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Op-Ed: Progress from the crisis


The COVID-19 pandemic has forced our medical community to critically examine our care delivery system. However, this is not the first example of a pandemic that forces such calculations. Almost 40 years ago, our country faced another infectious disease that threatened public health. It’s HIV / AIDS. In retrospect, the HIV / AIDS crisis, triggered by COVID-19, provides lessons on how to identify flaws and reform the modern healthcare system.

At the beginning of the HIV / AIDS epidemic, the US healthcare system was over-specialized, service fragmented, service gaps, and Poor coordination -Especially as AIDS has changed from a universally deadly illness to a chronic illness, it is not well-equipped to provide long-term care and funding. Recognizing these shortcomings helped drive the coveted change.

First, the HIV / AIDS epidemic has brought the United States closer to a more equitable accessible healthcare system. This should be reproduced in the current pandemic. In 1990, the Ryan White Program was enacted to provide comprehensive primary care, support services, and medications to low-income, uninsured individuals living with HIV.This program enabled a high rate of viruses Patient suppression -In 2017, 85.9% of Ryan White HIV / AIDS program clients were suppressed by the virus, surpassing the national average of 59.8%. Focusing on health fairness is just as important as the current pandemic. In the context of COVID-19, we are facing record height Unemployment rate, Now more Americans Become uninsured, Shows the limits of the employment-based health insurance model.No health system that guarantees and applies fair access to healthcare Community-based care modelReducing the spread of infectious diseases such as COVID-19 is hampered for testing, education, and resources, regardless of insurance status.

Second, we need to quickly broaden the range of value-based models to pay for health care. Much of the medical care in the United States operates under a service fee system where doctors are paid for the services they provide to their patients.Usually this is Overuse recipeBecause doctors are motivated to perform as many services as possible. During the pandemic, this model triggered a doctor’s bankruptcy. Patient avoids physical examination And other care they consider unnecessary. Value-based models provide a better way to move forward. In these models, physicians typically pay a fixed, risk-adjusted amount on a per-patient basis, with a bonus to the performance of the quality metric. Physicians are not motivated to maximize the amount of patient consultation, but to focus their efforts on the patients who need it most. This concept, in part, helped inform HIV treatments. Use team base A model of care.Widespread adoption of such payment systems will help support the finances of A group of doctors struggling In addition to encouraging low-cost, high-quality care, throughout the country.

Third, there must be a nationally coordinated integration of medical devices and consumables to prevent future resource limitations. Strategic National Stockpile (SNS) is responsible for supplementing the supply of state and local medical products. By early April, US stockpile of protective equipment Almost exhausted.. As the state was forced to procure its own supplies, the country was immersed in an avoidable bidding war, sacrificing valuable time and many lives. Former CDC directors Julie Gerberding, MD, MPH and other experts are calling for a rebuild of the social networking system. Reassessment of that role Adjust resource allocation.

The HIV / AIDS epidemic has paved the way for the federal government’s coordinated and institutionalized response to medical device shortages, recognition of laws such as the Ryan White Comprehensive AIDS Resource Emergency Act and the Food and Drug Administration Modernization Act. Was raised. The fight against COVID-19 today requires a strong national stockpile of medical devices and an efficient way to mobilize such resources when needed.

COVID-19 has Published vulnerabilities Access to US health care, healthcare funding, and medical device supply. Just as our healthcare system has been forced to address and improve its shortcomings through the HIV / AIDS epidemic, we must grow stronger through the ongoing crisis.

Platec Sharma And John Connally I am a second year medical student at the Perelman School of Medicine at the University of Pennsylvania.

Last updated: January 15, 2021


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