Many of us have grown up looking up to the American way of life and systems as the best in the World, which of course is true in many areas.
Having closely observed and followed the American Health Care system for decades, I can say with a lot of confidence, “This is one American system that no one else should follow”.
This is a system that spends trillions of dollars each year (about 17% of the GDP) which is more than the GDP of most of the nations including ours. However, the country has millions of citizens who do not have adequate access to health care. This is almost going to bankrupt their economy which is still number one in the world.
This is a system that promotes treatment of illness, but not wellness.
This is a system that promotes technology, protocolization and procedures over common sense and patient-doctor dialogue.
This is a system that promotes super-specialists over general practitioners, which completely negates a holistic approach to patients’ problems.
This is a system where citizens, without health insurance, seek medical attention for even trivial illnesses through the emergency rooms stretching the resources to a breaking point, which is insanely expensive for the tax payers. In my opinion, it is equivalent of using high-tech ambulances for regular transport because you do not have access to inexpensive public transport or cabs.
This is a system where it may take months to see a certain specialist. You may see a new doctor each time you visit the hospital and the personal touch is on its way out.
This is a system where litigation and malpractice suits have skyrocketed the cost of healthcare and we have ridiculous situations where certain specialists such as neurosurgeons and obstetricians dread starting a practice because the cost of malpractice insurance may be more than their earnings!
This is a system where certain medications and procedures may be 20 to 100 times more expensive than in a developing country with similar health care facilities.
This is a system where the profits of the device manufacturers, pharmaceutical industry, insurance companies, and malpractice lawyers have continued to skyrocket, but the doctors continue to be squeezed from all ends.
We, in the developing world, are fortunate to have a great opportunity to learn from their mistakes and deploy our healthcare in a far more sensible manner which are:
- Focus on Preventive and Primary care rather than tertiary care.
- Focus on wellness rather than treating illness.
- Use healthcare facilities judiciously only for the treatment of acute illnesses
- Educate the public on lifestyle modifications to reduce and prevent the burden of non-communicable diseases.
Having said that, there are many things that we have to learn from the western world such as standardisation and maintaining quality across the board. Huge thrust on Research and Development can result in great innovations. Documentation, systematic clinical research and publication of peer reviewed data that is published is available for everyone to adopt including the developing world.
All in all, it is still not too late for our planners and administrators to incorporate this in our health care system and make our country healthier and happier to live in.
God Bless India!
Dr. H Sudarshan Ballal, MD, FRCP (London)
Disclaimer: The views expressed in this article are of the writer and not of the hospital.