The solution to healthcare dysfunction

There’s not a nurse I know who thinks our current healthcare system “works.”
    Too much testing vs. not the right tests; too much documentation vs. documentation that misses the boat; hotel-style “customer service” scripts vs. from-the-heart empathic dialogue; rote protocols vs. critical thinking; factory-style “efficiency” vs. humane interaction (which takes time); cumbersome outdated policies vs. common sense and professionalism; virtual management, training and human resource access vs. real, live human beings with personalities who want to help you.

So, why are some folks so terrified of looking at alternatives to this dysfunctional system?

Fundamental change in systems and programs raise the specter of the unknown. We may not like the way things are, but we have figured out a way to manage within their constraints. The question becomes: Is a better way possible?

We look around the world and there are things we know:

    National health systems exist in every industrialized economy…except the United States. Not one country that has established such a system has voted or moved to abandon it. The satisfaction ratings in such countries are far higher than those in the U.S. They cost nearly half of what the U.S. pays as a percentage of the gross domestic product. The health indices in these systems are superior in nearly every standard to those in the U.S. These systems are built around a progressive taxation system rather than a “cost” system that discriminates against those with fewer means. These systems are not perfect, nor are they identical, and there are variations within systems. In the U.S., 42 percent of people with Cancer spend all their money within two years of their diagnosis. That does happen in a country with a national health system.

    The insurance industry has been described as the parasite of the healthcare industry. It provides no direct service, care, research or materials—and yet it is the key driver in costs and “professional aggravation”. It feeds off of inadequate treatments (no care = no cost to the insurer) and simply raises rates if complex care is required (always with a sweetener that further raises costs).

    Big Pharma is referred to as the predator of the healthcare industry. Hyper-inflation without regulation of drug prices (directly linked to the for-profit nature of the system) has led to increased morbidity and mortality for folks who cannot afford needed medications. Advertising and marketing has convinced people of the need to over-medicate or “selectively” medicate—with limited scientific basis. Providers lean on medication when confronted with insurance-mandated productivity requirements—instead of comprehensive, holistic care. Side effects and multiple medications have resulted in serious complications. And the opioid crisis is directly linked to such practices.

    These parasites and predators could be dramatically reduced or even eliminated with a universal system that puts people before profits. The repetitive checklists of the EMR could be reformatted to serve caregivers and patients rather than the hospital accounting department. The savings generated by eliminating multiple insurers’ share of the healthcare dollar, high drug prices, administrative overhead to manage reimbursement, unnecessary marketing and advertising could be used instead to hire desperately needed staff, allow for more time with patients, raise salaries for healthcare workers—employers would no longer “charge” us for health insurance as part of contract packages—and pay for research and innovative programs.

    Professionals could once again exert more control over our practice and avoid time-consuming workarounds to provide the care our patients deserve. Decisions could be based on need and best practices rather than what the insurance will cover.

    Clearly there are flaws in many national health systems, but such flaws are over-exaggerated by media controlled by parasites and predators—and the politicians and outlets that receive funding from them. Any new system can learn from the errors of previous or existing ones. What are the problems we can observe when we look at our neighbors in other countries? How can we avoid some of them?

    We are smart. Surely if we can figure out how to transplant organs, stop a cerebral or cardiac infarct in mid-attack, and eradicate and prevent fatal infections, we can create an equitable, quality healthcare system that includes everyone who needs care, while simultaneously respecting the caregivers who dedicate our lives to serving our communities. I

    mproved and expanded Medicare for All is not a dream.

    It is a necessity.

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