Final Critical Analysis
Healthcare delivery in the United States is complex system that is conditionally changing. New policies, physician availability, insurance trends, technology, population growth, and cultural influences shape patient access (Shi & Singh, 2013, p. 353). Healthcare reform is a highly debated topic in America today. By adding funds to the current system it is treating the symptoms and not addressing the cause of the delivery system problems (Moyers, 2009). There are many aspects of the health system that need to be evaluated and improved in the near future (Wexler, et al. 2014).
Controlling Insurance Costs
Controlling insurance costs is a significant political topic in America. The uninsured in America totals forty
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219). Expert evaluation of services to provide only medically necessary care, providing services that are less expensive while providing quality care, and revising a patient’s course of treatment with regards to changing conditions are ways managed care controls costs (Shi & Singh, 2013, p. 220). Cost sharing helps alleviate the costs on the insurance companies by having the insured take on some of the risk through premium cost sharing, deductibles, and copayments. Sharing the cost helps to control utilization of healthcare services (Shi & Singh, 2013, p. 136).
Increasing Coverage (access)
Persistent problems with the healthcare system have caused limited access to a large population of the U.S. There are many precipitating factors that can prevent access to healthcare (CDC, 2011). Higher social status, including money, power and prestige are always associated with better access to medical care and preventive treatments (Cerda, Tracy, Ahem, & Galae, 2014). Low income patients have problems accessing the healthcare system due to lack of financial means to pay for insurance and living in underserved areas (Shi & Singh, 2013, p. 328). Eighty eight percent of uninsured people in America required subsidiaries because they could not afford to pay for health insurance coverage (Moyers, 2009).
America is the only advanced county in the world that chooses to provide health care coverage through private
The United States has a unique system of healthcare delivery, it is complex and massive. Twenty-five years ago; American citizens had guaranteed insurance, meaning the patient could see any physician and the insurance companies and patients would share the cost. But today, 187.4 million Americans have private health insurance coverage (Medicaid, 2014). The subsystems of American health care delivery are Managed care, military, vulnerable populations and integrated delivery
One of this health care’s programs objective is to limit the number of uninsured (Shi & Singh, 2015). This controversial healthcare plan incorporates a privately funded insurance which is paid for through employment and solely by the patient and a publicly funded insurance by the government. Medicare is provided for senior citizens 65 and older, and Medicaid is provided for low income citizens. The federal government and state government both partake in the funding of Medicaid. Although insurance is provided to the low income through Medicaid, the United States continues to suffer from cost escalation spending 17.1 percent of GDP on healthcare in 2013, a 50 percent more than the second nation (Commonwealth, n.d.) The high cost and limited coverage continues to spark up the conversation for a
The U.S. is an industrialized nation that continues to be behind on providing health care coverage to all citizens. However, the German health care system came up with a plan that ensured all citizens are provided with some form of health care coverage; nevertheless, the U.S. continues to dispute health care reform and how to provide coverage to all citizens. “Health spending per capita in the United States is much higher than in other countries – at least $2,535 dollars, or 51%, higher than Norway, the next largest per capita spender. Furthermore, the United States spends nearly double the average $3,923 for the 15 countries ("Health Care Cost," 2011, table 1)”.
A key factor affecting access to care is economic inequality. Many racial/ethnic groups are considered to be of low socioeconomic status in the United States. When one has to worry about food and housing, health is not considered a priority. Lack of health insurance is a huge problem that many people face. The inequalities in income means less money can be put towards doctor’s visits and medications. Research done by Shi, LeBrun, Zhu, and Tsai (2011) shows
One reason that is frequently cited when asking the question of why so many people in the U.S. don’t have coverage is the cost. Many populations, in particular minorities, low-income, and women cannot afford health insurance or are underinsured thus putting them at a higher risk for disease, disability and death. In the U.S in 2010, there were 50 million people uninsured (Patel & Rushefsky, 2014). Private insurance companies have denied coverage to people with preexisting conditions (as seen in the Sick Around America video) and even pregnant women, this practice illustrates the inequality and inequity issues that have permeated the health care system. The Affordable Care Act sought to remedy the issues related to health insurance coverage being accessible for all Americans but there still exists many people without
Health care reform and access to insurance have been staples of the American political agenda ever since the end of World War II. From President Truman’s call for universal coverage in the late 1940’s to the creation of Medicaid and Medicare to the Affordable Care Act, both parties have debated how to lower the rate of uninsured Americans. After nearly 70 years of debate in Washington and beyond, the number of Americans with health insurance has certainly grown (Miller, 2014). However, the number of people in the United States without coverage is still unacceptably high and a problem that should be addressed with a great deal of urgency and care.
In the current U.S. system the free market prevails and companies, in this case, major insurance providers “compete” for business. This competitive business approach should in theory drive costs down. For some reason, however, an argument can be made that it has produced the opposite result in profiteering. The nation’s largest insurer, UnitedHealth, boasted over a 10 percent revenue increase in 2013 according to Forbes (2013). Health insurance affordability contributes to the disparity in access to health care, as evidenced by the fact that there are millions that are still uncovered. A greater majority of certain minorities lack both health insurance and the financial resource to seek out either health care or insurance. While insurance companies reap huge profits the percent of private sector companies offering health insurance has dropped to less than 50 percent (Kaiser, 2013). There is decidedly a lack of coordination of care for this at risk population as well, since treatment is rendered sporadically and with continuously changing providers. The last major challenge is that of improving the quality of health care. According to a 2010 report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), an estimated 13.5 percent of Medicare beneficiaries experienced adverse events during their hospital stay and an additional 13.5 percent experienced a temporary
Healthcare in the United States is facing numerous issues within the current and future turbulent times. I believe that two major issues are the disparity of provision of healthcare to varying societal groups as well as the projected shortfall of healthcare providers to adequately service the population in general.
Today uninsured Americans make up approximately 4.2 million people. Because these families cannot afford the high cost of insurance, they do not get the health care needed to maintain good health. They must live with the pain and worry of the problem and when they do get medical care, they assume huge debts and another worry of how to pay for it.
The rising healthcare cost is an issue that affects many working class Americans. Experts have tried to come up with different ways to make health care more affordable and easily accessible to all. Despite all the efforts and even after the Affordable Care Act, there are still millions of Americans without health insurance coverage and therefore unable to access the necessary medical care. According to a 2015 report by the U.S Census Bureau, there are over 33 million uninsured Americans. (“Health Insurance Coverage in the United States: 2014 - p60-253.pdf,” n.d.) The Affordable Care Act has unquestionably made healthcare more accessible and reduced the number of uninsured Americans. However, there are still millions of
“There are three basic goals for a National Health Care System; 1) keeping people healthy, 2) treating the sick and 30 protecting families against financial ruin from medical bills”, (Physicians for a National Health Program, 2016). No truer statement could there possibly be written or proclaimed as there is a crisis in healthcare costs across the United States. United States, one of the most developed western country, yet we suffer from – higher infant mortality rates, have shorter life spans and are affected by more chronic disease and or illness – than our contemporaries all while spending the most for insurance per capita and less annual doctor visits with less physicians, (OECD Health Data 2015). There is a question to be answered, “why”, why are we trailing our contemporaries and more important than that is, is our National Health Care system really working for us? The year 2010 was the beginning of change in the United States where we transitioned from primarily private insurance and welfare to a universal healthcare model, under President Obama with the signing into Law of the Affordable Health Care Act March of 2010. The purpose of the Affordable health care act is to ensure that all Americans have access to affordable healthcare, however in 2016 we are still questioning we’ve been successful based on funding, government sponsored healthcare programs, effects on the current HCO, elderly, military and accessibility.
Astronomical costs together with increased numbers of uninsured citizens in the United States creates an environment where health care premiums continue to grow at an astronomical rate with many businesses simply choosing to not offer a health plan—or if they do—they pass on more of the cost to employees. Employees facing higher health care premiums often choose to go without health coverage. Being uninsured does not mean going without health care; there are many clinics and services that are free to indigent individuals. However, any costs not covered by insurance are absorbed by the rest of the population, which translates to higher premiums for the middle class. (Messerli, 2014)
This year being an election year means that the American people are confronted with many issues and disparities that plague our nation. One of these hot button topics is that of healthcare. The United States is the only developed nation without a universal healthcare system, but spends the most for health services. With so many Americans lacking the adequate care needed or facing bankruptcy due to piling medical bills, one must look at the health disparities that are causing this super power nation to inadequately serve its citizens.
In addition, health care industry can affect every living person in United State in one way or another. For instance, the uninsured are excluded from services, charged more for medical services and die when medical care could have saved them(Berkin, 2012). America is known to have some of the best doctors, and healthcare facilities in the World, however two thirds of our country do not have an access to health insurance, or cannot afford it(Berkin, 2012). The Right to Health Care notes that the United States is one of the few, if not, only, developed nation in the world that does not guarantee
There are many issues that are causing changings in the healthcare system. Population aging, rapidly increasing costs of healthcare and the growing burden of chronic disease are challenges to health systems worldwide. To meet these challenges will require new approaches to healthcare delivery and comprehensive population health management. Many states are not prepared to tackle this issue yet. The US has the most expensive healthcare system in the world with health status indicators that are only average in comparison