United States Health Care System: The Inefficiencies and Possible Suggestions for Reform - Research Paper Example

United States Health Care System: The Inefficiencies and Possible Suggestions for Reform The human society nowadays is continuously facing spectacular transitions due to the processes of globalization. Apparently, it has been expected that there will be considerable changes in the health status of the people. Over the years, due to socio-economic changes, public and private health initiatives have strived to improve basic health indices. Many have come up with certain health plans depending on the needs of their target populations. Thus the emergence of Health Care System, which is consists of people, institutions and actions whose primary purpose is to provide provisions to promote, restore or maintain health (Watson & Ovseiko, 2005; Musgrove, Creese, Preker, Baeza, Anell, & Prentice, 2000). It is the complete interconnection of interested parties who finance, provide services or set policies for better administration. This endeavor has enormously contributed to better health, and has been of great help especially to the poor. Through the years, there have been growing expectations and demands regarding health care. The reason that the World Health Organization (WHO) continuously evaluate the existing health systems of different countries and incessantly recommends for the establishment of efficient, accessible, and responsive health care system. One of the responsibilities of the system is to improve the health of the people. However, it is also crucial to protect the people against the financial cost of illness and ensure that they were treated with dignity. Objectively, health systems were established in order to improve the health of the population, respond to the expectations of the people, and to provide financial protection against the costs of ill-health (Musgrove, Creese, Preker, Baeza, Anell, & Prentice, 2000). The report of the WHO released in the year 2000 showed the assessment of health systems based on the overall index of performance. In particular, the member nations were assessed according to the indicators set by WHO which includes the following: effectiveness of health-care system (including medical care and traditional public-health services) in reducing mortality and morbidity, responsiveness of the system to the consumers, and fairness of the system measured through the progressiveness of health care funding (Musgrove, Creese, Preker, Baeza, Anell, & Prentice, 2000). The Case of Crisis in the Health System of the United States of America The health care system of the United States of America is currently scorned as miserable compared to health systems in other developed countries. Americans, particularly economists, government officials, insurers and academes (Atlas, 2009) are pushing through their arguments and seek for alterations for an efficient and appropriate government role in health care system. The so-called deteriorating administrative efficiency of the United States health care system was observed decades ago. In 1983, as reported by Woolhandler and Himmelstein (1991), the portion of health care expenditures consumed by the administration in U.S. was 60 percent higher compared to Canada and 97 percent greater than that of Britain. During that time, the authors made an assessment of the effects of the existing health policy initiatives on the administrative efficiency of health care based on the components of the administrative costs in the United States. The latter was consisted of the insurance overhead, hospital administration, nursing home administration, and the professional billing of physicians and overhead expenses (Woolhandler & Himmelstein, 1991). Later in 2000, the World Health Organization (WHO) released an assessment of the health care systems in 191 member countries. It showed the United States as ranked number one (1) in health expenditure and responsiveness, however, when it comes to the overall health system performance and the level of health, the USA ranked 37th and 72nd, respectively (Musgrove, Creese, Preker, Baeza, Anell, & Prentice, 2000). This assessment of WHO had an immediate and enormous impact to the Americans. Most Americans hardly took the issue, while some were approved as per their observations and criticisms regarding their likely satisfaction on American health care. Many publications were made expressing different viewpoints because of this reprehensible connotation of the American health care system. Recently in 2010, the Commonwealth Fund released a publication comparing the performance of the U.S. Health Care system with six other nations namely Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom. The assessment which was based on the five indices of a highly performing health system, including quality, access, efficiency, equity, and healthy lives, ranked the United States as seventh in the overall performance ranking (Davis, Schoen, & Stremikis, 2010). In particular, the following are the present situation and the dilemmas faced by the Health Care System of the United States. Expensive Health Care As supported and exposed in most assessments conducted regarding the status of health care systems, the United States was shown to have the most expensive in the world. Nevertheless, comparative analyses consistently show the underperformance of United States relative to other countries (Davis, Schoen, & Stremikis, 2010; Musgrove, Creese, Preker, Baeza, Anell, & Prentice, 2000; University of Maine, 2001). Based on the health expenditures per capita (per person) the United States is spending $6,697. The reason for the existing expensive health care in the United States is attributed to the rising cost of medical technology, drugs, and high administrative costs (University of Maine, 2001). The United States does not Provide Health Care for all its Citizens Unlike other developed countries, the United States government does not ensure health care for the people. Instead, rely on private insurance which is mainly based on employment. The increasing insurance rates are causing employees to drop their insurance benefits (University of Maine, 2001). Medical Practitioners are not Paid According to the Quality of Care When it comes to the parallel payment for the quality of care delivered by doctors and other medical professionals, the United States, as compared to other countries describe by the Commonwealth Report, scores low than any other six countries, having only 30 percent (Davis, Schoen, & Stremikis, 2010). Absence of Universal Health Insurance Coverage According to Wolf (2010), 50.7 million, or 16.7%, from 46.3 million Americans are uninsured, which contributes to expensive health care. This is so because conditions which could have been prevented and treated during the early stages of the illnesses. As cited in the 2010 report of Commonwealth Fund, the reason why the United States ranks last in terms of the quality of care is due in part to the absence of a universal health insurance system (Davis, Schoen, & Stremikis, 2010). The Commonwealth believes that a comprehensive insurance is important for patients to have access to care and interactions with physicians. Since Americans, particularly the uninsured, are deprived to regularly check with medical practitioners, the most likely foreseen result is the lack of important information about the medical history of patients. Hence, this could contribute to the negative implications in care quality and medications. Fairness in Financing Fairness in financing is the measure of how financial contributions to health systems is distributed across the population. It is said that efficient health system is beneficial, especially to the poor. However, according to the report of WHO (as cited in University of Maine, 2001), the United States is least fair of all the Organization for Economic Cooperation and Development (OECD) countries. Unfairness in health care financing is likely to have greater consequences, especially to the uninsured citizens and the poor. For years, the increasing cost of health care has made it inaccessible to most Americans. Possible Solutions from Cross Country Examinations Australia ranks high on health outcomes and efficiency (Davis, Schoen, & Stremikis, 2010). The same with the United States, health systems in Australia is governed by private medical practitioners and private health insurance agencies. However, the Australian government has managed to construct a publicly financed health insurance system with a privately financed alternative (Altman & Jackson, 1991). Since one of the problems in the health care system of United States is the absence of universal health insurance coverage, the health system could be used as a model country. The U.S. government must also strive to establish a public insurance system that is accessible to all Americans, whether rich or poor. Since there are many private-owned insurance companies in the U.S., the government can make arrangements and agreements with these groups to come up with a “privately financed alternative”, just like in the Australian scenario. Since the lack of insurance among Americans is the root cause of other health care system problems, the idea of using the strategy of Australia could be of great help. Acquisition of insurance by Americans will drop other health care system problems. On the other hand, private insurance sectors in the state are also part of the country’s resources. Thus, making private insurance companies as part of the public institution is somehow a way to maximize resources for the benefit of improving the health care system of the United States. The problem with the United States as not providing health care for all its citizens will be answered thereof. As much as citizens will have insurance, means that they also will have access to physicians more easily and while paying a not so expensive professional fee. Since the insurance system is publicly owned, it is expected to be more affordable to the poor, thus early medications for illnesses will be taken care of. According to Davis, Schoen, and Stremikis (2010), the United States government has amended comprehensive health reform legislation into the law. This is one of the solutions to the existing inefficiencies in the U.S. health care system. Part of the legislation is the establishment of health insurance exchanges and market regulations, income-related premium subsidies, and minimum standard benefit packages. The reform will take effect in 2014, which is expected to help insured and uninsured Americans. Electromagnetic radiation (EMRs) is currently being used by majority of primary care doctors in Australia, New Zealand, and the United Kingdom. They also use electronic prescribing and electronic access to test results (Davis, Schoen, & Stremikis, 2010). Through this technology, integrated medical records and information will be available to doctors and patients. The American Recovery and Reinvestment Act, is also starting to adopt these health information technology. This will provide easy access and communication between the patients and their physician, to deliver more effective and efficient care. Overall, in order to improve the health system of the United States, looking at other countries perspectives towards an efficient, accessible, and fair health care system is very crucial. Since the “consumers” of health systems are the citizens, they are the ones who determine the performance of the health care system of the state. Still, humanity applies, that if the performance scores for equity are low, performance on other measures are also affected. Thus, failure to meet the needs of the lowly is also a failure in meeting the needs of the average citizen. References Altman, S., & Jackson, T. (1991). Health Care in Australia: Lessons from Down Under. Health Affairs , 129-146. Atlas, S. (2009, March 24). Research:10 Surprising Facts About American Health Care. Retrieved January 19, 2011, from National Center for Policy Analysis: http://www.ncpa.org/pdfs/ba649.pdf Davis, K., Schoen, C., & Stremikis, K. (2010). Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally. USA: The Commonwealth Fund. Maine, U. o. (2001). The U.S. Health Care System: Best in the World, or Just the Most Expensive. Maine: Bureau of Labor Education, University of Maine. Musgrove, P., Creese, A., Preker, A., Baeza, C., Anell, A., & Prentice, T. (2000). Health Systems: Improving Performance. France: World Health Organization. Watson, J., & Ovseiko, P. (2005). Health Care Systems. United Kingdom: Routledge. Wolf, R. (2010, September 17). News: Nation. Retrieved January 19, 2011, from USA Today: http://www.usatoday.com/news/nation/2010-09-17-uninsured17_ST_N.htm Woolhandler, S., & Himmelstein, D. (1991). The Deteriorating Administrative Efficiency of the U.S. Health Care System. The New England Journal of Medicine , 1253-1258. Read More