The American healthcare system is in a state of uncertainty. And it is failing patients.
At least that’s the assessment I’ve frequently come across over the past few weeks. Roiling politics and the resulting policies seem to be the root of this uncertainty. Be it the changes ushered in by the Affordable Care Act (ACA) or the looming changes brought by the election of Donald Trump and a Republican-controlled Congress, it seems that healthcare will be in a state of flux and disarray for the foreseeable future.
There certainly appears to be ample evidence to support one’s belief that the American healthcare system is in dire straits. All one needs to do is look at the growing out-of-pocket costs to patients, the disjointed nature of the delivery system, and the fact that America spends more on healthcare than any other high-income country in the world, but has some of the worst health outcomes.
Call me naive but I’m not convinced.
I don’t believe the healthcare system is in as much flux as some would have you believe and I certainly do not believe that the “sky is falling” with respect to the continued demise of the American healthcare system.
If we take a step back and see the forest for the trees, some obvious patterns and facts emerge that should temper some of the rhetoric that is swirling at the start of this New Year.
Only a fool wouldn’t acknowledge that the healthcare system has failed some Americans, despite record levels of spending. However, no country in the world has solved this problem yet. That is to say, no other nation has successfully provided broad access and high-quality care at an affordable price for everyone.
America is still the world destination for those looking to be trained or receive care at elite medical institutions. Let us not forget that much of the world’s health systems rely on American innovation. In 2015 the U.S. exported to the world $83.4 billion in medical equipment and $47.3 billion in pharmaceuticals. These pharmaceuticals are often offered at a discounted price in other countries - essentially subsidized by U.S. consumers. Undoubtedly, this contributes to lower per-capita spending for other nations as they enjoy pharmaceutical innovation without bearing the full cost of development.
For those looking for hard data, there is plenty available to indicate that a great deal of progress is being made by the American delivery system despite the doom and gloom pronouncements. The U.S. is currently enjoying one of the longest stretches of low-increases in healthcare spending. The uninsured rate has dropped to 8.6% - the lowest rate ever. Premiums for employer-sponsored coverage are lower than they would be if they kept growing at pre-ACA rates. Don’t forget that Americans now enjoy protections from practices like annual/lifetime caps and coverage denial due to a pre-existing condition. After years lagging behind other sectors, 96% of all reported hospitalspossess a certified EHR. Hospital readmission rates have fallen sharply – 565,000 readmissions were prevented across all conditions between 2010 and 2015. Better yet, hospital-acquired infections have dropped by 17% since 2010, saving an estimated 87,000 lives.
These numbers are just a snapshot of the positive trends in healthcare. When combined with the continued development and deployment of new technologies, devices, drugs, and medical procedures, the American healthcare system is uniquely positioned to deliver a higher level of care tomorrow than it is today.
Sure, some of the details will change with new political leadership but the major trends driving healthcare are likely here to stay. We frequently look at the world through the narrow lens of today often at the expense of history. If we broaden our gaze we can see that, despite challenges and looming policy changes, America’s healthcare system is strong because it is rooted in a long history of steady innovation that improves the lives of patients irrespective of politics. This historic march won’t abate in 2017.