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Despite the fact that the USA is one of the most developed countries in the world, it has major issues associated with health care availability to its citizens (Davis, Stremikis, Squires, & Schoen, 2014, p. 9). The country traditionally developed following the principles of the capitalist economy with people receiving an opportunity to improve their life by hard work instead of waiting for government support. The same approach remains popular today since many individuals do not wish to share their income to help their less wealthy fellow citizens.
The issue insurance coverage is currently raised once again, as Republicans keep viewing health care as a privilege for those who earn much money. Nowadays, millions of people remain uninsured and cannot access medical treatment due to its high costs (Ward, Clarke, Nugent, & Schiller, 2016, p. 2). Safety issues are also among the concerns associated with todays hospital service. Adopting a coverage system practiced in other countries may become a solution to American health care problems. In particular, reform can include providing free medical treatment to all citizens with a limited number of procedures, while private clinics should still be present to offer a wider range of services.
Major Issues
Accessibility and Disparity
Unfortunately, many citizens in the USA do not have a proper level of accessibility to medical treatment. Of course, big cities offer almost every type of services available in the industry. However, rural areas are marked by a small number of hospitals and financing. Doctors and nurses do not wish to work in places that lack proper material base. Top specialists often try to enter the market by choosing the most famous hospitals as their workplace upon graduation. This fact creates an imbalance when patients are sometimes forced to travel long distances to received quality health care.
Another issue is the disparity between services received in different states. The economic system of the USA implies that budget is not spread evenly. Each state has a certain level of independence, and its welfare depends on the level of income that is generated by people who work there. Thus, places with the highest density of the population that are considered large economic centers offer better medical services. Administration of such states can afford to buy the newest technology and hire the best specialists for their hospitals.
Finally, not all people can take advantage of hospital treatment due to the weak protection of employees. A lot of companies do not favor their workers being absent even if it is associated with health issues. Management may decide to hire another employee that would be present in a workplace more frequently, thus generating more income for a company. Of course, such practices are not supported by legislation, yet many employees are afraid to take long sick leaves for financial and career reasons, which makes them turn to unqualified help or self-treatment.
Rising Costs
Despite the fact that the government is interested in increasing the countrys demographics, it does not work towards holding the prices in the health care sector. Although there was no considerable change in the costs of resources or production, prices for hospital services and medication went up several times over the past few decades. Most issues associated with the health care industry are based on financial requirements imposed on people that wish to be treated.
The core problem of the American health care system is the insurance legislation. It defines that coverage can be either private or governmental, which depends on the level of income of an individual citizen. On the overall, the government sponsors the most disadvantaged portions of the population. There are two programs, Medicare and Medicaid, that are targeted at these groups of people.
Medicare is drafted to provide free coverage to citizens who are over 64 years old, as well to people with disabilities and those who have the terminal-stage illness. It is one of the largest programs that are financed mainly by the government efforts, though other methods are also present. Medicaid, as well as the Childrens Health Insurance Program (CHIP), are the initiatives traditionally targeted at providing care for families. The program is funded by the federal government from the countrys budget. The Affordable Care Act (ACA) signed under the presidency of Barak Obama aimed to expand the covered population by spreading the eligibility onto low-income families and adults that have no children (The Henry J. Kaiser Family Foundation, 2013).
Despite the fact, that the ACA can technically influence the nation in a positive way, many officials and ordinary people oppose it, claiming that this practice does not perceive individual input as significant. There are debates in the American society on whether health care is a right or a privilege. The former government represented by the Democrats, clearly identified that medical services must be affordable to everyone.
In fact, people are the countrys greatest asset, and they deserve to be taken care of despite their level of income. However, after the recent elections, the new President has given a start to the campaign aiming at canceling some of the ACAs policies (Nolen, 2017, para. 3). This initiative is widely supported by a numerous group of people, especially those who have a relatively high income, due to the fact that they do not want their taxes to be spent on those individuals who cannot manage to earn enough money to buy the insurance.
In fact, although health care can be perceived as a fundamental right, its provision relies heavily on the countrys resources, with the process of their distribution always being a controversy (Maruthappu, Ologunde, & Gunarajasingam, 2013, p. 16). In any case, while the nation cannot decide on whether to support low-income and disadvantaged communities, millions of people lack proper coverage and are at risk of having serious issues due to the improper health care.
Patient Safety
Another major issue facing the health care industry in the U.S. is the quality level of internal processes in hospitals. Not all clinics possess the proper technical supply to ensure patients can be treated safely. This fact also has much to do with staff qualification. Both issues arise from the factors mentioned above when the scarcity of resources makes highly professional doctors and nurses leave for big cities, and small hospitals cannot afford to buy expensive appliances.
One of the most significant problems associated with the patient safety is different illnesses that are acquired by patients in a hospital environment, predominantly of a viral or bacterial character. The post-surgery time, for instance, is one of the most high-risk periods associated with this issue. Patients immune system is usually damaged by an illness that caused them to contact a hospital, followed by a range of medical procedures posting a certain level of threat to the bodys defense. The failure of nurses to comply with safety guidelines such as washing hands before each examination or visit may result in transmitting infections from one patient to another, compromising the previous treatment.
Medical errors also contribute to the issue of patient safety. While it was not considered serious until the 1990s, reports provide statistics that there were several thousands of deaths that could be prevented by proper treatment. There are three factors contributing to the number of medical errors, which are the human factor, the complexity of treatment, and the failure of procedures associated with communication or usage of technology.
Most of the cases result from the complexity of medicine as a field of science, where there are no universal solutions, and each patient is a unique system that could or could not react to a certain type of treatment.
Nevertheless, communication is one thing that can be effectively managed in a hospital environment. Usually, the accuracy of a diagnosis relies on how well a doctor or a nurse has understood the patients state based on what he or she has mentioned. Sometimes, technical appliances fail to provide a clear picture, and additional evidence must be collected. Another issue associated with the communication is based on the numerous facts of diagnosis disclosure.
Doctors and nurses are not always professional regarding the legal field of health care, which often has adverse psychological effects on patients who had their diagnosis disclosed to the public. Sometimes a case requires several specialists to determine the best range of procedures, which puts extra significance on the communication process between doctors and nurses. This step requires a high level of teamwork in a hospital, which is usually monitored and inspired by an administration team.
Policy Plan
Having covered the main points of the American health care system disadvantages, there comes a realization of the necessity to adjust it to fulfill the needs of the population. It appears that the main issues that have to be solved are the high costs of medical services combined with their low quality in rural areas. The best set of policies aiming to improve the situation would be using the experience of European countries, which offer health care services for free, combined with implementing initiatives for increasing the motivation of qualified medical personnel to work all over the country instead of focusing on specific cities.
The European system implies that all citizens are entitled to free health care services, which are paid from the national budget. Thus, taxpayers are aware that they will be treated free of charge from the majority of illnesses. Additional costs usually include buying prescribed medicine or paying for a more comfortable environment. Of course, there are also numerous private clinics that offer their services for a fee.
Having the governmentally funded health care system has its drawbacks. For instance, there is evidence about long lines patients have to stand to get to a doctor or a nurse. Sometimes they have to wait for months to be accepted by a specialist. However, this concerns only those cases that do not require an immediate response, such as regular check-ups or consultations regarding health issues that do not severely affect the overall quality of life. In a case of emergencies, patients are taken to hospitals by ambulances. Those people, who do not wish to wait a long time, may attend a private clinic.
Such system would resolve issues regarding the affordability of heath care by low-income individuals in the United States. While every person would be entitled to free services, those who need extra procedures should address the private sector. Moreover, those citizens who have high income usually prefer a more comfortable hospital environment. If they wish to be treated exclusively, they will have to pay extra money. Nevertheless, it is not certain that the American society would favor such initiative due to their capitalist worldview, which implies the perception of a minimum government interference.
Another step that should become a part of the reform is motivating doctors and nurses to work in rural areas (Rice, Unruh, Rosenau, Barnes, Saltman, & Ginneken, 2014, p. 896). The primary motivation factor should be the payment rate. It should not be much different from what is offered in large cities like the NYC or Chicago. However, this step is quite difficult to achieve since the economic system in the U.S. leaves a high level of financial decision-making to each state. Nevertheless, the federal government should draft initiatives to distribute financing for it to be more or less equal in each part of the country.
Motivation can also be increased by career opportunities in hospitals. Of course, some health care jobs imply that there is a great portion of routine functions that has to be performed daily, and there is not much space for professional growth. However, most medicine specialists value the opportunity to achieve significant results in the workplace. The U.S. government should draft a program that would financially reward those hospital employees that dedicate some part of their working time to research and development.
After all, this step could boost the progress in discovering treatment methods for a range of illnesses. Besides, there is a shortage of young professionals entering the market. This is partially explained by the high costs of medical education. The government should increase the number of grants issued to medical students to help them in affording this education.
The primary question that stands regarding this set of steps is whether there will be enough money to cover all the costs. It is a fact that the USA is one of the wealthiest countries, yet most of its budget is not spent on the public sector. The government currently prefers to spend the budget on costly tasks like supporting the heavy industry and developing the countrys military. While these fields are also very important, it is up to citizens to decide how they wish to spend their resources.
The countrys officials should first make a referendum on this question, letting the nation decide on the priorities. However, risks also must be considered. Most of the people are not specialized in economic studies, and the current recession might make them wish to change the situation to best suit their needs, yet it could have the adverse effect on the whole country in the future.
Conclusion
The health care system in the U.S. must be completely reformed to make the medical services affordable to those millions of people, who now lack the proper insurance coverage. The rising costs, combined with the low affordability and issues with patient safety, are some of the most significant issues in this field. Taking a pro-social approach of the federal funding of public hospitals seems controversial, yet it can resolve the issue among the low-income communities, while there will be no disadvantages for the wealthy population.
References
Davis, K., Stremikis, K., Squires, D., & Schoen, C. (2014). Mirror, mirror on the wall: How the performance of the U.S. health care system compares internationally. Washington, D.C.: The Commonwealth Fund.
Maruthappu, M., Ologunde, R., & Gunarajasingam, A. (2013). Is health care a right? Health reforms in the USA and their impact upon the concept of care. Annals of Medicine and Surgery, 2(1), 15-17.
Nolen, J. (2017). GOP senators offer ACA replacement plan that would let states keep Obamacare. CBS News.
Rice, T., Unruh, L. Y., Rosenau, P., Barnes, A. J., Saltman, R. B., & Ginneken, E. (2014). Challenges facing the United States of America in implementing universal coverage. Bulletin of the World Health Organization, 92(12), 849-924. Web.
The Henry J. Kaiser Family Foundation. (2013). Summary of the Affordable Care Act.
Ward, B. W., Clarke, T. C., Nugent, C., N., & Schiller, J. S. (2016). Early release of selected estimates based on data from the 2015 National Health Interview Survey. National Center for Health Statistics.
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