Health economics and quality of care

Health Economics

In 2012, there were nearly 800 million doses of opioids prescribed in Ohio alone -- a figure which equates to roughly 70 pills for every individual in the state. The prescriptions were for 20% of the state's populace (Semuels, 2017). What's more is that these prescriptions are not helping people; on the contrary, as Katz (2017) reports, "drug overdoses are now the leading cause of death among Americans under 50." It is so bad that the country is now essentially addicted to pills and it is literally killing us.

The causes of the opioid crisis are directly related to the Sackler brothers who pioneered the art of Big Pharma's role in advertising and making relationships with physicians in prescribing drugs to patients (Mariani, 2015). The Sacklers pushed OxyContin onto the market and turned the country into a drug-dependent nation. This was purely a profit before people type of play. The Sackler Brothers were interested in one thing: getting their drug to market, despite warning signs that it might not be safe. Once that was achieved, they controlled the market and got Americans hooked.

This crisis could be contained or managed by eviscerating Big Pharma. The industry's relationship with. gov is corrupt and the oversight that should be regulating the industry simply is non-existent. Government and Big Pharma work hand in hand to enrich the few at the expense of the many. And so of course Big Pharma cannot really be eviscerated until our own government is eviscerated. It is a pay-to-play scheme all the way around and nothing will change until Washington changes. People need psychological help and instead of getting the help they need from doctors, the doctors are over-prescribing and making the situation worse.

This is not an economic problem but rather a social problem. Economics is but an effect of social interaction. Because our society, socially speaking, has been crippled -- families eviscerated, communities gutted by offshoring, and values and morals corrupted by agendas that are neither organic to America nor healthy for society have come to dominate the mainstream. In such an atmosphere it is impossible for anyone to receive the kind of help they need. They are too used to living under an authoritarian regime and too willing to trust their doctors when clearly doctors cannot be trusted in such a climate. The economic ramifications of such a situation are that people get worse and worse while the rich get richer and the poor get poorer. Poor mental, social and spiritual health is a prelude to a poor country, economically speaking.

Part 2

1

The medical errors that doctors in hospitals tend to make look like this, as Binder (2013) points out: "The sponge left inside the surgical patient, prompting weeks of mysterious, agonizing abdominal pain before the infection overcomes bodily functions. The medication injected into a baby's IV at a dose calculated for a 200 pound man. The excruciating infection from contaminated equipment used at the bedside." Other accidents include giving patients the wrong drugs (Silverman, 2014). These are just some examples of the medical errors that doctors make -- and they cost lives. In economic terms, these kind of errors cost even more because of lawsuits that follow, because of the way that families are impacted, lives are disrupted, jobs are lost, income is lost, stability is lost. Thus, the economic consequences of these mistakes are as large as they are tragic.

Some reasons that hospitals fail to provide simple and life-saving procedures is that they are understaffed and overworked. Nurses and doctors suffer from burnout which is caused by a number of factors, but essentially it amounts to nurses and doctors making mistakes while providing care -- mistakes that could have been avoided had the health care providers not been working such long hours or been on the job for so many days in a row without a break or been covering for another worker who failed to show for a shift.

Some ways that healthcare could be made safer would be to do what the emergency department at Children's Hospital in Dallas is doing: putting pharmacists in the ER to ensure that the right drugs are being given to the right people. This is one way to cut down on medication errors. But other errors such as those committed by nurses and physicians who are suffering from burnout or exhaustion can be corrected by making sure that nurses and doctors are not working more than 8-hour shifts and are not being overworked when they are on shift.

2

According to Goldhill (2009), the proposed health care reform falls short because it is based on incentives that put too much emphasis on treatment rather than prevention. Because so many deaths result from failures to practice preventive care, reform should focus on prevention -- but it does not; it focuses on treatment and government subsidies are all based on treatments given. The fact that health care is subsidized means that incentives are given for treating patients and not for preventing problems. This is the root cause of all the trouble.

It gets worse because as Goldhill (2009) points out, reform is focused on expanding the role of insurance when what should be done is reducing the role of insurance and eradicating the Ponzi-scheme type of financing that has turned the economic model of health care in the US into a farce that will result in prices going up ever higher while health and quality care decline ever more steadily.

Goldhill (2009) suggests that "he most important single step we can take toward truly reforming our system is to move away from comprehensive health insurance as the single model for financing care. And a guiding principle of any reform should be to put the consumer, not the insurer or the government, at the center of the system." By allowing free-market competition in health care and promoting transparency, a better system would naturally fall into place. Direct subsidies to those who cannot afford care instead of to those who provide care would also help erase the distortion in the market place that is caused by incentives. Essentially, the people need to be put before the profits and a more consumer-centric health care system needs to be put into place. By putting the people first, a better system can be had.

Part 3

The major issues in the delivery of health care in the US are that the system is protected by government, which subsidizes health care by incentivizing the providing of treatments that are often unnecessary or overly complex when instead quality care should be focused on protecting patients and preventing diseases and illnesses. Our health care system resembles and exploitation scheme in which patients are viewed not as people but rather as potential profit for the industry. Instead of looking to care for them based on the principles of health care, the patient is viewed as a means of running endless tests and providing endless treatments and drugs until the patient eventually taps out and dies. The point of all these tests and drugs is not to help the person but rather to pad the pockets of the industry. The government does not help because it colludes with the pharmaceutical industry, the insurance industry, the medical industry and so on. Government is there to protect the monopoly and ensure that a free market is never really allowed. To prop up the industry, the government sends tax dollars to providers who otherwise would never be able to charge their exorbitant fees, which are really just representative of the kind of extortion practices that health care has become.