An efficient healthcare system is well-coordinated, cost-effective, efficient, and patient-centered. Countries need to invest in their health care system to ensure quality provision of healthcare services. A well-coordinated healthcare system with excellent healthcare services delivery is exhibited by the country's healthcare outcome measures such as reduced mortality rate and increased life expectancy. The United States has tried to improve its health care system by enhancing the quality, cost reduction, and enabling healthcare accessibility to all the United States citizens. The country has also established and implemented healthcare policies to improve the healthcare delivery system. However, as much as the United States has improved and advanced healthcare systems, some loopholes and inefficiency still exist. I will outline an overview of the healthcare systems, the Affordable Care Act in the USA, and recommend possible interventions where weaknesses exist.
Overall Overview of the USA Healthcare System Based on My Perception
The United States' healthcare delivery system is quite efficient as most healthcare providers are competent and highly skilled in their fields. It also applies advanced technology, thus, ensuring accurate and improved diagnostic and treatment processes. Research done by Ridic et al. (2012) concluded that the USA healthcare system was well equipped with advanced technological devices resulting in a high life expectancy and an increased life span compared to other developed countries like Germany and Canada. A clear example can be drawn from the most current health crises that faced the USA prompted by the coronavirus pandemic. The state was adversely affected by the novel coronavirus pandemic. However, regardless of the high number of coronavirus patients, the healthcare system strived to ensure that it accommodated many patients who suffered fatal complications prompted by the coronavirus. Furthermore, those who exhibited minor symptoms received treatment at home, and the healthcare providers followed their progress and offered medical help where appropriate until they recovered fully. Based on the way USA healthcare delivery tried to handle the overwhelmed number of coronavirus patients, although it was a sudden outbreak, it is evident that the system is well equipped and structured, although the maximum potential is not yet achieved.
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However, the American healthcare system possesses substantial weaknesses that negatively affect healthcare services delivery processes. One primary weakness in the USA healthcare system is high medical costs (Overview of the American healthcare system, 2020). The United States spends medical costs twice per person on healthcare provision compared to other developed countries. Every year, the country spends over seventeen percent of its total GDP on the healthcare system. The issue of controlling health costs in the country is still an issue, although Ridic et al. (2012) argued that the cost has been reducing over the recent years. The inability to control costs can be associated with poor coordination and management of the general healthcare system.
Additionally, the USA government system has failed to provide broad national coverage of health insurance. The insurance is purchased from private commercialized institutions, which is quite expensive to a substantial population percentage. Based on Ridic et al. (2012) research, forty-two million US citizens do not have health insurance. This finding depicted weakness in the USA healthcare system. As exhibited in the report by Berchick et al. (2019), about twenty-seven million people were still uninsured. Consequently, the majority of the population below the poverty line finds it difficult to access medical services. Furthermore, the patient family’s finances are subjected to uncertainty, making it hard for the family below the poverty line to improve and cross-over the line.
I have encountered the repercussion of lacking a health insurance coverage due to an encounter that occurred to a close family member. The victim was uninsured, and he needed urgent major brain surgery. The surgery was costly, and the hospital would not operate on him without payment. We had only one option as a family, to contribute our resources for the surgery. Consequently, the majority of family members experienced financial constraints. This scenario drove me to reflect on our healthcare system. I felt that our healthcare system was inefficient; therefore, it needed improvement. In my perception, I think it is paramount for the government to ensure that all US citizens can access public health insurance.
Personal Review on the Affordable Care Act
The enactment of the Affordable Care Act (ACA) in 2010 offered hope to the American citizens on matters concerning health service accessibility. ACA pertained to three significant objectives: reducing healthcare costs, increasing the number of insured, and ensuring quality healthcare (Manchikanti et al., 2017). One of ACA's main objectives was to ensure that all American citizens could access quality health services by eliminating barriers that caused medical services' inaccessibility. The main obstacle was the lack of health insurance. Therefore, ACA aimed to provide numerous affordable insurance protections. Based on my opinion, ACA remarkably transformed the healthcare system. It managed to reduce the number of uninsured American citizens. The number of uninsured citizens dropped from 18% to 11.9% from 2013 to 2015 (Borelli et al., 2016). The majority of the low-income earners and the disabled in America could acquire health coverage through Medicaid programs through ACA implementation.
However, as an ACA consumer, I do not feel like the Act has successfully implemented and achieved its set standards. I think that the costs are still high and unaffordable to a notable population percentage. The Act has created a disparity in the provision of health services. For instance, the middle class and the working population, notably those who earn more than 400% of the federal poverty level, have been denied any financial help in accessing health care services (Manchikanti et al., 2017). Additionally, the efforts to achieve the ACA goal of providing quality care services have done more harm than good because more government entities and bodies have been established to regulate and oversee the hospital performance.
Consequently, the regulatory and compliance costs have escalated rapidly, prompting private hospitals' closure whose financial status cannot meet the compliance and regulatory costs. Furthermore, hospitals have decreased the number of employees to save extra fees to pay for compliance and regulations. As a result, quality service is not guaranteed. Based on these facts, I believe the Act has done more harm than good to American healthcare.
President Obligation Toward ACA
The enactment of ACA was based on the United States citizens’ good interest. It evident that ACA's primary agenda revolved around improving healthcare services and the system. However, implementation strategies have done more harm to the USA healthcare system. In this regard, I think the newly elected president should address, revise, and push various reforms to ensure that ACA achieves the initial objectives. I believe that with proper strategies to implement and revise ACA policies, the Affordable Care Act can still be used as a tool to improve America’s healthcare system and services.
For instance, the president should push for reforms advocating for fewer government entities responsible for overseeing the quality provision of healthcare services. Currently, there are several government bodies to oversee quality provision prompting increased costs; consequently, some hospitals end up closing down due to the inability to cater to the escalated costs. Hospital closures lead to diminished healthcare services accessibility. I believe that a well-coordinated single regulatory entity can correctly govern healthcare institutions to ensure quality services provisions. Additionally, the Medicaid program does not provide help with healthcare costs to all US citizens portraying inefficiency in the US healthcare system. . The program appears to be discriminative to particular individuals, notably ones suffering from chronic illnesses and those in the Medicaid gap. In Medicaid cost provision programs, people who earn less than 100% of the federal poverty level in states that have not incorporated Medicaid expansion do not receive help with healthcost (Borelli et al., 2016). These people are also not eligible for marketplace subsidies because their income is too low but too high for Medicaid, resulting in many uninsured adults in the USA. The Medicaid cost provision programs need to be reviewed and appropriate reforms formulated to solve the Medicaid gap problem.
Personal Thoughts on the Current Healthcare System in the USA
The current health care system in America is not well coordinated, thus explaining the inability to control costs; subsequently, the citizens have to pay more to receive healthcare services. The system has not achieved its objective on the provision of healthcare services at a reduced fee. Various weaknesses need to be addressed to fix the system and ensure that the entire system operates efficiently. However, since the Affordable Care Act enactment, there has been slight improvement in the US healthcare system.
Summary
In summary, the US healthcare system has strived to provide better healthcare services by employing competent health care service providers, investing in advanced technology, and enacting healthcare bills and programs. However, the healthcare system's weaknesses include high-cost healthcare services and inequality in health insurance protection provision. The Affordable Care Act was enacted to improve the US healthcare system, and it contributed significantly to transitioning and improving various aspects of the system. For instance, the Act advocated for an increased number of insured US citizens. Unfortunately, the Act also failed to achieve most of its objectives, including reducing healthcare costs and providing quality care services. However, I still believe that with proper strategy implementation and various revisions on ACA, it can be a vital tool to improve the USA healthcare system.
References
BERCHICK, E., BARNETT, J., & UPTON, R. (2019). Census.gov https://www.census.gov/content/dam/Census/library/publications/2019/demo/p60-267.pdf .
Borelli, M., Bujanda, M., & Maier, K. (2016). The Affordable Care Act Insurance Reforms: Where Are We Now, and What is Next? Clinical Diabetes , 34(1) (4714719), 58-64. https://doi.org/10.2337/diaclin.34.1.58
Manchikanti, L., Helm Ii, S., Benyamin, R., & Hirsch, J. (2017). A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few. Pain Physician , 20(3) (28339427), 111-138.
Ridic, G., Gleason, S., & Ridic, O. (2012). Comparisons of Health Care Systems in the United States, Germany, and Canada. Materia Socio Medica , 24(2) (3633404), 112–120. https://doi.org/10.5455/msm.2012.24.112-120
Overview of the American Healthcare System . Sphweb.bumc.bu.edu. (, 2020). Retrieved 27 October 2020, from https://sphweb.bumc.bu.edu/otlt/MPH-Modules/HPM/AmericanHealthCare_Overview/AmericanHealthCare_Overview_print.html .
