Health Care Reforms in U.S. - Part 7 - Why There Need Not be Reforms

What if U.S. has a best working health care system in the world - this thought always finds a way within me and subtly strokes its relevance time and again. Till now I am of opinion that health care in U.S. is abysmal. Let us look and evaluate the counter perspective as opinions change from time to time. After all, every dimension needs to be considered when you are looking at a complex problem. I had mentioned in 6 posts earlier on the necessity for health care reforms and better health care dispensation per se in U.S. These posts are all looking at negative shades of the health care outcomes. If we flip the coin, the other side tells as many positive outcomes emerging out from the work of this complex network. Even if there are 50% positive and 50% negative outcomes, I can vote against the reforms when I personally fall in the 50% positive bracket. Nothing will have all positives, or nothing will have all negatives. It would be too good to be true if we are looking at all positive trends. Hence a mix of positive and negative outcomes can be considered as a decent model. After giving out many reasons for reforms over the past many posts, I am flipping the coin to look at the other side, which also looks great. 

I would like to begin with my own experience with this network by making a statement – the U.S. health care affiliates has kept me alive for the past four years, gave me an avenue to express freely at work and beyond. To make it clear, I was employed in U.S. health care domain for the past 4 vigorous and rigorous years. If I was employed by giving a lifeline, respect, bread and butter; I cannot simply propagate against a system that it isn’t doing good. It is doing tremendously great by keeping me alive and my dreams afloat. Talking about the dreams, I came to U.S. onsite by virtue of this ‘complex network’ and working over here for almost 2 years. My dream of working in a job in U.S. was realized by this tenure provided by this system. If at all I was able to contribute collaterally (apart from my official work) to U.S., even if it was an iota (or more), it was because of this job in this domain. Indirectly, it is this health care industry which has contributed that iota (or more) to U.S. The entire credit goes to this job-givers, money-givers and platform-owners. When average individuals are employed and made great by industries, the countries will be feeling the immense ripple effects of the good times. Without seeing anything in future, the past four years are enough for me to devour and fallback for eternity. What more do you require for a lifetime or a generation – when your dreams are realized and everything incredible happening. Isn’t it reasonable from my own personal perspective to expect the ‘complex network’ to remain the same and operate the same for eternity and create many more stories like mine. And I cannot cut the branch I am sitting on, rather than strengthening it to allow many more to sit beside. Hence, there is a more valid view for the health care industry to be strengthened in its current form. Can you tell any better positive outcome for an individual and to the larger circle of influence from this industry than this one. When the network of individuals who require help are supported, nations will be enriched by the consolidated accumulation of these stories. 

Moving from this individual level and looking at the macro picture for the other side of the coin - The U.S. leads the world in biomedical research and innovation, producing many new drugs, devices, and procedures that improve health and save lives. The U.S. also ranks first in science and technology by a wide margin, as measured by the number of new drugs and medical devices gaining regulatory approval, the scientific impact in academia, and the research and development expenditures per capita. These many new drugs, devices, and procedures developed, such as vaccines, antibiotics, cancer therapies, organ transplants, artificial organs, and gene therapies not only improve health and save lives in this nation but all around the world. It certainly saved my life like nothing. 

The U.S. is the largest public funder of biomedical and behavioral research in the world, through the National Institutes of Health (NIH), which supports thousands of scientists and projects across the country and abroad. The NIH has contributed to many groundbreaking discoveries and achievements in biomedicine, such as the Human Genome Project, which mapped the full genome for the first time in 2003 with an international consortium of thousands of researchers. These great minds must be definitely aware of negative outcomes of this domain and the downsides of health care in U.S. This NIH and these thousands of scientists must have definitely thought-over and out-worked the raising health care costs or replace it with far better trade-offs. Many advantages need room for some difficult disadvantages. Foolish men will argue while intelligent researchers will stay silent and go about their work. 

Even if I was indirectly benefitted, one compelling case is the health care system keeping scores of people externally and around the world afloat by saving lives directly. As I mentioned already, their drugs, devices, and procedures save crores of lives all over. Two examples to be specific – 1. USAID has supported many programs and initiatives to improve the health and well-being of mothers, children, and families in low- and middle-income countries. USAID helped reduce maternal deaths by 44% in Afghanistan, increased the use of modern contraceptives by 24% in Ethiopia, and saved the lives of over 4.6 million children under five in 25 priority countries.  

2. Management Sciences for Health (MSH) has documented 10 stories of success from its work in strengthening health systems and improving health outcomes in various countries. These stories include empowering women leaders in Nigeria, expanding access to essential medicines in Malawi, and strengthening the response to Covid-19 in Peru. These are some of many organizations which intervene with health care objectives of countries around the world and help to create numerable positive stories. 

While the value proposition outcome is tremendous in some facets, another outcome is jobs and job creation. Job matters for me and anyone with a need. The healthcare industry focuses on helping people and provides services related to treating illness, managing disease, and maintaining wellness. As of today, believe it or not, healthcare is the largest employer in the United States. In the year 2000, there were 7 million more employees in the manufacturing industry than in health care. At the start of the Great Recession, there were 2.4 million more employees in retail than in health care. In 2017, health care surpassed both manufacturing and retail. At present, there are more than 22 million in this sector with 14% of the total employed or 1 in 8. This is not confined to domestic employment. I am a foreign employee in this area and there are many foreign nationals who are gainfully employed in the domain from many years. Adding up, the total number will be much higher, if we consider direct and indirect employees living upon this important domain. By the way, in India the number of total work force is a mere 12 million or 3.4% of total employed. Imagine 22 million for 33 crore population in U.S. versus 12 million for 140 crore in India. Health care is largely underserved in India with abysmal ratio of employment versus population as against a healthy rate of jobs given in the U.S. for its very low but aging population. Thus, the area which employs the largest workforce of the nation and has given jobs to many people like me must be doing many things right. 

We often talk about high health care costs and expenditure. The U.S. spends 17% of its budget or a whopping 4 trillion on health care. The same number in India is a low 98 billion dollar for its huge population. This is lesser by nearly 40 times between the countries to put things in perspective. Once again, if we look at where this high money funnels into - amazing things happen in U.S. with this heightened monetary activity in health care. 1. Investing in tremendous manpower which was just seen. Thanking one and all as I get this money too. 2. The U.S. healthcare system's financial investment supports a robust pharmaceutical and biotechnology industry. The substantial spending contributes to the development and adoption of cutting-edge medical technologies, pharmaceuticals, and research which leads to medical breakthroughs, improved treatments, and advancements in healthcare. 3. High expenditure is correlated with a high standard of healthcare services, including access to advanced medical treatments, highly trained healthcare professionals, and state-of-the-art facilities. 3. The U.S. has been a global leader in medical research, innovation, and healthcare delivery, with its institutions often setting benchmarks for healthcare standards and practices worldwide which we just saw earlier. 4. The high levels of spending can attract and retain top medical professionals and researchers, contributing to a skilled and diverse healthcare workforce. To keep the best and the finest to move the industry, you need to pay them well, which is obvious. 6. Higher healthcare costs supporting job creation stimulates economic activity in related sectors while comfortably saying that the healthcare industry is a significant contributor to the U.S. economy - directly, indirectly or in any crooked way possible. Remember my iota contribution to U.S. by virtue of my job. There are millions of iotas (or more) from millions of individuals. 

Thus, we examined several positive facets like of U.S. health care – Advanced research and procedures to save lives within and around the world, high job opportunities, higher cost and expenditure in health care putting the nation on top of the world in medical dispensation. After looking at these, do we still need the U.S. to mimic Europe for free universal coverage or India for lower health care costs or do we need the Europe and India to mimic U.S. Things stands in U.S. at where they are because of greater rationale behind and higher purpose which thoroughly validates the functioning of the system as it is today. This opinion is highly subjective because of my own individual interest and also highly objective because of ticking most of the boxes required to justify the functioning of this system as it is without many reforms. There needs to be strengthening of the system and improvements of status quo but need not be horizontal reforms. Thus, at this time, we can validate and pass the health care system test case of U.S. and pat their back for everything they had done.