Este artigo foi publicado recentemente no jornal OC Register pelo Dr.Isadore Rosenfeld que é membro do conselho da US Secretary of Health e retrata a atual situação do Sistema Americano de Saúde, acesso ,custos , managed care, etc. O título bem se aplicaria ao nosso sistema.Vale a leitura e reflexão.
We Must Fix Healthcare
These personal accounts painfully reflect the plight of 44 million Americans (one in seven) with little or no access to medical care because they have no health insurance. Most are between ages 18 and 44. These are not only the poor. A third of them earn at least $50,000 but still cannot afford the rising health insurance premiums and at the same time support their families and educate their children. Millions more lost their coverage when they were laid off from their jobs.
Many retirees too young to qualify for coverage under Medicare must insure themselves. (Only 38% of large companies and 10% of small ones continue to provide health insurance for retired employees.) The premiums often are higher than many retirees can afford to pay, forcing them into the ranks of the uninsured.
How did all this come about?
Ironically, health-care costs have, skyrocketed because of the great advances in medicine. Progress has been expensive due to all the new sophisticated tests and procedures: MRIs, CT and PET scans and the costly breakthroughs in treating cancer; heart disease and infection. Because we're living so much longer (life expectancy increased in the last century from about 50 years to almost cu for women and 74 for men), we also are prone to such chronic conditions as heart failure, arthritis, Parkinson's, paralysis after stroke and Alzheimer's.
All this means more medications, doctors' visits and other professional support, and rehabilitation programs. Many of the elderly, alone and unable to fend for themselves, need long-term custodial care. Insurers have had to raise their premiums in order to pay for this explosion of medical success, premiums that millions no longer can afford. If you are still working, chances are your mandatory contributions to your health insurance have risen by 50%. Companies struggling to compete in the global market have had to cut back on the extent of coverage they provide their employees.
All these problems have given birth to the HMO. While they try to make medical care affordable, most HMOs are businesses too and must turn a profit You don't have to be a mathematician or even an accountant to realize that, in order to do so the HMO must spend less on your health than the premiums you pay. That means , are slowed fewer consultations, tests and days in the hospital. As for providing the medications you need, the HMO--not your doctor-has the final say. Its focus is on the cost of the drug rather than its effectiveness.
All this has led to the overall decline in the quality of health care in this country. It's still the best in the world-for those who can afford whatever it costs.
How can we turn this around? Here are some suggestions:
First and foremost, we must guarantee access to medical care for every man, woman and child. We are the only industrialized nation that does not do so.
Second, we must reduce the current large malpractice insurance costs that are forcing doctors out of "high-risk" specialties and leaving many smaller communities unprotected. Any solution, however, must compensate realistically those who have been hurt by "bad medicine."
Finally, every patient must receive whatever medications he or she needs in order to enjoy good health.
Dr. Isadore Rosenfeld, PARADE's Health Editor, is a former member of the advisory panel to
the US. Secretary of Health and Human Services. His latest book is "Breakthrough Health 2004."
We Must Fix Healthcare
These personal accounts painfully reflect the plight of 44 million Americans (one in seven) with little or no access to medical care because they have no health insurance. Most are between ages 18 and 44. These are not only the poor. A third of them earn at least $50,000 but still cannot afford the rising health insurance premiums and at the same time support their families and educate their children. Millions more lost their coverage when they were laid off from their jobs.
Many retirees too young to qualify for coverage under Medicare must insure themselves. (Only 38% of large companies and 10% of small ones continue to provide health insurance for retired employees.) The premiums often are higher than many retirees can afford to pay, forcing them into the ranks of the uninsured.
How did all this come about?
Ironically, health-care costs have, skyrocketed because of the great advances in medicine. Progress has been expensive due to all the new sophisticated tests and procedures: MRIs, CT and PET scans and the costly breakthroughs in treating cancer; heart disease and infection. Because we're living so much longer (life expectancy increased in the last century from about 50 years to almost cu for women and 74 for men), we also are prone to such chronic conditions as heart failure, arthritis, Parkinson's, paralysis after stroke and Alzheimer's.
All this means more medications, doctors' visits and other professional support, and rehabilitation programs. Many of the elderly, alone and unable to fend for themselves, need long-term custodial care. Insurers have had to raise their premiums in order to pay for this explosion of medical success, premiums that millions no longer can afford. If you are still working, chances are your mandatory contributions to your health insurance have risen by 50%. Companies struggling to compete in the global market have had to cut back on the extent of coverage they provide their employees.
All these problems have given birth to the HMO. While they try to make medical care affordable, most HMOs are businesses too and must turn a profit You don't have to be a mathematician or even an accountant to realize that, in order to do so the HMO must spend less on your health than the premiums you pay. That means , are slowed fewer consultations, tests and days in the hospital. As for providing the medications you need, the HMO--not your doctor-has the final say. Its focus is on the cost of the drug rather than its effectiveness.
All this has led to the overall decline in the quality of health care in this country. It's still the best in the world-for those who can afford whatever it costs.
How can we turn this around? Here are some suggestions:
First and foremost, we must guarantee access to medical care for every man, woman and child. We are the only industrialized nation that does not do so.
Second, we must reduce the current large malpractice insurance costs that are forcing doctors out of "high-risk" specialties and leaving many smaller communities unprotected. Any solution, however, must compensate realistically those who have been hurt by "bad medicine."
Finally, every patient must receive whatever medications he or she needs in order to enjoy good health.
Dr. Isadore Rosenfeld, PARADE's Health Editor, is a former member of the advisory panel to
the US. Secretary of Health and Human Services. His latest book is "Breakthrough Health 2004."
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