Out of all of the health care systems in the developed world, the United States has been consistently underperforming in services, while managing to overspend. In a study done by the Common Wealth Fund, “[t]he U.S ranks last in Access, Equity, and Health Care Outcomes, and next to last in Administrative Efficiency.”
Obamacare should be credited for its positive impacts, for instance in the provision of preventive care, ensuring a list of 10 basic health services were provided, increasing the age children may stay on their parents plan as beneficiaries, and tax credits for mid-to-low-income earners. But it still missed the mark in making substantive, sustainable changes to the country’s system. And there are a good number of reasons why, which extend deep into the foundation of private, protected interests.
A Global Glance at Health Care
Ranking systems that examine the efficiency of health care around the world look at various factors including the rights of patients, wait times, and focus on prevention. It does not just take into consideration the number of people who have access, but the quality of the care that is given, and the efficiency to which it is provided.
Healthcare is funded through two primary avenues: through the government, or through private insurers. There is not a clear-cut answer for which is the best avenue, but the U.S is using a confusing combination of both methods, and it has not only proved to be an inefficient system, it is a very expensive one as well. In fact, the U.S spends more on healthcare than the UK does, and yet the UK ranks the highest in the world for health care in the developed countries while the U.S was listed as the worst.
If you’re wondering how the UK funds their health care, it is done through the government. But that is not the reason why it works. The Netherlands is another top-ranking country, and it, like the US, uses a combination of government and private insurers. The government provides a level of insurance that is managed by private insurance companies, but there are laws in place to ensure citizens are given proper coverage. There is an option to pay for more coverage, and if you are a low-income earner, you can apply for funding to receive extra benefits. They also make it mandatory for all citizens to have some health insurance coverage, which is a sobering comparison against the U.S who currently has 28 million who are uninsured.
The answer for affordable healthcare is therefore not simply a matter of government funded or private. If you examine the top-ranking systems, the common thread seems to lie in efficiency, genuine government interest in the welfare of its citizens, and solid primary care system.
Doctors and Big Pharma
Doctors can prolong their appointments to charge insurance companies more money, the billing systems, which should be straight forward, are a convoluted maze that includes an excess number of documents, and there is no standardized method of payment across insurance providers.
Reducing insurance providers, like under the Affordable Healthcare Act, is not necessarily the answer, though, as competition breeds competitive prices, while a monopoly encourages higher prices. But, the counter-debate to this argument, or a debate over how many companies is the ideal number to provide fair competition, may be misguided, as well. This is because, as countries like the Netherlands show, laws are needed to be put in place by the government in order to protect citizens from taking the financial burden caused through exploitation by privately-owned insurance companies.
Then comes Big Pharma, who makes approximately $460 billion annually on the sale of medication. This number becomes even more staggering when you consider that other countries spend approximately 56% of this (on the same medication!). Meaning this expenditure burden placed on American citizens is actually unnecessary and, some would argue, at best ethically questionable. Then there comes the loss of wages due to illness, which totals $1.5 trillion – and sick people need to see doctors, and require medication (and access to proper nutrition, which is a different topic entirely).
The cycle of the U.S health care system is therefore focused on monetary gain rather than actually caring for the health of citizens.
A Route for a Solution Requires Very Real Accountability
The government needs to be pro-actively and genuinely involved in making medical and pharmaceutical costs transparent. In other words, the interest needs to be rerouted to the care of citizens for any real and sustainable positive change to be felt by those currently at the mercy of a convoluted and financially draining system. Rather than adding systems onto the existing ones, and encouraging medical professionals to take advantage of them, creating a reliable system upon which claims are made, and money for health care expenses is allocated means certain people within the chain cannot profit from citizens vulnerability.
Big Pharma needs to take a backseat. It is no secret that they have a massive stake and influence in how the federal government creates and votes on policies and legislation, and profits on unprecedented levels because of it. An example covered by Global Research shares the example of Merck’s medication Vioxx, which killed over 60,000 people and injured an additional 130,000, with no immediate FDA recall. The company profited $18 billion (from a medication that was known to be defective), and their penalty rang in at $5 billion. Citizens are spending huge money – and often finances they do not have – not only on overpriced medical care but on medication that puts their life further at risk.
The lack of cohesion in the health care system means every case that goes into a doctors’ office or hospital is done on an individual basis, rather than a standardized process. This is not just stressful for individuals when they require medical attention (which is never a time anyone wants to have additional stress placed on them), but the paperwork, the time needed for nurses and offices to go through each case, is massively burdensome on administration throughout each level of the process. There are so many players involved, from the federal, state, and local levels and insurance companies. It has been estimated that between 15-30% of healthcare spending in the U.S goes toward billing, insurance-related, and administrative costs. Plus, it’s important to consider that along with bloated administration processes will come a high number of claim resubmissions, compounding this administration burden.
A Route for a Solution
Make laws and standardize protocols. The government needs to step up and put laws in place, with heavy penalties like the Netherlands has, that are aimed at protecting the interests of citizens. All countries have a responsibility to care for the health and safety of its citizens, and a developed country such as the U.S should not be leeching funds from its vulnerable members. Make a standard protocol across all insurance companies to ensure claims are submitted with ease and accuracy, which will lift the burden of paperwork from the individual to the local health-care facility and up. Standard protocols will then allow for transparency of processes, including laws and standards, which is important to protect the interests of American citizens.
Making affordable healthcare actually affordable is not as shallow as standardization of procedures. It means acknowledging the need for a complete overhaul on the internal structures and interests behind how health care is currently being allocated. Until then, any shifting of tasks or funds across various sectors won’t do anything for making sustainable, long-term changes.