Healthcare “Non-System” in Need of Major Change

December 8, 2009

Rebecca Matteo, a lecturer in sociology at Wake Forest University, teachers the first-year seminar “Health Care Reform:  A Sociological View of America’s ‘Non-System.’”   From preventive health to cost containment, the class explores the fragmented landscape of health care reform from the sociological perspective.  Here Matteo shares her views on the most important issues in health care reform today.

By Rebecca Matteo

As I tell my students, I think one of the biggest “issues” in health care reform currently, is the lack of understanding we, as a country, have about the “health care system” itself. I am excited to hear my students talk about conversations they have with family and friends outside of class related to health care reform. Their eyes are open … and they feel confident to have an opinion that they can both articulate and defend. What I believe is that our system is not truly a “system.” We currently lack centralization, regulation, communication, and organization in the way health care is provided, which is not to say that a socialized system is necessary. But, there are so many gaps in our current fragmented medical complex that the “where to begin” question is overwhelming. I am reminded of this at the start of the semester, when I realize that there are never enough weeks in the semester to consider every relevant topic.

In terms of health care reform in general, I believe that our “non-system” is in need of major change. Compromise is inherent in sweeping policy, but I do agree with the specific focus of removing pre-existing condition clauses from insurance plans, and greater coverage of Americans in general, without losing options (or choice) in coverage. Furthermore, continuity of care is something I personally believe will improve our system, but this requires access and availability of both insurance and general practitioners (potentially facilitated through electronic medical records). In an era marked with the proliferation of chronic disease management and increasingly expensive, yet beneficial, health technology, there must be an effort to support preventive health, both through individual and system-level changes, rather than continued “reactive” and “defensive” medicine, which ultimately lead to wasted time and money.

Within the long history of attempts to provide major reform to the health care system in the United States, I feel that President Obama has forced conversation to an unprecedented level. Creating a dialogue and making decisions transparent are critical ways to help alleviate fears of government control that are pervasive in our society. Sadly, as medicine developed into “big business,” market ideals became entangled with the altruism of the profession. We all suffer for that trend – as the collective interests of health care are now intertwined in a web of fear about life-threatening chronic illness, medical bills, losing insurance, malpractice – on and on. What we do know, is that Americans are very diverse in both their opinions about what is best for the health care system and their own individual health care needs. Whether reform is based upon cost containment, health outcomes assessments, or the satisfaction of patients and health care workers, what we need most is a level of security and consistency for health care providers and their patients.

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