Healthcare in the United States is a mess. In 2011, US healthcare spending reached $2.7 trillion, more than twice that of other wealthy countries, and with worse outcomes. In the United States, life expectancy is lower, infant deaths are higher, and there are fewer doctors and hospital beds available per person than other wealthy countries.
The US healthcare system is not just broken; it is highly controversial. The Affordable Care Act caused the government to shut down. And, outrage over the poor website and cancelled coverage forced President Obama to publicly apologize and backtrack on elements of his healthcare plan.
In order to fix our broken healthcare system, we need to look abroad for successful, scalable, and cost-effective solutions. Today, the most innovative healthcare models are not coming from Europe or Japan. They are coming from emerging markets. We are currently experimenting with these innovations in our healthcare system, but we need to do more.
Mobile health (mHealth) provides health advice and diagnostics through cell phones and tablets. It was initially launched to provide healthcare to the rural poor in developing countries. Organizations like the Mobile Alliance for Maternal Action (MAMA) provide relevant information to pregnant women and local healthcare workers. MAMA has reached more than half a million individuals in South Asia and Africa. The US Department of Health and Human Services is promoting mobile health applications for HIV and heart disease patients.
Community health workers are trained to provide basic medical care, from supervising treatment for tuberculosis patients to handing out anti-malarial bed nets and educating the community about sanitation. They are a resource in an environment in areas with a shortage of doctors and refer serious cases onwards to doctors and nurses. This model is particularly popular in sub-Saharan Africa, where there are only 2 doctors for every 10,000 people. A community health worker model was recently applied in Newark, New Jersey, after a Global Health Corps fellow based in the US heard about the model through another fellow in Nigeria.
Hyper-specialized hospitals focus on a small number of services to maintain quality while reducing costs. The Aravind Eye Hospital in India is the largest provider of eye surgeries in the world, focusing on causes of "needless blindness" among the poor like cataracts. By specializing, Aravind keeps costs low, maximizes its operating equipment, and increases the efficiency of its staff. Its eye surgeries are best in class- Aravind's rate of complications is half of that in the United Kingdom. Aravind is now consulting to 300 hospitals around the world on how to increase efficiency through specialization.
Of course, these innovations are not a panacea and would need to be adapted for local needs. Kirsten Gagnaire, Global Director of MAMA, recommends rapid prototyping to adapt and account for nuanced differences. "We don't just translate- we localize." Patty Mechael, Executive Director of the mHealth Alliance, also recommends implementing and adapting programs by keeping the beneficiaries in mind. "Whether or not people feel like a technology has been designed for them determines whether or not they will use it."
If we want to fix our healthcare system, we need to find new ways of delivering care. The constraints that emerging markets face- fewer resources, a shortage of doctors, and a lack of infrastructure- have forced them to be more creative. We can build on that creativity and integrate these solutions into our own healthcare system.