Congratulations to Scholarship Essay Winner Thomas Grasty Villanueva

MedMalFirm.com is proud to support college students with our $500 Scholarship Essay Contest. The winner of our Fall 2020 essay contest is Thomas Grasty Villanueva.

About Thomas Grasty Villanueva

Thomas Grasty Villanueva is an Industrial Engineer studying Business Engineering at the University of Chile. He has dedicated the last three years of work and study to design, development and deployment of data analytics projects and solutions. Thomas believes that the field of business engineering is one that can upgrade business processes and, in turn, can improve people’s lives in many ways.

In his personal time, Thomas holds to the mantra that “a healthy mind in a healthy body.” He enjoys boxing, running, playing basketball and playing soccer.

Read the Winning Essay

Essay has been edited only for formatting and posting purposes

Before saying anything about what’s the “proper” role of government in this regard let’s first see what is the current definition of the relevant institutions of their role in order to provide context. The Department of Health and Human Services (HHS) states that its mission is “to enhance and protect the health and well-being of all Americans”. At this level I think it’s easy to agree with it. Further on the HHS declares “…We fulfill that mission by providing for effective health and human services and fostering advances in medicine, public health, and social services,” here the key words are “effective” and “advances”: so the approach to fulfill their role is related to the quality of these issues. Quality that is supposed to be maintained in the future through the advances that will be fostered. Yet if we compare this mission with the “Flaws and Opportunities for Better U.S. Health Care” study by the Commonwealth Fund we see that The U.S. ranked last on performance overall, and ranked last or near last on the Access, Administrative Efficiency, Equity, and Health Care Outcomes domains even though it spends around 50% more (in terms of the proportion of the country’s GDP) than the second highest spender in the list (Switzerland).

So there’s clearly a gap between what healthcare is and what it intends to be. According to the Commonwealth Fund’s president, David Blumenthal , the main three reasons why we see this gap is because of:

1. Lack of insurance coverage: More than 27 million people in the United States were uninsured in 2016 (nearly a tenth of the population)
2. Administrative inefficiency: “while insurance coverage in general is great, it’s not ideal that different insurance plans cover different treatments and procedures, forcing doctors to spend precious hours coordinating with insurance companies to provide care.”
3. Underperforming primary care: “many primary-care physicians struggle to receive relevant clinical information from specialists and hospitals, complicating efforts to provide seamless, coordinated care.

Now if we drill down into injuries such as medical errors, we see that more than 250,000 people in the United States die every year because of medical mistakes, making it the third leading cause of death after heart disease and cancer . According to Dr. Martin Makary of the Johns Hopkins University School of Medicine this is caused by “inadequately skilled staff, error in judgment or care, a system defect or a preventable adverse effect. This includes computer breakdowns, mix-ups with the doses or types of medications administered to patients and surgical complications that go undiagnosed.” And to add one more thing to this issue, we can’t leave out the professional liability insurance cost that is eventually trespassed to patients making the bills even more expensive than they already are.

So with all these being said, the role of the government is critical to address the situation and effectively protect patients from injury. Given the healthcare system symptoms and the reasons that generate medical mistakes it’s clear that the system needs to be more efficient in terms of cost and effective in terms of quality. So clear initiatives in these directions are:

1. Reduce the cost of medical supplies and equipment: by associating the medical institutions and generating public biddings that lower the prices set by providers now.
2. Reduce the cost of human resources: by allowing foreign professionals to work in the US after proper validation of their professional skills.
3. Reduce the waste of time associated with processes that are sub optimal: by implementing technology for diagnoses (such as artificial intelligence ) and management of health processes so that they follow a structure with enough control points and relevant information (which we know is critical in primary care).
4. Generate policies to mandate that insurance covers standardized sets of procedures designed to eliminate the administrative time needed by professionals today.
5. Restrict incentives given by pharmaceutical and equipment providers so that procedures and drugs recommended to patients are not more or different than what they strictly need.

Then as medical services run with leaner and effective procedures, the cost of insurance will go down making the system more affordable in turn. As the system is more affordable also the coverage increases. So with these initiatives we can provide the government with the following needed roles:

1. Provide and purchase health care
2. Ensure access to quality care for vulnerable and non vulnerable populations
3. Regulate health care markets
4. Support acquisition of new knowledge
5. Develop and evaluate health technologies and practices
6. Monitor health care quality

We should also add to the list the role of coordinator and facilitator of regulations that support the rest of the roles mentioned. This way we can define a holistic view of how the healthcare system aligns its mission with its processes architecture and resources.

Sources:

• “HHS.gov.” https://www.hhs.gov/. Accessed 12 Jun. 2020.
• “High-Need, High-Cost Patients – Commonwealth Fund.” https://www.commonwealthfund.org/sites/default/files/documents/media_files_publications_fund_report_2017_jul_schneider_mirror_mirror_2017.pdf. Accessed 12 Jun. 2020. 3
• “The 3 Reasons the U.S. Health-Care System Is … – The Atlantic.” 22 Jun. 2018, https://www.theatlantic.com/health/archive/2018/06/the-3-reasons-the-us-healthcare-system-is-the-worst/ 563519/. Accessed 12 Jun. 2020.
• “Key Facts about the Uninsured Population ….” 13 Dec. 2019, https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/. Accessed 12 Jun. 2020.
• “Study Suggests Medical Errors Now Third Leading Cause of ….” 3 May. 2016, https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leadin g_cause_of_death_in_the_us. Accessed 12 Jun. 2020.
• “Medical errors third-leading cause of death in America.” 22 Feb. 2018, https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html. Accessed 12 Jun. 2020.
• “Artificial intelligence diagnoses with high accuracy.” https://healthcare-in-europe.com/en/news/artificial-intelligence-diagnoses-with-high-accuracy.html. Accessed 12 Jun. 2020.