Virtues and Values

Healthcare in Turmoil

The United States healthcare system is one of the most complex systems globally. The complexities surrounding the health care system have led to an increase in issues that adversely affect the consumers and communities. They have also led to the nation being ranked last in most healthcare aspects among developed nations. The last decade saw major improvements in the system with the sole aim of improving access. The Affordable Care Act was one of the changes that improved access to health insurance leading to over 20 million people being able to access health insurance (Somberg 2013). However, several issues still plague the health care system and adversely affect consumers and communities.

High Cost of Healthcare

The United States has the highest health care spending compared to other developed nations. The expenditure on health care has been increasing over the years. This has increased the share of health expenditure on the gross domestic product. In 2020, the health expenditure was highest, accounting for 19.7% of the GDP. According to CMS (2021), U.S. health care spending grew 9.7% in 2020, reaching $4.1 trillion. This can be translated to $12,530 per person. The assumption is that an increase in health care expenditure should translate to quality services and other aspects of health care. The increase in health care expenditure also means an increase in health care prices over the same period.

The average health care prices have increased annually with the increase of health care expenditure. The Health Cost Institute (2018) report shows an annual increase in healthcare prices of up to 15%. What was being charged in 2018 is not what is being charged in 2018, as there has been an increase of 15%. The per-person spending between 2014 and 2018 grew at an annual rate of 4.3%, increasing to $5,892. It is estimated that the annual growth rate of health care prices will outpace GDP growth. Consumers and companies in the United States keep spending more on health care. The cost has increased annually, making it difficult for some consumers to access health services.

There has been an increase in certain costs like hospital admission prices, prices for medication, and other services like laboratory charges. This means the consumer has to spend more annually to obtain medical services. The consumer faces the risk of bankruptcy if they develop a severe condition. Those who are uninsured cannot afford the rising cost of health care in the United States. This increases the prevalence rate of certain diseases, which are highly expensive as communities cannot afford the rising costs. The rising costs of health care also mean the prevention of certain diseases in communities will become problematic. Those who cannot afford the prices and lack medical insurance have to contend with living with the condition.

Health Care Access and Quality

Health care access in the United States is uneven. In most cases, it is tied to employment. This is an issue that has been around since the Second World War when employers used healthcare to attract employees to their firms. A scenario like the economic crisis of 2008 and pandemics like the COVID-19 will decrease the number of people employed. This will mean fewer people have access to health insurance. The COVID-19 pandemic led to massive lay-offs in the United States and globally. This meant that those who had access to health insurance could not access health services. Through various provisions of the Medicaid and Medicare programs, the government provided safety nets during this period (Randy, n.d.).

The ACA has had its share of criticism in improving healthcare access. The legislation's politics has led to uneven application of legislation that was meant to improve access in the U.S. The numerous court cases have threatened the full implementation of the law. The ACA does not fully guarantee access to all the citizens of the United States. This makes the country lag behind in the number of people who can access medical insurance. An increase in the number of people who cannot access medical insurance hurts the health care outcomes of the nation.

The mortality rate is likely higher with an increased number of people lacking access to affordable care and quality services. Consumers are affected by the quality of care being offered. The United States also lags in the quality of care among the developed nations. Poor quality of care means an increase in the number of medical errors. Medical errors are ranked as the third cause of death in the United States. Consumers and communities can benefit from improved quality of care as it will ensure positive health outcomes.

Benefits and Risks of National Health Insurance

Benefits

The national health insurance model has the overall benefit of reducing health care costs (Akande et al., 2012). The government will be able to control the rising prices of medical care as it will negotiate with physicians and other stakeholders. The government will also be able to control the cost of medical through legislation. Physicians will only deal with one government agency, a factor that will reduce the administrative costs that lead to the increase in medical costs.

National health insurance will improve coverage and access to medical services. The national insurance model is a system where the government can allocate funds and ensure all its citizens have access to the same level of health care. This improves access as everyone in the nation will access medical services through the system. This will eliminate the lack of access in the nation as all the citizens are covered in the program. One of the potential benefits of the national insurance system is the elimination of all the health-related barriers. These include barriers to health education and health services. The system will eliminate the factors that do not promote equality. Access to health care is made based on the needs if the patient. This removes the barriers where access to health care is based on the ability to pay for medical services. This will also promote equality in health care as all the citizens will receive equal treatment based on their health care needs.

Risks

The national health insurance model has been lauded for improving access to health care. However, the improved access means the citizens have to be taxed more for the state to fund the system. This means the government has to tax its citizens more as the system is costly. Those who are healthy have to pay for those who are the sickest. In the United States, chronic diseases make up 90% of the health care costs. Those who are the sickest will create approximately 50% of the health care costs, while the healthiest will create only 3% of health care costs. Therefore, the healthy have to pay for the sickest for the system to thrive. The government has to increase the taxes for everyone to fund the system.

The payment model for this system means that providers receive low payments for their services. This has an adverse impact on the quality of services being offered. The providers are not motivated to improve the quality of services being given. The government has to intervene with incentives and programs to ensure the quality of services is improved. The high cost of the system also means the government has to cut various costs that will also interfere with the quality of services being offered. Providers may reduce the number of services they offer to balance their books.

The funds being provided by the government may focus on offering primary and emergency health care. The system may be focused on offering primary care. This will lead to longer wait times for other procedures like elective procedures.

References

Akande, Tanimola & Salaudeen, A.G. & Babatunde, Oluwole & Durowade, Kabir & Emmanuel, Agbana Busayo & Olomofe, Charles & Ayomide, Aibinuomo. (2012). National Health Insurance Scheme and its effect on staff’s financial burden in a Nigerian Tertiary Health facility. International Journal of Asian Social sciences. 2. 2175-2185.