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Introduction
The recent researches carried out by
scholars and various companies in regards to the health sector in the United
States has found out that the country puts in roughly 15 percent of the total
gross domestic product on medical program (Buss, 2011) . It, therefore,
means that healthcare remains the largest single sector of the economy of
United States. It is a general perception that going by these statistics the
citizens of the United States should live longer and show signs of healthy
living than the citizens of other countries. On the contrary going by the
reports from the World health organization, it indicates that close to 46
million American citizens are uninsured which constitutes 18 percent of people under
65 years (Orszag, 2015) . At the same time,
the recommended health care services to the adults that get delivered are only
half. Therefore, this jeopardizes the quality of health delivery to the
American citizens. The provision of services is uniform across all cities
whether of lower or higher income levels. Whether with or without insurance,
penetration of managed care, and supply of hospital beds and physicians seem to
take a similar trend.
Given the critical issues that affect the
health sector mentioned, this paper is going to discuss these factors and propose
possible solutions. The main areas discussed are the quality of services
delivery, the health care costs, and insurance how these have affected the
health care system and suggested areas that need improvement
Quality of service
delivery
The United States as many other nations
face a significant challenge in its health system that call for an urgent
reform. The government over a long time has tried out the means to invest more
funding in this sector in addressing the quality of service provision, but it
still records poor outcomes. The country spend more on treating diseases since
it has invested very little in preventative measures leading to high
expenditure in chronic illnesses such as diabetes, heart diseases, and hypertension.
Despite the enormous expenditure, it comes out still that the patients going
through such treatment do not get the efficient treatment or services that aid
them in managing their conditions.
The problems in low-quality service
delivery are evident for all the patients those who have insurance, and those
that don’t have. Other than the unsatisfactory service delivery other patients
have been identified to receive medical care that is unnecessary to their
conditions or harmful. Research findings have indicated that that there is
existent of huge variations in hospital inpatients duration of admission,
procedures and testing and visit to specialists. All these differences do not
produce any evident impact on the patients treated with limited evidence of sufficient
measures and treatments. The failures to detect and minimize the errors further
creates a gap in the efficiency and quality of healthcare. The highly affected section of the Americans
are those with low income and a section of various ethnic and demographic factions
who frequently face inequality in health care.
Research conducted by a company in the United
States on health indicated in the outcome that patients often received only
half of the recommended health care. Across all the communities accessed it
came out that there is a similar trend with overall quality ranging between 59
percent in Seattle and in little rock 59 percent. The similar basic level of conduct
was realized for chronic, preventative care and acute diseases. It, therefore,
indicates that disparity in wealth or possessing an insurance cover does not
qualify one for quality services.
While medical practitioners are required
to offer quality services to patients in an equal measure and ensure a proper
service delivery it is the contrary in the health system. The research shows
that people who have chronic diseases such as blood pressure got close to 65
percent of the total recommended care while patients with alcohol dependence
received only 15 percent. The disparity explains that some diseases are less
attended and leading to possible deaths and more complications that would
easily be avoided. The variation in service delivery is evident across
communities for instance care for diabetes rated between 39 percent in little
rock and 59 percent in Miami (Aetna, 2015) . Another disease
that show variation among the communities is the care for cardiac problems,
which in Orange County and Indiana polis registered 52 percent while in Syracuse
it was 70 percent (Aetna, 2015) .
The concern about chronic diseases is also
very much evident among the communities in America, from the research it is
seen that they recorded a notable preventive measure through screening tests
and immunization. On the contrary, the preventative measures are not that
uniform in less chronic diseases such as sexually transmitted diseases, or
counseling for the substance abuse (James, 2012) . With such low level
of concern, it puts a lot under a critical status. The purpose of the governing
bodies and arms is to ensure that the public are educated, and all the availed
treatment and preventative measures are at their disposal it is important for
such people to be educated on the importance of preventions more.
The highlighted issues can be limited or
done away with if various measures are taken by the government and the
management of various institutions. The country should introduce a chronic
disease management system and technology that provides information about health (Jones &
Bartlett., 2008) .
From the previous evidence, it has been proven that particular approaches can
improve quality and health outcomes. Besides improving service delivery, it can
quicken the processes that may slow down the process of attending to a patient.
The costs incurred in treatment can also be cut to a greater extent hence
making it affordable. The government in an equal measure should invest in
comparative effectiveness research. The purpose for this is that it can help in
correlating the benefits, risks and cost of diverse health care practices. It can as well be utilized to evaluate and
revise policies that determine practices and develop schemes for targeted
services for precise groups of patients. Therefore, CER can help tolerate
continuing advancements in the service delivery system and minimize imbalance
in the health care grounded on geography, race and other factors.
Approaches to various patients should be narrowed
down to a specific population and not as broad as it is done currently. The
targeting treatment method can be crucial thereby promoting value and quality
of service delivery. The use of predictors for instance the complexity of
conditions and other clinical or personal characteristics may help amend
success in the benefits from the delivery system investments. The importance of
this targeted approach is that it helps in providing treatment to a valuable
group of patients such as those suffering from multiple chronic diseases,
patient undertaking care transitions and those with low incomes (Weisman,
2010) .
It
is important to improve the quality of healthcare service delivery in United
States to address an escalating costs, and an increasing number of the citizens
that do not have insurance cover. The reforms that are directed towards health
should better access to the correct care at an appropriate time and within a
proper setting. They
should ensure that citizens are healthy and have the knowledge to help prevent
common illnesses that are avoidable as much as possible. Well-constructed amendment
would encourage increased access to health-improving care — contrary to the
existing system, that encourages procedures, more tests, and treatments that can
be deemed unnecessary or even harmful.
Healthcare costs
The health care expenditure of the United
States is expected to grow to 4.8 trillion dollars by the year 2021, from 2.6
trillion in 2010 and 75 billion dollars in the year 1970, therefore, showing an
ever increasing cost (Aetna, 2015) . It implies that
healthcare expenditure will account for close to 21 percent of the total gross
domestic product (GDP) by the year 2021 which also translates to one-fifth of
the country’s economy (Sultz & Young, 2011) . Research carried out among employers indicate
that quit a number is struggling to offer insurance cover to their employees
while some have not been capable of doing the same. The insurance premiums seem
to be so expensive and can be managed by very few, for instance only 50 percent
of companies with less than ten employees offered coverage to their workers in
2012 (James, 2012) .
The escalating costs saw up to 49 million
American miss health insurance in 2011 a higher population that has never been
recorded before. It also led to a 7.2 percent gain in the share of health care expenses
between the years 2011 and 2012 for the consumers with health care coverage.
For instance in 2012, the healthcare cost for American families for the first
time exceeded 20,000 dollars (James, 2012) . The problems of straining
cost of healthcare is increasingly affecting the American citizens a considerable
number have reported on either them missing to pay medical bills or a family
member in 2013. Another 58 percent of the population recorded foregoing or putting
off medical care in the same year. The ever increasing cost of healthcare does
not only take a toll on the patients only but also strains the federal and
state budgets. It in turn hinders the nation’s power to procure important initiatives
required to address amicably other vital issues.
The scale of growth in the cost of health
care slowed down between the year 2002 and 2010 even though the cost of
healthcare increases continuously more than inflation. The United States
recorded 2.6 trillion expenditures on healthcare in 2010, out of which 51
percent spent in payment of the cost of medical service provided by hospitals
and physicians. Prescription of drugs represented a significant portion of the
overall expenditure at only 10 percent that indicates a success in slowing down
expenditure rates. In comparison with payment made to physician and hospitals
between 2009 and 2010, the growth of prescription of drugs cost 1.2 percent
against 4.9 percent. The private health insurance that has often received a lot
of criticism of the political circles only received 3.75 percent of the expenditures (Aetna, 2015) .
The reasons that have been fronted to
explain the high cost of healthcare in the United States is the underlying
costs in the medical care. Out of the research carried out between 2000 and
2010 while comparing the cost of health care in the US and other
countries that are members of Organization of Economic Cooperation and
Development nations. The United States was found to be the highest spender showing
a 60 percent higher with its expenditures on physicians, dentists and
specialist exhibiting almost two and half times higher than the member countries.
A
research carried out by Healthcare Cost Institute found that the cause for the
rising cost of care is the dominant cause of the hiking cost of care for the
privately insured Americans in 2011. The health care expenditures rose to 4.6 percent
in 2011 higher than the previous year that stood at 3.8 percent that was never
expected for the year 2011 (Orszag, 2015) . The prices of leading categories of the
healthcare such as hospital stay and surgical procedures recorded the fastest
growth for the outpatients. The driving factor in the hospital costs has been
linked to the high rate of hospital consolidations in the industry. The
acquisition rate realized an increment of 33 percent between the year 2009 and
2010. Research carried show that the concentration of the markets led to an
increase of 20 percent of the health care prices in 2011 (Aetna, 2015) .
The
provider prices of the healthcare institutions form another cause for the rising
cost of health care in the United States of America. In comparison with the
Europe United States show more expenditure and having a higher level of obesity
and better access to progressive medical technology becomes a main driver for bigger
spending. The data indicate that after hospital disbursement expenditure toward
physicians and clinical services highly increased between 2005 and 2009. The
costs accounted for 18 percent of the total growth or narrowed to 229 dollars
per person over the five-year period (Orszag, 2015) .
In the wake of industrialization, technology
gets further advanced, and the medical services provision embraces technology
more. For the country to acquire the required machines that can match the
present technology level in the medical industry it has to spend a lot. It,
therefore, becomes another reason as to why there are high expenditures in the health
care by the country. In a research carried indicates that the utilization of modern
medical technology explains the 38 percent to 65 percent increase in healthcare
spending. Despite the efficiency brought about by embracing technology, it
replaces simple and cheaper options of services delivery hence escalating the
cost of services in various facilities.
Wasteful expenditure of the funds
allocated to the healthcare sector leads to need for more funds allocations
hence straining the budgets. According to the calculations by PricewaterhouseCoopers
the country loses up to 1.2 trillion dollars due to wastages (Sultz &
Young, 2011) .
Other areas that leads to wastage in the sector if the failure to adhere to medical
advice and prescriptions smoking and obesity, these in the long run cause
health problems that have to be attended and the bills get paid. Unhealthy
lifestyle forms another burden for the health sector, it leads to various
chronic diseases i.e. obesity that affects the healthcare budget significantly.
Researchers predict that by the year 2023, there will be an increase of 42
percent in chronic disease cases which adds a budget of 4.2 trillion in
treatment costs and wasted economic output (Sultz & Young, 2011) . An increase in
taxes has also significantly affected the sector, for instance, the taxed
levied on the insurer, which the companies extends to the patient, therefore,
making the premium costs hike so much.
Uninsured
By the year 2010 the population of
Americans who did not have medical care insurance was at 49 million a number
that was predicted to grow over the years. The highest number of this
population had incomes that are above poverty level and hence could not qualify
for government entitlement. More than 80
percent of them came from families that are working or had jobs themselves and
notably are below the age of 65. By the year, 2006 about 60 percent of
nonelderly citizen had insurance covers provided by the employers while
Medicaid and non-employer based insurance covered the remaining population. The
cost of insurance premiums over time has become demanding for the employers, and
a larger number have considered stopping the offers as part of the packages for
the employees.
The effects of the uninsured population
are felt across all the levels of health care. The hospital emergency become
the highly affected both in government and public hospitals where these
patients seek primary health care but fail to pay hence forcing the hospitals
to absorb the loss. Research indicates that 51 percent of the uninsured often
get it very difficult to find a doctor if it is not an emergency issue and are
often turned away in clinics and hospitals they try to access (Buss, 2011) . The condition puts
the life of these citizens a high risk and survival expectancy is very minimal.
Preventative measure forms the basis of
control the dire effects of some diseases and, therefore, should be contained within
a stipulated time. The uninsured population, on the contrary, tend not to
undertake such measure for example screening due to the costs. It indicates
that the government budget for the disease treatment and containment would not
go as planned, it also makes it difficult for the management to plan for the patients
and how to attend to the ever growing unpredictable patient. A statistic taken
on people between the ages 50 to 64 those who have insurance and the uninsured.
The result showed that the uninsured were five times less likely to have
undergone a colon test standing at 10 percent against 50 percent (Sultz &
Young, 2011) .
It is imperative for the government to
regulate the insurance companies so that they may provide friendly premiums
that can cater for the low income and the higher income individuals. It will
reduce significantly the loss incurred by the hospitals that deliver services
to individuals who are not able to pay. The life expectancy for the nation will
also increase and the United States will have a healthy population.
Conclusion
A healthy society means a success for a country
since these are the same individuals that ensure that work is done in a
country. The United States must come up with a stringent measure to ensure that
the quality of service delivery to the citizen hits to a high notch. The
equipment in the various facilities should be revamped according to the
population of the area, and again the statistics that have been gathered previously
can help determine the patterns that the health services should take. The cost
of services provided by various hospitals should be keenly investigated to come
up with a clear reason as to why all these do happen and action taken
appropriately. The tax levied on insurance companies should be minimized for
these firms to provide cheaper health premiums manageable to all citizens. Patients
should be encouraged to realize how important their lives are so as to take up
prevention measures seriously to help do away with the various disease.
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Reference
Aetna. (2015, August 30). The Facts About Rising.
Retrieved from Aetna:
http://www.aetna.com/health-reform-connection/aetnas-vision/facts-about-costs.html
Buss, T. (2011). Expanding access to health care a
management approach. Armonk, N.Y.: M.E. Sharpe.
James, M. (2012). Utilizing agent based simulation and
game theory techniques to optimize an individual's survival decisions during an
epidemic. Manhattan, Kan.: Kansas State University.
Jones, & Bartlett. (2008). Health policy: Crisis and
reform in the U.S. health care delivery system (5th ed.). Harrington: C.
& Estes, C. L.
Sultz, H., & Young, K. (2011). Health care, USA:
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Bartlett.
Weisman, M. (2010). Targeted treatment of the rheumatic
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