A Broken Healthcare Model? Flashcards
Identify the strengths in the US HC system
exceptional technology: devices/discovery
rapidly expanding knowledge: data/science
novel therapeutic entities
large and exceptionally trained HCPs at upper end
exceptional HC facilities
endless supply of $$$$
enhanced precentative care: flu shots, colonoscopies/mammograms
engaging pts and understanding their preferences
safety through computerized alert systems and routine review of meds
Identify the current problems with the US HC system
too expensive: $13,000/yr/person; 17% of GNP
disconnect between what we pay for and what we value and outcomes achieved
compares poorly to other industrialized countries
too much is spent for older pts and at end-of-life w/o clear benefits
a small percentage of population consume most of resources
drug companies can charge whatever they wish
lack of transparency with respect to cost
access issues: especially for the poor/rural, geography, # PCP per 10k pts, avg costs of annual health insurance premiums
equity issues
good doctor can be hard to find; too few PCPs - poorly distributed, poorly reimbursed; practitioner burnout
lack of care coordination
healthcare lobby is very powerful; politicians dictating how HCP should practive: women’s health, pediatrics, public health (underfunded)
individualism in the US
most pts are poorly informed or misinformed about thier HC and associated costs
HC costs have been increasing for both employers and employees; employers have been shifting more costs to employees (deductibles and co-pays)
Disconnect between what we pay for and what we value and outcomes achieved
pay more for doing more; incentives to produce better health are lacking; life expectancy, infant mortality, maternal mortality, does not measure up
Compares poorly to other industrialized countries
top performing countries: provide universal coverage and remove cost barriers; invest in primary care systems to ensure high-value services are equitably available in all communities to all people; reduce administrative burdens that divert time, efforts, and spending on HC improvements; invest in social services, especially for children/working-age adults
Equity issues
adults with below average income have poorer access to health care, less timely care, and less engagement with providers
individuals who are employed by larger employers have better access to healthcare d/t better insurance coverage
race plays major role in HC access and equity
Workers at small firms pay
more in premiums and face higher deductibles than workers at large firms
Identify the potential roles that pharmacists might play in enhancing the US HC system
MTM services for complex pts with multiple meds
educate pts about preventative health services and about importance of nutrition, exercise, and smoking cessation
help pts navigate the complex HC system
educate pts about unnecessary care and meds
advocate for responsible HC policies
advocate for transparency
Cumulative % change in health sector and non-health sector employment
dramatic increase in # of individuals involved in HC
COVID caused decrease
Total national health expenditures
continues to increase
Average annual expenditures growth rate for select service types
hospitals/physicians and clinics have gone down; cost of Rx has fluctuated, now going up again
Relative contributions to total national health expenditures by service type
hospitals contribute most
Financial toxicity
major reason why individuals have to file for bankruptcy because of medical bill problems/debt
14% of individuals contacted by a collection agency for unpaid bills
Life expectancy at birth in US
is decreasing
Too much is spent for older pts and at end-of-life w/o clear benefits
most money spent in individuals 50+
US drugs compared to other countries
US drug prices sky-high in comparison to other countries
ex. humira going up becuase of the price driven revenue growth
brand and speciality drugs drive high costs in US
Public health has been historically
underfunded and thought to be a local responsibility
Minimal focus on preventable deaths
gun violence, drug overdoses, alcohol-related, injuries, suicide
Much of the public is uninformed or misinformed
lack of transparency about HC policy and it’s impact
lack of knowledge among most pts when making decisions about medical care
lack of transparency regarding the cost of medical care
great deal of misinformation on internet and social media
Managed care organizations often focus on
decreasing utilization of HC services and certain meds across the board vs targeted use
decision makers aren’t associated with the pt’s care
Waste
unnecessary care, care outside of standards and guidelines, fraud, providers’ time due to adminsitrative duties: PAs
Best care at lower costs
effective care must be delivered by collaborations between teams of clinicians and pts, each playing a vital role in the care process
Other problems with our HC system
no one reminds you to take your medicine
visits with MDs are way too short
you have to get out of bed when you have the flu
you can’t find an apple in a vending machine
you can’t email your MD
hardly anyone pays for prevention
negative information not published
