Taking a thorough history and performing a full physical exam are integral skills familiar to all of those who practice medicine. Understanding the root cause of any problem helps to establish a cogent differential diagnosis and is an essential step that allows us to formulate an appropriate treatment and plan. Our ailing U.S. healthcare system needs to be treated like any other chronically ill complex patient we encounter. We rely on good historians to obtain and document a pertinent review of systems, and these same historians must succinctly and accurately present the case in a manner which can be easily understood and acted upon. The American public remains too much in the dark and confused about the way our $3.6 trillion-plus healthcare economy works.

Meanwhile, the costs continue to rise — premiums, deductibles, out-of-pocket expenses, taxes, employer contributions, weak wage and salary increases because of employer contributions — and the public pays more and more, while receiving less and less.

Gaining access to quality care is becoming harder. Polls show that patient frustration is steadily rising, along with dissatisfaction over the severely limited time with a physician when one finally reaches the examination room.

How did we get here?

Typically, blame is placed on parts of the system that the consumer of medical care can see — physicians, insurers, and the drug manufacturers (aka Big Pharma). Consumers have a sense of being gouged by a system that can’t continue without some form of intervention.

But the reality of our $3.6 trillion-plus healthcare economy is vastly more-complicated than what the consumer sees. It’s largely in the shadows where the general public never glances and doesn’t have the time to penetrate and peel back the layers; but that’s where the special interests, the lobbyists, the politicians, and the regulators play.

Do you think that fully repealing “Obamacare” will lead us to paradise?

How about “Medicare for All,” something along the lines of the nationalized healthcare systems seen in other countries? Is that the path to Healthcare Heaven?

If that’s the way you think, be forewarned. The slogans on the bumper sticker are poor tools for understanding how the American healthcare system has become so desperately sick. And they won’t help in crafting a treatment that shows a serious understanding of what’s wrong. An underinformed public can easily be conned.

In a series of articles, I will explain “the drivers” of cost in our healthcare system, how certain entities you may not ever have heard of have risen to positions of control and self-enrichment. We will “follow the money,” pointing you to sources you can follow up yourself, and suggesting what you can do to advocate for a better path forward.

“…the public pays more and more, while receiving less and less…”

Our topic next time: American healthcare’s staggering administrative overhead.

Printed with permission of The Bucks County Courier Times, on which Dr. Mass serves as a member of their editorial board. This first installment was initially published in February of 2020.