Healthcare Costs: We Must Do Better

As healers and as citizens


By Wael Barsoum, MD


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Physicians are healers. Our purpose is to provide care. Whether we are directly in contact with our patients or our work is done behind a microscope or a lab console, our goal is to saves lives and advance the knowledge of medicine.

The opportunity to heal and help others is why most of us spent more than a decade in training, forsaking events and family and surviving on little sleep to work in medicine.

Physicians and hospitals also do what is required in an emergency. For most hospitals, it is a part of the mission, and it is also mandated by law.

On many occasions, emergencies happen when we least expect them to happen. This was the case when Dr. Sij Hemal, a second-year urology resident at Cleveland Clinic in Ohio, was traveling back to the United States during a transoceanic flight recently. During his flight, a woman went into labor and he helped deliver her baby.

Fortunately, the situation ended well and there were no complications. However, what happens in an emergency if there are complications or the patient requires treatment in a remote area or in a facility outside of their hospital network?

What if:

  • That baby, instead of being born in flight, had been born in a taxi and attended to by EMTs in an American city where his mother was traveling for her job?
  • Mom had suffered a blood clot or the baby required a NICU due to under-developed lungs or other unforeseen symptoms?
  • Mom’s health insurance was a skeletal plan that specifically excluded maternity care and required treatment in a neighborhood hospital?

Each of these scenarios takes on a significantly ominous tone, and we’re not talking about the medical care. Here, the EMTs, obstetricians, interventionalists and NICU doctors would have taken care of the patients, who, given today’s advances, have a good chance of surviving. Yet, how would the mother endure the financial burden in the aftermath of this emergency?

What comes after an initial emergency is where we are failing our patients. Medical emergencies are placing undue hardships on individuals and families. They’re what bankrupt people and brands the U.S. as a recessive nation in the eyes of many other countries.

As physicians, we can engage our patients in conversations about lifestyle, healthy living and better management of chronic conditions. In fact, many of us do this regularly as part of our practice. But can we do more to encourage our patients to eliminate unhealthy practices that cause emergencies brought on by smoking, lack of exercise and poor diet choices? Can we do more to advocate for regular screenings that keep chronic conditions under control before they become medical emergencies that contribute to skyrocketing medical costs? The answer is yes, we can and we should.

Most physicians believe that access to healthcare is a basic right that everyone deserves. It simply makes sense, and it is a staple of any civilized society. So how do we as a society tackle these issues, which should be of great concern to all of us?

As a society, we should be chastened by situations where patients’ insurance plans no longer provide broad coverage or when a life-threatening illness exhausts coverage during the first few months of any given year.

Consider the facts. In 2016, the average American family paid $9,996 for coverage alone, and if they met their deductible by using their insurance, they incurred additional costs of about $18,000. The U.S. Census Bureau says that the average American household had an income of approximately $73,300 in 2014, so it’s not hard to see the burden created by out-of-pocket costs of $27,996 – 38 percent of the ‘typical’ family’s gross annual income.


As physicians, the Hippocratic Oath requires us to swear that we will uphold a number of professional ethical standards. Since its first use during ancient Greece, the Oath has evolved and been adapted to many cultures.

Today, the American Medical Association’s Code of Medical Ethics (1996 edition) considers The Oath of Hippocrates an “expression of ideal conduct for the physician.” In fact, nearly 100 percent of all medical schools administer the oath today. The Oath also binds the greater community of physicians with responsibilities similar to the community at large.

Let’s get back to our overarching communal responsibility to heal and help each other and do whatever is necessary for the greater good of our society and the well-being of our patients.

Learn to become a physician leader with Cleveland Clinic Global Executive Education programs, including The Cleveland Clinic Way: IntensivesSamson Global Leadership Academy and the Executive Visitors’ Program.

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