Health care in America consumes over 18 percent of our gross national product (GDP), yet it is one of the most fragmented industries in this country. It still functions as a cottage industry. This leads to confusion, inefficiency and decreased quality of care. Let's follow a hypothetical patient through the system to try to understand this fragmentation.
The situation: Alice, 45, is married and the mother of two children, aged 5 and 9. She and her husband each have health insurance through their jobs. Other than to have her two children, Alice has never been in the hospital. Her mother is diabetic; her father, 67, died last year of colon cancer; and her sister, 51, has just been diagnosed with breast cancer. "Doc Jones" is their family physician. Alice has an OB GYN physician she used during her two pregnancies. The kids go to Dr. Young, a pediatrician.
Because of her sister's breast cancer, Alice decides she needs to have a checkup herself. Where to start? At the urging of her friends, she goes first to her GYN.
-She visits the GYN and asks for a mammogram. A limited exam is done.
-She has a mammogram at the House of Mercy Hospital. A sonogram is needed.
-She goes to the "Breast Imaging Center" at Metropolitan Hospital for a sonogram.
-She goes back to the GYN office to discuss the sonogram. She needs a biopsy and blood work.
-She gets lab work done at Health Tech. Her blood work showed elevated sugar.
-She gets a biopsy at the Surgi Center.
-She returns to the GYN, who recommends a lumpectomy followed by a short course of chemotherapy. First, she needs to see someone about the elevated blood sugar.
-She sees Dr. Sugarman. He decides she needs additional testing.
-She returns to Dr. Sugarman, and he confirms she has mild diabetes.