TIME Ideas health Changing the Face of Medical Education in the U.S. Getty Images
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The United States spends more money on health care than any other country in the world. So how does Costa Rica outperform the United States in every measure of health of its population?
Costa Rica is healthier because its government spends more money than ours does on prevention and wellness.
In our country, we have left vast segments of the population without affordable care and we do not focus on wellness or chronic disease management. We dont consistently control the glucose levels in diabetics and, consequently, too many go blind or lose a limb. Too often, hypertension goes untreated until the patient has a stroke or kidney disease. Then, all too often, these individuals go on medical disability with far more societal expense than the cost of the original health management.
Sadly, it has become the American way to leave many chronic diseases untreated until they become emergency situations at exorbitant cost to the U.S. healthcare system. For many patients, this care is too late to prevent life-changing disabilities and an early death.
When people ask me why we started the UC Riverside School of Medicine last year the first new public medical school on the West Coast in more than four decades I talk about the need for well-trained doctors here in inland Southern California. But we also wanted to demonstrate that a health care system that rewards keeping people healthy is better than one which rewards not treating people until they become terribly ill.
As we build this school, we have a focus on wellness, prevention, chronic disease management, and finding ways to deliver health care in the most cost-effective setting, which is what American health care needs.
We also teach a team approach to medicineanother necessary direction for our health care system. If you have a relatively minor problem, your doctor might refer you to a nurse practitioner or physicians assistant for follow-up. This kind of team care makes financial and clinical sense, particularly since we have such a national shortage of primary care doctors. The good news: Even among physicians, the team approach, or medical home model, is gaining ground, with the Affordable Care Act accelerating change.
For all the talk about the lack of health insurance in this country, we dont often discuss the other side of the problem the fact that many Americans get more care than they need. You may have heard advertisements that you should have your wife or mother get a total body scan for Mothers Day, because it will find cancer or heart disease. There is no evidence that this screening is a good idea. But in the U.S., we often encourage people to do things that have no proven benefit, and our churches or community centers sponsor these activities.
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