USHealth Care Systems: Evaluation
USHealth Care Systems: Evaluation
Generally,most Americans believe that the system of healthcare within theUnited States is far much better than in any other part of the world,and as such, a reform may only serve to threaten it. This isirrespective of the various problems that exhibit themselves withinthe system, such as cost, management, coverage and other issuesrelated to service delivery. The survey that was undertaken last yearfurther ascertains this, whereby 55 percent stated that they haveaccess to better health care quality than in other nations. However,only about 45 percent confirmed they believed the United States hadthe best health care system globally (Reuters, 2008). Inasmuch asthere is a general notion that the health care system of the US isthe best, and the various reforms may serve to make it even better, asubstantial gap still lies between the actual quality of the servicethat it is capable of providing and what it is currently providing.
Currently,the healthcare system of the United States presents itself as themost expensive globally, at about 16 percent of its GDP. However, itsindicators of health status are at averagely the same level with theother nations that are less costly. As such, the pressure towardsensuring cost effective care is increasingly becoming intense as anattempt in expanding insurance coverage and addressing the mostserious quality and cost issues pertaining to health (Gerdtham &Jönsson, 2010). The efforts that the United States put in placearound the 1970s with the aim of expanding health maintenanceorganizations (HMOs) to reduce costs failed due to the rebellion bythe patients and physicians based on the limited choices. Because ofthis, there has been a marked decline in the group practices, and anincrease in preferred provider organizations (PPOs). The attempts bythe PPOs to reduce cost and maintain quality are far much less,compared to the HMOs (Managed Care Digest Series, 2013). This has ledto a wide fragmentation, with most of the physicians practicing insolo and small partnership groups, hence, rendering the system verypoorly designed.
Theapproach by the United States to the prevention of chronic illnesses,and the improvement on the management of the existent patientssuffering from the same is notably on the increase. This is a measureto ensure a much more cost effective healthcare services approach tohelp in the improvement of general health of the population and theensured greater return on investment. Moreover, the recognition ofthe impact of the underlying physical, economic, social, andenvironmental determinants on the health status of a nation has beenon the increase. With respect to this, more sectors not within thehealthcare, such as agriculture, housing, transportation, andeducation are taken into consideration. As posited by (Sack &Connelly, 2009), this move is a total underscore as it will help inthe reduction of poor health and ensure the productivity of allindividuals. However, a recent poll conducted indicated a generalworry coming from the various reforms that the government has placedon the healthcare systems. Especially, the cost reductions andassured equal access to the various health care services poses as athreat to the quality of the healthcare services as this isassociated with a drop in the quality (Blendon, 2011).
Inaddressing the above challenges pertaining to health care, the US hasbeen shying away from the initially free-for-service system to amodel of payment. This system is dependent on an amount of dollar setper subscriber that enrolls in the overall, or a few selectedconditions. Such include, bundle payments ranging from a onetimepayment to the physicians as well as the hospitals for eitherspecific procedures or cases such as chronic illnesses, and rewardingthem for outcomes considered as quality (Connolly & Cohen, 2009).Such include a set of predetermined quality outcome such assuccessful prevention of certain illnesses, or realizing reducedcases of readmissions in hospitals. Besides this, the nation iscurrently carrying out experiments with the new forms oforganizations that have the potential of responding to the financialissues that have arisen regarding the various policies that it put inplace (Managed Care Digest Series, 2013). In the management realm,the innovations that the US has put in place are Patient-CenteredMedical home (PCMH), Population Health Management System (PHMS) andAccountable Care Organization (ACO).
Fromthe foregoing discussion, it is evident that the various reforms thatthe US has put in place may not be very instrumental in improving thecurrent health care system in the nation. Regardless of the heavyexpenditure that the nation has put on the various approaches andinnovations to healthcare services, there still are severalchallenges that are synonymous with the system. The government mustwork out ways of reducing the capital that it allocates to the healthsector, and instead find out other possible means of improving itwithout having to pump too much capital. The nation should noticethat its move to ensure cheap and equal access to the health carefacilities might only serve to lead to a decline in its level ofhealth systems. In essence, the nation is mainly evaluating itscurrent policies to do with delivery of healthcare in such a mannerthat it is done in the most cost-effective manner to help minimizethe ominous financial crisis that the nation may face.
Blendon,R. (2011). AmericanPublic Opinion and Health Care.Washington, D.C.: CQ Press.
ConnollyC. and Cohen J. (2009). MostAmericans Want Health Reform but Fear Its Side Effects.Washington Post, June 24.
GerdthamU, Jönsson B. (2010). International comparisons of healthexpenditure. In: Culyer A, Newhouse JP (eds). Handbook of healtheconomics. Amsterdam, Elsevier.
ManagedCare Digest Series 2013: HMO-PPO Digest. (2014). MedicalBenefits, 31(2),1-3.
Reuters(2008). Republicansand Democrats Diverge on Health Care Issues,March 20.
Sack,K and M Connelly (2009). InPoll, Wide Support for Government-Run Health.New York Times, June 21.