The delivery, Finance, Management, and Sustainability Methods of the U.S. HealthCare System

The delivery, Finance, Management, and Sustainability Methods

The United States is the richest country but not the healthiest. It lags behind other high-income nations in terms of health and life expectancy. The healthcare system in the US is characterized by high cost, unequal access, as well as below average health outcomes in comparison to Organization for Economic Cooperation and Development (OECD) countries (OECD, 2020).  Hospital care, clinical and physician services, and prescription drugs account for the major healthcare spending in the United States. The entities responsible for paying health care bill include the federal government, household and employed-based plans. Health care is reimbursed for by private health insurance plans, out-of-pocket and government programs. Having health insurance coverage is a threshold requirement for routine access to healthcare and facilitates entry to healthcare services. A large percentage of American population is underinsured and uninsured. Lack of health coverage affects access to continuous, safe, affordable and quality care. Healthcare costs are unsustainably higher in the US compared to other developed countries. The OECD reports that the US spends 16.8% of its gross domestic product (GDP) on healthcare in comparison to the next highest developed countries, such as France, Japan, Sweden and Germany at 11% of GDP each (OECD. 2020). Even though the US spends more on healthcare as a share of the economy, its quality of care and health outcomes often rank lowest among OECD countries. Moreover, there are large number of the UIS citizens without health insurance cover.  

The US has a unique healthcare system in contrast to the health care systems of other developed nations. It is fragmented and uncoordinated. Additionally, it emphasizes intervention over prevention plus comprehensive health management. It has range of insurance, delivery and payment mechanisms. The US lacks a system of universal healthcare delivery system and instead has multiple subsystems. These subsystems have developed through the need to care for certain populations or through market forces. This makes the care delivery system in the US very complex and massive.

The US Healthcare system is faced with cost and quality challenges. The country spends more per capital than any nation in the world. In total, these per capital expenditures represent 16.6% of the gross Domestic Product (OECD, 2020).  This high spending does not translate to better health outcomes, however. Fundamental flaws and weaknesses in the systems responsible for financing, organizing, and managing and delivering healthcare work to sabotage the organizational structure required to effectively translate scientific discoveries into regular patient care. Providers and insurance plans scramble to cope and survive in a highly competitive market.

Universal Health Care

Ensuring that all American people have affordable coverage that offers essential health services is necessary so as to build a healthier society. In addition to that, the healthcare system should start to address determinants of health which impact on population and individual health outcomes. To improve access, quality and reduce costs, universal health care system is hereby proposed. A publically funded, single-payer universal health care is the best approach to solve problem and reform the US healthcare system (Arno& Caper, 2020). The US should roll out   the universal health care system so as to improve health outcomes. This will make access to high quality healthcare services equitably distributed and more affordable. Universal health care coverage include array of basic, quality services, which cover health promotion, prevention, and treatment (World Health Organization, 2019).  The country should shift to providing universal healthcare with managed competition health insurance plans. Universal health care system provides basic routine health services to all residents. Universal health care implies that citizens have routine access to healthcare services they need without any undue financial constrain (World Health Organization, 2019). Most systems of universal health care are financed by payroll taxes or income taxes. This system would benefit the country by lowering overall costs. Here, the government controls the prices of premiums and physician bills through regulation and negotiation. The elimination of private insurers would result to bureaucratic and administrative savings. Similarly, doctors and hospitals are forced to give similar standard of service at affordable cost.

Most developed country with the exception of the US offer a system of universal health coverage for their citizens. This method ensures that all people receive basic health services they require without suffering financial constrains when reimbursing for them. Countries like Switzerland, German, Sweden and Norway provide a universal health coverage and have a large proportion of their population covered leading to better overall health outcomes. 

The key stakeholders include the government, policymakers, patients, employers, physicians, insurance companies and pharmaceutical firms.

References

Arno, P., & Caper, P. (2020). Medicare For All: The Social Transformation Of US Health Care. Retrieved on December 22, 2020 from https://www.healthaffairs.org/do/10.1377/hblog20200319.920962/full/   

National Academies of Sciences, Engineering, and Medicine (U.S.)., National Academies of Sciences, Engineering, and Medicine (U.S.)., National Academies of Sciences, Engineering, and Medicine (U.S.)., & National Academies of Sciences, Engineering, and Medicine (U.S.). (2018). Crossing the global quality chasm: Improving health care worldwide. Washington, DC: The National Academies Press.

OECD (2020). Health expenditure and financing—OCEP.stat collection from Joint OECD, EUROSTAT, and WHO Health Accounts SHA Questionnaires (JHAQ). Retrieved on December 22, 2020 from https://stats.oecd.org/Index.aspx?DataSetCode=SHA.  

World Health Organization. (2019).Universal health coverage (UHC). Retrieved on December 22, 2020 from https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)