Healthcare Expenses

The United States have the most expensive Health Care System of the whole world - why don't we have the best one?

This question has been discussed really often lately. But do you know the daily facts behind?

Let's look at some statistics:
Medical residencies traditionally require 36-hour shifts, separated by 12 hours of rest, during more than one hundred working hour weeks. These long hours are counter-productive, resulting sleep deprivation increases rates of medical errors.

The ACGME's recommends an 80-hour work week averaged over 4 weeks, the IOM recommends that duty hours should not exceed 16 hours per shift, unless an uninterrupted five-hour break for sleep is provided within shifts that last up to 30 hours to allow residents to catch up on sleep each day and make up for chronic sleep deprivation on days off.

Resident physicians have no alternatives to positions that are offered, meaning residents must accept all conditions of employment, including very long work hours, and that they must also, in many cases, contend with poor supervision. This process is resulting in low salaries and long, unsafe work hours.

The U.S. Occupational Safety and Health Administration (OSHA) rejected a petition seeking to restrict medical resident work hours, opting to rely on standards adopted by ACGME, a private trade association that represents and accredits residency programs.

A physician who complains about even longer working hours will loose his accreditation!

Are you aware of these working conditions?

Can you imaging to be a surgeon in a 30 hour shift doing your work with the pressure of a malpractice lawsuit on your back?

I reported lately on this blog that I had cancer. The surgeon who did the good work to save my life, retired when I left the hospital. I asked him why. He told me he would like to practice, he was over seventy years in age, but to be able to pay his 125.000$ premium for malpractice insurance per year he had a decision to make: work full shifts (with 80 hour work weeks) the whole year or quit. Nothing in between. I was struck.

Amitabh Chandra, a Harvard University economist, said “No serious economist thinks that saving money in med mal is the way to improve productivity in the system.”

How long are the working shifts of economists? Do they have to work 80 hours and more per week? This question should be answered by a psychologist with experience as a surgeon, but not by an economist. We are living in a world without mercy.

"Exorbitant malpractice premiums are making it harder for doctors to stay in the business, and hurting taxpayers whose money goes for publicly funded clinics", said William C. Parrish Jr., chief executive officer of the Santa Clara County Medical Association, based in San Jose, California. I am sure he is right.

But there are other facts:
Nearly every Western democracy follows the "English rule," which requires the loser of a civil suit to compensate the winner for his or her attorney's fees.
The "American rule" differs; in most cases, each party bears its own expense of litigation.

This "American rule" which is uncommon in any other part of world, is highly responsible for malpractice lawsuits in this country here.

Counting 1 + 1 together - the most expensive Health Care System of the whole world
and this "American rule" which is not known in any other part of world, are you still wondering why we don't have the best Health Care System but paying much more than anybody else in this world?

You just read the cause.

Healthcare systems are very complex. There is a diversity in structure - nursing units, pharmacies, emergency departments, operating rooms - and a complex professional mix - nurses, physicians, pharmacists, administrators, therapists.

Hospitals and healthcare services are vital components of any well-ordered and humane society. It is of the greatest importance that hospitals are places of safety, not only for patients but also for the staff and for the general public.

Let's strive for it!
Let's reduce the burden of our health care providers who do so much for all of us.