Healthcare Upside Down : A Critical Examination of Policy and Practice

Preface Other Publications by Dr. Buchwald Reviews of This Book Judith E. “Judy” Heumann Dr. David B Hoyt Dr. Joseph M. Vigneri Acknowledgements Contents About the Author Chapter 1: Statistics Life Expectancy Mortality Rate Potential Life Lost Years Infant Mortality Amenable Mortality to Healthcare Healthcare Access and Quality Index Healthcare Availability Healthcare Cost Summary Racial Discrepancy (See Chap. 9: The Underprivileged) Conclusions Sources Chapter 2: The Language of Change Conclusions Sources Chapter 3: The Medical School Medical School Origins The Medical School: Mission and Reality Teaching Teaching Primary Care Teaching Advanced Care Teaching Research Best of Current Medical Practice Medical School Research Costs of Running a Medical School Medical School Summary Conclusion Sources Chapter 4: The Clinic; The Office Conclusions Sources Chapter 5: The Hospital History Pre-twentieth Century Twentieth Century Transitions Hospitals in the Twenty-First Century Getting In; Getting Out; Getting In Again In-Hospital Medical Care Hospital Accreditation Hospitals: A Business Conclusions Sources Chapter 6: The Practice What Was What Is What Will Be Conclusions Sources Chapter 7: Payers Ultimate Payer Insurers Hospital Systems Pharmaceuticals and Medical Instrument Companies Summary The Business of Healthcare Conclusions Sources Chapter 8: Socialized Medicine Definitions Single Payer Socialized Medicine US Healthcare System Principals and Practices of Socialized Medicine: The Good and the Bad Universal Healthcare Equity of Care Exclusions from Care Access to Care Quotas Patient Freedom of Choice Physician Freedom of Choice Preventative Healthcare Use of Medical Care Quality of Care Conclusions Sources Chapter 9: The Underprivileged Historical Notes Ancient Egypt Ancient China Indian Subcontinent Ancient Greece Ancient Rome Early Europe The USA Colonial Times The 1800s; the Civil War The 1900s Early 2000s The Status of the Underprivileged in Current US Healthcare Native Americans African Americans Hispanic Americans Asian Americans Disabled Americans Gender All of Us Are Healthcare Underprivileged Conclusions Sources Chapter 10: Public Health and Pandemics Public Health Definition United States Public Health Service and Its Performance Public Health and Individual Health Epidemics and Pandemics Lessons Learned Conclusions Sources Chapter 11: COVID-19 The Statistics Responsibility Government The Public The Economy Healthcare Agencies and Experts What Is SARS-COV-2, the Cause of COVID-19? Beating COVID-19 Societal Isolation Vaccines Drugs Nature First Responders Conclusions Sources Chapter 12: Research Definition and Origin of Research Research and Pandemics Learning Research Funding Research The Soul of Research Healthcare Research Upside Down Conclusions Sources Chapter 13: Doctor/Patient Relationship The Doctor/Patient Relationship History Deterioration of the Doctor/Patient Relationship Personal Recollections The New World My Doctor, My Patient Conclusions Sources Chapter 14: Where Do We Go from Here? Ten Potential Remedies Healthcare Workers and Their Leadership Advocates of Public Health Medical Schools Medical and Social Research Insurers of Healthcare Providers: Hospitals and Clinics Government and Politicians The Media Philanthropy Everyone Conclusions Sources Epilogue Index Inspired by witnessing and experiencing the changes in healthcare and its delivery over the past 50 years, Dr. Henry Buchwald observes and comments on the current state of healthcare in the United States. His narrative includes the history, the historical data, and personal experiences of a healthcare system that has moved away from caring, first and foremost, for patients. This expensive, impersonal system, he believes may not be in the best interest either of the nation or of the people it purports to heal. As the title suggests, it appears that healthcare has been turned upside down to serve the administrators of the system and away from its basic function of offering the best care for patients. With this basic principle in mind, the topics presented in this book provide and discuss healthcare statistics and alterations to the language of medicine. The chapters themselves examine the transformations to the medical school, the clinic and the office, the hospital, and the practice. Additional chapters discuss the role of the payers, public health research, as well as pandemics, including COVID-19, the advantages and disadvantages of socialized medicine, as well as the broken doctor/patient relationship. Finally, Dr. Buchwald offers thoughts on the areas in which future healthcare efforts can most fruitfully be expended. Analysing today’s pervading administrative domination of essentially every facet of healthcare, Healthcare Upside Down thoughtfully considers the variety of ways in which we can turn the current healthcare system right-side up to serve those who should be the ultimate beneficiaries – all of us as patients, now and in the future.