How The America 's Health System Work

Medicare's finances are in peril for two main reasons. The first is steadily rising health-care costs. In 1996, Medicare spending, at 12.2% of the federal budget, was the third-largest budget item. Only Social Security (the federal government's pension plan for retirees) and defense spending consumed a larger share. Medicare spending totaled $196 billion in 1996, and according to estimates from the Congressional Budget Office (CBO), it will reach $312 billion in 2002.

Simultaneously, health and healthcare policy plays a tremendous role in the quality of life of every American. Likewise, by the government constantly interceding, health and healthcare is significantly influenced by the political climate and undertakings of administration; therefore creating a conflictual split between republicans and democrats. Health care is regarded as a product rather than a human right shaped by policymaking. Policies establish healthcare service stipulations, which are rooted in local, state, and federal statutes combined with landmark court decisions. Not only does policy focus on healthcare services; but, it also places a substantial emphasis on cost-efficiency and equality.

Health care spending in the United States of America as a percentage of the economy has reached astonishing heights, equating to 17.7 percent. This number is shocking when compared to other counties; in Australia health care is 8.9 percent, in United Kingdom 9.4 percent, in Canada 11.2 percent. If the American health care system were to hypothetically become its own economy, it would be the fifth-largest in the world. While these statistics sound troubling, they lead us to look for answers about the problems surrounding our system. The first health insurance company was created in the 1930s to give all American families an equal opportunity for hospital care and eventually led to a nationwide economic and social controversy that erupted in the 1990s and continued to be shaped by the government, insurance companies, doctors, and American citizens. In this paper, I will go in to detail about the various opinions regarding the controversy, the history behind health insurance companies, and the main dilemmas brought out by the health care crisis. Greedy insurance companies combined with high costs of doctor visits and pharmaceutical drugs or the inefficient hospitals all over America can only describe the beginning to this in depth crisis. Recently, the United States health care industry has become know for the outrageous costs of insurance models, developments of various social and health services programs, and the frequent changes in medicinal technology.

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.

The first characteristic of the US health care system is that there is no central governing agency which allows for little integration and coordination. While the government has a great influence on the health care system, the system is mostly controlled through private hands. The system is financed publically and privately creating a variety of payments and delivery unlike centrally controlled healthcare systems in other developed countries. The US system is more complex and less manageable than centrally controlled health care systems, which makes it more expensive. The second characteristic of the US health care system is that it is technology driven and focuses on acute care. With more usage of high technology,

On March 23, 2010, the President Obama signed the Patient Protection and Affordable Care Act (PPACA) which represents the most significant regulatory that impacts the U.S. healthcare systems. With PPACA, 32 millions of Americans are expected the coverage and expanded access to health care and medical care. Due to the baby boomers and the downfall of the economics, there will be millions of people are seeking for low rates medical care which will create great impact on U.S. healthcare. According to Commonwealth Fund analysis, the U.S. healthcare ranks last on every cost-related. Therefore, healthcare becomes the top social and economic problem that American is dealing with. Like all other well-developed countries, there are both private and public insurers in the U.S. health care system. ‘What is unique about the U.S. healthcare system in the world is the dominance of the private element over the public element’ (Chua, 2006). Healthcare system in the Unites States can be divided into three different groups: Medicare, Medicaid, and Managed Care. Each plan provides different coverages for different groups of people.

The healthcare system of the United States was established as a system of health and welfare programs created to provide affordable treatment to the citizens of the United States. Recently, the Affordable Health Care Act was passed changing the structure of the system (Mulvany, 2012). While in theory the new arrangement works, it has its flaws due to the resulting cost, slowness, and the government interfering with religious and personal beliefs. These problems have led many people to question the role of the government in the life of the individual.

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.

Primary care is the backbone of many industrialized nations, but is the US one of them? Unfortunately, the answer is no. The US lags behind such developed nations in its accessibility of primary care by a huge difference. The United States healthcare system fails to ensure the timely preventative and primary care for its residents. The current estimates indicate that there is merely one physician for every 2,500 patients. Not only Medicare beneficiaries, but also privately insured adults struggle in accessing the right primary care physician at the right time. Moreover, maldistribution of physicians only exacerbates the problem, especially for those residing in health professional shortage areas (HPSA).15 Approximately, sixty-five million Americans live in designated primary care shortage areas.13 Such underserved population faces higher disease and death rates and health disparities that then result in higher rates of hospitalizations and emergency department visits—in other words, expensive medical bills.21 More governmental control on the geographic location of primary care physicians can be a first-step to fixing the shortage problem.

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

Norma Raffel and Marshall Raffel’s The U.S. Health System: Origins and Functions presents a thorough history of healthcare in the United States and explains the present situation. The current U.S. system of federal healthcare came into being in 1965 through Congress’s amendment of the Social Security Act and the establishment of Medicare and Medicaid. Medicare began as a national health insurance program for persons age 65 and over, regardless of income or wealth. In 1973, coverage was extended for those on disability for at least two consecutive years. Medicare provides enrollees with a basic program of hospital insurance and supplementary assistance program to aid in paying healthcare bills (Raffel,

2008 was an election year and also the year Frontline’s program, Sick Around the World was made. A big topic pertaining to the election year was healthcare reform. How were the presidential candidates going to “fix” the U.S. health care system that is supposedly the best in the world? At the time of this program, the U.S. was 37th in the world in terms of fairness and quality (Palfreman, 2008). Other rich countries were ahead of this U.S. in this ranking but were spending a lot less. Frontline’s reporter, T.R. Reid traveled to 5 different countries to examine their health care systems on how this was possible and hopefully come away with any ideas that could potentially help with the U.S. health care system.

The Canadian system is often considered the model for the U.S. health care system. Both countries ' health care systems are very different-Canada has a single-payer, mostly publicly-funded system, while the U.S. has a multi-payer, profoundly private system but both countries appear to be similar and suggesting that it might be possible that the U.S. to clone the Canadian health system.

Health care systems are organizations that are formed to meet the overall health needs of the population. Health care is regarded as one of the leading cause in promoting not only physical and mental health but the well-being of the population. Legislation is implemented requiring government to offer services to all members of its society. The role of health services and the organizations that provide aid is to focus on the health of an individual and to uphold their human rights. According to WHO (2013), a “well-functioning health care system requires a robust financing mechanism, a well-trained and adequately-paid workforce, reliable information on which to base decisions and policies, and well maintained facilities and logistics to deliver quality medicines and technologies (World Health Organization; 2013).

The United States’ approach to health care policy is an anomaly among industrialized nations. Disagreement about what the federal government’s role in health care ought to be, combined with the structure of lawmaking institutions, have yielded generations of improvised policies and programs that intend to mollify individual issues created by the health care system rather than comprehensively addressing its flaws.