Universal health care in the United States
Like other developed countries, the United States has introduced universal health care system with the view of providing efficient health care facilities to the public. The country has spent large amounts of money on health care facilities. However, the healthcare system is facing criticisms due to its low quality service provision (Derickson, 2005). Health care system in the United States is extremely inefficient and becomes even more costly when the healthcare sector forms the larger portion of the country’s economy. In addition, there are irrational choices made concerning the US health care system, which when coupled with the high costs causes further irrationalities (Kougman & Wells, p. 95). This paper discusses the nature of healthcare system in the US and the obstacles that make the realization of universal healthcare a dream that has never come true. Evidence has showed that the major obstacle in the US health care system is associated with the manner in which it is fragmented. Reformers have always agreed that new technology should be embraced by the healthcare sector. However, unlike other economy sectors, advances in technology have generally resulted in rising of the health care costs instead of lowering them, resulting to additional spending (Schoen, 2005, p.904).
The European countries and the United States approach health care differently. In the case of the European countries, both the government sector and the private sector run the health care system, thereby encouraging competition between the two sectors. This implies that the government or the public can depend on either government or private service providers. Consequently, no single entity is able to monopolize health care facilities in the European situation. However, in the United States, the government runs most of the health care system. This creates the problem in which the United States depends heavily on government service providers. For example, the healthcare system in France is ranked as number one in the world. On the other hand, the ranking for the United States is number thirty-seven. This simple fact is a cause of great concern because our US healthcare system is in grave need for change (Sanchez et al, 2010).
The US has the history of having failed to introduce universal health insurance to its citizens. This has led the government to pay directly or indirectly for most of the health care of the nation leading to increased expenditure on healthcare (Schoen, 2005, p. 906). It is suggested that “The single-payer system offers the prospect of tremendously lowering per capita health care costs, but trade-off in quality and accessibility are valid concerns” (Sanchez et al, 2010, p. 53). This statement shows that the US has attempted to reduce the cost in order to reduce government expenditure on health care. This has negatively affected the quality of the health services. Thus, the US citizens are not able to obtain the same standard of health care services as the European citizens. This implies the need to reform health care administration of the US, so that the health care system can cater for the needs of large sections of the population.
Health care system in the US tends to divide its population into outsiders and insiders. The insiders are the wealthy who can afford good insurance and all the expensive services that modern medical technology can provide because they have high income. On the other hand, the outsiders are the low-income population who have no insurance or may have very poor ones and cannot afford the quality health care services (Kougman & Wells, 2006, p. 103). As people fail to obtain high quality service, they are compelled to approach the private health care providers, who provide high quality service at a higher cost. Low-income groups cannot afford to pay the service fee of private health care providers. Consequently, the American health care system has benefited only the richer sections in the society. Even though America spends huge amount of money on health care it has registered high adult and infant mortality rates and lower life expectancy when compared with the European countries (Sanchez et al, 2010, p. 53).
Scholars have realized the need for comprehensive healthcare reform in order to enhance quality of health care facilities offered to the poor people. It is suggested “…patchwork healthcare programs will be offered in place of the comprehensive national healthcare that is desperately needed” (Vassili and Vassili, 2007, p. 38). The government has failed to assess weaknesses in the health care system of the country. Recently the government attempted to introduce comprehensive reforms, which are essential to improve quality of life of common people. At the same time, one needs to emphasize that minor changes to the existing health care system is not sufficient to improve quality of health care system. Previously, the government authorities and other health care providers did not consider other options that could be used to provide satisfactory service to the population. Consequently, in recent years people have voiced their views concerning the status of health care reforms. The earlier policy compelled people to opt for health insurance policies from private players, but only the rich can afforded such expensive policies (Vassili and Vassili, 2007, p. 38). There is a need for comparison of US health care system with those existing in countries such as UK and Germany. The changes suggested by the Obama administration shows that the government has realized the need for substantial changes in the existing health care reform
The previous governments have attempted to introduce necessary reform to the health care system of the country, but such attempts failed. This is because of “… the growth and concomitant power of the insurance industry and of its lobbying capacities” (Richmond and Fein, 2007, p. 228). Before the year 2000, the government depended on its ability to implement health care program, but the government-controlled machinery has failed to achieve objectives of health care policy. Consequently, particular sections of the population could not depend on government sponsored health care system, as they had to approach the private players. Due to the failure of government agencies, market-based health care reforms were introduced. At the same time, the private players were given complete autonomy, which has affected the success of this health care system. The private players have pressured the government to introduce measures so that they would be able to sell their products (Derickson, 2005).
The private insurance players have introduced various insurance products in order to replace government health care plan, which has failed to provide satisfactory service to the population. It was believed that private players, when given freedom, would be able to deliver. Nevertheless, the recent crisis in the economy has showed that deregulation of private players do not result in success of health care plan. Actually, there is need for partnership between government and private agencies so that it is possible to monitor activities of private insurance companies (Richmond & Fein, 2007, p. 228). Total dependence on particular agency, public or private, has affected the health care system. This shows that the government needs to learn lesson from the European countries that have introduced the model of public-private partnership. It is true that health care should have autonomy; however, it is also important to monitor activities of private insurance agencies. On the other hand, the government has failed to control companies that provide health care facilities. There is need for legislation to punish private players who fail to provide satisfactory service to the consumers (Richmond & Fein, 2007, p. 228).
The major value system of America can be summarized as: “Individualism and self-determination, distrust of government, and reliance on private sector to address social concerns” (Shi & Singh, 2011, p. 101). It is not entirely correct to blame the government for its faulty policies with reference to the health care system. It is true that the government has a responsibility of caring for its citizens, but the government, in the past was constrained by pressures such as the need to protect interest of private parties. The American public, as a whole, believes in the concepts of individualism and self-determination. This implies that the government should not interfere in the life of individuals. The latter should be given an opportunity to decide their future, as they are their masters. The U.S government, unlike in many dictatorial regimes, cannot take decisions on behalf of citizens. In the past, this ideology had popular support. Consequently, the government believed in deregulation, wherein the market forces were depended. At the same time, the government did not realize that it needed to achieve welfare of common people who could not afford to pay the prices determined by market forces. Consequently, there was discrimination in distribution of health care facilities. The market forces demanded greater share of the income of the consumers, who were compelled to buy insurance products at the price determined by the private companies. The government could not interfere in deregulated regime. The consumers could not demand government intervention due to their ideological compulsion. Consequently, the private insurance companies benefited from such lack of regulation (Shi & Singh, 2011, p. 101).
The society has become more complex, due to globalization and migration of people from different parts of the world. The multicultural society of the US needs more regulation. The public needs to compromise with its ideology, as it is not possible to strictly implement the principles of individualism and self-determination. For example, people have lost their privacy because their data is available with the public and private companies. To achieve welfare of large numbers of people there is need for greater regulation of service providers. The failure of the health care system in the US is attributed to the overdependence on market forces.
Traditionally, the US government has followed the policy of ignoring health needs of poor people. For example, the workers in the early 20th century could not obtain necessary health care services, thereby affecting their ability to work. Unofficial studies have showed close relationship between poverty and health problems. The poor people lived and worked in unhygienic conditions. The government did not even initiate studies to analyze the condition of poor population. On the other hand, the rich people obtained health care as they were prepared to spend money on these services (Okunade & Murthy, 2002) . The US government had opposed socialistic measures to ensure universal health care. This ideological opposition has been responsible for failure of universal health care in the country.
In the beginning of 21st century, the government realized the need to ensure universal health care. This shows that the government lacks necessary expertise and experience in providing appropriate health care facilities particularly to the low-income groups. Consequently, the government had to depend on private parties to provide health care facilities to various sections of the population. It is true that private parties have provided quality health care to richer section in the society, but they failed to provide similar services to the low-income groups. It was suggested that social insurance policies could be introduced in order to deal with the problem of poor health of low-income groups (Derickson, 2005, p. 5). Nevertheless, they were not initiated in large numbers. This is because the government did not conduct independent studies to understand the real problems of poor population. Consequently, there was disparity between rich and the poor as far as health care is concerned.
The government policy of wage increase has not solved the problem of large numbers of poor people. This shows that government needs to undertake studies in order to comprehend the relationship between poverty and lack of health care. Due to poverty and lack of proper heath care services, poor parents could not properly educate their children. Consequently, poor children suffer from problems such as malnutrition, communicable disease and other infectious diseases. The government needs to understand its folly of giving advantage to the private parties in managing health care system of the country (Derickson, 2005, p. 6).
For nearly all of the past four decades, spending on health care in the United States grew more rapidly than the economy. This resulted into nearly tripling of the share of national income devoted to health care. This ongoing spending growth pervaded all parts of the health system including the nation’s public insurance programs. Although many factors contributed to that growth, most analysts have concluded that the bulk of the long-term rise resulted from the health care system’s use of new medical services, which was made possible by technological advances, or what some analysts termed the “increased capabilities of medicine.” Major advances in medical science have allowed health care providers to diagnose and treat illness in ways that were previously impossible. Most new services are very costly; others are relatively inexpensive but raise aggregate costs quickly because of the ever-growing numbers of patients who use them. Technological innovation can theoretically reduce costs and, for many types of goods and services, often does. Historically, however, the nature of technological advances in medicine and the changes in clinical practice that followed them have tended to rise the spending. This rise is because of the rising prevalence of disease in the population, changing clinical thresholds for diagnosing and treating disease, and innovations (new technology) in treatment (Shi & Singh, 2011). The rise in treated disease prevalence is linked to a rise in population disease prevalence. Changes in clinical thresholds for treatment have resulted in more patients being treated for asymptomatic conditions. This reflects a desire for preventive interventions by patients with asymptomatic symptoms of several cardiovascular disease risk factors such as diabetes, hyper- tension, and hyperlipidemia. Treatment thresholds have changed for these risk factors during the past twenty-five years. This reflects a desire for earlier clinical intervention to reduce the severity of each of these conditions. Because of these changing thresholds, the number of adults treated for these medical conditions has increased sharply. Innovations in medical treatment have also assumed a key role in the growth of treated disease prevalence. Most of the rise in spending per treated case is linked to innovations in pharmacologic treatment options as well as new treatment procedures because of the development of new medical technology. Health care experts indicates the development and diffusion of medical technology as one of the primary factors in explaining the persistent difference between health spending and overall economic growth, with some arguing that new medical technology may account for about one-half or more of real long-term spending growth. Technology applied to healthcare has unquestionably improved the quality of life; however, the economic implications of the use of technology in medicine have created considerable controversy (Vassili & Vassili, 2007).
Universal health care system has failed in the US due to the policies of the government. The government did not understand the problems of low-income groups. In addition, the government gave leverage to private health care providers who could not provide equal treatment to various sections of the population. In this sense, one can find differences between the US and European health care systems. European countries have developed a flexible health care system, which allows dialogue between government and private health care providers. The US, has believed in free market economy, which does not envisage role of the government in the health care system; private players have exploited this. It is only the rich who are given the services by the private players. The low-income groups have failed to obtain high quality service. Even though America spends more than any other developed country on health care, it has failed to ensure high quality universal health care. There is a need for public-private partnership in order to provide better services to the various sections of the population. Today, many scholars agree that there is a need for health care reforms in the country (Okunade & Murthy, 2002).
It is obvious that in the United States, we do not know what to do with our rising healthcare and the lack of coverage for our citizens. Increasing numbers of Americans are underinsured or not at all every year and this is affecting our economy dramatically. France has a good idea in its healthcare plans and policy and the United States can learn from them. We think of a socialized type healthcare system in the U.S. as some kind of plague idea but my research shows that it does and can work. So what is every citizen of this great country willing to sacrifice to have a universal healthcare system for all?
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