Question

The major issues of the health care system in the United States are the cost of health care, access to health care and quality of health care.

In a minimum of 250 words list and explain an example of each of the 3 major issues.

Answer 1

Health care is extremely costly in the United States. Although the rate of growth in spending has attenuated in recent years, per capita spending on health care is estimated to be 50 to 200 percent greater in the United States than in other economically developed countries.Despite leading the world in costs, however, the United States ranks twenty-sixth in the world for life expectancy and ranks poorly on other indicators of quality.

Evidence of the low value of United States health care has led researchers to try to identify specific sources of wasteful spending. Many of these efforts have evaluated regional variation in spending patterns,particularly Medicare spending within the United States. By finding that regional variation in spending is not generally correlated with patient outcomes,suggesting that some regions’ practices were not cost-effective, this literature captured the attention of policymakers and sparked public and private sector proposals to reduce unwarranted variation in treatment. Recent evidence suggests, however, that higher-intensity care may, in fact, improve patient outcomes, calling into question how much we stand to gain by reducing “waste” in health care spending.

Other problems in the quality of medical care also put patients unnecessarily at risk. We examine three of these here:

Sleep deprivation among health-care professionals.

Many physicians get very little sleep. Studies have found that the performance of surgeons and medical residents who go without sleep is seriously impaired. One study found that surgeons who go without sleep for twenty-four hours have their performance impaired as much as a drunk driver. Surgeons who stayed awake all night made 20 percent more errors in simulated surgery than those who slept normally and took 14 percent longer to complete the surgery

Shortage of physicians and nurses.

Another problem is a shortage of physicians and nurses .Proposals to cut federal deficit would worsen physician shortage, medical groups warn. This is a general problem around the country, but even more of a problem in two different settings. The first such setting is hospital emergency rooms. Because emergency room work is difficult and relatively low paying, many specialist physicians do not volunteer for it. Many emergency rooms thus lack an adequate number of specialists, resulting in potentially inadequate emergency care for many patients.

Rural areas are the second setting in which a shortage of physicians and nurses is a severe problem. Many rural residents lack convenient access to hospitals, health care professionals, and ambulances and other emergency care. This lack of access contributes to various health problems in rural areas.

Mistakes by hospitals.

Partly because of sleep deprivation and the shortage of health-care professionals, hundreds of thousands of hospital patients each year suffer from mistakes made by hospital personnel. They receive the wrong diagnosis, are given the wrong drug, have a procedure done on them that was really intended for someone else, or incur a bacterial infection.An estimated one-third of all hospital patients experience one or more of these mistakes

A related problem is the lack of hand washing in hospitals. The failure of physicians, nurses, and other hospital employees to wash their hands regularly is the major source of hospital-based infections. About 5 percent of all hospital patients, or 2 million patients annually, acquire an infection. These infections kill 100,000 people every year and raise the annual cost of health care by $30 billion to $40 billion.

Medical Ethics and Medical Fraud

A final set of problems concerns questions of medical ethics and outright medical fraud. Many types of health-care providers, including physicians, dentists, medical equipment companies, and nursing homes, engage in many types of health-care fraud. In a common type of fraud, they sometimes bill Medicare, Medicaid, and private insurance companies for exams or tests that were never done and even make up “ghost patients” who never existed or bill for patients who were dead by the time they were allegedly treated. In just one example, a group of New York physicians billed their state’s Medicaid program for over $1.3 million for 50,000 psychotherapy sessions that never occurred. All types of health-care fraud combined are estimated to cost about $100 billion per year

Other practices are legal but ethically questionable. Sometimes physicians refer their patients for tests to a laboratory that they own or in which they have invested. They are more likely to refer patients for tests when they have a financial interest in the lab to which the patients are sent. This practice, called self-referral, is legal but does raise questions of whether the tests are in the patient’s best interests or instead in the physician’s best interests.

In another practice, physicians have asked hundreds of thousands of their patients to take part in drug trials. The physicians may receive more than $1,000 for each patient they sign up, but the patients are not told about these payments. Characterizing these trials, two reporters said that “patients have become commodities, bought and traded by testing companies and physicians” and said that it “injects the interests of a giant industry into the delicate physician-patient relationship, usually without the patient realizing it” . These trials raise obvious conflicts of interest for the physicians, who may recommend their patients do something that might not be good for them but would be good for the physicians’ finances.

Private Health Insurance and the Lack of Insurance

Medicine in the United States is big business. Expenditures for health care, health research, and other health items and services have risen sharply in recent decades, having increased tenfold since 1980, and now costs the nation more than $2.6 trillion annually. This translates to the largest figure per capita in the industrial world. Despite this expenditure, the United States lags behind many other industrial nations in several important health indicators.

An important reason is the US system of private health insurance. As discussed earlier, other Western nations have national systems of health care and health insurance. In stark contrast to these nations, the United States relies largely on a direct-fee system, in which patients under 65 (those 65 and older are covered by Medicare) are expected to pay for medical costs themselves, aided by private health insurance, usually through one’s employer."Health Insurance Coverage in the United States, 2010" shows the percentages of Americans who have health insurance from different sources or who are not insured at all. 54 percent of Americans have private insurance, either through their employers or from their own resources. About 29 percent have some form of public insurance (Medicaid, Medicare, other public), and 16 percent are uninsured. This final percentage amounts to almost 50 million Americans, including 8 million children, who lack health insurance

Their lack of health insurance has deadly consequences because they are less likely to receive preventive health care and care for various conditions and illnesses. For example, because uninsured Americans are less likely than those with private insurance to receive cancer screenings, they are more likely to be diagnosed with more advanced cancer rather than an earlier stage of cancer. Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites. It is estimated that 45,000 people die each year because they do not have health insurance.