Final Critical Analysis : Healthcare Delivery

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

“There are three basic goals for a National Health Care System; 1) keeping people healthy, 2) treating the sick and 30 protecting families against financial ruin from medical bills”, (Physicians for a National Health Program, 2016). No truer statement could there possibly be written or proclaimed as there is a crisis in healthcare costs across the United States. United States, one of the most developed western country, yet we suffer from – higher infant mortality rates, have shorter life spans and are affected by more chronic disease and or illness – than our contemporaries all while spending the most for insurance per capita and less annual doctor visits with less physicians, (OECD Health Data 2015). There is a question to be answered, “why”, why are we trailing our contemporaries and more important than that is, is our National Health Care system really working for us? The year 2010 was the beginning of change in the United States where we transitioned from primarily private insurance and welfare to a universal healthcare model, under President Obama with the signing into Law of the Affordable Health Care Act March of 2010. The purpose of the Affordable health care act is to ensure that all Americans have access to affordable healthcare, however in 2016 we are still questioning we’ve been successful based on funding, government sponsored healthcare programs, effects on the current HCO, elderly, military and accessibility.

The U.S. health care system faces challenges that indicate that the people urgently need to be reform. Attention has rightly focused on the approximately 46 million Americans who are uninsured, and on the many insured Americans who face rapid increases in premiums and out-of-pocket costs. As Congress and the Obama administration consider ways to invest new funds to reduce the number of Americans without insurance coverage, we must simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps even for those with access to insurance coverage.

In addition, health care industry can affect every living person in United State in one way or another. For instance, the uninsured are excluded from services, charged more for medical services and die when medical care could have saved them(Berkin, 2012). America is known to have some of the best doctors, and healthcare facilities in the World, however two thirds of our country do not have an access to health insurance, or cannot afford it(Berkin, 2012). The Right to Health Care notes that the United States is one of the few, if not, only, developed nation in the world that does not guarantee

The United States is the only modern industrialized country with out a sound health care system. Since 1999, one in six, not including the elderly, went without health care coverage for the entire year. More males went without coverage then females. Those most likely to be covered were those who were elderly and under the age of 18. Even Canada has a system where every one in the country

In the current U.S. system the free market prevails and companies, in this case, major insurance providers “compete” for business. This competitive business approach should in theory drive costs down. For some reason, however, an argument can be made that it has produced the opposite result in profiteering. The nation’s largest insurer, UnitedHealth, boasted over a 10 percent revenue increase in 2013 according to Forbes (2013). Health insurance affordability contributes to the disparity in access to health care, as evidenced by the fact that there are millions that are still uncovered. A greater majority of certain minorities lack both health insurance and the financial resource to seek out either health care or insurance. While insurance companies reap huge profits the percent of private sector companies offering health insurance has dropped to less than 50 percent (Kaiser, 2013). There is decidedly a lack of coordination of care for this at risk population as well, since treatment is rendered sporadically and with continuously changing providers. The last major challenge is that of improving the quality of health care. According to a 2010 report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), an estimated 13.5 percent of Medicare beneficiaries experienced adverse events during their hospital stay and an additional 13.5 percent experienced a temporary

One of this health care’s programs objective is to limit the number of uninsured (Shi & Singh, 2015). This controversial healthcare plan incorporates a privately funded insurance which is paid for through employment and solely by the patient and a publicly funded insurance by the government. Medicare is provided for senior citizens 65 and older, and Medicaid is provided for low income citizens. The federal government and state government both partake in the funding of Medicaid. Although insurance is provided to the low income through Medicaid, the United States continues to suffer from cost escalation spending 17.1 percent of GDP on healthcare in 2013, a 50 percent more than the second nation (Commonwealth, n.d.) The high cost and limited coverage continues to spark up the conversation for a

A key factor affecting access to care is economic inequality. Many racial/ethnic groups are considered to be of low socioeconomic status in the United States. When one has to worry about food and housing, health is not considered a priority. Lack of health insurance is a huge problem that many people face. The inequalities in income means less money can be put towards doctor’s visits and medications. Research done by Shi, LeBrun, Zhu, and Tsai (2011) shows

The rising healthcare cost is an issue that affects many working class Americans. Experts have tried to come up with different ways to make health care more affordable and easily accessible to all. Despite all the efforts and even after the Affordable Care Act, there are still millions of Americans without health insurance coverage and therefore unable to access the necessary medical care. According to a 2015 report by the U.S Census Bureau, there are over 33 million uninsured Americans. (“Health Insurance Coverage in the United States: 2014 - p60-253.pdf,” n.d.) The Affordable Care Act has unquestionably made healthcare more accessible and reduced the number of uninsured Americans. However, there are still millions of

The ever rising cost of healthcare has made access to healthcare almost impossible to many households in the United States. That these households have stagnant incomes has further complicated issues (Collins, 2008). Many working families without insurance cover have been forced to pay for their own medical expenses that consume lion share of their incomes. Individuals have been forced to forfeit healthcare because of its inherent costs. The lower-income and middle-income families are a very vulnerable lot because they are either uninsured or underinsured (Collins, 2008).

Health care reform and access to insurance have been staples of the American political agenda ever since the end of World War II. From President Truman’s call for universal coverage in the late 1940’s to the creation of Medicaid and Medicare to the Affordable Care Act, both parties have debated how to lower the rate of uninsured Americans. After nearly 70 years of debate in Washington and beyond, the number of Americans with health insurance has certainly grown (Miller, 2014). However, the number of people in the United States without coverage is still unacceptably high and a problem that should be addressed with a great deal of urgency and care.

Healthcare in the United States is facing numerous issues within the current and future turbulent times. I believe that two major issues are the disparity of provision of healthcare to varying societal groups as well as the projected shortfall of healthcare providers to adequately service the population in general.

Consequently the U.S. spends more money than any other country on health care, and the medical care that is being provided may be compromised. Research has shown that the lack of health care insurance compromises a person’s health. However, there continues to be unnecessary death every year in the U.S. due to lack of health care

Managed care is a system of healthcare delivery that seeks to achieve efficiency by interpreting the basic functions of healthcare delivery. It employs mechanisms to control (manage) utilization of medical services and determines the price at which the services are purchased and how much the providers get paid.

Changes in access to health care across different populations are the chief reason for current disparities in health care provision. These changes occur for several reasons, and some of the main factors that contribute to the problem in the United States are: Lack of health insurance – Several racial, ethnic, socioeconomic and other minority groups lack adequate health insurance coverage in comparison with people who can afford healthcare insurance. The majority of these individuals are likely to put off health care or go without the necessary healthcare and medication that is needed. Lack of financial resources – Lack of accessibility to funding is a barrier to health care for a lot of people living in the United States