The Economics of the US Health Care System: A Personal Perspective
2014; American Academy of Pediatrics; Volume: 4; Issue: 4 Linguagem: Inglês
10.1542/hpeds.2013-0082
ISSN2154-1663
Autores Tópico(s)Healthcare Policy and Management
ResumoIn almost 20 years as an independent practicing physician (10 years as a hospitalist, after 8 years as a primary care pediatrician [PCP] in private practice), I have cared for a wide variety of patients. I have also had firsthand knowledge, from 2 sides of pediatric practice, of how the strange economics of the US Health Care System strongly influence my day-to-day practice. As I look back on my years as a PCP, I now realize that there were 2 main reasons why I chose to become a hospitalist. First, I missed caring for more acute, sicker patients. Second, I was extremely frustrated with the waste, inefficiencies and bizarre incentives of the system. The fact that taking a few minutes to reduce a nursemaid’s elbow was more valuable to the bottom line than spending 45 minutes with a family to break the news that their newborn has Down syndrome caused me a lot of stress and anxiety. The fact that as a partner in a private practice I had a responsibility to make sure we could pay our bills and keep the office open just made things worse. Much has been written about our broken health care system over the past several years. Experts enumerate many factors that led to our current state, including a high percentage of uninsured/underinsured, high prices, overutilization of some things, underutilization of others, waste, inefficiency, fraud, and fee-for-service.1–3 The question remains: which factors are truly responsible for the problems with our system? I do not know the definitive answer to this question, and I’m sure if you asked 10 experts …
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