Abstract
Health care provision in the United States is carried out by numerous and independent legal organizations with the authorization of the Federal government. The country has identified the importance of personal health and that is why it spends a lot of resources on personal health care schemes than any other country in the world. It spends about 15% of its GDP on the provision of health services to its citizen. It is expected that the percentage of GDP to be allocated to health care providers will rise in the future. In 2007 alone the government spent about $7,400 per person on health care which accumulated to 2.26 trillion dollars (Marcia, 2004).
The United States is the only developed country that lacks a universal health care provision. Many of the citizens access health care through health insurance that is availed through employment or individual purchasing of health insurance policies or enrolled in government health provision programs. The disadvantaged compromising of the poor, war veterans, disabled, elderly, and children are catered for by health care programs that are funded by the public. The law has a provision for people to access emergency health care regardless of the inability to pay. The government is seen as the largest insurer with its programs accounting for 45% of health care provision expenditures of the entire country (Leiyu, 2007).
System effectiveness
There is a lot of concern when it comes to efficiency and citizen’s access to health care in the United States. WHO has ranked the United States as the leading country as far as the health care system is concerned. Despite the country being ranked first in the health care system, it was ranked 37th in the performance of the system and a weak 72nd in the country’s level of health. There was a heated debate concerning the ranking, with some supporters of the free market citing that one of the assessing statistics was financial contribution fairness. There was also a study that found that the World Health Organization ranking did not relate in any way to the citizen’s satisfaction as far as health care provision was concerned and that some of the highest-rated countries experienced a high range of customer dissatisfaction (John Geyman, 2004).
A study by the Central Intelligence Agency and which was published in the CIA World Factbook ranked America as the 41st lowest in terms of infant mortality rates and also 46th for life expectancy. There has been a steady decrease in the deaths brought about by preventable causes in the country especially when compared to other developed countries. Research carried out by National Center for Health Statistics has reported that the majority of the United States citizens have excellent or very good health in the year 2006. The country also has the highest survival rates from terminal diseases especially cancer in the world (Marcia, 2004).
However, there are studies that have noted increasing gaps in health care provision and life expectancy that are related to geography and income. There are also gaps growing between the educated and the uneducated which loosely translates to gaps between the poor and the rich because the educated are mostly the rich people in the country. However, it is important to note that gaps are decreasing between men and women and between races. There is a rising concern over the rising death rates of high school dropouts while the opposite is being witnessed for college graduates. These are mainly attributed to drugs, smoking, stress-related diseases such as high blood pressure and also obesity (Leiyu, 2007).
The Foundation for Child Development released a report which indicated that child mortality rates in the country had significantly dropped and also there was a magnificent drop in children’s elevation of blood lead levels. There was also a decline in expectant women smoking. Obesity and low birth weight were reported to have increased and this was attributed to delaying of childbearing by the women and also elevated fertility drugs use (Marcia, 2004).
Among the citizens, there are different feelings toward the efficiency of the United States health care system with 45% of research respondents confirming their contentment with the system and they believe that the system was the best in the world. 39% of the respondents felt that the system needed improvement and cited that there were other countries that had better health care systems in the world. However, these differences and attitudes towards the system were influenced highly by the political affiliations of the respondents and the Republicans were overly conclusive that the system was the best. The Independents were torn between while the Democrats believed that there were other systems in the world that had better health care systems than the United States. This survey was carried out by Harris Interactive and the Harvard School of Public Health and it is important to note that it was during George W. Bush’s presidency (John Geyman, 2004).
The system’s inefficiency
There are noted delays in seeking health care and this often leads to people resulting in more usage of the emergency care. Most of the uninsured Americans do not seek health care in time and they also do not engage in preventive habits and this trend has increased the rate of health crises in the country. This has proven to be more costly than when the system is involved in giving treatment for various conditions. The uninsured people were more likely not to receive any treatment than the insured people in case of an injury or the initial stages of chronic disease. The uninsured people are also more likely not to have a follow-up that is recommended after a treatment but this does not apply to the insured people. This has brought in a culture where the uninsured people are frequenting emergency rooms putting a constraint on the system in terms of emergency care to be given to more urgent cases. The uninsured people were also reported to be diagnosed with late-stage terminal illnesses which would have otherwise been having diagnosed at a better time for its control (Leiyu, 2007).
There has developed a culture where the people who are not insured have their medical expenses taken care of by programs such as charity and these expenses are passed on to other citizens through taxation and higher insurance premiums. Programs such as Medicaid and SCHIP are faced with strains arising from the economic downturns. Research by Kaiser Family Foundation found out that a 1% rise in the level of unemployment would increase the programs with over a million enrollments and at such increase the number of uninsured citizens by 1.1 million. This implies that the state would increase its spending on the programs by 1.4 billion dollars and it was unfortunate that these increases would come at a time when the state was facing difficult times in economic terms. A previous downturn prompted the Jobs and Growth Tax Relief Reconciliation Act of 2003 (JGTRRA) to have a provision where federal assistance would be given to states and this would help in loosening the states’ Medicaid and SCHIP conditions of eligibility. This should also be considered in these times of financial downturns being experienced by the country (Barton, 1998).
There are numerous other inefficiencies in the system and these include the variation of medical care provided by different health care providers. This means that the income capability of some people dictates the quality of the health care they are going to receive. There are also the concerns of administrative costs that are very high at times. These costs are then subjected to the citizens through taxation and high-priced medical care services in the country. There has also been reported a disparity in health care provision to minorities in the country. Black Americans, Hispanics, Asian Americans, and Native Americans have been subjected to discrimination in the health care providers in the country (Marcia, 2004).
Politics and the health care systems
In the 1990s the prices of drugs became a common issue that was highlighted in the politics of the country. New drugs came at highly exorbitant prices and it was a rude shock to many citizens when they discovered that the government and the insurers could not cover the prices of these prescription drugs. Although the country is the world’s leading spender on pharmaceuticals, this only accounts for 12.9% of the health care budget. The government has taken the stand that the rising costs of drugs are brought about by the fact consumers are subsidizing expenses that the pharmaceutical companies cannot make up for in other countries. The politics involved suggest that other countries should come up with new policies which would clearly define the purchasing power the companies are supposed to deal with. The problem is brought about by the fact that foreign countries buy their drugs in bulk and they use this power to negotiate the prices of the drugs (Barton, 1998).
The Republican government put into law a Medicare bill which prohibited the government from negotiating drugs prices, a move was seen by the Democrats as a way of ensuring that the pharmaceutical companies profited from the Medicare program and notwithstanding the risk, the program is under of becoming financially insolvent (John Geyman, 2004).
How the new administration can change the system
The Obama and Biden administration can change the outlook of the country’s health care system in such ways as ensuring that there is the existence of universal health care coverage in the country. It should also come up with new health policies that are focused on the availability of government-funded insurance policies which would ensure that everybody has access to health care regardless of how urgent the care is needed. This administration has failed in that the insured people are the only people who can successfully access medical care when they need it, unlike the uninsured people who are more likely to get medical attention and follow-up. This kind of situation has led to the uninsured people being diagnosed with terminal diseases like cancer when it has reached a stage it cannot be managed or controlled (Leiyu, 2007).
The new administration should also look into the disparities that are involved in the system and ensure that every citizen has access to health care when it is needed. This means that the minorities which include Blacks, Hispanics, Asians, and Natives all get access to health care. The case nowadays is that there are involved a lot of disparities witnessed in the provision of health care. Other types of minorities like the poor, aged, disabled, children, and youths are covered fully by the government in terms of health care expenses (Barton, 1998).
The government should also come up with policies that make it easy for people to buy prescription drugs. These policies include encouraging the pharmaceutical companies to reduce the prices and also acts that should prohibit the companies from exploiting the domestic market. The case as it is seen today is that these companies are exploiting the internal market while they are selling drugs to foreign countries at very competitive prices because they are buying in bulk. The government can come up with a policy of buying the drugs from the companies in bulk and in turn selling them to the citizens at subsidized prices (Marcia, 2004).
The issue of insurance is also another major controversy that is witnessed in the system. The uninsured should be provided with easy insurance policies that do not require them to pay hefty sums for premiums. This is an initiative that the government should undertake to lessen the burden on the taxpayers and other health care programs (Leiyu, 2007).
Conclusion
The health care provider of the United States is one of the highly ranked systems in the world and although it has had its ups and downs, the system so far has been working in improving the health standards of the citizens of the United States. However, there are a number of issues that need to be changed, and that change can only be brought about by the government. One of the issues that need to be looked at is the insurance issue where many people who are not insured need to be insured (John Geyman, 2004).
Another issue the government needs to look into is the issue of disparity in the provision of health care and also the issue of the prices of prescription drugs which have led many people to suffer since they cannot afford the drugs (Marcia, 2004).
References
- Barton, P. L., (1998). Understanding the U.S. Health Services System. Foundation of the Amer College.
- Leiyu, S. Signh, D. A. (2007). Delivering Health Care in America: A Systems Approach. Aspen Publishers.
- John Geyman, M.D., (2004) Falling Through the Safety Net: Americans Without Health Insurance New York: Common
- Marcia Angell, (2004) The Truth About the Drug Companies: How they Deceive Us and What We Can Do About It. New York: Random House.