Introduction
When Medicare and Medicaid were enacted in 1965, the gross domestic product (GDP) attributable to health care was just under 6 percent. However, according to Davidson (2013), the United States now spends 17.2 percent ($8,608 per American per year) of GDP on health care. Out of 48 countries ranked, the U.S. landed in second place (behind Switzerland) for dollars spent. On the other hand, health care quality in the U.S. ranked 46 out of 48, just in front of Serbia and Brazil. Although Switzerland pays more per capita for health care than the U.S., Switzerland’s quality ranks in the top 10 (Davidson, 2013). The organization I work for, Novant Health, is not immune to the aforementioned statistics. The problem: The U.S. health care system is costly, highly inefficient and lacks quality compared to other industrialized nations. Why has this decline in the U.S. health care system and thus Novant Health left us towards the bottom of the barrel?
Methodology and Analysis
The Delp-type model systems approach presented at the end of this report (Figure 1, page 6) describes the interrelationship between health care system operations, health behaviors and socioeconomic conditions and the impact each has on Novant Health’s efficiency and quality of care. Included in Figure 1 are the following contributing factors:
• Chronic medical conditions
• Lack of healthy lifestyles
• Fee-for-service system
• Fragmented health care delivery
• Government subsidized insurance coverage (Medicare and Medicaid)
• Uninsured due to lack of affordable health insurance
• Inconsistent use of best medical practices
• Limited access to primary care
• Lack of preventive care
• Overuse of costly medical procedures
These factors can be subdivided into t...
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On a global scale, the United States is a relatively wealthy country of advanced industrialization. Unfortunately, the healthcare system is among the costliest, spending close to 18% of gross domestic product (GDP) towards funding healthcare (2011). No universal healthcare coverage is currently available. United States healthcare is currently funded through private, federal, state, and local sources. Coverage is provided privately and through the government and military. Nearly 85% of the U.S. population is covered to some extent, leaving a population of close to 48 million without any type of health insurance. Cost is the primary reason for lack of insurance and individuals foregoing medical care and use of prescription medications.
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In order to make ones’ health care coverage more affordable, the nation needs to address the continually increasing medical care costs. Approximately more than one-sixth of the United States economy is devoted to health care spending, such as: soaring prices for medical services, costly prescription drugs, newly advanced medical technology, and even unhealthy lifestyles. Our system is spending approximately $2.7 trillion annually on health care. According to experts, it is estimated that approximately 20%-30% of that spending (approx. $800 billion a year) appears to go towards wasteful, redundant, or even inefficient care.
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The contentious debate about our healthcare system is an epitome of the ongoing political circus in America. With the 2012 elections looming just around the corner, we can expect the vitriol to rise rapidly. Our country spends twice as much on health care per capita compared to other developed countries. The current system is so dysfunctional and projected spending will increase every year, putting an unbelievable strain to our fragile economy. Majority of health care dollars spending are channeled on to patients with chronic illnesses, many of which can be prevented. Unfortunately, medical doctors practicing preventive care are being squeezed out of the equation. The shortage of primary care doctors in America is inevitable because of limited income, lesser prestige, and fewer opportunities.
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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.
The U.S. expends far more on healthcare than any other country in the world, yet we get fewer benefits, less than ideal health outcomes, and a lot of dissatisfaction manifested by unequal access, the significant numbers of uninsured and underinsured Americans, uneven quality, and unconstrained wastes. The financing of healthcare is also complicated, as there is no single payer system and payment schemes vary across payors and providers.
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The US health system has both considerable strengths and notable weaknesses. With a large and well-trained health workforce, access to a wide range of high-quality medical specialists as well as secondary and tertiary institutions, patient outcomes are among the best in the world. But the US also suffers from incomplete coverage of its population, and health expenditure levels per person far exceed all other countries. Poor measures on many objective and subjective indicators of quality and outcomes plague the US health care system. In addition, an unequal distribution of resources across the country and among different population groups results in poor access to care for many citizens. Efforts to provide comprehensive, national health insurance in the United States go back to the Great Depression, and nearly every president since Harry S. Truman has proposed some form of national health insurance.
As of 2013 data, the US per capita government expenditure was $4307 while total per capita expenditure on health spending was $9146, which is 17.1 percent of the GDP (2013) for the total expenditure on health. The annual rate of growth in per capita government spending on healthcare has been roughly 5.1 percent over the past thirty years (WHO, 2015). This rate of spending on health care growing faster than the economy for many years creates challenges ...