We delivered wheelchairs to several elderly people who suffered strokes years ago and were paralyzed, never receiving medical care because of cost or lack of access. The missionaries who hosted us told us this was extremely common — only the upper class can afford insurance. Poor people who try to visit physicians might be put on a waitlist of a year or more.
One public hospital in Santiago stands out as horrifying. Rubber gloves and plastic bags that appeared to contain used medical equipment littered the floors. Homeless people crowded the hospital’s entrances for shelter. We carried wheelchairs up three flights of stairs because both elevators in the wing were out of order, something we learned is a common occurrence. All of the hand sanitizer dispensers I tried were empty.
This hospital saw nearly 2,000 patients a day, yet approximately 10 physicians were on call.
Six patients were crowded into the room we visited, two of whom were receiving wheelchairs to take home after being discharged. As it turns out, the hospital only had tabs on three wheelchairs as a result of theft, so patients are commonly transported around in other ways.
Giving the wheelchairs and meeting the recipients was a very emotional experience. The trip invited a lot of introspective thinking, and as a healthcare writer, I couldn’t help but compare the issues in Chile’s healthcare system to those of the U.S. In short, I thought to myself, this situation would never unfold in America.
Of course, there are certain socio-economic, cultural and political factors deeply embedded in Chile, and their influence on the state of its healthcare system can’t be ignored. Our starkly differently economic planes makes it unfair to compare the American healthcare system to Chile’s.
However, observing these many deficiencies first hand certainly forces one to reflect on his or her own situation. In the U.S. — even in rural regions experiencing physician shortages and access issues — everyone is still able to receive emergency medical care.
While it’s true that inefficiencies exist, our healthcare system is designed with the goal of providing high-quality, efficient care to everyone who needs it, which is not the case in so many parts of the world.
This is the foundation of the PPACA. The law’s primary goals are to reform the American healthcare system by providing more people with affordable health insurance, improve the quality of healthcare, regulate the health insurance industry and reduce overall healthcare spending.
Unfortunately, many of the law’s provisions and regulations impose onerous demands on both medical providers on the frontlines as well as administrative workers. For example, many physicians agree that too much regulation limits their creativity and autonomy in making clinical decisions, while new reporting mandates require more time for administrative tasks, which can mean less face time with patients.
Another example: Stringent meaningful use requirements make hospitals and systems with limited resources incapable of attesting to standards, and the pass-fail nature of the program prevents many organizations from attaining recognition, even if they show significant improvement.
The dissatisfaction surrounding certain aspects of the PPACA for those on the frontlines is understandable, but despite this frustration, most healthcare professionals can at least agree that the law’s intentions are in the right place. Unfortunately, the possibility of making real, meaningful change that could improve processes and regulations imposed on healthcare workers as well as care delivered to patients, is largely encumbered by Congress’ inability to cooperate across the partisan divide.
When collaboration becomes stifled by politics and the unwillingness to cooperate — and moreover, when energy and resources are devoted to political grandstanding instead of creating real solutions to problems — that is when the American healthcare system becomes the most flawed.
Cooperation is becoming more and more difficult in an increasingly polarized government, and though the PPACA is not bipartisan, reform can only happen through compromise.
Just yesterday, in a 239-186 vote, the Republican-led House of Representatives passed legislation to repeal the PPACA, but as in Republicans’ 60 other attempts to repeal the law, the legislation will likely not go far. Earlier this month, President Barack Obama said he would “happily” veto the most recent attempt.
Why, after five years of failed attempts to kill the PPACA, are politicians still trying? The more effective use of time and resources, it seems, would be to focus on designing solutions to the law’s flaws and moving forward.
It is neither accurate nor fair to boil industrywide dissatisfaction down to one sole cause, but the lack of problem-solving among those with the power to rectify many of the national healthcare system’s issues certainly creates a trickledown effect.
While I’ve been back at work for a few weeks now, I often reflect on my experiences in Chile. The U.S. has the infrastructure, resources and medical expertise to be one of the best healthcare systems in the world, but being caught in a political stalemate is obstructing its potential.
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