Reimagining Healthcare in the U.S.: A Comprehensive Look - Essay Sample

Introduction

Healthcare system is one of the most significant departments that require the highest level of commitment from every stakeholder. Health care delivery in the United States involves different stakeholders whose responsibility aims at delivering high-quality services to all individuals irrespective of their economic and social status. Though the health care system in the United States is complicated, it is highly developed and available to all citizens. The purpose of this text is to explore the United States healthcare system from various points of view.

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Health Care System Operations

The system of health care in the United States is unique as compared to that of other developed countries. The operations of the health care system are not universal; instead, they are operated through different sectors. The majority of health facilities are owned and controlled by private sector organizations, and health coverage is delivered by both private insurance and public health coverage (Hicks, Howard, & Murano, 2017). The government programs which are Medicaid and Medicare are designed specifically for individuals living with disabilities, low-income earners as well as the elderly. The rest of the population is required to obtain private insurance on their own or through their bosses. In case of an emergency, an individual without an insurance plan will get treated but will still be responsible for the medical expenses, which can be huge. Individuals with insurance policies are required to make co-payments once they visit a doctor to avoid receiving surprise bills.

Health Care Delivery System

The health care sector involves various health facilities, clinicians, and insurance plans as well as health services purchasers all operating either independently, as a network, or in multiple groups. Some of them are based in the private sectors as either non-profit or profit-making organizations, while others are in the public sector. The industry of health care includes various regulators that may be governmental or voluntary meant to provide order, integration, and accountability (Burkhardt, Abir, & Durning, 2019). However, the systems of communication, planning, and collaboration of health care facilities are limited, which hinders their operations. Though the United States health care practice is considered the best globally, health-related spending of the nation is yet to produce excellent health results for its citizens. The reason is because of the economic vulnerability of the organizational structure that is responsible for ensuring the effective delivery of health services. Health providers and insurance plans scramble to survive and adapt in an extremely competitive market.

Financing of the Health Care Delivery System

Medicare is financed through a combination of premiums, taxation, and other general incomes. Medicaid is financed through taxes and controlled by the states which are responsible for the operations of the program. Cash to fund the Medicaid program is received from the federal government at different rates, depending on their per-capita income. On the other hand, private insurance is obtained by individuals, but the private health sector is usually financed by tax-exempt premiums and voluntary. The cost of private health care is most often shared by workers and employers on an employer-specific basis, and at times it varies by the type of worker. Tax exemption of the employer is the third-largest expenditure the government spends on health care after the two programs, Medicaid and Medicare, which reduces the tax revenues. Private insurers in the United States pay providers amounts that are higher than those paid by programs run by the government, especially Medicaid. Lack of uniformity leads to vast differences in provider payment revenues and rates, which, to a large extent, depend on market power and payer mix.

Payment rates of Medicare are typically decided according to a fee plan with different adjustments based on provider and local attributes as well as the cost of living. The primary care physicians who operate in group-owned or small self-practice receive their payments through a combination of capitation and negotiated fees. Physicians working in public hospitals are paid with the administrative fees set aside for health services, and they also receive financial incentives (Herring & Trish, 2015). Cost performance and quality serve as the criteria for determining the financial incentives given to physicians, which are usually made available by public programs and some private insurers. The specialists working in both public hospitals and private practice are paid through capitation, negotiated fees, and administrative fees set. The specialists are not allowed to invoice an amount higher than that in the fee schedule for the health services offered.

In conclusion, the United States does have no universal accessible healthcare system. The health care system is financed privately and publicly, with the majority of Americans purchasing private insurance. The government offers Medicaid and Medicare insurance programs to the elderly and low-income earners as well as the poor.

Healthcare System in the United Kingdom

The system of healthcare in the United Kingdom is universal and covers all permanent citizens. Healthcare insurance is paid for by the general taxes and is free of charge at the point of need. Approximately 18% of the total income tax of citizens is directed towards healthcare. An overall 8.4% of the country's gross domestic product goes to healthcare (Gursoy, 2015). The majority of health facilities are publicly owned and operated independently, with the organization being divided into three hierarchical states, which include regional, district, and community hospitals. The healthcare system is decentralized and is regulated at the fundamental national level by various healthcare agencies.

The government-sponsored healthcare system in the United Kingdom is known as the National Health Service (NHS). It consists of various healthcare systems that are publicly funded. The United Kingdom residents are registered under this healthcare system, but they also have the option of obtaining private insurance. The main objective of the National Health Service is to provide patients with more information and power as well as offer more beds, hospitals, nurses, and doctors. The system also aims at reducing the wait times as well as improving healthcare services (Braileanu, Tavella, & Rousseau, 2018). According to a report submitted by the Commonwealth Fund, United Kingdom provides quality care and has the most efficient healthcare system. The healthcare system in the United Kingdom is devolved, which means that each region has its public and private funded health facilities. Each of the areas has a private healthcare sector, which is generally smaller than the publicly funded facilities. The responsibility of social care services is shared between the local government's Directors of Social Services and the local National Health Service. Locally accountable bodies and the Strategic Health Authorities are responsible for managing the actual delivery of health services in the United Kingdom.

Healthcare Coverage in the United Kingdom

The National Health Service is responsible for guiding and governing the healthcare system in the United Kingdom. It aims at publicly funding healthcare facilities in all of the various regions in the United Kingdom. Approximately 85% of the total healthcare expenditure in the country is supported by the National Health Service (Braileanu, Tavella, & Rousseau, 2018). The private sector is expected to cover the remaining spending of 15%. Private insurance is purchased by individuals who want to add more benefits, and it is also obtained through employer groups. Though there are various private health insurance agencies, the majority of the population is covered by the National Health Services, which is fully tax-funded.

Some of the private health insurance organizations include Bupa (formerly the British United Provident Association), which is the single largest insurance company in the United Kingdom. It provides health insurance covering various medical expenses such as dental, cancer, and heart treatments (Gursoy, 2015). Medicare International provides health insurance covering chronic conditions such as diabetes and asthma, among others. It also offers coverage for check-up procedures such as general visits, X-rays as well as specialist's fees, among others. Freedom Health Insurance is another private health insurance organization in the United Kingdom that covers aesthetic and sexual healthcare. It offers various services such as syphilis, chlamydia tests, and treatment as well as HIV tests, among others.

Healthcare Services to Individuals With Special Needs

Though the National Health Service provides all permanent residents with free healthcare, it offers special services to specific groups of people. Patients suffering from terminal illnesses are provided with home nursing services instead of care at hospitals. Citizens aged sixty years and above receive in-home care services, which the National Health Service aims to improve over time. The healthcare system also provides free influenza immunization to individuals with sixty-five years and above and is working towards improving oral health as well as increase access to dentistry. The disabled people are provided with Attendance and Disability Living Allowance, which is meant to cater to the additional costs relating to personal care.

Healthcare System Policies and Regulations

The main objective of the United Kingdom healthcare system is to improve safety standards and the quality of social and health care services. Various methods are used to address the issue of quality, which is monitored and assessed by different regulatory bodies. Providers are periodically evaluated, and individuals' issues regularly investigated to determine the best ways of practice that will result in quality services. Quality and Outcome Framework is responsible for measuring the quality of services provided by general practitioners in the United Kingdom (Namukasa, 2018). The Framework was established in 2004 and started its operations in 2005. Its objective is to provide incentives necessary for improving the quality of services offered, and practitioners receive points according to the patients' view as well as the organization of the practice. The United Kingdom Healthcare policies provide citizens with rights to receive health care despite their age, race, gender identity, political belief, religion, or socioeconomic status, among other factors. Citizens have the right to receive health care in a secure environment, free from all forms of harassment, abuse, and neglect.

In conclusion, health care services in the United Kingdom are provided to permanent residents free of charge by the National Health Service. The services are publicly funded and are usually paid for by taxation, which guarantees free care for all individuals. However, individuals purchase private insurance for additional health care services that are provided by various private insurance companies in the country.

Japanese Healthcare System

The healthcare system of Japan is known to be the best worldwide based on numerous reasons like efficiency and effectiveness. Over the last five decades, the country has attained reasonable demographic wellbeing, which is less costly. Among all countries in the OECD (Organization for Economic Co-operation and Development), Japan leads with the highest life expectancy, yet the expenses on health compared to the Gross Domestic Product are lower than the majority of the first world countries. Some of these developments are attri...