U.S. Health Care system
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Many people believe that the current of health care in the United States is the best health care in the world however it has major shortcomings that has become more visible for the whole world to see. The United States has the most expensive health care system in the world based on health expenditure per capita and on total expenditures as a percentage of gross domestic products. And also view has having the worst assess to the healthcare system for the poor and uninsured along with the quality of care that one does not receive being uninsured and poor. In this paper I am going to describe the general policy making viewpoints that exist today on each of the following healthcare issue like access to healthcare, the cost of healthcare, and the quality of healthcare a patient receive from the provider. And also analyze the role of five major stakeholders that has influence healthcare and how one’s receiving healthcare as a patient in the United States. The world we know today has come long way since the 1900’s in healthcare and how one’s access healthcare and how one’s going to pay for the cost of the treatment they receive as a patient and the type of quality care they receive if one’s have healthcare insurance.
Millions of people in the United States are affected by not having access to quality healthcare and these include the elderly, uninsured, minorities are at risk of for the lack of access to United States healthcare system due no having no healthcare insurance, or the cost of the care they might receive and they quality of care they will receive as a patient in the system. According to the U.S. Census Bureau estimate 47 million people do not currently have healthcare insurance and have little access to United States healthcare system which has the best technology in the world U.S. Healthcare to treat patients (U.S. Census, 2006). With this in mind our legislation in Washington D.C. vote to pass the Patient Protection and Affordable Care Act in 2010 and President Obama sign it in to law. The vote was very close by in the House of Representatives of 219 for the bill and 212 against the bill. As society what is our obligation to ensure access to the basic level of healthcare to every American citizen. According to the American medical Association every citizen should have access to adequate health care and patient has a basic right to having adequate health care.
Adequate Health Care “Society obligation to provide collective and fair opportunity does not entail a commitment to provide all possible health care to everyone” (CEIJ report, 2010). With new law in place it will shape the way people access healthcare and now many people access healthcare through the emergency room that as their main source of healthcare for the growing segment of population in America and according to CDC study the annual number of emergency room visits jumper from 90.3 million in 1996 to more than 120 million in 2006 a 36 percent increase (CDC, 2006). Which mean an increase in cost for the patient who receives treatment in the local emergency room than a clinic which would be much cheap than the emergency room visited. With this in mind California is the first states to implement its own healthcare insurance market under the Covered California. California Covered is program designed to cover the citizens of California with medical insurance. According the state of California there are 8.2 million that have no medical insurance and rely on some form of government assist to help cover the cost of the medical and assisting citizen with access the quality healthcare and without the burden of the cost or having to visit the local emergency room for treatment of their illness.
Having access to quality healthcare is major part of one’s life however the cost of care has been on the rise over the past decades and continue to rise every day due to many situation such U.S. Healthcare 4 as defensive medicine practice, new technology, malpractice lawsuit and the uninsured. New technology is the biggest factor of the rising cost of healthcare to treated patient of their illness. New technologies have seemed to be the driving force of high healthcare cost in America. The technology accounts for 38 to 65 percent of healthcare spending in America (Johnson, 2011). The annual spending of health care increased from 75 billion in 1970 to 2.0 trillion in 2005 and is estimated to reach 4.0 trillion in 2015 (Kaiser Foundation, 2013). U.S. citizens spent 5,267 per capita for health care in 2002- 53 percent more than any other country” (2005). “America spent 5267 per capita and in Switzerland they spent 3074 per capita” about 1821 cheaper than ours (Starfield, B 2010).
Controlling the technology isn’t easy thing to do because of technology prices are set by manufacturing and the installer of the new medical equipment’s. However, there other way that the healthcare provider can reduce the cost of healthcare the way physicians practice medicine. Defensive medicine practice by physician also has driving up health cost of care to patient and insurance companies who supply healthcare insurance to American citizens. Defensives medicine practice is the practice of diagnostic or therapeutic measures conducted primarily not to ensure the health of the patient but to safeguard the physician against the possible malpractice lawsuit through wrong doing and the fear of litigation has been the driving force behind defensive medicine practicing by physician throughout America healthcare system. According to study 2005 done by JAMA over 90 percent of physician in the surveyed admitted to practicing defensive medicine to protect them from unwanted malpractice lawsuit (JAMA, 2005). This is one of the factors that has driving up the cost of care in America healthcare system and most physician will continue to practice this form of medicine for the years to come.
Cost is the main U.S. Healthcare reason why so many American can afford healthcare insurance because the cost is passed along to the insurer in higher premium cost to insurance a person or their family. In a study done in Massachusetts physician stated that between 20 percent and 30 percent of x-ray, CT scan, MRI ultrasound and specialty were ordered primarily for defensive medicine practices to prevent malpractice lawsuit ((Hermer & Brody, 2010). There is other thing that has affected healthcare cost such as new medical technology and advances in medical technology have contributed to rising overall U.S. health care spending. These type of new medical technology include development of new treatment for previously untreatable terminal condition, including long term maintenance therapy for treatment of such diseases as diabetes, cancer, and HIV/AIDS. Then there major advance in clinical ability to treat previously untreatable acute condition such as coronary artery bypass graft and development of new procedure treatment such as treating secondary diseases within disease all play major role in health care cost.
Malpractice lawsuit also play major one in the cost of healthcare due to physician practicing defensive medicine. According America Medical Association more than 60 percent of doctors over the age of 55 have been sued at least once during their career. Their one certain specialties that are five times as likely to be sued and are Ob/Gyn which have decrease the number of Ob-Gyn in America which is the result of defensive medicine (Walker, 2010). Medical malpractice lawsuit has play a role in the cost of care given by physician or hospital due to the fact that they have to recouped money lost on the lawsuit by raising the cost of care that they provide to the patient and insurance company’s through high fee. U.S. Healthcare 6 In this part of the paper I am going to analyze the role of the major stakeholder that influencing healthcare policy such as access to care, cost of care and the quality of care one’s receive from the healthcare provider. The government play a major role in healthcare by making law that protect patient right to having access to health care and also protect provider from unjust lawsuit.
In 2010 the President Obama sign in to law the Patient Protection and Affordable Care Act which will provided affordable healthcare to some 46 million of American who currently have no healthcare insurance at all and are force to seek medical care from the local emergency room to treat their illness of injury and this law seek to reduce the impact that emergency room visit from the uninsured. The Patient Protection and Affordable Care act puts the consumers back in charge of their health care under part of the bill call Patient’s Bill of Right gives the American people the stability and flexibility they need to make informed choice about their health. There are lots of pros to this new law that will shape the health care system as we know today by putting ends to pre-existing condition exclusions for children. Then it keeps adults covered up to the age of 26. And then it end arbitrary withdrawals of insurance coverage and it guarantees your right to appeal. These are just some of the pros to the Patient Protection and Affordable care Act that protect patient’s right to quality care and affordable care.
The governments, insurance provider, along with the healthcare providers and citizens play major role in to enacting the law that will protect patient right and give quality care to every American. Another role the governments and healthcare providers are play in healthcare is reform in the way one’s suit over malpractice with a new law call the Tort Reform Act and Cost Control. This law was enacted to cut down on lawsuit and reduce the cost of healthcare. What is Tort Reform it’s refers to proposed changes in common law civil justice system that would reduce tort U.S. Healthcare 7 litigation or damages. Tort reform usually includes laws that limits or cap the amount of money that patients can receive as a reward from a clinician they suit for malpractice and caps the amount of punitive damages a judge can order the physician or hospital to pay and in turn low the cost of medical liability insurance a physician or hospital pay for and will lower the cost of care for patient and healthcare insurance.
The Georgia Medical Association re that physicians medical liability insurance cost have gone down 18 percent since the state enacted a law that changes the way patient can suit over malpractice bring much needed relief from skyrocketing insurance premiums in the state George. Does these type of law actually reduce the cost of healthcare well some people say yes but other say they only help the healthcare providers along with the insurance company’s. There is no pros to law the help reduce the liability cost from physicians being suit over malpractice lawsuit and holding them accountable for wrong doing. The cons to this type of law that it does not reduce healthcare cost because of several reasons one it doesn’t reduce the defensive medicine practice as it design too. “A town of McAllen, Texas, may illustrate this point best, as it is the home of the most expensive health care in the nation. Despite having caps on damages an injured victim may recover, doctors in McAllen still routinely order excessive testing and procedures. They don’t do so out of fear of lawsuits — Texas law already immunizes them” (Childers, 2010). When it comes to patient safely this law fall to the side in protecting a patient from wrong doing by the healthcare provider and allow for no accountable for the physician or hospital.
We can evaluate the pros and cons associated with laws that involve stakeholder but we they involve only one group of people and their stake to only protect them and not look out for other group and their safely and wellbeing just to save a buck. U.S. Healthcare 8 To predict the future direction of health care policy on the issue I have discuss from the perspective of a health care administrator. For the access to care is easy one for health care administrator is the new Patient Protection and Affordable Care Act make their job little easier than from the past. Because of the change in laws that allow people to purchase affordable health care they will be able to see physician of their choose at hospital and not worried about the cost and the healthcare administrator doesn’t have to write off the treatment due to the uninsured patient. Another they see that work in their favor is the quality of care they can give to the patient and not have to worried about limits on coverage on the patient because of the Patient Protection and Affordable care Act.
Now when it comes to cost of care health care administrator has number of factors that they have to consider such as defensive medicine practice, new technology, malpractice lawsuit and the uninsured even know that the new law make easier for people to purchase healthcare insurance however there are still going to be some who don’t buy healthcare insurance. As the healthcare administrator perspective to this problem in how to control the cost of care is hard thing to do simply when the look at new technology is not cheap to but any new equipment for the hospital such as new CT scan which run in the millions of dollar. Then there are some physician who sometime practice defensive medicine because of the patient they are deal with and don’t want a malpractice lawsuit. With quality of care the health care administrator has lot to think about, first they have the new law which help them deliver the quality care that they want the physician and hospital staff to deliver to the patient their care for.
With this in mind there no barriers not that will prevent U.S. Healthcare 9 them for delivering the quality care they expected for their staff. Since their no limit on coverage that would prevent their staff to perform at the highest that one’s will aspect them to. In conclusion there are lots of health care policy issue that affect the healthcare system in America from the government, to healthcare providers, insurance providers, and patient all having voice in how the America healthcare system should be ran. With the new Patient Protection and Affordable Act the outcome will eliminate lots of barriers for patient and the healthcare provider in allow them to deliver the quality care one’s expected to receive from the healthcare provider. Healthcare has lots of barriers that is access to care and the cost of care then finally quality of care and if we can eliminate these barriers America healthcare system can become one of the best in the world.
CDC. (2006). Emergency Room Visits Climb Amid Primary Care Shortage. Retrieved September 14, 2013 from: http://www. cdc.gov
U.S. Bureau of the Census. (2006). Income, poverty, and health insurance coverage in the United States. Washington, DC: U.S. Department of Commerce, Bureau of the Census Retrieved September 14, 2013 from http://www.usbrureau.govRobert Wood Johnson Foundation, (2011). Health Policy Snapshot, “What are the biggest drivers of cost in U.S. health care? July 2011. Retrieved September 14, 2013. from: http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf71331 Starfield, B.. (2010). Reinventing Primary Care: Lessons From Canada For The United States. Health Affairs, 29(5), 1030-6. Retrieved September 13,2013, from ABI/INFORM Global. (Document ID: 2037442941). Kaiser Family Foundation, (2013). Snapshot: How Changes in Medical Technology Affect Health Care Cost. Retrieved September 13, 3013. From: http://kff.org/health-costs/issue-brief/snapshots-how-changes-in-medical-technology-affect/ U.S. Healthcare 11 Childers, (2009). Pro & Con: Should liability damage caps be a part of health care reform Retrieved September 13, 2013