We are Trapped in Our Own Healthcare System

Quality and access are real issues in the American healthcare system, but the problems people deal with on a daily basis are rarely captured or even considered when people talk about fixing problems in healthcare. One doctor spoke about all the problems he faces with having ulcerative colitis in the current healthcare system. He tried various drugs to help his disease, but none worked until his gastroenterologist suggested an immunosuppressant.

As a doctor, he recognized it as a drug often used to treat cancer and with it came significant side effects such as the slight chance of myelosuppression, when bone marrow shuts down and produces too few blood cells. However, the medicine changed his life and he effectively manages his condition even when the healthcare system fails to help him do so.
The medicine is about $80 for a 3 months supply. Regardless of the price of the drug, he still has a hard time getting it since he needs a new prescription every 3 months. To get the prescription, there are many hurdles he must overcome. At various times, his insurance plan changes which laboratory facilities it will cover fully. Also, the laboratory and his doctor are in completely different healthcare systems, so he has to beg the lab to remember to fax over the results, which it often fails to do.

Processing takes time and sometimes the drug is on "back order" and he always runs out of medicine before he can get a new bottle. He does this four times a year and it’s always stressful and stress isn’t a good thing for a person with this disease. He knows it could be simpler in many ways and asks, "Why can’t I get this simple blood test more conveniently? Why can’t the electronic systems of the labs and the clinical offices talk to each other? Why can I use only one pharmacy when the medication is generic and so inexpensive?" It is clear that the system is the main problem here and reform is needed to deliver care more efficiently and improve outcomes more effectively.

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