What is your evaluation of the effectiveness of the U.S. health care system in the context of delivery, finance, management, and/or sustainability? What are the issues that prompted a need for health care reform? Support your answer with a credible data reference. Do not use a reference already used by another student. Purchase the answer to view it Purchase the answer to view it
Evaluation of the Effectiveness of the U.S. Health Care System
In evaluating the effectiveness of the U.S. health care system, it is essential to consider its delivery, finance, management, and sustainability. These factors are critical in determining the overall performance and quality of the healthcare system.
The U.S. health care system is renowned for being one of the most expensive in the world, yet it falls behind in terms of overall health outcomes compared to other developed countries. According to a report by the Commonwealth Fund, the United States ranked last out of 11 high-income countries in terms of quality, efficiency, access to care, equity, and healthy lives (Davis et al., 2014). Therefore, one can argue that despite its high costs, the U.S. health care system is not living up to its potential.
In terms of delivery, the U.S. health care system faces several issues. One of the primary concerns is the lack of universal health care coverage. According to the U.S. Census Bureau, in 2019, approximately 8.0% of the population (26.1 million people) did not have health insurance (U.S. Census Bureau, 2020). This lack of coverage leads to unequal access to care, with many individuals delaying or forgoing necessary medical treatments due to financial constraints. Moreover, the fragmentation of the health care system, with its reliance on private insurers and various public programs, adds complexity and hampers the coordination of care.
Regarding finance, the U.S. health care system faces challenges in terms of cost containment and affordability. The country spends considerably more on healthcare per capita compared to other developed nations. In 2018, the United States spent $11,072 per person on healthcare, more than twice the average of other Organization for Economic Co-operation and Development (OECD) countries (OECD, 2020). Despite this high level of expenditure, many Americans still struggle to afford necessary medical care, with high deductibles and out-of-pocket costs.
Moreover, issues of management and organization plague the U.S. health care system. Administrative costs in the U.S. are significantly higher than in other countries. The complexity of the system, with multiple payers, billing processes, and varying regulations, contributes to substantial administrative expenses. A study published in the New England Journal of Medicine found that administrative costs accounted for 34% of total health care expenditures in the U.S., compared to 17% in Canada (Woolhandler & Himmelstein, 2016). These excessive administrative costs divert resources away from direct patient care and contribute to the overall inefficiency of the system.
Sustainability is another fundamental concern of the U.S. health care system. The aging population, rising chronic disease burden, and advances in medical technology are driving healthcare costs upward. This poses a significant challenge to the long-term sustainability of the system. The Congressional Budget Office (CBO) projects that health care spending will continue to increase, reaching 19.7% of GDP by 2029 (CBO, 2019). Without effective measures to control costs and promote more efficient care, the financial burden on individuals, businesses, and the government will become increasingly unsustainable.
Several issues have prompted the need for health care reform in the U.S. One primary concern is the lack of access to affordable care. The high cost of health insurance premiums, coupled with rising out-of-pocket expenses, has left many Americans unable to afford comprehensive coverage. As a result, individuals often delay seeking medical care until their conditions worsen, leading to higher costs and poorer health outcomes.
Another issue is the inequity in access to care. Disparities exist based on income, race, and geography, with certain populations experiencing higher rates of uninsured or underinsured individuals. This inequity in access leads to significant disparities in health outcomes, as marginalized communities face barriers to timely and appropriate care.
Furthermore, the complexity of the U.S. health care system creates inefficiencies and confusion for both patients and providers. The fragmented nature of the system, with multiple payers and varying coverage options, adds administrative complexity and can lead to gaps in care coordination. This lack of coordination can result in duplication of services, unnecessary tests, and delays in care delivery.
In conclusion, the U.S. health care system faces several challenges in terms of delivery, finance, management, and sustainability. It is evident that the system’s effectiveness is hindered by issues such as lack of universal coverage, high costs, administrative complications, and access disparities. These factors have prompted the need for health care reform to address the shortcomings and improve the overall performance of the U.S. health care system.