fact, the patient’s heart was hale and hearty.

Cardiac clearance was received and the surgery rescheduled for July.

While everyone seemed to mean well, was all of this really necessary? Are all of these doctor’s visits, tests and medications normal? The patient is not cynical by nature but…

Sue (Sunni) Patterson, CMBA, Co-Founder
As an accomplished marketing professional, entrepreneur and lifelong learner, Sunni constantly seeks out dynamic business opportunities. Sunni started in the healthcare industry as a senior medical claims processor with a major insurance payer and since then has partnered with RMK123.com, a top medical billing and revenue management firm. Sunni leveraged this to create Medical Bill & Claim Resolution (MBCR), a medical bill patient advocate firm assisting individuals with interpreting their medical and hospital bills, disputing erroneous charges and resolving/understanding insurance claim decisions. Sunni holds the specialist Certified Medical Billing Advocate (CMBA) designation, which is issued through the Medical Billing Advocates of America upon successful completion of their exam.

Shortcoming In The Healthcare System In Thailand

As Thailand is becoming a destination for medical tourism, attempts are being made to promote Thai health facilities quite actively. However, the average Thai is not deriving any benefits from the medical tourism as there are certain shortcomings in healthcare and hospital facilities which provide medical treatment to the locals.

Efforts are underway to improve the healthcare system in Thailand but a lot has to be done before we see some concrete results.

The first shortcoming in the healthcare system in Thailand is that there is no primary healthcare system. Most doctors in Thailand are generally specialists. So, it usually becomes difficult to find good general practitioner for minor ailments. If a person is suffering from common cold and cough, a visit to the general hospital means being examined by a doctor who is specialized in one of the medical fields and the doctor may not be able to handle such a small ailment.

However, critics beg to differ. They say they most private and university hospitals have general practitioners and one only needs to ask for them.

The other problem is that most doctors working in hospitals in Thailand do not do so full time. Most physicians and surgeons end up working in several hospitals across Bangkok. Besides this, these doctors also have their own private clinics. Therefore, post-operative care can be a nightmare if you doctor is communicating with the nursing staff on a mobile phone. Another grievance that a Thai patient might have is that he does not see his doctor as often as he would like during his stay in the hospital. And if he does, it is at unusual hours after the doctor finishes his clinics in various other places.

Why Our Healthcare System Isn’t Healthy

Most people are well aware that an estimated 45 million Americans currently do not have healthcare, but is the crisis simply the lack of health insurance or even the cost of health insurance? Is there a bigger underlying problem at the root of our healthcare system? Although the U.S. claims to have the most advanced medicine in the world, government health statistics and peer-reviewed journals demonstrate that allopathic medicine often causes more harm than good.

People in general have always felt they could trust doctors and the medical profession, but according to the Journal of the American Medical Association in July 2000, iatrogenic death, also known as death from physician error or death from medical treatment, was the third leading cause of death in America and rising, responsible for at least 250,000 deaths per year. Those statistics are considered conservative by many, as the reported numbers only include in-hospital deaths, not injury or disability, and do not include external iatrogenic deaths such as those resulting from nursing home and other private facility treatments, and adverse effects of prescriptions. One recent study estimated the total unnecessary deaths from iatrogenic causes at approximately 800,000 per year at a cost of $282 billion per year, which would make death from American medicine the leading cause of death in our country.

Currently, at least 2 out of 3 Americans use medications, 32 million Americans are taking three or more medications daily, and commercials and advertisements for pharmaceutical drugs have saturated the marketplace. Although our population is aging, exorbitantly expensive drugs are being marketed and dispensed to younger and younger patients, including many children who years ago would never have been given or needed medication, for everything from ADHD to asthma to bipolar disease and diabetes. Clearly, the state of health in this country is not improving even though there are an increasing number of medications and treatments. Between 2003 and 2010, the number of prescriptions are expected to increase substantially by 47%. In recent years, numerous drugs previously deemed safe by the FDA have been recalled because of their toxicity, after the original drug approvals were actually funded by the invested pharmaceutical companies themselves.

According to the media, thanks to advances in U.S. drugs and medical procedures, Americans are living longer statistically, but they are living longer sicker, with a lower quality of life, and often dependent on multiple expensive synthetic medications that do not cure or address the underlying causes, but only suppress symptoms, often with a plethora of dangerous side effects to the tune of billions of dollars for the drug industry. Considering that the U.S. is supposed to have the most advanced technology in the world and the best health care system, it is at odds that we spend the most on healthcare, yet are the most obese and most afflicted with illness outside of the AIDS epidemic in some third world countries.

Unless you have an acute emergency that requires emergency room care, being admitted to a hospital environment may be more dangerous to your health than staying out. In 2003, epidemiologists reported in the New England Journal of Medicine that hospital-acquired infections have risen steadily in recent decades, with blood and tissue infections known as sepsis almost tripling from 1979 to 2000. Nearly two million patients in the U.S. get an infection while in the hospital each year, and of those patients over 90,000 die per year, up dramatically from just 13,300 in 1992. Statistics show that approximately 56% of the population has been unnecessarily treated, or mistreated, by the medical industry.

Additionally, as a result of the overuse of pharmaceutical drugs and antibiotics in our bodies and environment, our immune systems have become significantly weakened, allowing antibiotic-resistant strains of disease-causing bacteria to proliferate, leaving us more susceptible to further disease. Not surprisingly, incidences of diseases have been growing at epidemic levels according to the CDC. Now diseases once thought conquered, such as tuberculosis, gonorrhea, malaria, and childhood ear infections are much harder to successfully treat than they were decades ago. Drugs do not cure. They only suppress the symptoms that your body needs to express, while they ignore the underlying root cause. Side effects of synthetic and chemical drugs, which even if they are partly derived from nature have been perverted to make them patentable and profitable, are not healthy or natural, and usually cause more harm than any perceived benefit of the medication.

Where “physician errors” are concerned, these may not be entirely the fault of the doctors, as they are forced to operate within the constraints of their profession or risk losing their license, but doctors have become pawns and spokesmen for the drug companies, and the best interest of the patient has become secondary. In the name of profit, physicians are also under great pressure from hospitals to service patients as quickly as possible, like an assembly line, increasing the likelihood of error.

In conclusion, increases in healthcare costs are not just the result of frivolous law suits, but are primarily the result of a profit-oriented industry that encourages practices that lead to unnecessary and harmful procedures being performed, lethal adverse drug reactions, infections, expensive legitimate lawsuits, in-hospital and physician errors, antibiotic resistance due to overprescribing of antibiotics and drugs, and the hundreds of thousands of subsequent unnecessary deaths and injuries. Many people do not realize that there are healthier natural options, and anything unnatural or invasive we are exposed to is likely to cause either immediate or cumulative damage over time.

Healthcare Systems and Their Structure

Constantly under review and scrutiny, the issues on healthcare Systems have become international.

Made up mainly of organizations and individuals, these healthcare structural systems are designed to meet a target population’s need for health care. On an international level, there is a diverse variety of health care systems. In some countries the planning of the health care systems are market driven and participated in by the private sector. In other countries the systems are composed of government and non-government entities such as religious groups, trade unions charities and or other coordinative bodies that are centrally run and planned, to enable the delivery of healthcare services to the populations they target. In other words, health care planning has evolved.

According to a World Health Organization report in 2000, the main goals of health systems are the ability to provide a responsive health service alongside considerations of fair financial contributions. In order to appraise overall health care systems, a proposed two-dimensional approach was conceived. The first dimension consists of equity and the second is composed of efficiency, quality and acceptability.

Several proposals have come from the Senate in the United States and the White House. Health care system issues according to President Obama are issues that should be addressed immediately and placed them on a top priority list. A universal health care system does not exist or is practiced in the United States. Some countries subsidize their universal healthcare directly from government coffers. This kind of universal healthcare is called socialized medicine, which is a combination of private and public delivery systems, with most countries spending public funds for this service delivery. Government taxes plays the role of funding this system supplemented and strengthened with private payments.

The World Health Organization (WHO) report of 2000 ranks each member country’s health care system. Discussions on the positive and negative aspects of replacing health care systems with insurance systems use this report’s quotation. However, the WHO has remarked that as ranking healthcare systems is a complex task, these ranking tables will no longer be produced. Infant mortality and life expectancy are two main variables that are used in the ranking. Out of 198 countries, Canada ranks thirtieth and the US ranks thirty seventh. The World Health Organization ranks France, San Marino, Italy, Andorra, Singapore, Malta, Spain, Austria, Oman and Japan as the world’s top ten.

With the founding of the UN (United Nations), there was planning and discussion on the need for a single entity to serve, observe and assess global health care system trends. Thus the World Health Organization was formed in 1948 on April 7th with headquarters based in Geneva, Switzerland. Annually the WHO is recognized by the celebration of a World Health Day. The WHO is the coordinative and directive authority for United Nations’ member countries individual health systems. Member countries of the United Nations are allowed WHO membership through the acceptance of the WHO constitution. To date there are a total of 198 member nations participating in WHO programs.

Impact of Communication Technology on Healthcare Systems

Explosion of technology and the information revolution has greatly impacted our healthcare system for the better. Not just at the level of treating diseases, but the fact that a greater number of people are now inside the healthcare network is a testament to the improved and increasing presence of technology.

In the not so distant past, people still had to physically be available for consulting a doctor but information technology and communication has now made remote patient consulting and tele-medicine common place. The barriers of time & distance are increasingly shrinking in our times and this means that more & more patients can have access to quality healthcare.

Communication technologies are also greatly improving patient experiences; besides improving hospital response times. Response time is critical for emergencies, someone in distress is least likely to be willing (or be happy) if he or she is made to wait endlessly. The role of technology is not just limited to reducing response times but also towards improving overall patient-care experience.

Some of the ways wherein patient-experiences can be improved with better communications & technology are outlined below:

Provide call handlers with complete patient information to help them better response or offer advise

Send or receive multimedia files such that it is easy for the patient to send investigative reports etc.

Call forwarding or remote calling facilities to enable the same consultant to be available for a patient irrespective of his or her location.

The advancements in communications have expanded the horizons of consumer expectations are it is imperative that healthcare providers are able to embrace these technologies to better serve their patients.

Real-time connect with the patients helps provide preventive services, consultation on prevalent health hazards and nutritional information. As healthcare providers work increasingly on the preventive model of healthcare dispensation it is imperative for them to seek real-time patient information. Patients, on the other hand, need to know that the healthcare provider will be available whenever required and that all emergency situations are well-catered to.

Technology also helps create convenience and comfort resulting in an overall better patient experience. With our worlds more interconnected today than they have been ever before there is a greater convergence of the different spheres of our lives. Being able to access medical information on the go, set up doctor appointments, order medicines and consult with doctors remotely are all various facets of the ever increasing patient demands – which healthcare providers can now cater to with advancements in communication technology!

Benefits of a UK Healthcare System

If you live in the UK, you probably know that the healthcare here is a great option compared to what other countries have. Even the United States cannot compete with the services that the UK offers and the price at which those services are provided. Much of that comes from the idea that the UK has the National Health Service. This national insurance program is designed to ensure that everyone in the country has access to the healthcare that they need and that they don’t go bankrupt because they can’t pay for it, or struggle because they can’t pay insurance premiums. That’s very important. Areas like the US have good insurance programs, but only for those people who have a lot of money.

When people don’t have much money and they can’t afford health insurance, it becomes easier for them to simply ignore their health. They don’t go to doctors as much, they don’t go and get screened for diseases, and they generally don’t spend much time taking care of themselves. They might be given a prescription for something but they don’t take it because they can’t afford it, or they might think that they have something wrong with them but they don’t go and get it checked out because they can’t afford the doctor visit. With that in mind they often end up in the emergency room with a problem that could have been treated much more easily (and cheaply) if they would have gone to the doctor in time.

With the UK healthcare system, those kinds of things that are so wide-spread in other countries aren’t really seen in Britain and surrounding areas. There are still some people who won’t go to the doctor for other reasons that have nothing to do with insurance – anxiety, distrust, etc – but there are not that many of these people. It’s much better to have the option to go to the doctor and get medical treatment when needed and not to have to worry about things like not having enough money. This is especially true for families with children, because when children are sick people work very hard to get them the medical care that they need. It’s difficult for parents who find that they are not able to do this, but parents in the UK need not fear their children having no medical care if they need to be treated for something.