Fragmentation in the Health Care System

The U.S. Healthcare Systems
1
The U.S. healthcare system is fragmented by the fact that incentives do not align with the actual goal of healthcare (Enthoven, 2009). For instance, healthcare facilities are incentivized to “treat” patients rather than to help them lead healthier lives. As Goldhill (2009) points out, healthcare treatments are subsidized by taxpayer dollars—and there are powerful lobbies in the healthcare field that promote the use of pharmaceuticals or new health technology (like hip replacements, which could end up leaking cobalt into one’s body). Moreover, care providers are encouraged to perform tests on patients even though there is no real need for them and they may in fact lead to overdiagnosis and to a deterioration of the patient’s quality of life, as the patient becomes obsessed with every minor health problem (Lichtenfeld, 2011).
Fragmentation impacts patient care in a negative way because it leads to the patient being viewed as a source of profit for the health care industry rather than as a person with whom care providers should form relationships. A patient may go from doctor to doctor looking for a solution to his fatigue, be prescribed myriad drugs and have none of them work because doctors are only focused on selling prescriptions rather than in providing actual preventive medicine (Strange, 2009). Patients need to be viewed as people first, not as a potential source of profit. The health care industry also needs to engage in preventive care and treatments have to stop being subsidized, because that subsidization corrupts the system and causes it to fragment. People want to be able to trust their doctors, but if doctors are overdiagnosing instead of explaining the reality of the situation to patients, as Lichtenfeld (2011) points out—namely that not all symptoms and irregularities need to be treated because no human body is perfect.
2
Alternative medicine or homeopathic approaches to healing are popular among certain people, and some health care professionals are even open to this concept of healing. They are distrustful of the pharmaceutical industry in general and feel that the industry has betrayed patients and helped to create the opioid epidemic currently sweeping across the nation. Some studies are out that indicate as much (Califf, Woodcock & Ostroff, 2016). However, there is not enough statistical data available to justify or to show empirically that homeopathic approaches to healing are appropriate or that they are effective in treating specific symptoms.
Therefore, as Vickers (2000) points out, too many homeopathic studies published have little statistical value. For example, I have a family member who suffers from chronic asthma and would like to begin taking a homeopathic approach to healing, but is not sure whether this is a wise thing to do. Different care providers are divided on whether it is appropriate or not because of the lack of satisfactory data available on the subject. I would like to be able to provide some information to her to help but there is not much statistical evidence to show that homeopathic approaches to healing are effective when it comes to chronic asthma. So this is one case in particular that I can think of that would be supported by more statistical data. The more statistical evidence there is to show, one way or the other, the better patients can be about making the right choices when it comes to their health.
References
Califf, R. M., Woodcock, J., & Ostroff, S. (2016). A proactive response to prescription
opioid abuse. New England Journal of Medicine, 374(15), 1480-1485.
Enthoven, A. C. (2009). Integrated delivery systems: the cure for fragmentation. 
American Journal of Managed Care, 15(12), S284.
Goldhill, D. (2009). How American health care killed my father. The Atlantic.
Retrieved from https://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/
Lichtenfeld, L. (2011). Overdiagnosed: Making people sick in the pursuit of health. The
Journal of Clinical Investigation, 121(8), 2954-2954.
Stange, K. C. (2009). The problem of fragmentation and the need for integrative
solutions. The Annals of Family Medicine, 7(2), 100-103.
Vickers, A. J. (2000). Clinical trials of homeopathy and placebo: Analysis of a scientific
debate. The Journal of Alternative and Complementary Medicine, 6(1), 49-56.