Introduction
American health care is the most expensive worldwide, and it is a widely known sad reality. The U.S.’s health expenditure is twice as high as that of any other developed country (Yanushevsky, 2021). Although the U.S. has the most expensive medical care, patient outcomes are worse than in European countries (Yanushevsky, 2021). According to Jordan and Boucher (2019), “the USA … has become the standard-bearer for inefficiency and poor allocation of resources associated with healthcare” (p. 90). Indeed, the Commonwealth Fund ranked the American medical system last among the eleven most developed nations (Jordan & Boucher, 2019). Despite low international scores, many U.S. citizens who possess health insurance to consider that hospital care accessible to them is excellent (Jordan & Boucher, 2019). However, this viewpoint is not accepted by those Americans who cannot afford insurance plans. Hence, this paper aims to discuss the causes of expensive health care in the U.S. and propose a solution for this issue. It appears that this problem needs to be assessed, and a single-payer model should be adopted in the United States to reduce medical costs.
Defining the Problem
The U.S. healthcare system can be divided into private and public sectors. The former is insurance plans, while the latter is Medicare and Medicaid. Since only some population groups are eligible for the federal programs, most people have to buy insurance. Still, this system is not as simple as it may seem because it involves many actors. For instance, it incorporates “federal, state, and local governments in the public sector” and hospitals, physicians, nursing homes, physicians, insurance companies, and different interest groups in the private sector (Patel & Rushefsky, 2019, p. 4). Moreover, even though the 2010 Affordable Care Act reduced the number of uninsured citizens, about 29 million Americans still do not have any coverage (Patel & Paterick, 2018). It appears that this problem stems from the fact that clinicians have high salaries, medications and equipment costs are high, and medical education is long and expensive (Wheeler et al., 2018). However, no progress is observed towards switching to universal health care.
The Analysis of the Issue
The two main reasons for costly health care in the United States are high physicians’ salaries and expensive pharmaceuticals and medical equipment. However, it is also crucial to discuss the underlying issues of these causes. One impetus for this situation was probably the inflated education costs in pre-med programs and medical schools. To exemplify, on average, students pay about $55,000 per academic year, totaling $220,000 for four years (Yanushevsky, 2021). Since the training of physicians takes more than ten years, they usually can start repaying their debts only after completing their residencies. Furthermore, the cost of Medical Practice Liability Insurance ranges from $7,500 to $50,000 per annum, depending on the specialty (Yanushevsky, 2021). Moreover, the manufacturers of medications and equipment are incentivized with a monetary benefit when they establish prices (Wheeler et al., 2018). They certainly adjust for factors like market demand, customer satisfaction, and brand loyalty, but costs for some items remain elevated (Wheeler et al., 2018). Overall, regardless of causes, the problem of overpriced health care in the U.S. is not resolved to date and requires plausible solutions.
Possible Approaches to the Problem
Multiple strategies can be implemented to reduce health care costs in the United States. The first solution is reducing malpractice liability payments for doctors and making medical education less expensive (Yanushevsky, 2021). The second suggestion is to lower the salaries of doctors (Yanushevsky, 2021). Another possible approach is to restructure the entire healthcare system to a single-payer model that will involve financing hospitals from general taxation, minimizing out-of-pocket payments, and eliminating the problem of unaffordable insurance. The fourth solution can be for the federal government to control manufacturers’ prices and offer them alternatives for the diminished cost of medical supplies and therapeutics.
The main problem, in this case, may be that physicians and pharmaceutical companies will not agree to these conditions. Since clinicians will not have enormous educational debts and malpractice insurance payments will be lower, they should not be significantly affected by diminished salaries, which will remain one of the highest globally. On the other hand, large corporations may not agree to the new terms because it can directly impact their income. The argument that may convince them is that more insured people will mean more purchasing of medications and equipment; thus, the total revenue for these firms will rise.
The Proposed Solution for Reducing Health Care Costs: A Single-Payer Model
The single solution that is proposed for implementation in this paper is introducing the single-payer model. Although this can be a challenging transition for hospitals and private insurance providers, the ultimate result should benefit American society. Indeed, this program will provide coverage to all American residents, simplify billing, and reduce diagnostic and treatment prices (Cai et al., 2020). However, the process may take at least a decade until it is adequately established in all healthcare institutions and before the advantages of the universal plan are seen. Nevertheless, it is essential to initiate these changes because the old system’s inadequacy was revealed during the COVID-19 pandemic, which took away hundreds of thousands of lives, disproportionally affecting vulnerable groups (The Lancet Rheumatology, 2020). Moreover, according to Cai et al. (2020), 55% of U.S. doctors and 75% of citizens support the idea of universal coverage, also known as “Medicare for All.” In fact, the single-payer health model was successfully introduced in such countries as the United Kingdom, France, Germany, and Sweden (Yanushevsky, 2021). Overall, its central features include uniform payment from governmental agencies or non-profit organizations and small deductibles.
The Implementation Plan
The health system will become universal in the U.S. when all residents receive access to medical care. The implementation of the proposed plan to attain ubiquitous coverage will be done in four stages. The first step will be a promotional campaign to educate people about the proposed model. The second step should be diminishing the tuition cost in medical schools and making malpractice liability less expensive. Simultaneously, the doctors’ salaries should also be reduced gradually (Yanushevsky, 2021). The third step is to transfer all private plans to federal medical insurance. Indeed, all employed citizens will pay a special tax that will ensure universal health coverage. Furthermore, additional funding can be obtained from for-profit and non-profit organizations in the form of donations. The fourth stage is re-training of the current personnel in hospitals and perfecting the introduced program. Although the plan will require revisions and adjustments before and during its execution, the idea of changing the non-functional distorted system to a united health network gives hope for millions of Americans.
The New Program’s Potential Benefits
The advantages of the proposed solution are delayed but not impossible. One of the primary gains will be lowering the incidence of fraudulent and irrational spending in health care through a single billing system (Cai et al., 2020). In fact, about 40% of U.S. medical expenditures are deceitful; thus, introducing one payment agency can minimize this issue (Cai et al., 2020). Other expected benefits are better quality of life and the rise of life expectancy (Jordan & Boucher, 2019). Lastly, the postponed advantage, which will possibly be evident only in several decades, is the acceleration of economic growth due to improved nation’s health.
Conclusion
In summary, the current healthcare system in the United States is inefficient and overpriced. Indeed, the U.S. spends a substantial amount of money on this sector, compared to other states of the developed world, but patient outcomes are not better than in those countries. Moreover, the old private-insurance-based plan showed its ineffectiveness during the ongoing COVID-19 pandemic. Therefore, the transition to a new single-payer model can provide all citizens with a health plan and improve patient outcomes. In fact, implementing this program will require lowering medical schools’ costs, diminishing malpractice liabilities, reducing clinicians’ salaries, and negotiating prices with manufacturers. Although it may be challenging to convince interested parties of the benefit of this system initially, informational sessions and campaigns can help eliminate this doubt. Finally, the future use of applying this plan can reduce fraudulent and inefficient expenditures, improve patient outcomes, result in higher life expectancy, and lead to economic prosperity due to the enhanced health of the nation.
References
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