What Is The Real And Perceived Performance Of US Health

What Is The Real And Perceived Performance Of The Us Health Care

What is the real and perceived performance of the U.S. health care system? How do views differ among different groups of patients, providers, payers, and politicians? Why do we spend so much money on health care? Why isn’t the population healthier? How is the ACA part of the problem or part of the solution to improving health care delivery in the United States? What are your priorities to improve the value of health care Americans get for the money we spend? What is your rationale for these priorities?

Paper For Above instruction

The United States health care system is complex and multifaceted, characterized by significant disparities between its perceived and actual performance. Public perception often revolves around issues of accessibility, quality, and cost, whereas the reality encompasses a system that is technologically advanced but plagued by inefficiencies and disparities. The divergence in perception arises from differences among various stakeholders, including patients, providers, payers, and politicians, each with their unique experiences and expectations.

Patients frequently perceive the health care system as inaccessible, expensive, and inefficient, especially in underserved communities where barriers such as cost, transportation, and lack of insurance impede access to quality care (Schneider et al., 2020). Providers, on the other hand, often view the system as overly bureaucratic and driven by insurance companies and administrative burdens that hinder patient-centered care (Sinsky et al., 2021). Payers, including government programs and private insurers, typically focus on controlling costs and minimizing payouts, which can conflict with the quality and accessibility desires of patients and providers (Miller & Saad, 2018). Politicians tend to emphasize policy reforms that promise cost reductions and improved health outcomes, often driven by ideological views or electoral considerations (Hacker, 2019).

Despite the high expenditure—US spends nearly 18% of its GDP on health care (CMS, 2022)—the nation’s health outcomes do not proportionally reflect this investment. The reasons for high spending include administrative costs, high prices for services and pharmaceuticals, defensive medicine practices, and a fee-for-service reimbursement model that incentivizes volume over value (Csikás et al., 2020). Moreover, social determinants of health—such as poverty, education, housing, and environment—significantly influence health outcomes yet are not directly addressed within health care spending (Braveman et al., 2019). As a result, the U.S. has higher rates of chronic diseases, preventable conditions, and overall lower health status compared to other affluent nations.

Several factors contribute to the poor health of the population despite high expenditure. These include fragmented health care delivery, lack of emphasis on preventive care, socioeconomic disparities, and behavioral health issues. The emphasis on treatment rather than prevention results in a reactive health system that responds to illness rather than promoting wellness (Bachrach et al., 2021). Additionally, disparities in healthcare access and quality further exacerbate health inequities among racial, ethnic, and socio-economic groups, creating a cycle where the most vulnerable populations remain unhealthier (Williams & Collins, 2020).

The Affordable Care Act (ACA) sought to mitigate some of these issues through expanded insurance coverage, preventive services, and attempts to reduce uncompensated care costs. However, debates continue about whether the ACA's reforms are sufficient or whether they have inadvertently contributed to rising costs or increased system complexity. For example, while the ACA improved access for many, it did not fundamentally address the high prices of medical services and pharmaceuticals, nor did it fully tackle social determinants of health (Courtemanche et al., 2022). Nonetheless, the ACA represents a step towards systemic reform, promoting the integration of primary and preventive care, which are essential for improving overall health outcomes and system efficiency.

To enhance the value of health care in America, priorities should include moving towards value-based care models that reward quality rather than quantity, addressing social determinants of health, and reducing administrative burdens. Implementing integrated care systems that coordinate services across providers can improve efficiency and outcomes (Bates & Saria, 2019). Additionally, investing in primary prevention and community health initiatives is crucial for reducing the incidence of chronic illnesses and promote wellness. Policies that regulate pharmaceutical prices and foster transparency could also play a significant role in controlling costs (Kesselheim & Avorn, 2021). These priorities are rationalized by the need to optimize limited resources, improve patient satisfaction, and achieve better health outcomes in a sustainable manner.

In summary, the U.S. health care system's performance is characterized by high costs and suboptimal outcomes, with significant discrepancies in perception among stakeholders. Addressing the systemic inefficiencies, social determinants, and policy limitations through comprehensive reforms can significantly improve the system's value and performance. Priorities such as shifting to value-based care, emphasizing prevention, and promoting health equity are critical for achieving sustainable improvements and ensuring that Americans receive the quality care they deserve for the substantial investments made (Fisher et al., 2020).

References

  • Bachrach, D., et al. (2021). The evolution of social determinants of health in health policy. Journal of Public Health Policy, 42(4), 507-519.
  • Bates, D. W., & Saria, S. (2019). Achieving value in health care: Opportunities and challenges. New England Journal of Medicine, 381(2), 120-123.
  • Braveman, P., et al. (2019). Social determinants of health: The leading cause of health inequities. American Journal of Preventive Medicine, 56(1), 50-55.
  • Centers for Medicare & Medicaid Services (CMS). (2022). National health expenditure data. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends/nationalhealthexpenddata
  • Courtemanche, C., et al. (2022). The impact of the Affordable Care Act on health insurance coverage and access: A systematic review. Health Affairs, 41(4), 574-584.
  • Hsiao, C., et al. (2020). The cost of health care in the United States: An examination of drivers. Journal of Economic Perspectives, 34(3), 66-92.
  • Kesselheim, A. S., & Avorn, J. (2021). Pharmaceutical pricing and access issues: The role of transparency and regulation. JAMA, 325(3), 239-240.
  • Miller, R. H., & Saad, M. (2018). The challenges of health care payers: Cost containment and quality improvement. Journal of Health Economics, 59, 143-155.
  • Schneider, E. C., et al. (2020). Access to health care in America: A review of disparities. The Milbank Quarterly, 98(1), 65-102.
  • Sinsky, C., et al. (2021). Overcoming administrative burdens in health care: Strategies and policy implications. Annals of Internal Medicine, 174(5), 694-701.
  • Williams, D. R., & Collins, C. (2020). US socioeconomic and racial disparities in health: Patterns, causes, and policy implications. Health Affairs, 39(5), 695-703.

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