1. Introduction
The health care system in the United States is considered to be unique among other developed countries, including those participating in the Organization for Economic Co-operation and Development (OECD). What is more, the system is recognized as one of the most complex ones across the globe. This attitude towards complexity is mostly associated with high costs which derive from the necessity to cover the expenditures of doctors’ training and education, prices on drugs, equipment and technologies as well as costs of chronic diseases. Moreover, access to quality health care refers to another side of complexity, because uninsured and underinsured people may fail to obtain the medical services needed to improve their health. As a result, these observations establish two major problems of the US health care system: high costs and insurance coverage. In order to eliminate risks related to the complexity, the 2010 Affordable Care Act under the Obama government endeavored to cut costs, provide the population with the choice of the relevant insurance plan and advance with quality health care accessed to by each individual.
2. High Health Care Costs
Delivering the best services to the ill and injured people is prioritized in the United States. Nonetheless, the delivery relates to high costs on the part of individuals who have to pay for such medical care. Although health expenditures, which are “twice as high when compared to the OECD countries” (Fuchs 33), show that “the United States spends the most per capita on health care across all countries” (US 592), the population still has to pay substantially for the obtained medical services. The inability to pay for unaffordable services leaves individuals behind the quality health care system.
Such high health expenditures are referred to the system of funding. Specifically, the percentage of government funding amounts to 46%, which is lower than in other OECD countries. Also, a tax-supported system is not so developed; otherwise the government could take measures to lower significant health care costs. As for other sources of financial support, they are characterized by absence of concentrating funding to control investment. Actually, Fuchs insists that the lack of sufficient control is explained by political pressure (33). Therefore, the funding system should be reorganized so that individuals obtain affordable medical services.
The payment system typical of the US health care system is not sustainable enough. According to Emanuel, the current fragmented payment system enables providers to “shift costs from public payers to private payers and from large insurers to small insurers” (949). In this regard Americans face a choice by paying for services that may appear to be excessive for them. Meanwhile, it is vital to “provide price information that reflects negotiated discounts with specific providers” (Emanuel 951). Efficient collaboration between all types of payers as well as availability of the sustainable federal budget can assist in reducing high health care costs.
Health costs are also associated with the mix of provided services. Namely, the focus is on high-tech services rather than physician visits and hospital days. New technologies and equipment specify that high-tech services are rather expensive (Fuchs 33). Again, some Americans either have to pay a significant amount of money for the services or even reject them. Consequently, high costs may prevent the population from accessing health care. Emanuel supports this view by asserting that people “severely restrict their consumption of health care and might forgo necessary care” (953).
2. Disparities in Insurance Coverage
Shortell claims that “it is the health of the total population that contributes to the quality of life and economic well-being of the entire community” (1121). However, it should be noted that the United States “lags behind other high-income countries for life expectancy and many other health outcome measures” (US 592). This statement establishes problems germane to the US health care system. In particular, the US Burden of Disease Collaborators acknowledges that “marked disparities across communities, socioeconomic groups, and race and ethnicity groups” (592) relate to the population health outcomes.
The US population is characterized by more “individuals without insurance and greater income inequality” (Fuchs 33). Furthermore, the US Health care system lacks universal health coverage (US 592) which could provide access to quality health care. Elimination of the consequences may relate to the attempts to promote health policy and legislative initiatives by means of the Affordable Care Act. The initiative addresses the issues of access, efficiency and quality of health care and as a result emphasizes population health outcomes (US 592). In this respect population-centered approach is a top priority. This marks the necessity to shift to the places where people live and work rather than hospital-based settings. Other specialists should be engaged in promoting health to the overall population as well.
Disparities in insurance coverage refer to health outcomes, which should be extensively improved. There are difficulties in maintaining the improvements, since the health care system mainly targets personal behaviors, social and environmental determinants and genetic predisposition at the expense of preventing deaths. Nevertheless, the improvements make sense when interdependence among the following stakeholders increases: health care delivery system, the public health sector, and the community development and social service sectors (Shortell 1121). Furthermore, other sectors should be involved, such as education and urban planning, which should contribute to production of health. Additionally, disparities in insurance coverage can be mitigated by providing the population with the choice of the relevant insurance plan which can promote access to the quality health care.
4. The OECD Health Care System
The developed US health care system differs greatly from the system in other countries. It is especially evident in comparison with other countries of the OECD. Among them are Austria, Brazil, Canada, Germany, Hong Kong (China), Japan and New Zealand which represent different continents. The comparison establishes findings which do not correspond to advances in population health among other wealthy nations. The findings indicate that “poor health outcomes in the United States are not preordained” (US 598) due to the fact that “the bridge between health care delivery, public health, and community development and social services is only partially built” (Shortell 1121).
There is general statistics about specific measures relevant to all 35 OECD countries. Namely, the US rate of mortality declined by between 5 and 9 from 1990 to 2010, and the United States largely ranked high for age-standardized years lived with disability rates. Additionally, it had higher mean rates for a number of leading diseases and injuries than other OECD countries. Among the diseases are COPD, road injury, diabetes, Alzheimer disease and interpersonal violence. On the other hand, the 2010 evidence suggests that the US rates were below the mean in both men and women for stroke. Also, the 1990 lower mean rates were typical of a great number of diseases and injuries contributing to years of life lost due to premature mortality (US 598). The statistics establishes necessity to introduce more initiatives to advance with quality health care accessed to by each American individual.
As an example, the Canadian system of health care could serve as a model for the one in the United States. It is proved by a number of differences. Firstly, the US health care system is known for its private funding, whereas the Canadian one tends to be publicly funded. Secondly, less expenditure may indicate better health outcomes, as in the case of Canada. Next, universal access to health care is more typical of the Canadian system although the United States is characterized by a large proportion of uninsured or underinsured population. These examples state that “the US health care system can do a better job of providing patient care while moderating the rate of increase in cost” (Shortell 1121). Accordingly, all Americans will get the health system they deserve (Emanuel 953).
5. Conclusion
The system of health care in the United States is rather different from the one in OECD countries, including Canada. The complexity of the US health care poses two major problems with reference to high costs and disparities in insurance coverage. On the one hand, health costs remain one of the major challenges, since medical services prove to be rather costly. Reduction in the costs arises from the sustainability of the federal budget, like in Canada. The government should also award grants to promote the improved model of the health care system. On the other hand, there is a restricted access to quality medical care because of disparities in insurance coverage. It is crucial to maintain expansion of insurance coverage and thus provide universal coverage, like in Canada. Such improved public health programs are likely to provide access to quality health care. Applying beneficial features of the Canadian health care system to the American one can be advantageous.
Works Cited
Emanuel, Ezekiel, et al. “A Systematic Approach to Containing Health Care Spending.” The New England Journal of Medicine 367 (2012): 949-954. Print.
Fuchs, Victor R. “How and Why US Health Care Differs from That in Other OECD Countries.” JAMA 309.1 (2013): 33-34. Print.
Shortell, Stephen M. “Bridging the Divide between Health and Health Care.” JAMA 309.11 (2013): 1121-1122. Print.
US Burden of Disease Collaborators. “The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors.” JAMA 310.6 (2013): 591-606. Print.
