A Failing Healthcare System
The United States of America is amongst the prosperous nations in the world with adequate democracy and a high living standard that most third world countries could only dream. However, the United States healthcare system is failing its majority of the population. A recent research deducted that nearly one third of American aged 65 years and below have no health insurance (Garber & Skinner, 2008). Therefore, this means that in a developed country like the United States, some of its people still cannot access quality healthcare. Thus, this can be viewed as paradoxical because of the massive amounts of money invested by the government in the healthcare industry.
Moreover, the Commonwealth Fund, which frequently ranks the health structures of the developed nations, has concluded that the countries with the best healthcare systems are Britain, Netherlands, and Australia. On the other hand, the US health care industry performed relatively poorly as compared to other developed nations despite its spending more in funding its healthcare system than any other country. In fact, a 2009 report by the Urban Institute concluded that the healthcare system of the United States is lagging behind regarding mortality rate and handling of preventable diseases (Garber & Skinner, 2008). Hence, the quality of the system is questionable. Therefore, the aim of this paper is to assess and evaluate the effectiveness of the United States healthcare system.
Firstly, the United States healthcare system is increasingly becoming unsustainable due to its high associated costs of funding. In fact, the US spends nearly 18% of its annual GDP on healthcare-related investments (Chernichovsky & Leibowitz, 2010). In 2015, the government spent nearly 3.2 trillion on healthcare. As a result, this is the highest investment by a government in the healthcare industry. It can be observed that no other country spent as much as the US regarding healthcare. However, a country like Sweden come a close second concerning healthcare spending as it invested nearly 12% of its yearly GDP on health care. On the contrary, this is still significantly high as the average spending on health care for developed nations was 9% of the GDP. However, even with this massive investment in healthcare, Americans still don't have access to quality healthcare. As such, the US healthcare system is less effective than that of its counterpart developed nations who spend significantly lower on healthcare. Such a massive investment in healthcare expects that this will be translated into a healthier population. However, this is not the case as the child mortality rates in the US are as high as 7 per 1000 children and American's can expect to live up to 79 years (Chernichovsky & Leibowitz, 2010). Unfortunately, this is significantly lower achievements for a healthcare system that has immense funding. In comparison to Japan, which spends slightly lower on its healthcare system than the US, the American system is outperformed. This is because someone in Japan has a life expectancy of 84 years. Therefore, there is a clear indication that the health care Industry in the US is overfunded but the result does not trickling down to improve the healthcare efficiency.
The American health insurance is costly. Hence, not every American citizen is capable of having health insurance. As a result, nearly one-third of Americans age 65 and below does not have health insurance. Conclusively, this is a clear indication that there is a significantly large population of American citizens who do not have access to quality healthcare. On the contrary, the American government has introduced the Affordable Care Act (ACA) which has led to the insurance coverage of many needy individuals by providing subsidies to them. The act led to the number of uninsured elderly American citizens decreasing from 44 million to 28 million in 2013. However, even with the introduction of ACA, there is still a large population of the uninsured (Chernichovsky & Leibowitz, 2010). This can be attributed to the relatively high insurance cost. Most of the uninsured are jobless and do not have any cover through a job or have any capability of paying the monthly stipend for the insurance. As a result, the lack of insurance coverage can be blamed on how the US healthcare system is managed. Most people have argued that the US healthcare system is operated as a business with more focus being on making profits for stakeholders who include the insurance companies than on providing adequate healthcare (Woolhandler & Himmelstein, 1991). Majority of insurance payers are forced to dig deeper into their pockets to afford an insurance cover. However, the government can do more by providing legislation that can significantly lower the cost of insurance purchase.
Further, the US healthcare system is burdened with excessive administrative inefficiencies. Woolhandler and Himmelstein claim that the United States spends 60 percent more on healthcare administration cost than their neighboring country Canada, and 97 percent more than Britain (1991). Health care researchers have attributed the healthcare administrative inefficiencies to resource wastage which increase the administrative complexities. Most of the resource wastage according to the Commonwealth Fund can be attributed to the time wastage during doctor and patient billing and insurance claim. On the contrary, other countries like the Netherlands were able to reduce the administrative burden on providers by standardizing benefit packages which ensured that the patient has predictable payment plans. Therefore, the American health system should strive to regulate its healthcare insurance packages, and in doing that doctors will spend significantly less time in coordinating insurance claims to provide care. Also, the US health care system has a lot of operational wastage (Bentley, Effros, Palar, & Keeler, 2008). Operational wastage is defined as the excessive and unrequired usage of resources in the supply of health services. As a result, ineffective and disorganized health services can incur more financial burden on the stakeholders. For example, medical errors can lead to more time wastage in clarifying the mistake which translates into more costs for the patients in clarifications. In addition, the medical errors are attributed to the deaths of more than 98,000 patients yearly in US hospitals. Therefore, it is imperative that the government work on the administration inefficiencies in the health care system to provide value to the patients.
Impact of Quality and Prevention on Healthcare
In a research that was conducted by the Commonwealth Fund, the United States emerged as the last country in a pool of the most developed countries regarding quality and efficient health care system. On the contrary, the United States was found to be the biggest spender in the healthcare industry. However, it is in the public domain that health care is an expensive endeavor and quality can be associated with cost. Nevertheless, the Dortmouth Institute researched the American healthcare industry and deduced that there were significant disparities in healthcare expenditure and the quality in health care services across all States in the US (Schuster, McGlynn, & Brook, 2005). Unfortunately, the research also concludes that regions in the US that received more health care funding by the government were more likely for patients not to receive the recommended treatment, therefore, significantly affecting the quality of the health care services. On the other hand, the US has highly specialized and educated medical health care work force. However, with the current health care system there is a lack of prioritizing in lower priced and low intensity health services that could potentially improve the current state of public health. Further, the Food and Drug Administration (FDA) doesn't provide regulations for new drugs released to the market to be more reliable and cost-friendly than the existing drugs (McLoughlin & Leatherman, 2003). Therefore, there has been an implementation of new drugs on the market without the appropriate consideration of cost efficiency and drug effectiveness. As a result, expensive treatments are accepted without the proper knowledge of their effectiveness on the patients. For example, the recent approval of cancer medication that cost slightly over 100,000 USD yearly without the appropriate research of their effectiveness on improving the cancer patient's lifeline (Schuster, McGlynn, & Brook, 2005). Therefore, the cost of healthcare is not correlated with the quality of health care, and more funding doesn't justify that efficient health care services.
Conclusion
Despite the US government highly funding the healthcare industry, there still exist gaps within the industry that ensure the US doesn't compete at par with other developed nations concerning healthcare. One of the critical factors that ensure the US healthcare industry is on a decline is the unsustainable funding. As a result, the funding is 18% of the country's GDP against the developed nation standard of 9%. The significant funding, however, doesn't translate to quality health care. Further, the US insurance is costly and the majority of the low-income families are not able to afford it. Therefore, some of the population has no access to effective healthcare. Lastly, the healthcare sector is burdened with excessive administrative inefficiencies. On the other hand, the question of quality in healthcare doesn't correlate to cost. Therefore, it is recommended that the government eliminate non-beneficial care services that do not improve health care quality.
References
Bentley, T., Effros, R., Palar, K., & Keeler, E. (2008). Waste in the US health care system: a conceptual framework. . The Milbank Quarterly, 629-659.
Chernichovsky, D., & Leibowitz, A. (2010). Integrating public health and personal care in a reformed US health care system. American Journal of Public Health, 205-211.
Garber, A., & Skinner, J. (2008). Is American health care uniquely inefficient? Journal of Economic Perspectives, 27-50.
McLoughlin, V., & Leatherman, S. (2003). Quality or financing: what drives design of the health care system?. BMJ Quality & Safety, 136-142.
Schuster, M., McGlynn, E., & Brook, R. (2005). How good is the quality of health care in the United States? The Milbank Quarterly,, 843-895.
Woolhandler, S., & Himmelstein, D. (1991). The deteriorating administrative efficiency of the US health care system. New England Journal of Medicine,, 1253-1258.
