Health Care Issues in The United States

Introduction

American Healthcare issues (essay)

Currently, the US healthcare system is flawed and is littered with unnecessary costs and bureaucratic red tape. As Americans attempt to deal with this system, they will not only see the inefficiencies of our system, but the high costs that our privatized, multi-payer system is known for. American healthcare is set up with four main payer groups - the uninsured, the poorly insured, the insured, and lastly those insured by the government. While getting care at American hospitals, the price for a procedure varies drastically depending on who is paying the bill; each individual sector of providers has to individually negotiate prices directly with each respective Hospital. This allows the bigger providers tremendous bargaining power, gifting the insured with moderately low prices and leaving the 20% of Americans with no or inadequate insurance coverage paying the highest prices. These high costs often lead many Americans into debt. Through these individualized high costs for specific individuals, our system causes “650,000 Americans to go bankrupt due to medical bills each year”. These individualized prices, the lowest often being higher than the highest international prices, are the main issue with American healthcare; they not only evade the original capitalistic goals of privatized healthcare - to provide the lowest prices possible - ,but also harm hundreds of thousands of Americans through overcare and massive bills.

The American healthcare system is truly flawed in its ideals of healthcare costs; despite the initial push for the relatively unregulated privatized system (where officials believe a “magic hand” would allow prices to remain competitive through competition) Americans were stuck with secretive multi-billion dollar corporations allowed to charge whatever they want. In many industries, customers are allowed to shop around for the best prices, but “American healthcare doesn’t allow for the shopping around that was initially a deciding factor in the switch” to a privatised system. Which American will have the ability to shop around for the cheapest healthcare when you are in your most vulnerable state, sick? Nobody! When we need healthcare, we typically need it immediately. Either being sick ourselves or having a close family member in need of medical assistance, there is no time or even ability to do the shopping around that would promote the reduction of prices. When in need of medical assistance, there is no possibility to divert an ambulance to a cheaper hospital; trying to do this could possibly risk death and will lose you valuable time in an industry where seconds are the difference between life and death. This false promise of the ability to shop around, not only harms each and every American, but also allows for the misscare and overcare of patients. The lack of a standardized pricing system in American Hospitals incentives hospitals to perform the most complex, over the top procedures in an effort to get the most money out of each patient. Since “hospitals are reimbursed for the costs of care they provide” they usually take every opportunity to increase their operating costs. These high cost procedures were so prevalent that “within 5 years we saw the rapid increase in healthcare spending”. America’s healthcare system is set up in a way that not only incentivises the over care of patients through the use of more expensive procedures or multiple redundant tests, but also its a system that does not allow for the basics of capitalistic competition to reduce prices. This complex system not only harms Americans, but is the reason for America's extremely high healthcare spending costs and the severe debt that is caused by it.

Despite these obvious downfalls of the current private American healthcare systems, American political leaders have taken efforts to implement public healthcare initiatives following in the steps of European healthcare models. Specifically democratic presidents of the past have tried their best to implement plans, through their efforts “they have created medical programs such as the Affordable Care Act as well as the Medicare for All act” (Obamacare and Health) in an effort to reduce the costs of healthcare for millions of Americans as well as to discourage the overcare millions of Americans experience. Additionally, with one of the main downfalls of the American healthcare system being the lack of availability and the numerous financial barriers of entry the implementation of these systems added “provisions that prevent insurance from denying coverage for people with pre-existing conditions”. These newly developed systems helped 2.6 million people keep or gain coverage between 2013 and 2015. Additionally, besides just drastically improving the accessibility of medicare, other provisions within the newly implemented system directly improved the financial aspect of medicare; through passing new bills “legislators hoped to contain the costs associated with prescription drugs by making them more competitive, ultimately helping overall costs of healthcare”. Ultimately, bureaucrats saw the flaws within our current healthcare system and did attempt to implement changes in an effort to help Americans. These changes, however well intentioned, did fail to truly help America alleviate any of the stresses that are brought upon by US healthcare.

America’s Affordable Care Act and Medicare, although has been beneficial in a few aspects, it has also been corrupted by an abundance of flaws within its implementation and creation. Because of the strict limitations of the actual scope of medicare coverage a majority of people were still lacking medical coverage. In fact, “in 2009,” after the implementation of Medicare for All, “more than 16% of the US population, nearly 50 million people, did not have health insurance”. These high numbers of people still lacking coverage despite the new provisions shows what the legislation was lacking. Healthcare, being such a controversial topic, forced congress and the government to make dozens of edits and remove a number of provisions from the original proposals of the healthcare plans. These edits eventually led the final bills of the healthcare plan to only cover those 65 and older, limiting the coverage of this government healthcare. In addition these major cuts to the bills proposed shows the true connections of government and private business. These connections within government show the disinterest in truly helping the public and only served to fill the pockets of bureaucrats through effective lobbying from major hospitals. In the “3 quarters of a century (or more) the medical industry and its political allies have garnered public support for all programs which benefit the industry exclusively” (The Healthcare System) these benefits private hospitals enjoy have come about through extreme monopolistic tendencies, allowing for these hospitals - who have total control over prices - to essential over charge, over care, and miss manage patient care. Even though we have seen the government try to fix these glaring issues, the deep roots connecting bureaucrats with private business puts government officials in a position to try and benefit these hospital executives rather than the public itself.

These mounting issues, a staple for American Healthcare, are not present throughout the rest of the world. Other Countries, those with regulated private sectors and public full coverage systems, have many benefits--those that actually help their citizens--over America’s majority unregulated, multi-payer private system. In fact, in regards to pricing, America pays so much more than other countries to cover the same care. Other countries have been able to efficientize their coverage to create a beneficial system helping everyone in that country while also charging significantly less, “the difference [in administrative costs] between Canada and the US is enough to cover all the uninsured, but to also eliminate all the copayments and deductibles, as well as to amp up home care for the sick and elderly”. This efficiency in pricing not only comes about through efficiency within the system, but through strict regulations are the major driving force behind the leading health care systems. “Other countries have a master list to foil price markups and over charges. A list of set prices which are non-negotiable” unlike the American system in which no prices are standardized. In America the same procedure could cost $500 in one hospital then $50,000 in another, that is why these non-negotiable prices are truly what is helping the citizens in the European countries get coverage. Whether they be in the top 1% or the bottom, they will still be paying the same, low, price for healthcare. These European systems, proven time and time again to help the public are what America should implement, at least in part to help its citizens and fix the corrupt medical corporations.

America can fix its healthcare system by taking cues from the more efficient systems of the world, the countries with regulated private sectors and those that enforce total coverage for its entire population. Effectively, a combination of both the public model used by many European countries and the highly regulated German model will greatly improve care, coverage, and cost in America. Throughout Germany no matter who you are you will “contribute 7.5% of your salary to the public pool” (Raz) this money goes into subsidising care as well as covering those who are uninsured. This standard contribution, if implemented in America, would easily help cover those not able to cover themselves. This fixed rate based on salary would also take more out proportionally from those with higher income, than those working for minimum wage. Through the ammassing of these funds America could cover their entire population and then some. However, this health fund contribution would mean nothing if the hospitals were still largely unregulated and allowed to do business without oversight. In an effort to fix this oversight issue, many European countries have implemented strictly regulated systems used to deal with private healthcare providers. “They use a highly regulated privatised system. It encompasses both standardized pricing and regulations to prevent the turning away of patients” (Healthcare Reform) essentially fixing both of America’s biggest problems with healthcare. By taking the European healthcare systems as an example the US has the ability to help its citizens thrive and not worry about costs when someone's life could be in danger.

Despite the benefits America has the ability to gain through the implementation of a combination of multiple more progessive healthcare systems, some believe America should stick with the system they currently have. They believe due to its roots in competition and the use of economies of scale (the ability to provide cheaper products as you grow) it allows for economically lower prices, however we must start a transition to improve our system to regulate this highly powered unchecked industry. Despite the fact that competition does lower prices in many industries, this just isn’t true in the medical sector “studies evaluated this system review do not support the claim that the private sector is usually more efficient, accountable, and medically efficient” (Rein). Relying on such an ineffective unregulated system is foolish, and if left unchecked will continue to increase prices to a level even Americans with high incomes will not be able to afford. Additionally, through the implementation of a small tax based on salary “we can afford universal coverage with a single payer system, not just universal coverage, but first dollar coverage for everybody in this country” (@IlhanMN). This incredibly necessary tax will finally allow America to get full coverage for all its citizens, giving tens of millions of people coverage they never before had.

Conclusion

Throughout America millions of people are struggling to care for their families, themselves, and their other loved ones due to the enormous pitfalls of the current American healthcare system. Through this inability to care, they are constantly made to wait in long lines, are typically over tested & over treated in an effort to make hospitals more money, and grossly overcharged for simple procedures. These traits, all which should not be associated with organizations which literally hold your life in their hands, are the reason why the people affected though this system need a hero. This hero needs to be a way to reduce healthcare costs and it needs to be a way to provide every single citizen with health care coverage; the only way for this hero to come about is through a reworked healthcare system that takes inspiration from the wide coverage, single payer, European models. This reworked system not only would provide everyone in America with an affordable healthcare system, but provide them with the hero they need.