A quick Google search limited to the past couple months yields several pages of returns linking to news items across the globe that mention the term “healthcare crisis.”
To hear it from these news items, the drivers of these crises all seem to be due to some critical deficiency, like:
- A lack of urgency. In a piece for IrishExaminer.com, politician Micheál Martin blamed a 45 percent increase in hospital waiting lists over the past two years to “a lack of urgency to tackle the healthcare crisis” and a decision by the health minister to retire the National Treatment Purchase Fund, a “body that was set up to buy…private medical treatment for those forced to wait on public waiting lists.”
- A lack of planning. In a piece for EuropeanSting.com about the Greek healthcare system and its effort to provide services to refugees, medical students Vassiliki Samartzi and Nikolaos Karvelas write, “the state machine is replaced by individuals who are trying in despair to offer help without any planning. Unfortunately, awareness on this healthcare crisis is limited, especially concerning our target group, medical students.”
- A lack of policy. In a piece for MiamiHerald.com about Haiti’s hobbled healthcare system, Jacqueline Charles writes, "Ronald LaRoche, a Haitian-trained doctor with degrees from Yale and Harvard, said the healthcare crisis has been caused by three things: medical students unhappy with their pay and lack of supplies; aid from foreign countries spent on facilities and specific diseases but not primary care; and the overall lack of an integrated health policy.”
- A lack of money. In a piece for BeckersHospitalReview.com about Puerto Rico's collapsing healthcare system, Tamara Rosin writes, “Most recently, Puerto Rico's only 24/7 stroke center shut its doors over a lack of funding and a shortage of neurologists. Last week, the island's only active air ambulance company suspended its services, citing more than $4.4 million in debts it simply cannot afford to pay. Now, as the Zika crisis worsens, the island’s healthcare crisis will only be further strained.”
- A lack of ethics. In a piece for WashingtonExaminer.com titled “The looming healthcare crisis in 2016 (candidates take notice)”, San Diego surgeon Munish K. Batra writes, “…we face the prospect of becoming one of those underserved nations in Asia. Doctors remain competent, but we are constantly beholden to uncaring insurance and cooperative managers whose only interest is in preserving their job or the bureaucracy itself.”
I believe that, rather than being drivers, these are all consequences of the actual drivers of our healthcare crisis—of the whole planet’s healthcare crisis. Unlike the regional examples above, these drivers affect all countries.
- The world’s population is living longer. Studies have shown that healthcare per capita spend accelerates at around 60 years of age, and the World Health Organization projects the proportion of the world’s over-60 population to double from 11 percent in 2000 to 22 percent by 2050, thanks to advances in science and medicine keeping people alive longer—a desired, yet costly, outcome for healthcare systems globally.
- There’s a significant increase in the reported incidence of chronic disease, which results in greater costs for a healthcare system. Chronic diseases are characterized as long-lasting conditions that can be controlled but not cured, such as diabetes, stroke, and heart disease. The World Health Organization states that chronic diseases are by far the leading cause of mortality in the world, representing 60 percent of all deaths. In the U.S., five percent of the population account for 50 percent of the healthcare budget, due to the prevalence of chronic conditions, while nearly one-third of U.S. adults are obese and nearly half of adults have a chronic illness, including heart disease and diabetes.
- Hospital visits are incredibly expensive. Between 1997 and 2010, the average cost per stay in the U.S. increased 45 percent to $9,700. Certain hospitals around the world are now sending “well” inpatients, such as C-section recipients, to five-star hotels for their recovery because it’s more cost effective than occupying a hospital bed. Additionally, many hospitalizations are apparently unnecessary. According to the Agency for Healthcare Research and Quality, approximately one in 10 of the nearly 40 million hospital admissions in 2008 were potentially avoidable. These admissions were primarily for conditions such as diabetes, dehydration, and certain heart conditions and infections, which can be treated with appropriate outpatient care.
- The risk and probability of medical errors are increased by—and unnecessary hospital admissions result from—the lack of a coordinated healthcare system, and this carries a significant cost. The Inspector General of the U.S. Department of Health and Human Services has estimated that 13.5 percent of hospitalized Medicare beneficiaries experience adverse events during their hospital stays, of which 44 percent were preventable. Additional Medicare expenses associated with adverse temporary harm events cost Medicare an estimated 5 percent of its budget in 2009, equating to $4.4 billion.
The healthcare crisis—caused by the trend in burgeoning costs—needs urgent attention and rectification. Globally, the focus needs to be on improving the efficiency of healthcare spend while enhancing health outcomes and the patient experience. We need to keep people healthy and out of the hospital. We need to focus on managing the health of a population, which requires having access to all of an individual’s health information and a system for turning that information into action. We need an information technology infrastructure and a focus on greater IT adoption and integration.
But most of all, we need to raise consciousness about what the true drivers of the healthcare crisis—the planet’s one healthcare crisis, not any one region’s healthcare deficiency—are, or else we risk perpetuating the recurrence of such deficiencies instead of cutting them off at their source, giving the world’s healthcare systems a chance for themselves to heal, and making it impossible for those deficiencies to rear their ugly heads the way they so regularly do today.
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