IQ Test For Kids

The 2019 coronavirus disease (COVID-19) pandemic has exposed many structural challenges to the health care system in the United States. Although the United States is not expected to perform at peak levels during rare crises, when the tide on the healthcare system calms, many challenges become more apparent. Now that you have all eyes on these challenges, it's time to discuss them together.

The first 45 days of the pandemic brought some clear lessons. The United States does not have enough personal protective equipment, there are poor infection control protocols in many health centers in the United States, there is a lack of interoperability to share information quickly and easily, and there is a labor shortage in key jobs as therapists. respiratory. An unstable supply of vital drugs, a human end-of-life guidance is lacking for people dying alone from highly contagious diseases, and diagnostic testing capabilities are so weak that the list is actually longer and could get longer. precise.

Health workers, patients and their families paid for these deficiencies from the first 45 days. A national focus and investment in the right areas, process redesign, readiness, data warehouses, and more explicit accountability can help fix these problems so they don't recur.

Emerging structural challenges

But as the epidemic continues to cope, deeper and more serious structural challenges emerge. As millions of people start to lose their jobs, stop going to doctors' offices, and delay getting medical care, clinics, especially small ones, are in disarray and hospital systems are being depleted. Millions of people have lost their main source of care. America's healthcare system has stopped working for anyone except mediators whose only job is to facilitate care: insurance companies.

To the extent that the healthcare system has failed, it has disappointed some people even more - that is, people who have failed miserably, black people and people of color in particular. The elderly, the sickest and the poor suffer most of the illness and death, not only because they were more exposed to the effects of the virus, but also because of the deep inequality and racial prejudices that put them at greater risk of suffering. deficiencies in the health system.

Critical changes

To address the shortcomings of the US healthcare system, 3 critical changes are required. First, the United States must move away from a system in which people pay insurers to a system in which people pay doctors, hospitals, and other institutions directly for the desired outcome. This will keep the income of physicians and medical institutions constant and equip them to better meet the needs of patients. Second, insurance must be linked to existence, not employment. When American workers lose or change jobs for any reason, they don't have to start over. Third, equity and inequalities in health should not be discussed as an afterthought, but ending racism in the provision of health care should be part of the fundamental design of the system.

How is the United States achieving these crucial changes? An important step is determining the capital: paying a specific amount to each patient who receives care in a medical practice or institution, with a component of quality and result, at least half, if not all, of the payments of the health care provider . All payers, including Medicare, Medicaid, and private insurance companies, must pay the same price. Mediators who help facilitate payment, coordinate care, or provide reinsurance should receive a small sum from medical offices or institutions for those tasks, but not stand between the patient and the caregiver. Through thick and thin, doctors and hospitals will be able to stand up and invest in the basic needs of their patients to keep them healthy.

 

Unlinking health insurance from employment should be done by eliminating the employer's health insurance tax deduction and instead giving everyone in the United States a subsidy to buy health care and insurance. Hundreds of billions in annual savings in budget, payroll and corporate taxes could replace the funding of employer benefits that workers receive today. Health care should be as simple as choosing a doctor, care team, or other health care provider organization. 10 Essential Health Benefits of the Affordable Care Act Progressive income support should be the foundation, but support should be increased and expanded to include middle- and upper-income residents of the United States. Artists, contractors, and temporary workers must have access to health care under the same conditions as corporate executives.

Achieving health equity will be the toughest challenge and will require uncomfortable change to make it real. Diversity and inclusion can no longer simply exist in an isolated department or be covered in a medical school conference; They must be integrated into everything separately every day. Achieving health equity must go beyond all aspects of problem solving, from the bed to the boardroom. Collecting and reporting results by race and ethnicity to see where racism affects results is a critical starting point.

With the price of each fixed payer, access to care will expand for everyone. However, it is important to avoid this by providing care differently to communities that are difficult to access. Home and community care, personal midwives, compensation for family caregivers, broadband and telemedicine, and significant increases in the health care workforce that resembles the community they serve, are part of the solution. Rewarding and punishing caregivers for reducing disparities is vital.

Does this just describe a version of a single drive system? Maybe and maybe not. Go beyond description and ideological arguments and note that there are dozens of ways to make these changes, along with many decisions that remain to be made: about reimbursement levels, outcome measures, out-of-pocket costs, coordination of care, fringe benefits, and many other items. The government cannot do this alone. Innovative private sector companies can find an enabling role, if they add value.

These reforms will inevitably affect the many people whose jobs will be changed or eliminated in the changing healthcare system. These people need to be assured that if they add value today, whether someone studies data, focuses on improvement, or supports the care process in some way, they will adapt to common sense ways of doing it. And if they don't add value to the care process, it will be hard to say that they just don't get in the way.

Society wants a health system that focuses on people, but has the support of institutions rather than one that focuses on the institutions through which people have to move. People should not worry about how changes in their lives, related to the pandemic or otherwise, will affect their ability to care for their families. At its core should be the relationships of physicians with patients and communities. Neglected, neglected and abused people should take center stage, perhaps for the first time.

In times of crisis, good systems do not exacerbate challenges, they enhance them. That didn't happen when the COVID-19 pandemic hit the United States and showed that major adjustments need to be made. Definite moments are supposed to trigger a change in things that were broken long ago. If the United States cannot learn from the events of 2020 and make the necessary changes, when?