We’re discussing our nation’s top health care concerns, and the biggest obstacles we face in finding good quality, affordable health insurance. Over the 2008 holiday season, thousands of people across the country joined together to discuss these important issues. Small groups gathered in all 50 states, dedicated to finding solutions for health care reform. After all the groups had met, a comprehensive Report on Health Care Community Discussions was published, providing an intricate and detailed overview of our current health care system. This week, we’ve talked about several concerns that many Americans have, including the cost of health care, health insurance costs, the availability of both health care and health insurance, and the importance of preventive care. Today we would like to discuss the last major concern: quality of care.

Although most people were concerned mainly with the quality of the overall health system, various other concerns included the overuse of health care services and the high number of medical errors. Mostly, though, people felt that the quality of health care received in various health care facilities was not up to par with other countries – especially considering how costly it is.

From Northampton, Massachusetts: “While the US has by far the highest per capita cost for health care in the world, we fall near the bottom among developed nations for standard outcomes such as infant mortality and life expectancy.”

Some of the biggest quality problems noted were misdiagnosis, the failure to correctly and quickly diagnose problems, and delays in treatment. And many seniors felt that health providers tried to rush their treatments, leaving them vulnerable to future problems. For example, a group in Bella Vista, Arizona, attended mostly by retirees, mentioned that “poor discharge planning resulted in people being re hospitalized.”  Their argument is that proper care during the first hospitalization would have resulted in a successful recovery, and no need for a second hospitalization.

Granted, every institution makes mistakes. We are all guilty of it, and we certainly cannot expect perfection from anyone. However, the statistics on medical errors and hospital-acquired infections is astounding. We’ve actually posted about it a few times, mentioning what Medicare and the State of Ohio are doing to reduce these errors. And while medical errors are seen in all health care facilities in all areas of the country – from infections to mistakes during surgeries, etc… – many people find that specific populations feel the brunt of the issue, such as adults with severe disabilities and senior citizens.

From Lincoln, Nebraska: “Nursing homes…often do not provide the ongoing physical therapy that is needed for maintenance of basic body functions…In other words, care is canned, not individualized.”

From Palm Beach Gardens, Florida: “When patients with disabilities are hospitalized, they often go without basic needs (food, hygiene, toileting, communication) unless a family member or friend can stay with the person.”

Several groups noted that health care has become less “humanized” over the last few years. Individual patient concerns are not valued as much as they should be, and the patients are rushed through their visits as quickly as possible. And while many patients feel that their doctors do not spend enough time with them personally, they don’t necessarily fault the doctor for that. Doctors are typically overworked and overwhelmed. There is a know physician shortage in the country – and we are constantly talking about the Nurse shortage. These shortages stem from a variety of other problems, including the high cost of medical malpractice liability insurance and the cost of medical school.

From Fredericksburg, Virginia: “Doctors are forced to see too many people in too short of time. [This] results in doctors treating symptoms without every being able to counsel patients on root causes, healthy lifestyles, or alternative therapies. [They] cannot develop doctor-patient relationships that can really address health issues.”

From Albuquerque, New Mexico: “We’re finding it harder and harder to talk to our doctors, and we’re feeling that our day-to-day health concerns are being increasingly marginalized.”

Many people complained about the overuse of certain medical services, such as prescription drugs and surgeries. Rather than accurately diagnosing and treating the problem, many patients felt that their doctors simply prescribed medications to treat the symptoms. Similarly, several groups felt that doctors were too quick to recommend surgery, without suggesting alternative treatments or second opinions.

And although the quality of health insurance wasn’t really discussed in great detail in the report, it was mentioned as a concern. Many people feel confused by their health insurance coverage, and don’t feel that health insurance providers do enough to help them understand the process. In fact, many people don’t even know how to properly read and analyze a health insurance statement or a medical bill. And that is definitely something that everyone should learn. Just was we mentioned earlier, everyone makes mistakes, and that includes the hospital billing offices and the health insurance providers. Everyone should review both their medical bills and health insurance statements for accuracy.

From Cambridge, Massachusetts: “The biggest problem in paying bills was the fact that nobody seems to know what their health care should cost. Nobody could cite a situation where they understood their medical bill or knew whether the insurance company was providing proper coverage for rendered services.”