“America was not built on fear. America was built on courage, on imagination and an unbeatable determination to do the job at hand.” – President Harry S. Truman

As President Truman stated, the United States is globally perceived and glorified to be the land of innovation and execution (Truman, 1947). This innovation and execution extends out to healthcare; America’s in-depth biomedical research and adept patient-care attract a plethora of immigrants each year looking for an improved life and medical opportunities. However, should the United States’ health care system be extolled to this extent? How does the United States rank among other countries in the world and are there other countries that can serve as an equal or even better replacement for those seeking top-notch health care? Dr. Kenny Mok — a physician, associate clinical professor of medicine at UCSF medical school, and a co-founder of a non-profit organization – helps to shed some light on the pros and cons of America’s healthcare system.

Dr. Mok began to embark in his interest in public health in a time of concern as he stated, “I became really demoralized when I saw that patients were not getting well, not getting healthy.” Dr. Mok also works on an initiative that aims to reduce 30-day patient readmissions. Although the United States allocates 17.1% of its GDP on health care expenditure, the highest in the world, the benefits are not reciprocated (Squires et al., 2015). According to the World Health Organization, the United States ranks 37 in the world for health outcomes. What is wrong with the way the United States hospitals provide aid to their patients? Dr. Mok wonders, “For example, there are way more smokers in other countries, and America has such explicit commercials to prevent smoking. But America still has bad health.” In fact, when compared to other countries, especially European countries, the United States has a much smaller percentage of smokers (13.7% of the population) ( Squires et al., 2015). This discrepancy between the initiatives the United States undertakes and the health outcomes of the American people is what prompted Dr. Mok to make an impact in this field.

Although the United States ranks quite low globally in patient health outcomes, the country’s healthcare system does have redeeming aspects about it. Dr. Mok recalled his fascination in volunteering in third-world countries. “Going to a third-world country was one of my high school ideals – I wanted to change the world” , and changing the world he is doing based on his experience in a hospital in Rwanda. There were mainly practitioners instead of full-fledged doctors that had to help the people of Rwanda and although the Rwandan government subsidized 90% of the health care costs, 10% out-of-pocket pay was too much for the patients. “In America, patients are given oxygen like water upon admittance to the hospital. However, if Rwandan patients did not have the money, they would not receive oxygen to live. It made me realize how we take things for granted in industrialized countries. The cost of human lives is different.” Dr. Mok explained that the surgeons in Rwanda had to make use of every single instrument, but also had to effectively ration medical supplies so that many patients could be helped. This was not always the best option as quantity was emphasized over quality, which could have led to further

medical complications. “In Rwanda, aside from all other inequities, mental health was essentially non-existent. They were so focused on physical health and staying alive that mental health was completely disregarded. Mental health is one of those problems that are not talked about in developing countries.” Per the World Health Organization, about 75% to 85% of mental disorders in developing countries are left untreated and according to Bertolote, Fleischmann, De Leo, and Wasserman, over 80% of the world’s population that is suffering from a mental disorder live in developing countries (Ngui, Khasakhala, Ndetei, & Roberts, 2011). The United States, on the other hand, emphasizes mental health as much as it emphasizes physical health.

Despite its flaws in the health care system, the United States is still a powerhouse in the medical field. Its ability to focus on all aspects of health provides a safe haven for those who live in underdeveloped countries and seeking better medical treatment. However, there is room for improvement. For example, the amount of money spent should be reciprocated by an increase in positive patient outcomes. In the words of President Truman, America should use its “unbeatable determination” to efficiently use its funds to create a lasting impact on patients and reduce readmission to the hospital (Truman, 1947).

References

Truman, S., H. (1947, January 8). Special Message to the Congress: The President’s First Economic Report. Retrieved from: https://www.trumanlibrary.org/publicpapers/viewpapers.php?pid=2043

Squires, D., Anderson, C. (2015, October). U.S Health Care from a Global Perspective: Spending, Use of Service, Prices, and Health in 13 Countries. Commonw Fund. Retrieved from: http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-glo bal-perspective

Tandon, A., Murray, C. J. L., Lauer, J. A., & Evans, D. B. (Date of publication). MEASURING OVERALL HEALTH SYSTEM PERFORMANCE FOR 191 COUNTRIES. GPE Discussion Paper Series, 30 . Retrieved from: http://www.who.int/healthinfo/paper30.pdf

Ngui, E. M., Khasakhala, L., Ndetei, D., & Roberts, L.W. (2011, January 1). Mental disorders, health inequalities and ethics: A global perspective. Int Rev Psychiatry, 22, 235-244. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935265/

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Posted by Jahnavi Kola

Jahnavi is a freshman studying Molecular and Cellular Biology and Public Health Studies. After a public health course piqued her interest in the subject and added to her passion of improving health for all, she immersed herself deeper into the subject by writing for HMR's Global Health committee. Outside of HMR, Jahnavi explores her other health-related interests by participating in Patient Delirium research at Johns Hopkins Medical Campus, volunteering at Johns Hopkins Out-Patient Oncology Clinic, and participating in SHARE: a medical supply distribution team. She hopes to ultimately become a pediatric surgeon and concentrate her future research efforts in Trisomy 21.