Health Care Vs Managed Care

has the world’s most expensive healthcare system, yet one-sixth of Americans are uninsured. Approximately one-third (31%) of adults and a little more than one-half (54%) of children do not have a primary care doctor. Federal spending on healthcare in 2005 alone totaled $600 billion, a massive one-quarter of the federal budget. Someone files for bankruptcy every 30 seconds in the U.S of health concerns. And every 1.5 million families lose their homes to foreclosure due to unaffordable medical costs. The U.S. spends six times more per capita on the administration of the health insurance system than Western European nations, who insure all citizens.“ www.realtruth.org/articles/090203-005-health.html. “In United States, the annual cost of health care per capita is $5,711. http://www.visualeconomics.com/healthcare-costs-around-the-world_2010-03-01/#ixzz12f0I1lbk

The U.S. Health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance.” (WHO, 2000, p. 1) Progression in the United States has not kept up with the advances in other wealthy nations dealing with the population health. Disease and chronic disability report almost 50% of America health problem (JAMA, 2013).

There are many problems with healthcare in America today. One of them including the astronomical cost. According to CDC.ORG in 2007 the average person spends seven thousand four hundred dollars per year on health care alone. This rise in healthcare is extremely detrimental for families, seniors, and people of all ages. With such a high cost of insurance people are forced to make hard choices in

true? Well, a document stated that Europe, mostly northern parts, perform the highest in the health population, fair financial contributions, responsiveness of the system, preventable deaths, affordability and so on and so on. So America doesn’t have the BEST health care system in the nation. But they do meet a similar economic levels.

This paper examines the benefits and issues with managed care. The benefits include patients receiving preventative care, lower premiums, lower costs of prescriptions, fewer, unnecessary procedures, and less paper work. Some issues with managed care include limitation on doctors that patients can choose from, restricted coverage, the possibility of under treatment, and compromised privacy. Managed care effects nursing by causing significantly few jobs for registered nurses, more opportunities in non-acute health care settings, and more use of advanced practice nursing.

The single most important impetus for healthcare reform throughout recent history has been rising costs (Sultz, 2006). In the book called The healing of America: a global quest for better, cheaper, and fairer health care, Reid wrote that the nation’s health care system has become excessively expensive, ineffective, and unjust. Among the world’s developed nations, the US ranks near the bottom for healthcare access and quality. However, the US ranks at the top for health expenditure as a percentage of the Gross Domestic Product (GDP) and average of $7,400 per person (Reid, 2010). Therefore, Americans are spending

The cost of healthcare has and will continue to rise in the United States. Some factors that contribute to those hikes are due to the consumer demanding more complex services from health care providers. Things such as new technology, equipment, research and testing procedures, along with pharmacy, and the number of uninsured are all dynamics of the increased cost in health care. The U.S. health care system relies heavily on third-party payers; these payers include commercial insurers and the Federal and state governments. According to the Centers for Medicare and Medicaid Services, or CMS, the National Health Expenditure grew 3.6% to $2.9 trillion in 2013, or $9,255 per person, and accounted for 17.4% of Gross Domestic Product (GDP). Id.

What is managed care? According to the Oxford English Dictionary, managed care is “a system of health care in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.” Managed care is a variety of techniques designed to essentially reduce the cost of providing health benefits and advance the quality of care. In the United States alone, there are various managed care programs, that span from less restrictive to more restrictive. As recently stated in the National Institutes of Health, the future of managed care is uncertain. It is enthralling to note that in spite of the advances in the health care systems, such as our hospital’s ability to provide patients

Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster

In an attempt to understand the impact of managed care in the U.S, I look at the most commonly expressed complaints against the organization. In a survey of consumers, 60% said that managed care had not made a difference in health care cost or had actually been the cause of the increase of health care cost. Managed care has had an impact on slowing the rates of growth in the costs of two major health care producers: hospitals and physicians. Little evidence has suggested that the current reimbursement are inadequate to the care provided. The quality of care is a highly debated issue. Physicians are concerned that the quality of care in managed care organizations may reflect the loss of professional autonomy through pre-authorization procedures.

According to the Centers for Medicare and Medicaid Services (CMS), health care spending in the United States has grown at a rate of 3.7 percent since 2012 to $2.8 trillion, costing the U.S. 17.9 percent of total its GDP and ranking it number one spending on health care (Martin et al 67; world bank). Despite having the most expensive healthcare per capita, according to The Commonwealth Fund - a private American foundation dedicated to the promotion of a high performance healthcare system - the U.S. ranks at the bottom of the top ten wealthiest nations in terms of “access, efficiency, and equity” (Davis

The fact is that the U.S. spends more money on health care than any other country in the world, even when adjusting for relative wealth, according to a 2008 study by Mkcinsey Global Institute (MGI). In 2012 that number was about 2.6 trillion dollars or 18.6% of their gross domestic product (GDP) (13), in other words the U.S. spent about 8,915 dollars per person on health care, or more than twice what they spent on food and more than China spent on all goods and services combined (See Figure 1, MG1 2008). The amount spent on health care is expected to continue to rise , though that rise has slowed in the last three years, estimates suggest it could reach nearly 4.8 trillion dollars by 2021; which would be roughly one fifth of the U.S. GDP (15)

When it comes to the U.S. healthcare system, there are two sides of the argument. Some Americans may argue that the U.S. healthcare system is the best in the world given the many state-of-the-art healthcare facilities and innovative and advanced medical technology available, and there are those who argue that it is too costly and inefficient on many different levels (Chua, 2006). Despite the large amount of spending invested on their healthcare system, the U.S. consistently underperforms on most indicators of performance compared to other countries (Davis, Stremikis, Squires, & Schoen, 2014). Healthcare costs such as doctor visits, hospital stays, and prescription drugs are more expensive in the U.S. than any other country in the world.

The United States has a unique system of healthcare delivery, it is complex and massive. Twenty-five years ago; American citizens had guaranteed insurance, meaning the patient could see any physician and the insurance companies and patients would share the cost. But today, 187.4 million Americans have private health insurance coverage (Medicaid, 2014). The subsystems of American health care delivery are Managed care, military, vulnerable populations and integrated delivery

In the year 2012, expenditure on US health care amounted to 2.8 million trillion dollars, accounting for 17.2 percent of the total Gross Domestic Product (GDP) of the US. The annual average cost of health care for the characteristic American family of 4 amounted to more than