I think there is another major problem with the healthcare system:
The lack of diverse educational backgrounds making scientific, medical and bioethical decisions. The people who are directly involved in the day to day operations of the US health care system should have at minimum 51% control over health care issues and policy. No disrespect to lawyers, politicians, scientific lay people, but this is a MAJOR problem that I see as an aspiring physician.
Due to the "old system" of medicine which is commonly described in many essays about medical professionalism (the idea that the generation of physicians before us protected negligent doctors simply because they work together and the stereotype of rich doctors who work 2 days a week, play golf 5 days a weeks and burn money in the fire place instead of wood because they like the smell of burning money, etc), the ability of physicians to govern the medical profession, to properly set medical standards, to establish good, long-term patient-doctor relationships, etc has been dramatically weakened.
By definition, pre-medical students dedicate themselves to becoming the keepers of scientific and medicinal knowledge so that they can use this knowledge to improve the health and livelihood of the community that they live in. They sacrifice a lot to do this...I dont need to tell you all as you all know just as well as I do, but just for amusement -
When you are an undergrad and your buddies at school are going out and having the time of their lives, you may find yourself learning about how to turn toluene into m-nitrobenzoic acid. What fun, right? They will come to you and ask why you are so lame and why you spend countless hours in a library, why you do community service, why you want to do research and why you have grown to enjoy coffee so much. You will try to tell them that you want to be a compassionate, knowledgeable doctor, but they will not understand. They will understand later a little better if they ever have a medical issue and have to see you or another physician who practices in your field of medicine, but that will still only give them a glimpse. You all also are spending a small fortune to simply apply to the schools that are already almost impossible to get into, fully knowing that you will also have to buy a suit for interviews, spend the money to go to those interviews, to stay at a hotel or for a gift to give to your student host, etc. You also have to study about any school that you are fortunate enough to be invited to interview at so that you will sound like you REALLY want to go to their school. You need to learn about how to explain your weaknesses in numerous ways. You may do all this and still get many thin envelopes in your box 🙁
Then you wait...It is you and the mailbox (both electronic and real). Once you get (if you get) a big envelope, you now look at the cost...you are now going to take loans comparable to what your other friends might take out to buy a house...and you still have to pay for room and board!
Why do we all go through this? Many reasons, but I would be willing to bet that a vast majority of students, if polled and answering seriously, would say that they want to go through all this so that they can go into a profession where they can wake up each day, look themselves in the mirror, put on that white coat and go make a difference in the lives of their patients. It is just a little harder to do that now....
Today's physicians are finding themselves fighting an uphill battle against politicians, lawyers, insurance agencies and drug companies. What was once an autonomous profession has now been forced to implement a system of checks and balances that do not check and balance anything at all.
Hypothetical A: You are a family physician or a pediatrician and you have a pool of patients that live in your area whom you service. You can look at the name of the patient on that chart before you go into the room, but it would be nice if you could walk into the room blindly and have the patient say "Hey Doctor Yourname! Hows it going?" And you would respond with a joke to your patient or with some sort of conversation that shows that connection between the patient and you. You talk about something going on in the town, you talk about a sports team, a family member, a common friend, the weather- anything at all that represents this personal relationship and makes the patient feel comfortable. However, for those fortunate enough to have insurance (and enough coverage), their employer that offers the patient a health care plan may switch to another company. There goes your patient(s). Additionally, here is the power of the insurance company. They say, we insure 48% of your patients. Therefore, even though it costs you X dollars to do something, we will pay W dollars. If you dont like it, we will not work with you and you will lose 48% of your clients. They can bundle procedures when payment time arrives and they can deny claims on the basis that your practice will have two options:
1. Do nothing because you do not have the manpower to spend so much time to refute denied claims
2. Refute claims and pay people to do that rather than other things they should be doing in your practice
This is no skin off the insurance company's back...you either refute it or dont. If you do, then they may still deny it, or they may pay it. Regardless, it is one more level that they can stick it to the medical professionals.
Then there are the lawyers which I dont feel we even need to go into here.
Next comes the politicians. These people who are often scientific lay people are making law governing the medical profession. As if bans on stem cell research were not enough, some government bodies are taking it upon themselves to directly attack the source of premedical students - in high school, middle school and elementary school. Evolution and creationism? Science supporting intelligent design? Religious views aside, we can clearly see the difference between religion and science. Religion belongs in a religious studies class - NOT in a science class. Science does not have faith and does not leave room for it - it is something concrete that can be tested and retested. It functions to work within the constraints of the scientific method - not within the lack of constraints the blind faith entails. I may personally believe in god, but I can see the difference between religion and science. At the early ages where some kids begin to gravitate towards science and medicine, it is imperative that society does not provide misrepresentations about science. The lack of control that the medical profession has on itself is a scary situation and has allowed for these problems to take place.
I am not suggesting total autonomy, but I do not believe that corporations, lawyers, politicians and religious officials should have more control over the fate of the US healthcare system.
Just my two cents, but in summary, I believe one of the major problems with our health care system is the lack of control that medical professionals have on the profession itself.
with your quest of information!
