The Chronic Cough Enigma by Jamie A. Koufman

Author:Jamie A. Koufman
Language: eng
Format: epub
Publisher: Katalitix
Published: 2021-03-30T13:43:01+00:00

Restructuring Healthcare

Where did this excessive, inefficient, and unnecessarily expensive medical mess come from? The healthcare industry has shown a strong propensity to chase funding. When Medicare agreed to cover renal dialysis, for example, new dialysis centers quickly sprung up everywhere.

Remember, US healthcare is private industry, but much of it is paid for by the government, e.g., Medicare, Medicaid. A big part of the problem is lack of accountability—there is little or no objective scrutiny in healthcare. What do we get for our money? Fifteen-thousand-dollar-a-piece screws?

Specialist medicine has proliferated in part because Americans want to have the “best.” They like seeing the best doctors just as they like seeing the best sports teams. The problem, however, is what doctor to see when your self-diagnosis is wrong? The best at what?

Furthermore, while the idea of seeing the “best doctor” is appealing, there is no such doctor when it comes to non-pulmonary chronic cough, silent airway reflux, and vagally mediated neurogenic syndromes.

Today, people are skeptical and cautious, and at this point consumer confidence cannot be restored by the marketing claim that “We are the best.” Patients are rightly mistrustful of the current healthcare system.

People no longer believe that healthcare providers necessarily have their best interests at heart. It is now clear that patients must be their own advocates and that for-profit medicine leads to more attention to gain and less to quality patient care.

We pay two to four times more than any other developed country for healthcare, and we rank thirty-seventh in quality of care. Last year, the price tag for US healthcare was $2.7 trillion.* Strip away the excesses and the price would probably have been closer to $700 billion ($0.7 trillion). That’s a lot of excess!

We need a healthcare system that is less fragmented and self-serving. Specialists often do what they do well, but nothing more.

If chronic cough, airway reflux, reactive airway disease, and (vagal) neurogenic syndromes are so prevalent—almost one-out-of-five (18 percent) Americans has airway reflux3 and falls into one of the above categories—then the current system is wasting massive healthcare dollars on inappropriate diagnostics and ineffective treatments.

Maybe we don’t need so many gastroenterologists, pulmonologists, and otolaryngologists. Maybe we need doctors who take better care of the whole patient with aerodigestive diseases. Reflux is the tip of an appalling iceberg.

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