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aAmerica’s healthcare system is bankrupt. And America’s healthcare system must be fundamentally transformed to lead its repair.
Let’s look at the data first: the United States is currently $4 trillion a year About healthcare. This equates to nearly 20% of the gross domestic product.Yet the average life expectancy in the United States is Literally lagging behind dozens of other countries— Including Portugal, Slovenia and Turkey — Up to 7 years difference. If this trend continues, 64th in the world By 2040, life expectancy will increase, but per capita spending will continue to increase significantly more than almost any other country.
Diagnosing this disorder is not difficult. Nearly all the money we spend on healthcare goes towards the cost of medical interventions.However, at best clinical care is responsible for 20% of health outcomes. The vast majority of factors that determine an individual’s health are built into his or her surroundings. That is, how many times you have to change buses to get to the store that sells fresh vegetables. Is there light and fresh, clean air coming through the windows at work? How often do they face the stress and pain of being discriminated against because of their skin color?
These are the social drivers of health, but for too long our healthcare system has largely ignored them.
They have partially ignored them. pursuit of profit. You can make money by claiming for cancer treatment. Not even using institutional leverage to demand sidewalks, parks and streetlights in poor neighborhoods.
Myopia function is also built into the system.Recent Analysis of board members Top US hospitals have found that less than 15% of their board members are medical professionals. Nearly 57% came from the financial and business sector, mostly in private equity, wealth management and banking. They are accustomed to looking at spreadsheets rather than wrinkles of anxiety etched into patients’ faces, and their decisions reflect that experience.
Read more: Why so many Americans are dying young
This status quo is no longer acceptable.
Hospitals and health systems have enormous wealth. The largest companies (even those technically listed as non-profits) have billions of dollars in cash and investments on their balance sheets, some with billions of dollars in cash and investments. Some companies do. record a surplus during a pandemic. The health care system is also highly influential, often being the largest employer in the region and a source of large political contributions.
It’s time to use that wealth and influence to address the social factors that promote health. Hospitals and health systems are as aggressive as they attack cancer with advanced drugs and surgeries to treat and ultimately prevent diseases caused by poverty, inequality, racism and loneliness. should be mobilized to
There are several promising models in this study.
Kaiser Permanente promised $400 million The fund plans to build 30,000 affordable housing units by 2030. The fund also supports economic development in low-income communities. In Portland, Oregon, six large healthcare systems work together to make up nearly the entire healthcare system. 400 apartments These are supported by extensive case management services for those without shelter or at risk of losing their homes. Similar projects are being launched by hospitals and health systems. Denver, Torontoand elsewhere.
Other hospitals are focusing on improving access to nutritious food. food pharmacy Stock up on fresh produce and host a free cooking class.
While these are welcome initiatives, they are just the beginning. To transform America’s health, any profitable healthcare system will need to commit real money (we recommend at least 2% of its annual budget) to addressing a variety of social factors. Identifying local needs and promoting local solutions requires building true partnerships with community groups. And we must develop champions for this initiative in our executive leadership and on our boards.
At a time when there is a widespread shortage of health care providers, it may seem unfair to ask hospitals to take on this task. burnout and exhaustion.
However, there is growing evidence that Disillusionment Healthcare worker burnout is caused not by the sheer amount of work, but by problems in the healthcare system. No wonder. Doctors and nurses do their best to save patients from a medical crisis, but the lack of nutritious food, safe housing, affordable child care, and mental health counseling is causing another medical crisis. will only send the patient back to an almost certain area. within a few weeks. It is discouraging and depressing.
In the short term, we hope that serious efforts by the health system to address the upstream drivers of worsening health conditions will energize health care providers. I am convinced that in the long run it will bring great benefits not only to individual well-being, but also to improving national welfare. The declining health of Americans is taking a toll on productivity, the economy, and even national security. Addressing the social factors that promote health has tremendous growth potential.
where do i start? One of us previously said “Challenge with 10 teamsFor medical systems. Here we add another area of focus to the original framework.
The list below raises obvious questions. Are hospitals in the business of strengthening voting rights or reforming the prison system? Of course, they always do so not as leaders, but as active and generous conveners and participants.
We recognize that we are proposing a fundamental shift in the US medical business model. This is going to be a lot of work. It takes decades. But it has to be done. Anything less than that is a medical malpractice.
All hospitals and health systems should commit resources towards measurable progress in:
- universal health insuranceAccess to regular preventive care is an important first step in promoting good health.
- food security, To ensure that everyone has access to healthy, nutritious food.
- residential securityincluding evidence-based ways to end chronic homelessness.
- Medical and social support for immigrantsThat includes the 10 million illegal immigrants in the United States who often lack access to preventative care.
- A Criminal Justice System Based on Healing and RecoveryIt will go a long way in dealing with mental illness and substance abuse.
- Decarbonization of healthcareThis is because the industry accounts for about 8.5% of global greenhouse gas emissions.
- voting rightsensuring that all adult citizens have a voice in choosing policy makers who listen to the needs of their communities.
- strong schoolBecause education level is highly correlated with health.
- Quality support for pregnant women and babiesTo dramatically reduce maternal mortality and give babies a good start in life.
- Social support for the elderly To end loneliness and isolation, which are major causes of debilitation.
- Ending Gun Violencedestroying too many lives.
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