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10 Biggest Problems in Healthcare and Possible Solutions

Are you an entrepreneur or employee in the healthcare industry? If YES, here are 10 biggest problems in healthcare their possible solutions, and the opportunities they present.

There is hardly any industry that is not confronted with major challenges and the truth is that these challenges bring in the level ground for players in the industry to work their way up to the top.

This is how it works, when there is a major problem in an industry, any company in the industry that proffers solutions to such problem tends to automatically raise to become one of the top players in the industry and the healthcare industry is not exempted.

For the purpose of this article, we are going to be looking at the 10 biggest problems that cut across the healthcare industry in the United States of America and all other parts of the world, and we will try to proffer workable solutions to these problems.

Biggest Problems in Healthcare and Possible Solutions

  1. An Unstable Federal Reimbursement Model


One of the biggest problems in the healthcare industry today in the United States of America and perhaps in other countries of the world is an unstable federal reimbursement model amid an uncertain regulatory environment. This problem is indeed a major challenge and of course, will likely present a threat to businesses that operate in the healthcare industry.

Usually, the government of different nations formulates policies that will allow citizens who are qualified to access treatment via health insurance, and then the government pays whatever is expected of them to pay either annually or as it is spelled out in the contract.

For example, in the United States, although federal funding for Medicare and Medicaid is expected to increase in 2018, continuing reimbursement pressure and regulatory uncertainty was a major problem and it will remain a potential threat to the healthcare industry.


A workable solution to the above-stated problem is for the government of each nation to formulate policies that will ensure that much more than playing their part in any agreement reached with the healthcare industry, they should ensure that they do it on time so that it will allow for seamless flow of the process and all the hitches that usually cause inefficiencies in the value chain will be eliminated.

If the health plans, Medicare and Medicaid pay providers for whatever services they deliver, regardless of whether the service truly benefits the patient.

  1. Awkward Incentive Model (How We Pay for Health Care Services)


In the United States of America and all other nations that operate similar policies, another major problem in healthcare today is the awkward incentives model. It is expected that in health plans, Medicare and Medicaid pay providers for whatever services they deliver, regardless of whether the service truly benefits the patient.

In most cases, most of the patients under these health insurance policies complain of the services received but that does not stop the government or the health insurance company or health management organizations from paying the agreed amount.


Healthcare services providers should be appraised regularly so as to ensure that they are performing as expected and if they are providing services that are below standard, should be de-listed. During the appraisal, the patients should also appraise the healthcare service providers since they are at the receiving end.

With that, healthcare services providers will be put on their toes and they will be forced to continue to perform excellently well if indeed they want to keep the contract.

  1. Double Customer Services Standard


If you have ever been under any health insurance cover or under a health management organization and also as a private patient that is paying from your pocket, you would have observed that the customer services offered are usually different.

Different surveys conducted shows that most hospital would rather attend to private patients paying from their pocket than attend to patients who pay through health insurance companies.

This is because a patient paying from his or her pocket will pay on the spot while the payment from a patient paying via health insurance usually goes through some bottleneck bureaucracy. Please note that this problem is not universal, it is usually noticed in countries with weak regulatory enforcement policies in the healthcare industries and other industries.


Hospitals and other medical clinics/facilities should ensure that there are no disparities in the discharge of their duty. If they have agreed to provide treatments to both private patients and those under health insurance policy cover, they should do that without bias.

One of the ways of ensuring that they are not biased in their customer service is to ensure that a regulatory body is constituted to oversee the services offered by these hospitals and medical care facilities.

  1. Lack of Transparency in Assigning Hospital


Another notable problem in the healthcare industry that cuts across many countries of the world including the United States of America is the lack of transparency in assigning hospitals to customers under health insurance policy cover.

Those that are under health management organizations have restrictions on where they are to receive treatment. As it is expected, the average health insurance company or health management organization would usually work with hospitals and medical centers that will favor them at the expense of topflight hospitals perhaps due to their prices and other expectations.

For example, a patient that is under a health insurance policy coverage may need to urgently receive treatment for a life-threatening emergency in a hospital that is not listed under his cover, if such a patient goes ahead, he may likely pay from his or her pocket.


Patients should be allowed to be part of the stakeholders that select hospitals that should be listed under their health insurance policy coverage. With that, the issue of lack of transparency in assigning hospitals will be dealt with.

  1. Lack of Transparency in Selecting Drugs and Medications Used in Hospitals


Another major problem in the healthcare industry today is the lack of transparency when it comes to selecting the brand of drugs and medications that are to be issued to patients after prescription by the doctor. Surveys conducted across many hospitals show that profits and benefits rather than the effectiveness of the drug and medications are what comes up first in their selection criterion.

For example, a drug manufacturer from India may have a preference over a drug manufacturer from The united kingdom not because of the effectiveness of the drug but because of other factors that ought to come second in the selection.

Usually, patients that are under health insurance policy coverage are given drugs after prescription and they don’t have a say on what kind of drug they should be given. It is a major problem because sometimes they usually go out to buy other drugs from their pocket if they don’t like the one given to them from the hospital.


Patients or health insurance policyholders should be given the opportunity to be part of the stakeholders that select the brand of drugs and medications that should be used for treatments in hospitals listed under their health insurance policy cover or under their health management organization. With that, it will be easier to reduce the lack of transparency when it comes to the selection of drugs and medications.

  1. Irregular Disaster Preparation Policy


Irregular disaster preparation policy is yet another major problem in the healthcare industry. The fact that we don’t expect disasters to happen frequently does not mean that we should not be prepared for them. You would have noticed that during disasters, healthcare services providers are usually overwhelmed hence the loss of some lives that would have been saved.

It is a major problem, especially in underdeveloped and developing countries of the world. As a matter of fact, it takes the intervention of WHO and other stakeholders to be able to handle disasters in some countries. The Ebola outbreak in Liberia and other African countries is one of the health-related disasters that readily come to mind.


The government regulatory bodies in charge of the healthcare industry should make sure that they enforce regular disaster preparation policies in the health sector of their country. The truth is that hospitals, medical clinics, and other players in the healthcare industry need to go the extra mile with disaster preparedness in order to keep healthcare services going.

Part of what they need to do is to ensure that their staff members (health workers and support staff are also ready), provision is made for equipment and supplies in the warehouse that can take care of emergencies and the unnecessary bottleneck is eliminated when handling medical emergencies.

  1. The Pay Before Treatment Policy Should Be Reviewed


Although this might not be a universal problem in the healthcare industry, in some countries of the world, when you visit a hospital or medical facility, you are expected to at least deposit a reasonable amount before you are treated or attended to even if it is a medical emergency. As a result of this problem, many lives have been wasted because of the delay in raising the cash required for treatment.


The government of countries where this practice is still ongoing should ensure that they formulate policies that give preference to treating people or at least stabilize them when they are rushed in for treatment during medical emergencies.

Much more than formulating such policies, enforcement should also be taken seriously to ensure that hospitals and clinics abide by such laws.

  1. Lack of Free Quality Healthcare to The Poor and Senior Citizens


Another problem in the healthcare industry that is of major concern, especially in third world countries is the lack of free quality healthcare to the poor and senior citizens who cannot afford to pay for quality treatment. The truth is that even if the government offers free treatments to senior citizens and the less privileged, the services or treatment they get are usually below the expected standard.

This problem might not be universal, but in countries where this occurs, it is due to corruption from government officials in charge and perhaps in connivance with players in the healthcare industry.


One of the international bodies that can oversee the healthcare industry and ensure that nothing but the best healthcare services is provided for the senior citizens and the less privileged people is the WHO. They are in a better position to help build capacity with the host nation to ensure that free and quality healthcare is made available to everyone who cannot afford it.

  1. The Rise of Alternative Medical Treatment


A major problem that is confronting the healthcare industry not just in the United States of America but all across the globe is the rise and no doubt the wide acceptance of alternative medical treatments. The truth is that chiropractic clinics, Ayurveda clinics, and Naturopathy clinics are beginning to welcome more patients than in previous years.

For example, naturopathy is a complementary medical practice that uses natural remedies to help the body heal itself. It embraces many therapies, including herbs, massage, acupuncture, exercise, and nutritional counseling.

This includes therapies from the sciences of clinical nutrition, botanical medicines, homeopathy, physical medicine, exercise therapy, lifestyle counseling, and hydrotherapy, which is the use of water to treat a disorder or disease. The fact that the natural approach is adopted for treatment is that it enables people who are tired of synthetic medicine to embrace this mode of treatment.


The healthcare industry should as a matter of urgency begin to put strategies and modalities in place that will help them enter into strategic partnerships with players in the complementary medical practice industry. With that, it will be easier for them to maximize profits especially when they refer patients to them.

  1. Interference of Major Financiers and Policy Makers in Ground-Breaking Research in the Healthcare Industry


Lastly, one of the biggest problems in the healthcare industry today is the interference of major financiers and policymakers in groundbreaking research in the healthcare industry. One will begin to wonder why it is that we don’t yet have a permanent cure for terminal diseases like cancer, HIV / AIDS, and other related diseases?

The truth is that with the capacity of the human race in terms of resources and exposure we would have come up with lasting solutions (drugs, medications, and treatment procedures) that will cure cancer, HIV /AIDS, Ebola, and other sicknesses without care just like we did for malaria, tuberculosis and the likes.

Some schools of thought believe that the reason why this has not been done yet is because of the inability of major financiers and policymakers to give their full support. Perhaps it might be because they are benefiting that is why they are not committed to supporting research that will bring a permanent cure.


Major financiers and policymakers should be pressurized by the masses to give their full support to research that will lead to the invention of drugs, medications, and treatment procedures that will help eliminate or cure diseases such as cancer, HIV/AIDS, and other terminal diseases.

There you have it, the 10 biggest problems in the healthcare industry today and some of their possible solutions.

Medical & Healthcare Industry Analysis

The hospital and healthcare industry comprises of operators who are licensed as general medical and surgical hospitals that provide surgical, nonsurgical diagnostic, and medical treatment to inpatients with medical conditions. In general, medic clinics maintain inpatient beds and usually provide other services such as outpatient services, operating room services, and pharmacy services.

There is indeed a very large market for healthcare service providers in the united states and of course in most parts of the world.

For instance, the World Health Organization (W.H.O) estimated that there are about 9.2 million physicians, 19.4 million nurses and midwives, 1.9 million dentists and other dentistry personnel, 2.6 million pharmacists and other pharmaceutical personnel, and over 1.3 million community health workers worldwide. This goes to show that the healthcare industry is indeed one of the largest segments of the workforce of any nation.

Results from studies conducted in the United States of America shows that in 2011, healthcare costs paid to hospitals, physicians, nursing homes, diagnostic laboratories, pharmacies, medical device manufacturers, and other players in the healthcare system business value chain, consumed an estimated value of 17.9 percent of the Gross Domestic Product (GDP) of the United States.

This is indeed the largest of any country in the world. As a matter of fact, experts projected that the healthcare share of the GDP of the United States will continue to grow, reaching 19.6 percent of GDP by 2016. One thing about the healthcare industry is that irrespective of the part of the world that your business is domicile, you cannot run away from the challenges that confront the industry.

This is because some of the problems that players in the industry face are global in dimension; meaning that if it can affect a healthcare business in the United States of America, it can also affect a healthcare provider in Nigeria or any other part of the world. Though you should note that there are some problems in the healthcare industry that are peculiar to locations.