The American healthcare model is an excellent example of a market-based system. In comparison to other healthcare systems in other dominant European nations, the one in the US ranks lowest where low-quality care is concerned. Furthermore, while the healthcare models in the former offer governmentally centralized care, the one in the latter is rather decentralized and functions on a contractual basis, mostly between private insurance companies, medical organizations, as well as medical professionals and patients. According to Ngafeeson (2015), labor income, which is offered by the private sector is the primary source of funding for the US healthcare system. Irrefutably, the recent economic crisis has negatively affected this system more than it has other European models. The significant levels of unemployment have reduced the number of insured individuals while the economic recession has compelled employers to reduce health coverage for workers who have been retained. Therefore, there is a dire need to reform this system to ensure that the healthcare goals set in each medical institution are successfully attained.
The proposed healthcare reform is anticipated to foster the provision of health coverage for all uninsured American citizens. It is also expected to reduce the costs of medical services and coverage, making healthcare services more cost-effective and available to each American citizen, regardless of whether they are insured or not. Finally, the implementation of the proposed changes will undeniably augment the quality of healthcare services, improving the health of many individuals in the society.
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Health Care System Comparative Analysis
An analysis and comparison of non-US healthcare systems which have succeeded in making medical services not only cost-effective but available to all enable one to determine the specific changes that should occur in the US healthcare system. Canada and Germany are examples of some of these systems. The main similarity between the healthcare systems in these two nations is that they both cover the entire populations in these nations. In detail, the government of Canada runs a Universal insurance system known as NHI, which ensures that everyone enjoys various health benefits. A single taxpayer system is also adopted, and general taxes are used to finance the program (Liu & Brook, 2017). Canada’s system is referred to as Medicare, which is quite distinctive from the US Medicare for the elderly. It is compulsory health insurance which not only covers a specific population segment such as in the case of the US but everyone regardless of their age.
The insurance plan caters for both the costs of hospitalizations, as well as the services offered by physicians, which differs from the US system, which relies heavily on private financing and delivery. Patients are generally exempted from the reimbursement process, which exclusively involves the government, which is the public insurer and healthcare providers. There is no monetary exchange between patients and healthcare providers. Each Canadian province has a ministry of health which controls healthcare costs. According to Ridic, Gleason, and Ridic (2012), fixed global budgets and predetermined physician salaries are used to achieve cost control. Frequent negotiations occur between the health ministry and the provincial medical associations to determine the salaries that physicians should receive for certain services. No additional fee, aside from the predetermined physician fee, is imposed on patients.
Germany operates on the principle of social insurance. Just like Canada, Germany is also divided into provinces, sixteen to be exact, each with the same level of independence on matters pertaining to health. The system ensures that the entire population has access to healthcare. It is also mandatory for every citizen to have an insurance cover. However, individuals who earn less than thirty-five thousand dollars are required to join sickness funds for their coverage. These refer to private insurance corporations which are responsible for gathering premiums from workers and their employers (Ridic, Gleason, & Ridic, 2012). Citizens who earn more than the previously stated amount have the freedom to choose private insurance. The German system is highly similar to the one in the United States. In detail, self-governing insurers, large employee groups, and healthcare providers reach agreements without any government involvement. Just like the US, the German system also relies on a mandated approach in which it is mandatory for various medical conditions to be covered as stipulated by the law (Ridic, Gleason, & Ridic, 2012). The Canadian system is different from these two since the government is directly involved in the healthcare system.
The rationale for the Proposed Change
The US should adopt a universal, single-tier health service. The system would ensure that every citizen enjoys vast medical benefits based on need, as opposed to income. The success of this plan is contingent on changes regarding the manner in which the US healthcare system is financed. According to Mukherjee et al. (2019), the nation would be able to raise healthcare revenues through taxation, private health insurance, and out of pocket expenditures. Furthermore, Universal Health Insurance (UHI) would ensure that all American citizens are insured for the same package of medical services, decreasing the existing health disparities. UHI will ensure that every American citizen, regardless of their age, ethnic background, and employment status, among others, accesses quality and affordable healthcare services.
The single-payer system is also recommended due to its perceived role in reducing healthcare expenditures. Additionally, a purchaser-provider split should also be adopted because it also fosters effective control of healthcare expenditures. Just like Canada, the US should also involve the government in its healthcare system. Concurrently, effective decisions regarding the fee that physicians should receive for the services they offer would be expertly made. Policies that inhibit physicians for imposing extra charges on patients for the services they have provided, aside from the stipulated fee should also be developed.
Financial and Health Implications
The UHI approach will significantly decrease health care costs in the US. The US government will have control over the price of medical services and drugs via negotiation and regulation. Generally, the approach will force physicians to offer similar standards of service at significantly low prices. Furthermore, UHI will make preventative care more accessible to American citizens, improving the overall of individuals in the community, by ensuring that various medical conditions such as cancer are identified during their initial stages (Mukherjee et al., 2019). Concurrently, this would enable individuals to save the vast amounts of money that they would otherwise spend treating the disease when it has progressed. Despite these benefits, UHI will lead to the neglection of education infrastructure since most of the funds will be allocated to the health sector.
If the US fails to implement these changes, then the rates of mortality are likely to increase, especially among the poor and unemployed, since they are unable to access medical covers. The prevalence conditions such as cancer necessitate the accessibility to medical services. Furthermore, the present system also makes preventative care inaccessible to the poor (Mukherjee et al., 2019). The increase in the number of sick individuals will also put pressure on the government, forcing it to allocate significant amounts of capital to the health sector. Irrefutably, it will incur high losses and forego substantial investments in areas such as education, transport, and infrastructure. Health deterioration leads to the unavailability of human labor, which negatively affects a country’s economic growth.
Conclusion
The US healthcare system has increased health disparities between the wealthy and the poor. The system relies heavily on private insurance corporations, and those who cannot afford health insurance coverage are unable to access quality care. The health of most individuals in American society has, therefore deteriorated considerably. It is imperative for the universal health insurance coverage to be adopted, to make medical services more accessible to all American citizens.
Appendix
Table 1: Health Care System Comparative Analysis
| Outcomes | [Health Care System 1] | [Health Care System 2] | [the U.S. Health Care System] |
|---|---|---|---|
| Ensures that everyone enjoys various health benefits. | Canadian Health System | German Health System | US Health System |
| Decreased health disparities | Exempts patients from the reimbursement process, which is reserved for the government and health care providers (Ridic, Gleason, & Ridic, 2012). | Every citizen has an insurance cover. | The government is not involved in the healthcare system. |
| Accessibility to preventative care. | Taxation is the main source of healthcare revenue. | Those who earn less than thirty-five thousand dollars (Ridic, Gleason, & Ridic, 2012) annually are required to join sickness funds for their coverage. | Focusses more on income, as opposed to healthcare need. |
References
Liu, J. L., & Brook, R. H. (2017). What is Single-Payer Health Care? A Review of Definitions and Proposals in the US. Journal of general internal medicine , 32 (7), 822-831.
Mukherjee, J. S., Mugunga, J. C., Shah, A., Leta, A., Birru, E., Oswald, C., ... & Atun, R. (2019). A practical approach to universal health coverage. The Lancet Global Health , 7 (4), e410- e411.
Ngafeeson, M. N. (2015). Healthcare information systems opportunities, and challenges. In Encyclopedia of Information Science and Technology, Third Edition (pp. 3387-3395). IGI Global.
Ridic, G., Gleason, S., & Ridic, O. (2012). Comparisons of health care systems in the United States, Germany, and Canada. Materia socio-medica , 24 (2), 112.
