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BUSINESS

AT THE HELM:

CREATING A SYSTEM WHERE

HEALTH OUTCOMES ARE PARAMOUNT

By Jorge Arango

Healthcare in the United States is no longer focused primarily on of network”, patients pay more and/or cannot access the doctors
care provided at the point-of-service. It now requires a broader per- of their choosing. Meanwhile, doctors have to deal with a myriad
spective such as a focus on health promotion, population health, of obstacles unrelated to the doctor/patient relationship.
and individualized approaches. The main goal is to achieve the Furthermore, doctors spend an inordinate amount of time filling
Triple Aim: Patient Satisfaction, Better Health Outcomes, and Re- out questionnaires or as scribes typing endlessly on keyboards. At
duced Costs. great expense, they hire personnel that sit all day calling insurers or
The Triple Aim is of course an oversimplified objective – a goal. health plans and asking for pre-authorizations for diagnostic pro-
To get there one must come to the realization that our healthcare cedures, labs, or prescription medications.
system has to be first radically transformed. In her new book, An One must recognize that the American healthcare system is one
American Sickness: How Healthcare Became Big Business and How of the best ones in the world. We have prestigious training institu-
You Can Take it Back, Elizabeth Rosenthal, MD., examines the cur- tions, some of the best doctors and hospitals in the world, as well
rent state of our health care system and concludes that it is in a state as some of the most advanced and ingenious technology. However,
of disrepair. due to administrative costs and third party meddling, we have mis-
Due to third party involvement and the takeover of finances (in- erably failed in controlling the costs on healthcare services across
surance/health plans), we have failed miserably in controlling the the country. In 2018 we have approximately 55 million Medicare
cost of administered healthcare services across the country. We beneficiaries, and by 2030 we will have close to 80 million. If noth-
spent $10,000 per person in America in 2016, which is almost twice ing is done about this, our healthcare system will only get worse.
the average cost in most developed countries. Today, we are at a Dr. Robert Pearl, CEO of Kaiser Permanente’s medial group in
staggering $3 trillion according to data from the federal government California and an authority on our health care system, says that
and the Robert Wood Johnson Foundation. Americans are dying unnecessarily from failure of prevention or
Although they are at the core of the system and the reason for complications of chronic illness. “We value intervention over pre-
the existence of the medical universe, doctors and patients are not vention: we value the newest advance over the things that are tried
being served well. Often times, they are left out of the decision mak- and true. To achieve improved outcomes we would need not only
ing process and have to beg their way to either provide a service or better coordinated care but also the use of technology.” Dr. Pearl
receive the clinical services they want. Because of concepts like “out is an advocate of virtual visits, telemedicine, and other technologies

26 San Antonio Medicine • October 2018