Analyzing the State of Health Care in the US

Health care is an essential part of people’s lives because it allows people to be healthy and stay alive. This is an aspect of life that everyone in the world has in common. There are some countries that have a well-run health care system and there are others that do not. Health care in the United States is good many areas but falling behind overall compared to other developed nations.

The Current System

It is important to understand the current health care system in the U.S. The U.S. does not have a national health care system. It is a combination of private health insurance and public health care through the government. According Ridic, Gleason, Ridic (2012), “About 84% of the population is covered by either public (about 26%) or private (about 70%) health insurance. Approximately 61% of health insurance coverage is employment related”. A majority of health coverage is from private insurance and 16% of the population is uninsured. Many people get health insurance through their employers as a benefit for working.

There are several systems in place that involve government funded health care in the U.S. such as Medicare and Medicaid. Medicare was passed in 1966 and it is a national public health insurance program for older and disabled people, which covers 13% of the population (Ridic et al., 2012). One part of Medicare is a voluntary or a supplemental part that provides several services that is funded through a tax, which is like private insurance with a deductible and a co-payment (Ridic et al., 2012). The other part is paid through monthly premiums that account for 25% and general taxes accounting for the other 75%, which is for long-term care (Ridic et al., 2012). Medicare helps older and disabled people who have higher costs for health care because they need specialty care to live or live longer.

The other public health care program that is provided by the government is Medicaid. It is a program that is for groups of people who are disadvantaged financially, which is paid for by the federal and state government (Ridic et al., 2012). The federal government pays for 50% or more depending on a state’s income per capita and each state has different eligibility requirements (Ridic et al., 2012). Medicaid’s plan differs from state to state, it is the only government funded program to pay for long-term nursing home stays, and it covers about 12 % of the population (Ridic et al., 2012). Medicaid provides health insurance to those who are poor and would have limited access to health care without it.

This leaves about 16% of the population being uninsured with limited access to proper health care. Ridic et al states, many uninsured people do “receive health care services through public clinics and hospitals, state and local health programs, or private providers that finance the care through charity” (2012). Uninsured people can face financial problem and can end up in an emergency room because they lack proper health care (Ridic et al., 2012). Uninsured people may have access to health care, but it is not the same level as those who are insured. Getting insurance could cause financial strain if they cannot afford it, which is why many end up in the emergency too late. With a person going to the emergency room, it may mean their condition is worse than if they had gotten basic care before.

The Problem

The U.S. has good health care, but it is falling behind other countries based on several statistics. One way to judge it is with life expectancy and the U.S. life expectancy is currently 79.3 (World Health Statistics 2016, n.d., p. 8). This is not a bad number but it is lower compared to other countries. There are currently 30 contries ahead of the U.S. in terms of life expectancy such as Japan (83.7), Switzerland (83.4), Singapore (83.1), Australia (82.8), Sweden (82.4), Canada (82.2), United Kingdom (81.2), and Germany (81.0) (World, n.d., p. 8). This is a statistic that can provide some insight into the state of health care in a country because it is the age people are expected to live. Health care may be limited if the life expectancy is low and it may be effective if life expectancy is high. Life expectancy is good in the U.S. and it is certainly better than other countries, but it is not the best with 30 other countries ranked higher.

Another statistic that helps to determine the quality of health care is the maternal mortality rate, which means deaths per 100,000 live births. The U.S. ranks 46th in the world with 14 maternal mortalities per 100,000 births. This number is good because there are countries that have a much higher rate with many in the hundreds. There are countries with better numbers including Greece (3), Iceland (3), Czech Republic (4), Sweden (4), Austria (4), Japan (5), Switzerland (5), Denmark (6), Germany (6), Canada (7), and United Kingdom (8) (The World Bank, 2015). This shows that while the U.S. has better numbers than other countries, it is falling behind other countries.

The statistic that can also be used to determine the quality of health care in noncommunicable disease, or diseases that are chronic and preventable. According to World Health Statistics (n.d.), the four main noncommunicable diseases are cardiovascular disease (CVD), cancer, diabetes and chronic respiratory disease (p. 70). The probability of death in the U.S. from the four main noncommunicable diseases from age 30 to 70 is 14.3, which is good compared to other countries, but it is not the best with the U.S. ranked 43rd ((World Health Statistics 2016, n.d., p. 8). Switzerland (9.1), Japan (9.3), Australia (9.4), Sweden (9.9), Canada (10.7), United Kingdom (12.0), and Columbia (12.4) all rank higher (World Health Statistics 2016, n.d., p. 8). This data shows the U.S. is falling behind in yet another health statistic.

Another way to analyze the quality of health care is the cost of pharmaceutical drugs. According to Paris (2014), the U.S. is spending almost $1,000 per person per year on pharmaceuticals drugs. This the highest price in the world with other countries paying less. It costs around $600 in Canada, Japan, Germany, Greece, Switzerland, Australia, and Austria (Paris, 2014). Other countries are much lower such as Norway, Denmark, and New Zealand being under $400 (Paris, 2014). The U.S. is spending much more on pharmaceutical drugs that people need than any other country by spending nearly double the average of the other countries.

Spending is another indicator of the efficiency of a health care system. OECD (2015) states, “health spending measures the final consumption of health care goods and services including personal health care and collective services but excluding spending on investments”. The United States spends the most with 9,451.3 U.S. Dollars per capita with other countries being lower such as Switzerland (6,934.7), Germany (5,267.1), Denmark (4,942.8), and Japan (4,149.8) (OCED, 2015). This combined with the other statistics shows that the United States is spending more than any other country on health care with worse outcomes. The U.S. is spending the most while not having the highest life expectancy, lowest maternal mortality rate, and lowest percentage of deaths caused by noncommunicable diseases.

Possible Solutions

There are many possible solutions to the problems the U.S. faces with health care, which involves looking at what other countries are doing to get better health outcomes.

Single Payer

One way to improve the U.S. system is to implement a system called single payer health care. According to Christopher, a singer payer health care system involves a single or somewhat public agency that provides the funding for the system and provides health care for all citizens while allowing people to choose where they receive their care (2016). Christopher states, “Overall expenses and wasteful spending could be better controlled through cost control and lower administrative costs, as evidenced in other countries… has more incentive to direct healthcare spending toward public health measures” (2016). The negatives would be longer wait times and restricted availability for some treatments like elective surgery or cosmetic procedures (Christopher, 2016). This system can be considered better than the U.S. system because everyone is covered at lower costs by allowing the government to control costs. It is a simpler system because it has one source that funds it, everyone receives care, and people are still able to choose where to receive their care.

Universal Health Care

Universal health care is a system that provides coverage to all citizens. According to Williams, “everyone is provided coverage regardless of their income, race, age, pre-existing conditions, gender, or wealth” (n.d.) One major difference universal health care is run by the government and not private insurance companies, which lowers costs because there is no profit incentive (Williams, n.d.). It is funded through several methods such as a single payer system, using the private sector to subsidize the coverage, having tax credits by handing out vouchers, or having a mandate that requires people to have a form of coverage (Williams, n.d.). It shares the positives and negatives of single payer while having multiple funding options.

The Health Care System of Japan

Another option would be to look at Japan’s health care system because they are towards the top in several statistics. According to Matsuda, the system in Japan is called the universal public health insurance system (PHIS) where the government regulates almost the whole system (n.d.). The national and local governments must provide good and appropriate medical care, which “the national government sets the fee schedule and gives subsidies to local governments, insurers, and providers” and private insurance is minor and supplementary (Matsuda, n.d.).

This system provides universal primary coverage with more than 3,400 insurers where, “citizens are mandated to enroll in one of the PHIS plans… those who fail to keep up their enrollment must pay up to two years’ worth of premiums when they reenter the system… age 40 and over are mandatorily enrolled in long-term care insurance” (Williams, n.d.). The system in Japan is a program funded and regulated by the national government. Private insurance still exists but is a minor part of the system. Positives include cheaper care, better outcomes, availability to visit a doctor while being seen almost always on the day they want, and everyone is covered (Harden, 2009). The possible negatives include being unsustainable due to being a low-cost system, doctors making less, overcrowded emergency rooms, and overworked hospitals.

Conclusion

Health care is an important topic that is constantly being debated and can always be improved upon. The United States system is good but is falling behind in statistics that involve medical outcomes and cost. It is a system that has flaws while also not covering every citizen. Solutions to the health care problem would be to look at what other countries are doing like Universal Health care, singer payer, or PHIS in Japan. These systems may have some flaws, but the fact is they are cheaper, more efficient, and have better outcomes. Health care is an important aspect of life due to the fact people depend on it to stay healthy and alive.

References

Christopher, A. (2016, June 27). Single payer healthcare: Pluses, Minuses, and What it Means for You. Retrieved from http://www.health.harvard.edu/blog/single-payer-healthcare-pluses-minuses-means-201606279835

Harden, B. (2009, September 7). Japan's Health-Care System Has Many Advantages, but May Not Be Sustainable. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2009/09/06/AR2009090601630.html?hpid=topnews

Matsuda, R. (n.d.). The Japanese Health Care System. Retrieved from http://international.commonwealthfund.org/countries/japan/

OECD (2017), Health spending (indicator). Retrieved from https://data.oecd.org/healthres/health-spending.htm (Accessed on 21 February 2017)

Paris, V. (2014, February 7). Why do Americans Spend so Much on Pharmaceuticals? Retrieved from http://www.pbs.org/newshour/updates/americans-spend-much-pharmaceuticals/

Ridic, G., Gleason, S., Ridic O. (2012). Comparisons of Health Care Systems in the United States, Germany and Canada. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633404/

The World Bank. (2015). Maternal Mortality Ratio (modeled estimate, per 1,000 births). Retrieved from http://data.worldbank.org/indicator/SH.STA.MMRT?year_high_desc=false

Williams, Y. (n.d.) What is Universal Health Care? – Definition, Pros and Cons. Retrieved from http://study.com/academy/lesson/what-is-universal-health-care-definition-pros-and-cons.html

World Health Statistics 2016. (n.d.). Retrieved from http://www.who.int/gho/publications/world_health_statistics/en/