Fragmentation in the Health Care System Essay

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The U.S. Healthcare Systems


The U.S. healthcare system is fragmented by the fact that incentives do not align with the actual goal of healthcare (Enthoven, 2009). For instance, healthcare facilities are incentivized to “treat” patients rather than to help them lead healthier lives. As Goldhill (2009) points out, healthcare treatments are subsidized by taxpayer dollars—and there are powerful lobbies in the healthcare field that promote the use of pharmaceuticals or new health technology (like hip replacements, which could end up leaking cobalt into one’s body). Moreover, care providers are encouraged to perform tests on patients even though there is no real need for them and they may in fact lead to overdiagnosis and to a deterioration of the patient’s quality of life, as the patient becomes obsessed with every minor health problem (Lichtenfeld, 2011).

Fragmentation impacts patient care in a negative way because it leads to the patient being viewed as a source of profit for the health care industry rather than as a person with whom care providers should form relationships. A patient may go from doctor to doctor looking for a solution to his fatigue, be prescribed myriad drugs and have none of them work because doctors are only focused on selling prescriptions rather than in providing actual preventive medicine (Strange, 2009).

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Patients need to be viewed as people first, not as a potential source of profit. The health care industry also needs to engage in preventive care and treatments have to stop being subsidized, because that subsidization corrupts the system and causes it to fragment. People want to be able to trust their doctors, but if doctors are overdiagnosing instead of explaining the reality of the situation to patients, as Lichtenfeld (2011) points out—namely that not all symptoms and irregularities need to be treated because no human body is perfect.


Alternative medicine or homeopathic approaches to healing are popular among certain people, and some health care professionals are even open to this concept of healing. They are distrustful of the pharmaceutical industry in general and feel that the industry has betrayed patients and helped to create the opioid epidemic currently sweeping across the nation. Some studies are out that indicate as much (Califf, Woodcock & Ostroff, 2016). However, there is not enough statistical data available to justify or to show empirically that homeopathic approaches to healing are appropriate or that….....

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Califf, R. M., Woodcock, J., & Ostroff, S. (2016). A proactive response to prescription opioid abuse. New England Journal of Medicine, 374(15), 1480-1485.

Enthoven, A. C. (2009). Integrated delivery systems: the cure for fragmentation. American Journal of Managed Care, 15(12), S284.

Goldhill, D. (2009). How American health care killed my father. The Atlantic. Retrieved from

Lichtenfeld, L. (2011). Overdiagnosed: Making people sick in the pursuit of health. The Journal of Clinical Investigation, 121(8), 2954-2954.

Stange, K. C. (2009). The problem of fragmentation and the need for integrative solutions. The Annals of Family Medicine, 7(2), 100-103.

Vickers, A. J. (2000). Clinical trials of homeopathy and placebo: Analysis of a scientific debate. The Journal of Alternative and Complementary Medicine, 6(1), 49-56.

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