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Armando Madrigal English 803 Prof. Potratz November 30 2009 Health Care Spending Crisis in America According to the World Health Organization report America ranks third place in handling overall healthcare expenditures, and number one when it comes to health care spending as a percentage of gross domestic product (GDP). What are the causes for the poor performance America takes in controlling its healthcare costs? What advantages do other nations like France and Taiwan have over ours? To lower healthcare expenditures and save the healthcare system time and money, America needs to change its’ emergency care system, its’ medical and information storage system, and its’ public hospital system. One change the United States could make to improve our healthcare system is to revamp our emergency care system, which would save the system money and would improve car people with true emergencies. In France, the emergency medical services, or EMS, are a branch of emergency services dedicated to providing out-of-hospital decisive medical care to patients with real illnesses. The emergency medical services are also dedicated to transporting patients with real illnesses to separate medical facilities that offer specialized treatment to the patient. Within France’s emergency medical services lies The Emergency Medical Assistant Services (SAMU). In France, when you have a medical emergency, you must first dial the number 15, which the call is quickly received by the SAMU call center. There a physician, attended by secretaries, determines the most suitable response. After a short and precise telephone conversation with the caller, the “regulator doctor†also known as emergentists, who takes into account the resources available at the time, decides on the most suitable solution to the problem posed. The emergentist then assumes responsibility for starting up the appropriate procedures, monitoring its progress, and coordinating all the personnel involved. Upon arrival at the scene, the entire staff comprised of a regulator doctor, nurses, and technicians, treat the patient at the scene. On average it takes 45 minutes for SAMU to treat the patient. If the patient does need further treatment, the regulator doctor chooses a hospital not by its’ proximity, but its specialty. In France, the idea is to bypass the emergency room all together. In America, there are little similarities compared to France’s emergency care system. In America, the emergency medical services are comprised of ambulance teams of paramedics or EMTs. The ambulance teams in America are dedicated to transporting patients with real illnesses to the nearest hospital. In America, when a person has a medical emergency they must first dial the nationwide phone number 911, where the emergency dispatch center quickly receives the call. There a dispatcher, attended by a supervisor, determines the location of the emergency and sends an ambulance team to the scene. Upon arrival at the scene, the goal of the paramedics is not to treat the patient at the scene, but to stabilize the patient in the ambulance in order to take him/her to the nearest hospital center. The entire staff of an ambulance team is comprised of only paramedics, who are trained in first aid safety and handling of medical equipment. The average time it takes an ambulance team to reach the scene, stabilize the patient, and transport him/her to a hospital is roughly 25 minutes. Once the paramedics reach the emergency room, too often the patient will have to wait until a bed or room clears before being treated by an E.R doctor. In America, the idea is not like France’s treat the patient at the scene, but a direct pickup and go type of situation. Emulating France’s system of emergency healthcare is a time and cost effective measure because out of every 1000 calls SAMU receives, only about 50 turn out to be real medical emergencies. This is part due to the regulator doctor who answers the calls, determines if the patient needs a team of SAMU or not. That means in more than 95% of the cases, France’s SAMU team can deal with the call without using the full team, evidently reducing costs of the emergency services. Adopting France’s system of emergency care would help the American system save time, money, and treat those with true medical emergencies. Another change the United States could make to improve our health care system is to change the way hospitals and medical clinics store our medical and personal information by using electronic cards. This would save the healthcare system time and money, which would lower costs on overall healthcare expenditures. In Taiwan, the standardized health record system uses highly innovated technology called integrated circuit smart cards. The electronic medical records (EMR) are a system of medical and personal information storekeeping of patient’s records. With the adoption of the National Health Insurance and medical records, all medical examination record in it's an essay of 5 paragraphs.
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