Healthcare Upside Down
A Critical Examination of Policy and Practice
Inspired by witnessing and experiencing the changes in healthcare and its delivery over the past 50 years, Dr. Henry Buchwald observes and comments on the current state of healthcare in the United States.
His narrative includes the history, the historical data, and personal experiences of a healthcare system that has moved away from caring, first and foremost, for patients. This expensive, impersonal system, he believes may not be in the best interest either of the nation or of the people it purports to heal.
As the title suggests, it appears that healthcare has been turned upside down to serve the administrators of the system and away from its basic function of offering the best care for patients. With this basic principle in mind, the topics presented in this book provide and discuss healthcare statistics and alterations to the language of medicine. The chapters themselves examine the transformations to the medical school, the clinic and the office, the hospital, and the practice.
Additional chapters discuss the role of the payers, public health research, as well as pandemics, including COVID-19, the advantages and disadvantages of socialized medicine, as well as the broken doctor/patient relationship. Finally, Dr. Buchwald offers thoughts on the areas in which future healthcare efforts can most fruitfully be expended.
Analysing today’s pervading administrative domination of essentially every facet of healthcare, Healthcare Upside Down thoughtfully considers the variety of ways in which we can turn the current healthcare system right-side up to serve those who should be the ultimate beneficiaries – all of us as patients, now and in the future.
The system has been turned upside down to serve the administrators of the system and away from its basic function of offering the best care for patients.
All of us are not getting a fair return for what we are paying.
Life Expectancy
The United States ranks 46th among nations in life expectancy.
Healthcare Costs
The United States has the highest healthcare costs in the world, at 17% of its GDP.
Where Do We Go from Here?
Ten Potential Remedies
Healthcare Workers and Their Leadership
Advocates of Public Health
Medical Schools
Medical and Social Research
Insurers of Healthcare
Providers: Hospitals and Clinics
Government and Politicians
The Media
Philanthropy
Everyone
Each individual member of our society as a healthcare consumer needs to learn what she/he is purchasing with tax or out-of-pocket dollars. Though some of the purchases may be excellent, much of it could be improved. In far too many aspects, healthcare today is not consumer friendly. To achieve affirmative change—to turn healthcare right-side up—is the responsibility of individuals working through all their available affiliations. The will of the people must be heard by government and private initiatives if healthcare is to truly serve the people.
“The opening moment of life—birth—involves healthcare for mother and child. Growing up and achieving adulthood involves healthcare. Being able to live a mature life, to work, to love, to have children is dependent on healthcare. And, the final chapter, aging, can be realized and even made pleasurable by healthcare. Healthcare is, therefore, integral to life, from beginning to end. Healthcare is not a commodity but a necessity. Healthcare needs to be treated with respect. The establishment, practice, and financing of healthcare affects everyone, and should not be neglected by anyone. It must be the top concern of all of us.
I have been a doctor for sixty years, and during those years at times I have also been a patient. I have held the hands of my patients; I have been the one whose hand has been held. I have received trust and given trust. The therapeutic decisions my patients and I reached were not subject to the interdiction of a third party. I do not want to have my life’s role as a physician and surgeon, my joy in the process, usurped by an administocracy. As a patient, I do not want to hold hands with a robot and confide my health problems to a faceless entity. As a doctor, a patient, a person, I reject the currently shattered doctor/patient relationship.
Healthcare is upside down. Let us set it right-side up.”