Dr. Richard Rose, a private practice doctor specializing in treatment of infectious diseases, gave a lecture titled "How we got into this mess" on the problems with the U.S.'s health care system during the UT science forum Friday.

Rose, a graduate of Emory Medical School, became the chief of infectious disease treatment at UT Medical Center in 1982. He's now practicing as a primary care doctor at Summit Medical Group.

Rose described health care practices in the Unites States from the time of the Neanderthals up to present day.

Fossil records show that early man provided trauma care to their injured tribe mates, Rose said. However, up until the 1800s many doctors believed that disease was "the wrath of the gods," he said.

The discovery that insulin injections treat diabetes changed the face of medicine, he said. Instead of doctors simply treating acute diseases with one visit, chronic disease treatment became common practice for doctors.

Our health care system is not a system -Dr. Richard Rose, Summit Medical Group"In the 20^th century, long term management of disease became a necessity," Rose said.

Before chronic disease treatment was an option, doctor-patient relationships were very limited because there was no need for long-term association, and the payment system reflected that, Rose said.

"For most of the history of man, 'fee for service' made sense because it was based on episodic care giving," said Rose.

The main problems with the American health care system arise from the fact that the payment system was not reformed when treatment of chronic disease became an option in the health care industry, Rose said. The payment system is based around episodic care, while much of the treatment given is for chronic problems.

"A system developed around treatment of acute diseases was now translated into treating chronic diseases," Rose said.

It is not effective to provide care for long term treatable diseases in a health care model based around treating acute problems, he said.

Within the system today, 30 percent of the money being pumped in to the health care industry goes toward funding the administrative component of the hospital and not patient care, Rose said.

 In the 20th century, long term management of disease became a necessity.   -Dr. Richard Rose, Summit Medical Group

By basing patient care around the treatment of acute illness, each procedure or checkup has a set price attached to it and those prices tend to be inflated, he said.

"Our health care system is not a system," he said.

Within the health care industry, large numbers of people and problems fall through the cracks and it creates a huge waste of resources, Rose said.

Insurance creates waste because it gives patients a sense of entitlement when it comes to their care, he said. More unnecessary procedures are being performed because the insurance companies pay the doctors no matter if the procedure is necessary or not. Plus, however unnecessary a test was in the first place, a negative test result puts a patient's mind at ease, Rose said.

As far as the presidential election goes, Rose feels that neither of the candidates' plans for reform will have much of an effect on the problems with health care.

"Their plans are really just tweaks," Rose said. "I'm not basing my decision on their health care plans."

Rose admitted he doesn't have the answers to these problems.

"I just told you how we got here, but I'm not going to tell you how to get out," Rose said. "I'll leave the solutions up to you."

The UT science forum is in its 75th year. Ben Fitzpatrick, assistant professor in ecology and evolutionary biology, will be the speaker next Friday, Oct. 31.