Healthcare is the treatment, preventions and management of diseases. It is also the preservation of mental and physical well being. Healthcare entails palliative, prevention and curative intervention. This research paper is about health care in America. Its main focus will be to establish whether Americans have access to cheap and quality healthcare and whether patients get the attention they deserve from the physicians when they go to hospitals. This paper will try to find answers to all these questions.
Forty years after medical care and medical acts were passed, and afterClinton’s administration failed to provide health care to all parts the American health care funding system is on the verge of breaking down. The health care bill is growing six times the rate of inflation and employers, consumers and the government are finding it hard to provide free healthcare to all people. Its citizens cannot get quality health care for les. Businesses can’t afford to provide health insurance to its employees. They share the cost of hospital bills with their clients and thus forcing employees to dig deeper in their pockets.
This makes people to assume that their families will not be attacked by diseases. It is not their wish not to have health insurance cover but the problem is that they cannot afford it. About forty five million do not have access to the health insurance cover and therefore they have no other alternative but to frequent hospital emergency rooms for regular medical check ups. The government is projected to be unable to provide healthcare to its citizens if the expenditure growth rate continues to increase at the rate at which it is growing now.
According to a survey that was conducted by the Kaiser foundation and the health research and educational trust revealed how health care insurance premiums in 2004 jumped at an average of 11.2. This was an increase from 2003’s results. In 2003, the insurance premium were at an average of 13.9 percent which was more than five times the inflation rate (Mayes R., 2006)
According to the same research theUSAgovernment spends about 5,000 dollars per person in providing healthcare. This amount is twice the amount that is spent by other industrialized countries. A country likeCanadawhich is already industrialized spends 60% less when compared withAmerica’s and yet its citizens have longer life expectancies.
In 2003, the number of people without health care coverage was more than forty five million. This was an increase from that of 2002. Californiais one of the states that have so many uninsured populations. 18.2% of its population or about 6.4 million people are not covered. Working families are experiencing the increase of health care cost in double lights. The cost of paying doctor visits and for meeting the prescription has gone up beyond the Americans capabilities (www.pnhp.org)
The intention of employers to slash health care coverage is a major concern to the Americans. In fact there was a strike inCalifornia. The lack of quality health care in theUnited States of Americais as a result of lacking proper insurance programs and comprehensive quality measure. Again an American healthcare system lacks safety control mechanism that would protect frontline workers and patients.
Healthcare in the united states(Herzlinger R.E., 2004) is provided by various legal entities which are separate and it spends more healthcare as a proportion of GDP- gross domestic product and on per capital income compared to other nations in the world. The health care cost ofAmericais projected to reach 19.6% of gross domestic product by 2016. USA is the only country that lacks government run and subsidized healthcare for all people amongst the industrialized nations about 84% of USA citizens are covered by health insurance either through employer’s efforts, their own efforts or provided by the government programs. There are some publicly funded health care programs that take care of the disabled, children, veterans and the poor. The federal law ensures public access to emergency services whether you can afford to pay or not.
In the United Nation’s top ten highest spenders who are members of the UN,USAis amongst them. In 2006, Americans without health care insurance coverage were about 16% of the whole population or about forty seven million people. The high cost of health care insurance and medical bills are the main reason for personal bankruptcy in theUnited States.
Many debates in USAabout health care touch on access and on the quality guaranteed by high sums that are spent. In 2000, the world health organization ranked USAas 37th by overall performance, first by expenditure, 72nd by health quality amongst the 191 countries which were analyzed in the study. The results were severely criticized by the conservatists. According to the CIA world fact book United States was ranked to position 41 in the world nations with the lowest mortality rate and 45th for the countries with the highest life expectancy rate. As per the national health interview center for health statistics which are released annually by the centers for disease control 66% of those who were interviewed in 2006 said that they were in good health (Press Release:
June 21, 2000)
The American health care provision system is taken care of by diverse individuals and legal entities commercial, charitable and governmental entities offer services to inpatients and outpatients. This system is not fully funded but it is provided by both public and private bodies. In 2004, the private insurance paid 36% of personal health expenditures 15% were paid out of private pockets while the federal, state, and the local government paid 44%.
InUSA(Cutler D.M., 2005) there is what is called ‘ambulatory care’ this refers to the health care that is given without staying in the hospital. Majority of those who receive health care attention are out patient. There are also home health care services. These are mostly enterprises though they are run by physicians. Another health care provider is private sectors which take care of outpatients. There is medical care that is provided by personal primary care physicians who are specialists in internal medicines, family medicines and pediatric medicine. There are also subspecialty physicians who are people like cardiologists and gastroenterologists. Still under personal primary, care physicians we have non-physician like nurse, practitioners and physician helper.
InUSA, there are both private and public hospitals. The private operated hospitals are profit oriented as opposed to the public ones. The public ones are allover the country and are operated by the county government, state government, religious denominations and independent non-profit making organizations. Outpatients are provided with health care in emergency rooms and clinics but these are basically meant to provide health care to inpatients only. Hospice services are given to those who are terminally ill. They receive subsidized health care services from charities and government. These are people who are expected to live for less than six months. The prenatal family planning and “dysphasia” clinics are obstetric and gynecologic specialty clinics respectively which are government funded and are run by staffed nurses’ practitioners.
In this year, the workers who are single pay an average of 16% of insurance premiums when compared to that of for the family which is 28% but still they get additional charges in the form of co-payments and deductible. The employer pain health is subsidized by the government by exempting their contributions from taxation as income 36.7 million of those who are not insured against health risks are legal U.S citizens, 10.2 million are non-citizens this is according to the Census Bureau (Mayes R.,2005)
The provision of health care is greatly commercialized inUSA. It is “a fee for service” strategy. A patient must dig into his/her pocket to pay for all services rendered. This makes access to health care for all impossible because the poor Americans cannot afford these services.
Most of the big private companies that offer health insurance cover are Medicare and Medicaid and the Veterans administration. In 2006 for example, 38.3 low income American earners were given health insurance by Medicare and Medicaid provided to 40.3 million elderly and disabled Americans. There is also what is called the state children’s health insurance program (SCHIP) that was formed in 1997 by the federal government. It takes care of children of families that earn a lot to quality for medical aid but they cannot afford health insurance. The program is still running though it is facing funding problems.
According to the free market advocates, there is a relationship between the much the government spends in health care provision, the interventions in health care and the health care costs. Increased utilization is the main cause of increasing cost of the health care. Government intervention sometimes have unintended results for example in 1973 the US federal government passed the health maintenance organization act which was supposed to create market incentives that would lower health care costs though these health maintenance have achieved nothing so far. To the study done on market based reform policy packages, it was concluded that when market reforms are not implemented systematically with appropriate safeguards, they can cause result to more shortcomings that can solve (Coombs J.G., 2005)
The healthcare provision to Americans differs from that of White Americans to that of Black Americans, Native Americans, Asian American and Hispanics. This may be as a result of racism. Racial bias in medical care poverty, racial discrimination stress and inferiority complex may have serious consequences on health. According to the former majority leader Tom Delay (RTX) there are 47 million people who do not have health insurance but that doesn’t mean American are ever denied health care inAmerica.
InAmerica, physicians and hospital staff do more work for less pay. This drives some institutions out of business and force doctors to retire earlier than they should. These patients do not get enough attention from physicians as they deserve. About a century ago there were enough physicians in both urban and rural areas. Today, rural countries with a population of below 25,000 do not receive more physicians. There is shortage of physicians which is attributed to the social and professional isolation of rural people and is also because of well paying hospitals in the city and well equipped.
According to the American medical association, some states obstetricians and rural family physician they do not help women in delivering babies. Also high risk specialists no longer provide counseling to the traumatized or take surgery procedures. The most affected are those in rural areas.
In the recent past (Derickson A. 2005; 58) the management of health is delivery is deeply affected. Managed care such as restrictions, on physician choice, productivity requirements do reduce the time patients would spend with their physicians but according to the AM news report published in the health affairs in 2005, the access to health care and quality in is the same as that of urban areas. The study is in centrally to the widespread perception of shortage of enough physicians in rural areas. However, according to the August Medicine Report, there is shortage of medical care in rural communities. Some researchers argue that though there are fewer physicians in rural areas compared to the population does not mean that there are no enough physicians to meet the need.
InAmericaonly 30% percent of Americans get access to daily care. When Americans are compared with Dutch find it hard to access to health care at right and during the weekends. According to a report released by the national association of community health centers shown that about one in five Americans do not have access to primary care this is due to lack of shortage of health physicians.
Let me conclude this by saying that inAmericait is very hard to get cheap and quality health care. The strategy that is used inAmericais “fee-service”. So, if you do not have enough money, then you cannot get proper health care. The cost sharing of paying health insurance premiums and hospital bills, have rendered many people bankrupt. ThoughAmericais one of the big spenders in health care, the access to health care is limited. It has the lowest life expectancy rate amongst industrialized nations in the world. Also inAmericapatients do not get the attention they deserve from physicians though there are many doctors. Those in rural areas are more affected than those in urban areas. In fact during nights and weekends it’s hard to get medical attention from doctors according to the findings.
Derickson A. Healthcare Security for All: Dreams of Universal Healthcare in America. John.HopkinsUniversity Press, 2005
Herzlinger R.E. Consumer Driven Healthcare: implications for Providers, Payers and policy makers. Jossey-Bass, 2004
Mayes R. Universal Coverage: The Elusive Quest for National Heath Insurance. University ofMichigan Press, 2005
Press Release: World health organizations assess the world’s health system. WHO/44 June 21, 2000.
Cutler D.M. Your money or Your life: Strong Medicine for America’s Healthcare System.OxfordUniversityPress,USA; 2005
Coombs J.G. Rise and fall of HMOs: University ofWisconsin Press, 2005
www.pnhp.org: Physicians for a National Health program-Healthcare is a Human Rights