The Future Of Health Care In America Mitchell Dool

The Future Of Health Care In Americamitchell Dool

The Future of Health Care in America Mitchell Dooley Econ 322: Economics Seminar Dr. McCain 04.29.2016 The Issues Health care in America is currently a hot button issue. Its future, and the government’s role in it, is dividing individuals on and against party lines. Numerous plans have been proposed to change the future of health are in America, but one thing is certain. The current path has not been effective and must be modified to ensure that all Americans receive high quality health care in a timely fashion.

Specifically, the U.S. has issues with providing a health care product that is accessible to people regardless of their place in our country’s demographics. America is capable of, and in some instances is, providing high quality health care. But, it is not always delivered in a time or cost efficient manner. And, when compared to other developed nations, we have some ground to make up. There are a number of issues with the current health care system in America.

The U.S. system is unique in that it has both great and poor qualities. The Commonwealth Fund is a private organization that funds independent research with the goal of identifying which health care systems provide the best quality care to their patients at the most efficient costs. A study that they completed in 2014 compared the health care models of 11 developed countries with the goal of creating a system that ranks these countries on the effectiveness of their policy choices. *(The Commonwealth Fund, 2014) The U.S. ranked last in an aggregate of the scores. Specifically, the U.S. also received poor ratings in the access that is provided to health care as well as the efficiency, equity, and health or quality of life categories.

Conversely, it did perform relatively well in the quality and effectiveness of the care that it provided. In this study, efficiency refers to the time and money spent navigating the health system. For example, the U.S. received poor marks here because there were repeat instances in which, due to some human error, duplicate testing would be ordered for a patient. This was also affected by patients’ over reliance on the emergency room and the poor or often nonexistent communication between healthcare providers as wells as insurance agencies. Equity measures the overall health level that a population lives at.

The U.S. did poorly here because of individuals who have chosen to live with their health issues rather than have them diagnosed or receive treatment. The main drivers behind these choices are the still too high costs and wait times associated with specialist and emergency room visits in the U.S. system. Specifically, roughly 40% of adults who receive a below average income reported that they have chosen to live with a health condition rather than deal with the above-â€mentioned issues. Comparably, less than 10% of adults with similar conditions made the same choice in Sweden, Norway, Canada, and the U.K. To sum this up, the U.S. ranks dead last in every measure of cost-â€related access.

This is an issue that speaks, not to the quality of the medicine that we can offer, but to whom we deem worthy of receiving it. The quality of the care that is offered in the U.S. has received mixed feedback as well. On the negative side, we deliver an incredibly high infant mortality rate. The CIA categorized an infant death as any death that occurs before a child reaches one year old. In the ranking of nations that they observed, Afghanistan ranked the worst with 115.08 infant deaths per 1,000 live births.

In this list, the U.S. ranks 167th. In this case, a higher ranking is better. At number 167 and 5.87 deaths per 1,000 live births, the U.S. is one spot better than Serbia and slightly worse than Croatia. Meanwhile, France is 213th with 3.28 deaths, the U.K. is 187th with 4.38, Australia is 188th with 4.37, and Singapore is 221st with 2.48. This is a poor outcome for the U.S. and is an area that we can markedly improve in (Central Intelligence Agency, 2015).

This is not a new issue as the CDC reported similar findings in 2010 when it placed the U.S. behind 25 other developed nations in terms of infant death rates (MacDorman, et. al., 2010, 1-â€6). Meanwhile, the U.S. ranks in the top 10 in the world by proportion for women still alive five years after being diagnosed with breast cancer. As of 2012, there are 970, 693 women in the U.S. who are still alive five years post breast cancer diagnosis. This requires a high quality diagnosis process and culture as well as an effective treatment system following diagnosis. Furthermore, in addition to being more expensive than other developed nations, health care costs in America are far from transparent.

Specifically, health spending in this country is higher in both average dollars per capita and in purchasing-â€power dollars per capita measures. This distinction represents a real price disparity between America and other developed nations. Interestingly enough, this greater price point is accompanied by a lower usage rate of health services in America than in other developed nations. Below are two charts from the International Federation of Health Plans that help illustrate this point. The two graphs compare costs for a common procedure and a popular medication for high cholesterol, an ailment that affects 32% of American adults (Center for Disease Control and Prevention, 2015).

In both instances, costs in the U.S. more than double the closest country. Also noteworthy is the range of costs in the U.S. In the majority of industrialized nations, health care prices are either set by the government or they are set by negotiations between large associations of health care providers and insurers. Conversely, prices are set here in the U.S. by negotiations between individual insurers and individual health providers. Health providers include private practices, hospitals, and drug companies.

This method results in a low bargaining power for the small, fragmented insurers leading to the large disparity in prices that is visible on the graphs. Furthermore, a lack of transparency makes it difficult to determine where in the range a specific provider falls until a patient receives a bill. This situation favors large insurers and health provider administrations. It hurts the patients who have minimal bargaining power in this situation and who may not even know what they will be paying until after a transaction has taken place. The high cost of health care in America has affected more than the low income demographic.

Annually, the U.S. spends the equivalent of 17% of its GDP on health care. Meanwhile, the average for developed nations is 9%. And France, another high spender, on only allocates 12% (The Economist Newspaper Ltd., 2015). And issues like this that lend the Obama administration to pass the Affordable Care Act. The ACA The Affordable Care Act was introduced in October of 2009, signed into law in March of 2010 and had the first enrollment period starting in October of 2013.

Its effects have been covered by a great number of reputable sources. This paper will pull from some of them but will rely on the work of Amanda E. Kowalski, an economist at Yale University. In her study, Ms. Kowalski used a series of regression analyses to compare the pre-†and post-â€reform health insurance markets.

Specifically, she observed the number of individuals with coverage before and after the ACA, health insurance premiums before and after, and the average costs to insurers before and after. To begin, she noted a significant increase in coverage as a result of the ACA. Specifically, she attributes the insurance of 4.2 million individuals to the use of the Affordable Care Act. This, at the end of 2014, brought the nations total enrollment to 13.2 million people. This is a 32% increase over the rise in insured individuals that would have occurred naturally without the ACA.

This is a more than significant increase. The Economist supported this increase in reporting that 16.2% of Americans lacked coverage in 2009 while only 12.3% lacked coverage by 2015. They also found evidence that the ACA decreased the cost of health care to the government. Annual spending per Medicare patient was $12,000 in 2011. By 2014, it was $11,2008, an almost 7% decrease per patient (The Economist, 2015).

Initially, the ACA led to a rise in premium costs in a majority of states. Historically, premiums are volatile and more likely to rise than to fall. Kowalski reports that Forbes predicted a 49% increase in individual health insurance premiums. She also states that her model returned a value lower than Forbes did. In her study, Kowalski examined the average cost to insurer on a state-â€by-â€state basis.

She observed an inverse trend between the premium rate and the cost to insurers. The link may or may not be casual but there is a correlation. State to state, there was little constancy in the change to the average cost. Overall, the nation experienced a 32% increase in costs linked to the ACA. These markups could potentially eliminate the welfare gains from increased coverage, but more time will be needed to measure the exact benefits of the additional coverage.

In the majority of states, the pre-â€reform market was adversely selected. As a result, the ACA led to more low cost individuals obtaining coverage. This is a positive indicator for the long-â€term costs of health care in the U.S (Kowalski, 2014).

Paper For Above instruction

The future of healthcare in America remains a contentious and complex issue driven by economic, political, and social factors. Current challenges include high costs, unequal access, inefficiencies, and poor health outcomes compared to other developed nations. As the nation grapples with reform proposals, understanding both the systemic issues and potential solutions is crucial to shaping a more equitable and sustainable healthcare future.

One of the most pressing issues is the high cost of healthcare, which significantly impacts both individual patients and the economy at large. According to research by The Commonwealth Fund (2014), the U.S. ranks last among eleven developed countries in overall healthcare performance, particularly in access, efficiency, and equity. Despite delivering high-quality medical care, the U.S. struggles with inefficiencies such as duplicate testing and poor communication among providers, leading to increased costs and lower patient satisfaction. These inefficiencies stem from a fragmented system in which prices are negotiated individually, resulting in disparities and lack of transparency. Consequently, high costs correlate with underutilization among low-income populations, leading many to delay or forego necessary medical treatment (Center for Disease Control and Prevention, 2015).

Infant mortality rates exemplify the disparities in health outcomes. The CIA World Factbook (2015) indicates that the U.S. ranks 167th globally, with 5.87 infant deaths per 1,000 live births—worse than many European countries. This reflects underlying social determinants such as access to prenatal care and socioeconomic status. Conversely, the U.S. demonstrates strength in cancer survival, notably in five-year survival rates for breast cancer. This suggests that while some aspects of care are effective, others need substantial improvement to address disparities and enhance overall health outcomes.

The high expenditure on health care is another critical issue. American healthcare spending accounts for approximately 17% of GDP, compared to the 9% average of other developed nations (The Economist, 2015). This disparity is partly due to prices being set via negotiations between individual providers and insurers, rather than centralized regulation, leading to wide price variations and lack of transparency. Studies have shown that costs for common procedures and medications, such as cholesterol treatments, are more than double those of other countries (International Federation of Health Plans). This inefficiency contributes to the overall high costs without corresponding improvements in health outcomes.

Reforms like the Affordable Care Act (ACA), enacted in 2010, aimed to address some of these systemic flaws. As analyzed by economist Amanda Kowalski (2014), the ACA expanded coverage remarkably, adding approximately 4.2 million insured individuals by 2014, reducing the uninsured rate from 16.2% to 12.3%. The law also managed to decrease Medicare spending per patient by nearly 7%, illustrating some improvements in cost efficiency. However, premiums initially climbed in many states, with some estimates predicting increases of up to 49% (Kowalski, 2014). Despite these challenges, the ACA introduced mechanisms to mitigate adverse selection, resulting in more low-cost individuals obtaining coverage, potentially leading to lower long-term costs.

Looking ahead, the future of American healthcare depends on addressing these deep-rooted issues. Efforts to improve efficiency through technological integration, efforts to increase transparency, and reforms to control costs are vital. A shift towards a more centralized pricing system could help reduce disparities and contain costs. Additionally, expanding access and addressing social determinants of health can help reduce disparities in outcomes such as infant mortality and chronic disease management. Incorporating lessons from successful models in other countries—like universal coverage and negotiation-based pricing—can inform reforms that promote better health for all Americans.

In conclusion, the future of healthcare in America will depend on the nation’s ability to reconcile high-quality care with affordability and equity. This requires systemic reforms grounded in transparency, efficiency, and equity. While the ACA represented significant progress, ongoing adjustments and innovations are essential for creating a sustainable health system that serves the needs of all Americans.

References

• The Commonwealth Fund. (2014). US Health System Ranks Last Among Eleven Countries on Measures of Access, Equity, Quality, Efficiency, and Healthy Lives. Retrieved from health-system-ranks-last
• The CIA. (2015). The World Factbook. Infant Mortality Rankings. Retrieved from factbook/rankorder/2091rank.html
• MacDorman, M. F., Mathews, T. J., Mohangoo, A. D., & Zeitlan, J. (2010). International Comparisons of Infant Mortality and Related Factors: United States and Europe. National Vital Statistics Reports, 63, 1–6.
• Center for Disease Control and Prevention. (2015). High Cholesterol Facts. Retrieved from https://www.cdc.gov/cholesterol/facts.htm
• The Economist. (2015). Don’t kill Obamacare: As the Supreme Court considers whether to gut Obamacare, evidence is mounting that the law is working. Retrieved from considers-whether-gut-obamacare-evidence-mounting-law
• Reinhardt, U. E. (2013). U.S. Health Care Prices Are the Elephant in the Room. The New York Times. Retrieved from elephant-in-the-room/
• International Federation of Health Plans. (2015). Comparative healthcare costs data for procedures and medications.
• Kowalski, A. E. (2014). The Early Impact of the Affordable Care Act State-By-State. Brookings Papers on Economic Activity.
• Additional source details omitted for brevity, all studies and reports cited directly in text.