Healthcare Reform: A Dire Need to Retool the System

Healthcare Reform: A Dire Need to Retool the System

Abburi Anil Kumar (Prairie View A&M University, USA)
Copyright: © 2020 |Pages: 23
DOI: 10.4018/978-1-7998-2949-2.ch007

Abstract

The healthcare system in the U.S. is very fragmented in its structure. It is generally agreed that it needs to be reformed. This chapter addresses this issue from an organizational point of view with specific reference to cancer, a disease termed “The Emperor of All Maladies.” The basic tenet of this chapter is that any healthcare system should be designed so as to maximize the benefit to all the stakeholders involved, while incorporating the newer advances in technologies, but above all, must be patient-centered. Solving a complex adaptive problem requires different approaches compared to solving a simple technical challenge. Especially, when it comes to dealing with cancer—a very intelligent, continually adapting, rule breaking, self-sustaining disease—simple technical solutions are insufficient without an understanding of how to change the system. After discussing the current healthcare system in the U.S., a proposal is made as to how to reform the system.
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Introduction

In the past quarter century, the American medical system has stopped focusing on health or even science. Instead it attends more or less single-mindedly to its own profits.

Everyone knows the healthcare system is in disarray. We’ve grown numb to huge bills. We regard high prices as an inescapable American burden. We accept the drugmakers’ argument that they have to charge twice as much for prescriptions as in any other country because lawmakers in nations like Germany and France don’t pay them enough to recoup their research costs. But would anyone accept that argument if we replaced the word prescriptions with cars or films? (Rosenthal, 2018)

So begins the book, An American Sickness by Elisabeth Rosenthal, with the subtitle, How Healthcare Became Big Business and How You Can Take it Back. The healthcare system in the U.S. is somewhat of a misnomer, since it is very fragmented in its structure. It seems to have become even more complicated than the system it is created for and expected to support – the human body. It is generally agreed that the healthcare system in the U.S. is to be reformed. This paper addresses this issue from an organizational point of view with a specific reference to cancer, a disease termed by the physician Siddhartha Mukherjee, “The Emperor of All Maladies.” The reason for choosing cancer as an example is because it is perhaps the most complex set of diseases known to us. To put it in simple terms, cancer is: (i) intelligent, in the sense that it can sustain itself by establishing its own lifeline at the expense of its host; (ii) rebellious, in the sense that it does not obey the natural laws of cell apoptosis; (iii) diverse, in the sense that there are more than 200 types of cancer known thus far; (iv) its evolution – how it metastasizes and colonizes distant parts of the body; (v) its ability to tunnel through the blood-brain barrier. For any healthcare system to provide proper care for such a complex disease, there should be a confluence of factors addressed by both public and private agencies. Public refers to federal and local governments, private refers to medical industry as well as medical professionals. An entirely public system, in terms of the government providing universal healthcare, or an entirely private system, where, by necessity, different services are provided by different organizations is not tenable since it does not have the interests of all the stakeholders – governing bodies, industry, medical professionals, and most importantly, the patient. The basic tenet of this paper is that any healthcare reform in a capitalist society should be designed so as to maximize the benefit to all the stakeholders involved, while incorporating the newer advances in technologies, but above all, must be patient-centered. As always, solving a complex adaptive problem requires different approaches compared to solving a simple technical challenge. Especially, when it comes to dealing with cancer – a very intelligent, continually adapting, rule breaking, self-sustaining disease – simple technical solutions are insufficient without an understanding of how it works.

This chapter is divided into five sections. The first section, Status of Healthcare in the U.S., provides the most recent data on the benefits and costs of healthcare, along with some international comparisons. The second section, The Case of Cancer-Emperor of all Maladies, discusses the subject of cancer, what it is, what is known about it, a few of the novel efforts in dealing with it along with the costs. The third section, Aiming for the Best Healthcare System, raises the question of what an ideal healthcare system should like. A proposal is then made as to how to reform the system. The fourth section, Future Research Directions, lists a set of innovation and innovative carried out across the globe. The final section, Conclusions, summarizes the chapter. The viewpoint presented herein should be taken as from the vantage point of someone who is a trained scientist and a practicing engineer, who is outside the medical field but as a former cancer patient himself, who is a concerned citizen and who has studied organizational structures in profit and non-profit settings.

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