COMMENTARY AND QUESTIONS:  Please consider the following series of inter-related questions that address the evolution of health care in the United States as well as the role of health services professionals in delivering quality health services to patients located both within and without the borders of the United States.  Remember to post three different times on three different days, and to make your posts progressively responsive to the posts of your fellow classmates.  I look forward to participating in your posts on this question.  Please feel free to post more than three times to the dynamic question below. Answer all 3 questions

“The economy, stupid” is a phrase coined in 1992 by Bill Cliniton’s political strategist, James Carville.  According to Wikipedia, Carville’s statement was directed to campaign workers and was intended as one of three messages for them to focus on.  A second phrase for the campaign workers was “Don’t forget health care.”

Today, the U.S. economy continues to suffer negative effects of COVID, including business closures, unemployment, employee shortages, inflation and supply chain problems directly attributable to the COVID-19 virus pandemic that reportedly began in Wuhan, China and immigrated to the United States in January 2020.  The first reported case can be traced to November 17, 2019 according to unpublished Chinese government records. .  On January 19, 2020, the first case was diagnosed in the United States in Snohomish, County, Washington.  The patient had just returned from Wuhan, China where the novel coronavirus allegedly began. https://www.nejm.org/doi/full/10.1056/NEJMoa2001191. 

In just under two years, the virus spread from that one international traveller to infect 72,310,575 people in the United States and result in 870,195 COVID-related deaths.  .  These numbers are staggering compared to the March 2020 data when there were just 5,738 positive cases and 80 deaths in the United States.   .   

Early in the COVID pandemic crisis, the United States did not have an adequate supply of personal protective equipment (PPE), such as respirators, gloves, face shields, gowns, hand sanitizers, etc.  The PPE was needed to protect our front line health care workers from becoming infected.  The United States was also experiencing a shortage of common medical supplies needed to treat hospitalized patients.  You may recall news reports of ordinary people sewing home-made face masks and shipping them to hospitals across the country.  China – where the COVID-19 virus originated, is a major manufacturer of the PPE and medical supplies that were in short supply. 

The shortage of PPE and medical supplies in the United States can be attributed to multiple causes, including problems with the global supply chain that were also impacting other countries.  It was reported that China produced approximately half the worlds face masks before the pandemic.  As the infection spread across China, it stopped exporting face masks to other countries.  As China’s infection rate slowed, it began shipping masks to other countries as part of goodwill packages. The United States, however, was not a major recipient of the good will packages.  https://www.nejm.org/doi/full/10.1056/NEJMp2006141.

The pandemic highlighted that healthcare in the United States has evolved such that it is dependent on global economic transactions.  In addition to PPE and medical supplies, China produces pharmaceuticals, medical devices, technology and rare minerals that are essential to the delivery of modern U.S. health care services. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31908-7/fulltext.  

The globalization of healthcare is also evident in health care transactions unrelated to the COVID-19 pandemic.  India has developed a robust telemedicine industry to provide remote medical services to U.S. health care providers. .  India, Mexico and other countries actively market lower cost medical procedures to U.S. health care consumers. .  On a personal note, in a recent conversation with a distant family member, I learned that his girlfriend was in the country of Columbia for a complex dental procedure that would only cost her $6,000 compared to the $60,000 she would pay in the United States.  Reportedly, Columbia has developed an expertise in dental procedures and markets to the global medical consumer.  

Similarly, U.S.-based health care providers provide telemedicine and other health care services to developing countries that cannot provide these services on their own.  The United States and other countries also provide global relief health care workers to assist with public health crises in developing countries.  

The foregoing are only a few examples of the impact of health care on the global economy, and the inter-connectedness of the U.S. health care system to global economies is perhaps endless. 

Please discuss the following:

1.  What does the impact of the COVID-19 virus in the United States tell us about the inter-connectedness of U.S.-based health care, the U.S. economy, and the rest of the world?

2.  Does the globalization of health care improve the health of people living in the U.S. or does it create a greater risk to our health and/or economic security?  

3.  Should health care executives and/or policymakers seek to develop global alliances to bring high quality health services to U.S. consumers at the lowest cost?  Why or why not?