The Curious Paradox of the U.S. Healthcare System

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Today healthcare in the United States faces enormous challenges. For one thing we still have not succeeded in extending the benefits of healthcare to the entire population. Even with the latest affordable care act fully implemented, we still will not truly have universal coverage in the United States.

Almost every country is having a problem in the distribution of health services is to those who are unreserved, particularly in rural areas, or in poor areas. It's clear that this problem does not fix itself. It does not naturally lead to doctors, nurses and other health professionals going to work in underserved and remote areas.

So, we do need to apply the proper incentives, the proper recruitment of health professionals who come from areas where they can be comfortable going back to serve their own communities and where we provide the kind of environment which celebrates and reinforces the choices of doctors to choose to serve those in need.

Secondly we still have a problem of uneven quality of care in the United States especially in rural areas, in less well served areas, in populations that are disadvantaged, the quality of care is not what it should be. And third in the United States we have a tremendous challenge of affordability of health care.

The cost of care are truly astounding in the United States. The US spends more on healthcare than the entire economy of France and yet our results are only middling to fair. We have dozens of countries today with lower child infant mortality than the United States we have dozens of countries that have longer life expectancies at birth than the United States.

So we are like that football player prospect who may not be big but he's slow. We have the worst of both worlds. We are spending a lot and we are not getting the results that we deserve. The fundamental problem is that we are not oriented enough to preserving and promoting health instead we focus almost entirely our resources, our attention on caring for people after they they get sick.

If we could change that balance, and put more attention on promoting wellness and good health we would go a long way toward solving our problem, but that would take some time. In the short term, we've got to deal with our immediate problems in care. In the long term and short term we need to do much more to prevent disease before it starts.

I don't believe that US health care system is broken, I think it's limping. I think it's laboring under some severe handicaps. I think it's not performing up to its own potential. But there are many strengths in the US health care system. We have a phenomenal research establishment still, others are catching up, but the US leads in the world, in biomedical research.

We have at its best, the very best medical care that you can obtain in the world, and it's a curious paradox that we recognize others have better health outcomes. But who in the United States would prefer to go elsewhere to get their care if they had a serious illness. Almost all of us would prefer to go to the best doctors, the best health care centers here in the US.

But we do have a disconnect between those excellent attributes and the overall performance of our health system. We need to bring the best of American health care to every citizen in the United States and we need to emphasize the prevention of disease, so that everyone can enjoy a longer more healthful life.