U.S. Health Delivery Crisis: Escalating Costs & Limited Access to Quality Care - Essay Sample

Paper Type:  Essay
Pages:  7
Wordcount:  1756 Words
Date:  2023-03-16

Introduction

The U.S. health delivery system is in a crisis primarily due to the escalating costs of healthcare and limited access to affordable and quality healthcare services because of unequal insurance coverage among its populations (Dorning, 2016). According to Schreck (2018), 17.9 percent of the U.S Gross Domestic Product (GDP) in 2016 was spent on healthcare, and in the same period, the U.S. government spent approximately U.S. $ 9900 on health care per individual. The U.S. remains as the only developed nation around the world without universal health insurance coverage in place for its citizens (Dorning, 2016). Therefore, I believe that the provision of universal insurance coverage in the health sector will serve as a significant effort toward improving the overall healthcare delivery system in the U.S.

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I opine that the U.S. should establish and implement universal insurance coverage rightly to its citizens. I propose universal insurance coverage to be called the Consumer Universal Health Coverage (CUHC). The inclusion of the word "Consumer" is to emphasize that the program must be people-centered or focused in all its dimensions. The CUHC program should be entirely run by the government and should be enrolled for all the Americans. Additionally, the government should be solely responsible for regulating the health sector and simultaneously determining the amount of fees that various healthcare providers or professionals, together with hospitals, should be paid upon the delivery of services.

The program should be national and organized such that it covers almost everything in the healthcare delivery systems, including long-term health care, which is usually excluded from most of the health insurance plans in the country. CUHC would cover almost every aspect of the healthcare delivery system, including but not limited to primary care services, drug prescriptions, dental care, and medical-laboratory services, among others. Consequently, CUHC must invest in long-term care, especially in the current times where the U.S. is experiencing an increase in chronic illnesses such as cancer and a rising population of the elderly who need continuous healthcare assistance over an extended period. CUHC will eliminate the exemptions which have been hampering with the effectiveness of ACA towards universal insurance coverage.

Furthermore, CUHC would propose the use of the single-payer approach towards the payment of healthcare services provided to the residents in the country. The single-payer system will demand the government to wholly fund the health program through a pool of public funds, which will be raised through taxation (Tikkanen, 2019). Since the aim of the CUHC is to provide a universal healthcare plan, the health program will have to replace Medicaid and Medicare slowly. However, individuals will be allowed to purchase private insurance policies if they want to add it to the CUHC such that the private insurance would cater to specific medical requirements.

Moreover, CUHC will be broad enough to cover all the residents of the country. The health plan will ensure that visitors in the U.S. would receive free health care when seeking services related to emergencies and suspicion of any infectious ailments. Also, the residents will have to seek free but quality healthcare services in the nearest facility at reduced prices. The U.S. government will be in a position to demand low healthcare costs because it's the sole regulator of the entire sector.

The government will be responsible for funding the CUHC program through taxation wholly. However, healthcare providers will have the choice to operate directly under the government or through private entities. The program will be beneficial economically because it will reduce out-of-pocket expenses incurred by the citizens, as well as minimizing copayment costs, especially in drug prescriptions. CUHC is probably going to gain significant appeal from a considerable population because of its primary focus on achieving universal insurance coverage, containment of costs, and simultaneously improving the quality of health care services (McClure, Enthoven, & McDonald, 2017). Also, the CUHC program will be essential in reducing the administrative costs such as those that accompany billing.

Improving Quality and Population Health Status

The U.S. health sector is known to have significant spending in healthcare services per person among the developed countries. However, the considerable expenditure does not reflect in quality indicators as the U.S. health delivery system ranks poorly when compared to other developed countries According to Dorning (2016), the U.S. was ranked fifth regarding the quality of care as compared to other developed nations. The U.S. health care system is experiencing challenges in providing quality care because the country has, in some ways, neglected primary and preventative care. The U.S. health delivery system must make changes and improve the quality of care to its citizens.

Efficient care coordination and effective communication among the stakeholders must be improved. The aspects of care coordination among the multi-disciplinary teams and healthcare facilities, coupled with effective communication among the vital stakeholders, play significant roles in minimizing medicals errors and preventing overutilization of the health-based resources (Berger, 2015). For instance, a multi-disciplinary team of different health professionals can utilize electronic health records to facilitate easier access to the patients' medical information and make informed decisions regarding the health status of the patients.

Consequently, there is a need to provide universal health insurance coverage in the U.S. to facilitate the affordability of quality care at all levels ranging from individuals, families to the government. Through the universal health plan, the U.S. government will have the power to regulate the entire sector not only through setting prices for medical services and health providers, but also the quality of these services (Dorning, 2016). The universal health program will significantly assist in eliminating the health disparities in the U.S. by ensuring that every resident can easily access quality care services on a timely basis and within the nearest health facilities. Such an effort enables an individual or family to seek health care services without discrimination, which may be based on numerous aspects such as socioeconomic status, gender, age, and geographical location.

Additionally, there is an urgent need to replace the fee-for-service model of payment because it undermines the quality of healthcare services provided while reimbursing the healthcare institutions and professionals based on the quantity of the services they perform. A pay-for-value model will be appropriate as the government will be reimbursing hospitals and healthcare providers, primarily based on quality rather than the volume of services (Pearl, 2015). The shift to a pay-for-value system will not only promote the appropriateness of care provided but will also considerably facilitate patients' outcomes and the overall population health status (Pearl, 2015). The new reimbursement model will encourage healthcare institutions to be more innovative and con-currently, providing affordable care. Also, the new model will enhance care coordination and facilitate affordable and quality care services because it pays the healthcare providers based on the health outcomes of the patients (Odland, 2015).

The U.S. health care delivery system must heavily invest in primary and preventative care, which seems to be neglected over time. This means that the government must increase its funding to ensure that it employs more healthcare providers, such as physicians, to serve the individuals even at the community level. The rolling out of universal health coverage will increase the number of people seeking health services hence the need for more physicians to meet the growing demand for quality care services (Dorning, 2016). The growth in the elderly population requires more healthcare providers to provide quality long-term care. Both primary and preventative care will be vital in detecting chronic illnesses at early stages instead of the late phases, hence improving the population's health status. Primary care professionals are significant in the community because they play an indispensable role in maintaining and promoting the health status of the people. The primary care providers have the responsibility of evaluating, monitoring, and treating the population (Merelli, 2019). Also, they have the mandate of assessing and preventing the emergence or rise of diseases or unhealthy conditions in the community, thus primarily focusing on preventative rather than curative care (Merelli, 2019).

In the management arena, it is known that an initiative or program is only controlled and regulated if it can be measured its effectiveness. Therefore, the U.S. healthcare delivery system must establish and sustain a national non-profit-making organization that will be given the mandate to carry out quality and cost-based assessment of healthcare providers and provide the accurate ratings in the various health markets (McClure, Enthoven, & McDonald, 2017). The organization will use a valid, reliable, and transparent methodology to collect and interpret data such that the consumers can understand the findings and ratings of healthcare providers. Also, this national organization will monitor and review the effectiveness of the overall CUHC program around the country. A uniform framework or methodology within specific markets will be embraced to bring a sense of fairness when comparing the ratings and performance of different providers in the given medical marketplaces (McClure, Enthoven, & McDonald, 2017). Regular measurement will be emphasized upon the implementation of the CUHC to detect whether it is working as anticipated and whether there is a need to make some adjustments (Leibbrandt & Botha, 2015).

Decreasing the Inflation Rate for Healthcare Spending

The adoption of universal health insurance coverage will stand as one of the critical pillars of reducing the high healthcare spending experienced in the U.S. economy. The use of a single-payer approach depicts that the U.S. government will be in a position to control and regulate the pricing of healthcare services (Dorning, 2016). Such a move would ensure that healthcare spending in an economy is reduced. The government will be responsible for paying the healthcare providers hence having the power to negotiate low costs and affordable care for its population (Merelli, 2019). Also, the implementation CUHC would ensure that individuals are prevented from incurring prohibitive out-of-pocket expenses as they are allowed to seek healthcare services at no charges.

High administrative costs serve as one of the reasons contributing to the skyrocketed healthcare expenditures in the U.S. (Dorning, 2016). Therefore, the move of replacing most of the insurance coverage with the CUHC will bring the healthcare expenditure down by reducing administrative costs such as those related to billing, which emerges while dealing with numerous insurance companies (Dorning, 2016). The CUHC will also emphasize on administration efficiency to ensure that healthcare spending is relatively affordable for the individuals and the government by large.

Moreover, the prescription of drugs has contributed to the high expenditure in the health arena. As the sole regulator and price-determiner, the U.S. government should utilize its influence to negotiate low prices for prescription medicines, and simultaneously purchase them in bulk to receive disco...

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U.S. Health Delivery Crisis: Escalating Costs & Limited Access to Quality Care - Essay Sample. (2023, Mar 16). Retrieved from https://proessays.net/essays/us-health-delivery-crisis-escalating-costs-limited-access-to-quality-care-essay-sample

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