Health care costs began to rise rapidly in the 1960s, as more Americans became insured and demand for health care services increased. Health care costs have also increased due to preventable diseases, including complications related to nutrition or weight problems. Nowadays, all it takes is a surprise medical bill to bankrupt a patient. So what exactly does healthcare do in the U.S.
UU. So expensive? Health insurance prices? Government regulation or lack of it? The pharmaceutical industry? TMRW spoke with experts about different aspects of the health system, who identified five general reasons:. The most important reason is that the U.S. Health care is based on a for-profit insurance system, one of the only ones in the world, according to Carmen Balber, executive director of Consumer Watchdog, which advocates reform in the health insurance market.
In the U.S. UU. ,. On the contrary, many other countries have some element of something private, but there is this basic understanding that health care is a right, not a privilege, Balber said.
The underlying motive for making money has a domino effect that increases prices, he continued. For example, insurance companies spend an enormous amount of money reviewing utilization, the process that determines if a medical service is covered by a given plan, and add that the goal is not to pay consumers for care they thought they were insured. Similarly, Dr. Georges Benjamin, executive director of the American Public Health Association, pointed to the lack of universal health care, in which access is guaranteed to all without having to go through financial difficulties, as one of the main reasons for the high costs.
Health care exists in a system where patients are charged based on the services they receive, another reason why almost everything is more expensive here, Dr. Harlan Krumholz, cardiologist and professor of health policy at the Yale School of Medicine, told TMRW. As a result, there is less use of primary care, Benjamin said, because the pay-for-service model encourages overutilization. Balber argued that fee-for-service creates a perverse incentive to offer more procedures, rather than helping patients be healthier, so the country as a whole needs fewer procedures.
It also spends less than other countries on social support systems and long-term care, Benjamin added. For example, a recent study found that private insurance companies paid almost two and a half times more than Medicare would have paid for the same medical service at the same facility. To make things more expensive, the U.S. The government doesn't regulate what most companies in the health sector can charge for their services, whether it's insurance, medications, or care itself.
The health system itself can be fragmented; in many parts of the country, there are only one or two companies offering health insurance or medical care. This means that, once again, there is little or no incentive for them to reduce costs, as patients don't have many options. In addition, healthcare providers are paid, on average, much more in the U.S. As in other countries, both Benjamin and Krumholz stood out.
This finding provides a new explanation for why U.S. spending is so excessive. According to researchers at Harvard's Chan School, what sets the U.S. In addition, prices may be inflated in all areas.
Hospital services and diagnostic tests cost more. And much more money is spent on the planning, regulation and management of medical services at the administrative level. In other areas, despite the general opinion, there seems to be less discrepancy between the United States, the United States. And other countries than is commonly thought of.
Experts previously suggested that high utilization rates could explain high spending in the U.S. . It's not that different compared to other countries. In fact, compared to the average in all countries, Americans seem to go to the doctor less often and spend fewer days in the hospital after being admitted.
Expert groups such as the Brookings Institute have suggested that low social spending could also be partly to blame, since funding programs to help low-income families, the elderly and the disabled would mitigate the demand for health care. But, again, the researchers found no substantial difference in the U.S. Spend less than average, but not much. Another popular argument is that the US system has an unnecessarily high number of specialists, who generally earn more than general practitioners, and that increases costs.
The real difference between the U.S. health system and systems abroad is pricing. Meanwhile, administrative costs accounted for 8 percent of total national health spending in the U.S. For the other countries, they ranged from 1 percent to 3 percent.
Health professionals in the United States also reported a higher level of administrative burden. A survey showed that a significant portion of doctors consider that the time they waste due to issues related to insurance claims and the presentation of clinical data is a major problem. Even so, they conclude, it is not clear whether innovation justifies high levels of spending. In terms of wages, high incomes can boost performance, and studies have suggested that some countries don't pay their health professionals enough.
In addition, high wages in the U.S. It may reflect the time and larger amounts of money that American health professionals must invest in their education and training. In general, researchers believe that prices in these areas should be analysed and reduced whenever possible. “It continues to struggle with high spending on health care, and it's critical that we make progress in reducing these costs,” said author Irene Papanicolas, visiting assistant professor in the Department of Health Policy and Management at Harvard Chan School.
One of the most notable findings of this report is that, at least in some areas, the quality of healthcare in the U.S. Long waiting times for treatment, for example, aren't as much of a problem for Americans as they are elsewhere. When treating heart attacks and strokes, the U.S. In fact, it had the best record of any country.
Therefore, contrary to previous findings, the quality of care may not be much worse in the U.S. However, it has still been proven that the nation's health system is the least accessible. According to the report, an estimated 22 percent of the population has missed a consultation because they couldn't afford it, compared to an average of 11 percent in the eleven countries. The percentage of the population with health insurance has increased since the Affordable Care Act was passed, according to the report.
Even so, a substantial proportion of people would benefit from coverage but would still be uninsured in the U.S. The report sheds a new view on how the U.S. The health system compares with its peers, and the fact that the cost of labor, pharmaceutical products and administrative organization seems to be driving spending. It also points out that, despite that level of spending, too many of its citizens are still uninsured and uncovered.
While legislation signed by the president influenced the continued growth in healthcare spending, the ACA is not solely responsible for this unsustainable trend. All stakeholders, including providers, health insurers, pharmacies, federal and state governments, patients, and others, have a financial interest in the healthcare business. In a country founded on capitalism, where competition accelerates innovation and reduces costs in virtually every other sector of the economy, it makes sense that the United States could maintain a health system based on the same principles. However, that theory has not been true in practice.
While virtually all stakeholders that contribute to the U.S. healthcare system. they do so with the primary goal of helping patients and improving healthcare outcomes, their parallel goal of obtaining benefits (a totally reasonable expectation) has often added unintended consequences and costs to an already complex system. It's no secret that the nation's health care system needs reform.
Today, families face rapidly rising insurance premiums and out-of-pocket expenses, making it difficult for many people to buy care. Whether measured per person or as a part of national income, the country's healthcare spending dwarfs what other countries spend. And, what's worse, costs are rising. An increasing proportion of workers' salaries are being spent on health insurance premiums.
There are several underlying factors that can increase price and utilization, increasing healthcare spending. The gap between patient perception and actual healthcare spending is due to the fact that patients often pay a disproportionate share of the cost of medications compared to other healthcare expenses. This dynamic, which doesn't reward patients for being responsible for their health and isolates them from the true cost of health care, is starting to change, but without the expected positive outcomes. The United States is the only for-profit healthcare system in the world, and it is perhaps no coincidence that this country also has the most expensive healthcare of all countries.
Prices are another important factor in healthcare spending in the United States; the cost of health services generally grows faster than the cost of other goods and services in the economy. Since people age 65 and older, on average, spend more on health care than any other age group, the increase in the number of older Americans is expected to increase total health care costs over time. The payer administration acts as an agent for consumer protection, but budgetary restrictions and rapid increases in healthcare spending have highlighted financial concerns. Patients are the central figures of any health system and, although they are often victims of misaligned incentives, they also have some responsibility for rising costs.
This complex and convoluted mess caused by misaligned incentives has led many experts to declare the capitalist experiment in health a failure and to advocate for a public option or a single-payer system. .