What interests me most throughout the course is how actors such as big pharma, insurance companies, medical providers, policy makers and consumer groups influence the medical landscapes today on a macro level. Unlike most of the premed students in the classroom who resonate with the medical professionals more often, as a business major student I think more about the regulatory environment and sustainable growth for the companies (outside the limitation that defining ourselves by our majors, I surely learned a lot from my classmates and adjusted my opinions along the course). Not surprisingly, the mainstream sentiment in the teaching materials is the anger towards almost all the for-profit entities. But since further commercialization is inevitable in our social development, we need to shift from being angry to collaborating with the businesses with new corporate social responsibilities to create a better healthcare system. Furthermore, policymakers have huge power to allocate the interests among different groups thus shifting the whole landscape. For example, the coverage change in Medicare can transform the model of nursing homes, create a new industry such as Hospice, or significantly impact the life of certain population such as people diagnosed with cancer. Those topics are probably outside the scope of this course, but they could be very good extensions and leave questions for further research. Besides, I have only been in this country for about four months, so all the assumed knowledge towards US healthcare system is very new to me! Therefore, this course has been very eye-opening and rewarding.
Coming into this class, my knowledge regarding the U.S healthcare system was limited. I would see articles online and hear stories on the news about Medicare, Medicaid, and rising health care costs and have superficial understanding of what this truly meant. Being a pre-med student I have been exposed to various settings in the healthcare field but have always been a one-sided observer, seeing only what was clearly presented to me. For example, during my senior year of high school, I shadowed with nearly twenty different healthcare providers, ranging from a cardiologist to an oral surgeon to a pathologist who performed autopsies. After being presented with the various facts, statistics, and personal accounts shown in class I often find myself reflecting back on those shadowing experiences with an entirely new perspective and noticing things I did not notice before. For example, while shadowing a veterinarian I remembered being asked if I would like to stay for a luncheon and presentation provided by a drug company, not knowing the Big Pharma’s manipulation of healthcare providers. Moreover, I also shadowed an ER physician in a public hospital located in a poverty stricken area. I remember seeing one child on the entire floor of the ER and reflecting back I realized that this public hospital, rather than a private hospital with a pediatric ward, was probably one of the few places in which the parents could afford to take their child and their insurance would be accepted.
There are certain statistics as well personal accounts from this class that I will not easily forget. This includes certain facts such as how much the U.S. spends on healthcare and how little we receive in return compared to other countries, the existence of overtreatment and a chargemaster, and the influence of the pharmaceutical industry in medicalization and drug pricing. I also did not realize the tremendous amount of people underinsured or lacking insurance all together. Next year being the first time I can vote, this has greatly influenced my candidate choices. With that said, the portion of this course I found most interesting was the beginning of the course, involving the high costs of healthcare and the role of commercialism and consumerism in the healthcare field. This has given me an entirely new perspective on the healthcare field and at times has made me reconsider if I want to be part of this “business.” I have concluded that when I do enter this field one day, I want to avoid the profit driven mindset existing in modern healthcare.
All in all, this has been one of the most informative and eye-opening courses I have taken at BU thus far. I would highly recommend this course not only to those who are health majors but also to anyone who has limited knowledge of the healthcare field.
Throughout the course of this semester, we covered a very broad range of topics. I feel as though I have come out of this class more educated about healthcare in general. I also feel as though I am more aware of the many problems that we currently face in terms of healthcare, and what potential problems could develop in the future. Before taking this class, my knowledge of healthcare in the U.S. (and the world in general) was sadly lacking, and I feel that the information I have learned is definitely important. In my personal opinion, every person around my age should be aware of the issues that we discussed in class; we are going to be able to vote in the 2016 election, and soon enough it is going to be our responsibility to face and try to solve all the issues that are developing in today’s society.
Looking back over the semester, I think the idea that stands out the most to me or that is most shocking is the disparity between how much money we spend in the U.S., but how bad our health outcomes are in comparison to countries of comparable economic status. Studying abroad in France made me somewhat more aware of how our system here rations healthcare, but this class has truly opened my eyes to the disparities in healthcare in our own country. The fact that the United States, a country considered to be a world superpower, does not guarantee healthcare to all of its citizens is completely stupefying to me. What is a basic human right, if not the access to healthcare? This is just one of the upcoming problems that we face in this country, and it is going to be an especially important topic in the upcoming 2016 election.
For my last Process reflection I’d like to say that as a whole the class has been very informative and interesting. The discussions have also gotten more involved in the last few weeks of the course which I thought made more information stick and generally made the course more interesting. I specifically liked the inclusion of the debate in the final Discussion, it forces us to take a more involved look into the many viewpoints on what we are being taught and cements that there are many possible solutions that all deserve to be heard. I think the class can be improved by making those debates more frequent in the coming semesters.
One issue that I’ve had with the course from the start and believe is still as much of an issue as ever however is this blog. It seems very disjointed from the rest of the class and although it is used by the discussion leader in class to bring up the points of individual students for examples, it just seems like an unnecessary addition that feels like busywork. The Analytical postings were interesting but never revisited after they were done for the most part. These process reflections would also be more useful to the instructors if done as a final assignment at the end of the semester rather than multiple peppered throughout, as one month is not very much time to take into account the opinions of more than one hundred kids and adjust the syllabus accordingly. Beyond that the blog is an unnecessarily complicated site to learn the use of for a single class and then most likely never use again
In all I’ve thoroughly enjoyed this class and it’s lectures and would definitely recommend it to others on the pre-med track. I just hope that it stops over relying on the blog format and busywork that comes with that.
Looking back on this semester, I realize I have learned so much more than I ever thought I would. I came to this class knowing that the healthcare system was considerably flawed, but this class opened my eyes to the extent at which our healthcare system is flawed. Some politicians (more recently some presidential nominees) talk about fixing this country’s healthcare as if it could be accomplished overnight and suddenly everyone who should be covered, would be covered. However, the healthcare system is so much more intricate than that as its problems stem from a wide variety of sources, starting from the very birth of healthcare. Where most people think that its problems stem from doctors charging a lot for their services or insurance companies being unwilling to cover certain medical treatments or procedures, these people fail to see that it is also the fault of pharmaceutical companies, the way it is so difficult for people to attain a higher socioeconomic class, and so much more that influences the amount and level of care that is accessible and also importantly, affordable to everyone in this country.
It’s hard pill to swallow when one sees exactly how many people are without adequate healthcare or medical insurance in this country, more often than not through no fault of their own. We even went through stories in class of people who worked their entire lives, bought a house, and have retired, only to be pulled out of retirement and lose everything they had because of a medical issue that they have to pay out of pocket for. It’s an even harder pill to swallow when we see how people from other countries thrive under their country’s version of healthcare, other countries having universal healthcare. Politicians in the United States argue that our government cannot afford to provide universal healthcare for everyone in the country. How then, are other countries able to afford universal healthcare for their citizens? In addition, how then does US government have enough money to spend trillions of dollars on wars in the Middle East? Though many of these questions will take more research and taking related classes to answer, SO215 has primed me to begin questioning these aspects of healthcare not just through the length of the course, but for the rest of my life as an active and voting citizen of this country.
Before taking this class, I will admit that I had a very narrowed view of the healthcare industry, and was not familiar with all the intricate components that make up the healthcare sector. The beauty of becoming a doctor is all too glamorized, and many fail to realize that the healthcare industry is not solely about the doctor and their practice. Medicare, Medicaid, pharmaceutical companies, healthcare laws, the doctor-patient relationship, elderly care, overtreatment, overdiagnosis – these are just a few of the many things that this sociology class has introduced me too. As a future healthcare provider, I now realize the importance in understanding these individual components and how they shape the way patients receive care.
The most fulfilling thing this class has instilled in me is a desire to change all the negative aspects of healthcare. One of the major parts that we focused on in class is the lack of care millions of Americans receive, despite Medicare, Medicaid, and private insurance companies. I was baffled by the staggering numbers of Americans that find themselves unable to provide medically for themselves, and find themselves resorting to alternative methods, foreign country care, or simply avoiding medical care altogether. As I’ve discussed before in a previous reflection post, I believe the most impactful way to change the course of our current healthcare is to become educated, and vote. This upcoming presidential election is inching closer and closer, and educating myself of each party’s platform and ideals in the best way to see change in the healthcare world.
Although I initially took this class as a fulfillment for my Public Health Minor, the wealth of knowledge I have acquired will better me as a healthcare consumer, and a future healthcare provider. Even after finishing this class, I plan to keep educating myself on the persisting changes in the healthcare world.
As I look back on this semester, my thoughts toward our health care system have changed. To be honest, I enrolled in this class because I needed an elective for my public health minor. I did not have any expectations coming into this course as I thought it would be just like my previous healthcare course I took in Sargent. At the end of the day, I learned so much from this class and I hope to use this knowledge and understanding as I pursue my career in the health care industry. Continue reading “Hope for Our Nation? (Process Reflection)”
Before taking this course, I knew generalities about healthcare but never anything too specific. I knew, mainly, that everything involving an aspect of healthcare in the U.S. was overpriced. I was hoping that this high cost of healthcare was for a reason, better equipment, better doctors, better medicines, etc. Unfortunately, as I found out, this was not the case. This course has completely changed my perspective of healthcare and has influenced my decisions of re-evaluting a profession that I thought to be flawless. Continue reading “A New Understanding of Healthcare”
As we finish off this course, I realized I have developed a new perspective and outlook on the entire medical system of the U.S.. Having grown up in another country for most of my life, I have always known my own country’s medical system (Taiwan) and thought everything should be like that as it would make things much easier. I also thought in a more than naive way that the U.S. would have a similar system. This course helped me shine a light on what is wrong with the entire medical system of the U.S., but also gave me hope for what little hope there is left. It allowed some thoughts of reform and of change, which provided a rather bleak life with a sort of hopeful outlook. Even as we ended the class talking about end of life care, we managed to squeeze in some happy notes by explaining what we could be doing instead of what we are doing now. In that sense, I don’t see this class as teaching new material as a typical class does, but rather provoking conversations and viewing the world from an outsider view. Instead of teaching the basics, we learned to question the society we live in and what can we do as individuals to improve it. After all, we are going to be future doctors which will have a major impact on the medical field. If we can bring what we learned in this class to our future careers, maybe we really can bring change to the medical field and possibly reform it completely.
In terms of actual teaching, I think Dr. Guseva did a great job explaining many of the past concepts in lecture. She brought her own point of view as well as explained the current trends, and allowed us to think about what we should do to contribute, such as conversations about death. I think discussions were helpful as well, but I would’ve preferred if they went a little faster or more in depth into the lectures that we went over in class. We usually went over the readings which were helpful, but were something we really could’ve done in our own time.
To bring it all into context with what we have been learning about for the past few weeks, I think we really should bring all of what we learned into context to be change, however slight, in the world and change perspectives of how we view healthcare, illnesses, and death. What is rather stigmatizing to think about should not be so, and should be more talked about as the more we stigmatize them, the less we treat people with these certain conditions. This course really has brought a lot of new thoughts to my mind about healthcare and I’m glad I took this course to discuss these thoughts!
Prior to this class, I wore rose-colored glasses: my perspective of the healthcare system was naive and microscopic. As a student and young adult, I never had to seriously think about buying my own insurance or getting treatment for a particular life-threatening disease. This class has filled a gap in my knowledge that I believe will fare me well in my future years as a healthcare professional, patient, and advocate. I hope to follow in Dr. Atul Gawande’s footsteps, someone that I tremendously admire for taking a critical stance of his own profession, which is, to say the least, not an easy feat.
There were so many new concepts presented throughout this course that shocked me, particularly, the soaring costs of healthcare. Recently, one of my friends visited the doctor’s office and was charged with $160 ($320 total, half was covered by insurance) for two spritzes of freeze spray for treating a wart on his skin. My friend was in disbelief, but I nonchalantly told him, “That’s the American healthcare system for ya.” Like Dr. Guseva did with her boot, I decided to follow the money and investigate. I checked that the retail price of a medical freeze spray on Amazon was $19.99. My friend’s experience completely confirmed just how different healthcare services are from other markets: no true cost, no buying power, and no prices are known in advance.
I wholeheartedly agree with Dr. Atul Gawande: all it takes is a willingness to try to make this system better. We won’t know what works best unless we try. Without my rose-colored glasses, I feel like my life has just begun.