Welcome back. Let's briefly talk about Health Care. Why is health care important? All of these services, including primary care, cancer screening, ophthalmic care, laboratories, imaging services, pharmaceuticals are all incredibly important for saving lives. What are some of the desirable features of a healthcare system? Well, you want to have universal coverage, which is accessible and affordable. You want to have an efficient administration. In other words, you want to have the best results with a minimum expenditure of time, money and personnel. You want to have an effective care process that gives consistent quality care. You want your care to be equitable. In other words, fair and impartial health care to all. You want to have desirable outcomes. In other words, healthy people. You need to have the infrastructure, the qualified personnel, the equipment and effective therapies. You need to continuously evaluate your healthcare system through data collection and monitoring. If you want to have high-quality care, there are challenges of paying for health care. The question is, should health care be publicly funded through government services or should it be privately financed through corporations and businesses? Or should you have a combination of public and private financing? How should catastrophic illness, injury or long-term rehabilitation be covered? In other words, you want to have the best outcomes for the least amount of money and resources. So you want to target funding towards patient care and not towards administrative costs. You want to minimize the opportunities for corruption, fraud and abuse. Finally, you need to get young and healthy people to buy into the insurance coverage to offset the costs for the elderly and the sick. Health care expenditures or the amount of money that you pay, does not necessarily translate into a longer life expectancy. For example, as seen in this graph, the United States spends more on health care than any other country but it doesn't have the highest life expectancy. Another way to look at it is with this map. Again, the United States spends more on health care than any other country on the planet. That does not necessarily translate into the longest life expectancy. Administrative costs account for about a quarter of all spending in US hospitals. That's more than twice the proportion seen in Canada. Costs are generally higher in for-profit hospitals than in not for profit hospitals. But unfortunately, there is no link between higher costs and better outcomes. The United States spends more on drugs than any other country. There's low levels of price regulation in the United States. New drugs get launched faster in the US than in other countries, that has its pluses and minuses. As previously mentioned, the United States spends more than any other country on health care but it does not have the highest life expectancy. This map illustrates that, Canada, parts of Europe, Australia, Japan, have higher life expectancies than the United States. The maternal mortality rate is much higher in the United States than many other countries. Although there are a few countries such as Mexico, Chile and Hungary, that have higher maternal mortality rates. The United States has the highest infant mortality rate compared to other wealthy countries. However, the infant mortality rates in the United States, vary state-by-state and you can see some states have much higher infant mortality rates than other states. We should keep everything in perspective. In the 1800s, child mortality rates were over 50 percent all around the World. Compared to the 1800s, when the childhood mortality rate was over 50 percent in all countries. In 2015, the picture is very different and of course, some countries are going to have a higher mortality rate than others but still nobody has a greater than 50 percent child mortality rate. People who don't have health insurance or who don't have access to health care, are likely to delay seeking treatment when they become sick. This becomes a particular problem during a deadly epidemic. When you have people delaying seeking health care, it means they're out in the community spreading the disease to others. Health care is a national security issue. Whether the outbreak is naturally occurring or deliberate. A country's preparedness is only as good as its health care system and it's public health infrastructure. During the anthrax attacks of 2001, all of the people who were exposed to anthrax had health care insurance and particularly the Federal Postal Workers. This was extremely important in the fact that so few people died. Universal access to health care is absolutely essential to reduce the risk of people delaying seeking care. In 2014, the Ebola virus ravaged three countries in West Africa, Guinea, Liberia and Sierra Leone. All three of these countries had suffered from years of war, extreme poverty, extensive government corruption, making them among the least capable of nations to handle a deadly diseases like Ebola. Because this virus had not been seen in any of these countries before, there was a delay in diagnosis and treatment in the initial patients. Unfortunately, by the time the outbreak was discovered, it had already spread far and wide. One of the reasons why thousands died, is that the countries had inadequate health care and public health systems. Now, Nigeria was better prepared than those three countries. A Liberian American became ill with Ebola when he landed in Lagos, Nigeria in 2014. He was immediately ushered to a nearby hospital and was quickly diagnosed with Ebola. Nigeria is fortunate and that it has a large cadre of physicians, epidemiologists and 1800 health care workers who were trained to care for Ebola patients and they were provided with protective gear and isolation wards. Nigerian leaders established an Ebola Emergency Operations Center, that coordinated efforts with other organizations, including the Nigerian Health Ministry, the World Health Organization, the CDC and others. Nigerian health workers visited 26,000 homes, made 18,000 face-to-face visits and held almost 900 people in house quarantine to stem the spread of the virus. Nigeria was able to contain Ebola to 20 cases and eight deaths. In contrast to Nigeria, let's examine what happened with the United States dealing with its Ebola patients. In September 2014, a Liberian National had helped a sick woman get to the hospital before he flew to Dallas, Texas to be with his fiancé and family. While visiting his family, he became ill with a high fever, abdominal pain and a severe headache. He presented to the Texas Health Presbyterian Hospital Emergency Room, was given a bottle of antibiotics and pain relievers and was sent home. Now it's noted that he did not have health insurance but by sending him home, the hospital inadvertently increase the risk that he was going to infect his family and to others. His symptoms worsened eventually and his family summoned an ambulance. When the ambulance took him to the hospital, he subsequently tested positive for Ebola and was placed in isolation. His fiancé and his family were placed in quarantine for 21 days. The two nurses caring for him were given inadequate instructions or protective gear to protect themselves from being exposed to the virus. Subsequently, they developed Ebola after caring for him. He died while in the hospital. Inexplicably, the CDC allowed one of the nurses, despite having a low grade fever, to fly on an airplane. Eventually, the nurses were hospitalized in special biocontainment units outside of Texas. One of the nurses sued the hospital for improper policies, procedures and equipment and her case was settled out of court for undisclosed terms. So the importance of health care workers cannot be stressed enough. Health care workers must recognize and diagnose infectious diseases. They are the key to rapid outbreak responses and they must be well educated and trained. They must also be well-paid or they will seek employment elsewhere. Veterinarians are the invisible health care workers. They diagnose diseases in companion animals and food animals. In general, they are valued less than physicians and are paid less than health care workers who care for humans. Despite being the invisible health care workers, veterinarians are essential in providing care for animals and improving the health of all species. So the questions for this session include, why is access to health care important during a pandemic? What are four desirable features of a health care system? Describe three challenges in paying for health care. Which country pays the most for health care but doesn't have the highest life expectancy? Why do you think this discrepancy exists? Who are the invisible health care workers? Why are they invisible and what do they do? With that, I'd like to thank you for your time and attention.
