History and Evolution of Healthcare Economics

The United States healthcare industry is facing some serious long-term issues. The number of uninsured people is in millions.

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.

Globally, the United States has one of the largest and most convoluted healthcare systems, whereas universal healthcare coverage seems extremely farfetched. Annually, the US spends over $3 trillion on healthcare. Nevertheless, we have the worst health outcomes when compared to other industrialized countries. As stated by Anja Rudiger (2008), “Recent data suggest that around 101,000 deaths a year can be attributed to the underperformance of the US healthcare system.” Thus, the United States’ healthcare system greatly relies on revenue. Both funding and the distribution of services are commercially structured and held accountable by investors to increase financial gains. According to Andrew Jameton and Jessica Pierce (1997), “the US healthcare system increasing appears to have

Cherry, B., & Jacob, S.(1997). Chapter 7 Paying for Health Care in America: Rising Costs and

Employers are continuing to face rising health benefit costs and are constantly looking for alternatives to control these escalating costs. Health benefit premiums continue to increase at a double digit pace for employers and employees (Poor, Ross & Tollen, 2004). This escalation is putting environmental pressures on all impacted stakeholders. Companies and insurance providers are squeezing this industry to get a handle on cost while still providing an appropriate level of care. This cycle puts the patient front and center as the ultimate stakeholder who incurs changes in health benefits. This mandate of cost control, efficient operations and market share has facilitated a constant analysis of the dynamic health

A series of events has recently occurred to cause the passage of PPACA. Economics are explicitly linked to health care. In the United States, health care coverage is provided primarily through an employer-based system. This system began in the depression era when pay was federally frozen. Companies, in an attempt to lure scarce workers, used benefits packages including health care as bait. Described as a “uniquely American” “private social security” health care system, the employer-sponsored system is the “cornerstone” of United States health care system (Blumenthal, 2006). This system has left many un- or under-insured. Blumenthal states (2006), “The United States’ dependence on employer-sponsored insurance means that the protection of its citizens against the costs of illness depends directly on the ability of private businesses to manage and absorb health care expenses that have defied all efforts to contain them.” Recently, economic downturn and the need to reduce expenses to better compete on the global market has caused many companies to both reduce their insurance benefits package and their work force causing many to lose their health care coverage. The employer-based system merged with the economic downturn, unaffordable health care costs for businesses, and

Creating a health care reform plan for the U.S. health care system is no easy task. Multiple things must be taken into consideration. These include making insurance affordable, making sure the plan is economically feasible, and creating a plan that will still work in the future. What hindered the reshaping of health care into a sustainable system in the past, are the health sectors interests that prefer the status quo. By continuing to cling on to yesterday’s model, the health care industry is creating its own peril (Schaeffer, 2007).

Healthcare costs in the United States have been rising for several years and show no sign of stopping. In 2008, the United States spent on 2.3 trillion on healthcare, more than three times the $714 billion spent in 1990, and over eight times the $253 billion spent in 19801. Although the large amount of money invested in healthcare does translate to better care for Americans, the worsening economic situation, rising costs, and federal government’s deficit have placed a great strain on the system. This includes private employer-sponsored health insurance coverage and public insurance programs such as Medicare and Medicaid. According to the Henry J. Kaiser Family Foundation, a private and non-profit healthcare analysis organization, “in 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries”1. Concerns for the enormous strain on the financial systems that fund healthcare and the desperate need to provide adequate healthcare for Americans have driven many a President since Theodore Roosevelt in 1912, to seek some type of healthcare reform and universal healthcare for all Americans. President Barack Obama succeeded where many had failed and on March 23, 2010, a national health reform law, the Patient Protection and Affordable Care Act was signed into law. On March 31, 2011, the Department of Health and Human Services (HHS) issued new rules

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

Regulations that prevent insurance companies from participating in interstate commerce have caused competition to grow stagnant in the United States. This lack of competition has allowed the adoption of wasteful procedures by healthcare providers, which in turn passes the increased expenses back to the insurance companies. Therein, insurance costs increase, crippling consumer’s cash flow and quality of life. While healthcare costs continue to rise, people must scrutinize the current healthcare system.

The U.S. health care system consumes a huge amount of the U.S. Gross Domestic Product, and is a massive system that provides essential and world-class care to millions of people (Niles, 2016). As a result of this huge burden of cost associated with it, the U.S. healthcare system has been critiqued, and has played a major role in sparking debates about changes to the way the U.S. healthcare system is run and organized. Thus, healthcare has been on the forefront of many American and politician minds over the last decade and beyond, and many proposals and attempts have been made to change and adapt the complex and influential U.S. healthcare system. One such attempt, that brought about incredibly influential change to the U.S. healthcare

One of the greatest changes in healthcare in the past ten years has been the rise of managed care, much to the displeasure of many patients and physicians alike. Managed care arose out of concern about spiraling healthcare costs and was designed to encourage physicians to give patients treatments that were cost-effective out of their own financial interests. "The consumer strategy was directed at imposing some barriers to use by levying various forms of co-insurance. The most common approaches used either deductibles (where the consumer paid the first portion of the bill a technique familiar in other types of insurance) or co-payments (where the consumer paid a portion of the bill and the insurance company the rest) or a combination of both' (Kane et al 1994). Managed care has given health insurance companies an increasingly significant voice in how treatment is administered and allocated. Managed care has proliferated in the past decade despite considerable criticism of the practice of 'nickel and diming' patients as well as the considerable bureaucratic red tape it is has generated. Also, research indicates that healthy, well-insured patients tend to over-consume care without meaningful co-pays but poorer, sicker patients can be deterred even by moderate co-payments and suffer negative health consequences (Kane et al 1994). However, managed care has not gone away and is a reality that all healthcare

Less than a hundred years ago, in the late 1920’s and 30’s, almost 90% of Americans did not have health insurance (Fall of HMO’s 4). They used a variety of home remedies and when medical assistance was truly needed, they paid for it out of pocket, even incurring vast amounts of debt. This had been the case throughout history, and it changed due to an important factor, medical equipment. The industrial revolution finally caught up with the medical industry and the country saw a vast change in the scientific instruments used by physicians. These instruments required a lot of money to make and care for which caused prices to rise. Due to this massive problem, a committee was formed of health care professionals and after a 5 year study, the Committee on the Cost of Medical Care suggested that health insurance co-operatives start. These corporate medical practices became known as Health Maintenance Organizations (HMO’s) and preferred provider organizations (PPO’s), and up until the 1970’s, were an experiment to regions across the U.S. Factors that hindered health care included bullying of “money politics” from both sides of the isle as well as Presidential views and tactics as well. President Nixon first

1A. Market failure is a situation in which the allocation of goods and services is not efficient. In any given market, the quantity of a product demanded by consumers does not equate to the quantity supplied by suppliers. This is a direct result of a lack of certain economically ideal factors, which prevents equilibrium.

There is an ongoing debate regarding the potency of the new health care reform—Patient Protection and Affordable Care Act—from the outset of its proposal. Many attempts had been presented in the past years but the root of the issue remains prevalent today, that there is a lack of quality in its delivery and the cost of care is continuously increasing beyond national economic edges. In this manuscript, we will discuss several factors that can positively sway the long-term significance, impact, and structure of the United States health care system. Many are wondering whether the Universal Coverage, to which will give more control and