Posted: March 23rd, 2023
Thesis Statement: Besides efforts made to deliver progressive healthcare in the United States, the elderly, unemployed, and low-income earners remain significantly under-represented due to inadequate government control and budgetary constraints.
The healthcare system has several challenges that can be managed through government commitment and collaborations with the private sector. It is necessary for the government to control the operations to encourage progressive insurance plans and improve service delivery.
The United States is one of the established nations in relation to infrastructural development. As one of the G20 countries and the world’s richest economy, it would be expected that its healthcare system is responsive to the needs of its citizens. However, the American healthcare system experiences methodological challenges that disenfranchise part of the population. The purpose of this paper is to discuss the U.S. healthcare systems to identify the systemic flaws or operational limitations, successes, and future projections. Although the U.S. is comparable with G20 nations based on infrastructural developments, its healthcare system is inadequate to meet the needs of special groups.
The industrial revolution era was characterized by workplace hazards, leading to a higher prevalence of accidents in the manufacturing sector. Employees’ unions advocated for various forms of sickness protection policies. A significant attempt to introduce health insurance was made by President Theodore Roosevelt in 1905 but did not succeed due to limited goodwill. In 1920, during the post-World War I, healthcare costs escalated when physicians and hospitals charged more than ordinary citizens could afford. The period of the great depression and World War II saw the introduction of employer-sponsored health insurance. The initiative was a motivation to mitigate the low wage and salary policy for workers. Besides several attempts to deliver progressive healthcare to the American people, the elderly, unemployed, and low-income earners remain significantly underrepresented due to inadequate government control and budgetary constraints.
Since 1910, U.S. healthcare policies have been the subject of divisive debates between government-owned facilities and private investors. However, the challenge of American systems to date has been based on medical health insurance for the working class, low-income citizens, and the elderly. President Bill Clinton’s policy on healthcare in 1993 sought to introduce a health security card that would guarantee a comprehensive package of benefits for both public and private partnerships (Rampell, 2009). Nonetheless, Clinton’s healthcare perspectives did not succeed due to fears of budgetary deficits and concerns about the autonomy of doctors over pricing systems. Budgetary allocation affects the implementation of a comprehensive healthcare system and should be addressed through effective legislation and political goodwill.
The U.S. government spends more on healthcare compared to other developed countries. However, little value to its citizenry has been recorded since child mortality and life expectancies are comparable to other developed nations (Cockerham, 2017). President Obama implemented the universal healthcare system in 2010, which was packaged as an economic stimulus model meant to benefit individuals under 65 years not covered by their employers and ineligible to government policy. Although the plan seemed successful during the preliminary implementation stages, opponents of the program have supported a free market-based plan. Therefore, the U.S. health system remains non-responsive to the comprehensive healthcare needs of the majority of citizens with no work-based or privately sponsored insurance packages.
Highly qualified professionals provide services to the American healthcare system. According to a survey published by the American Hospital Association (2018), 5,534 hospitals are registered in the U.S. with 4,840 community hospitals, 2,849 non-governmental and non-profit facilities, 1035 investor-owned, and 956 state or local government facilities. Other facilities include 209 federal government hospitals, 88 nonfederal psychiatric facilities, and 88 categorized under others (American Hospital Association, 2018). The categorization is based on AHA criteria for registration and ownership. Accordingly, Statista (2018) estimates the number of physicians in the U.S. as approximately 501,296 total specialties. They include psychiatry at 53,678, surgery at 51,927, anesthesiologists at 49,170, radiology at 46,965, and emergency medicine at 53,018 among several other specialties. Therefore, all those professionals consolidate their efforts to deliver effective healthcare services to the citizens.
Access to healthcare and quality health insurance remains a challenge. According to Cohen, Zammitti, and Martinez (2018), over 9.1 percent of Americans representing 29.3 million are uninsured. In a report published by the National Center for Health Statistics (NCHS) and authored by Cohen et al. (2018), 12.8 percent of adults aged between 18-64 years and 5 percent of children aged between 0-17 years were not covered under any health policy (Cohen et al., 2018). Accordingly, 136.6 million adults aged between 18-64 years have private health insurance cover. In addition, Cohen et al. (2018) reveal an increase of between 39.4 percent in 2016 to 43.7 percent in 2017 of the adults under the age of 65 years enrolled under the high-deductible health plan (HDHP). Although available data indicate an increase in health insurance plans, a significant population is yet to access the coverage due to operational limitations.
Poverty levels affect the enrollment rate, and hence, access to a comprehensive healthcare system. Cohen et al. (2018) reveal that among adult citizens aged between 18-64, 12.8% did not have health insurance coverage. In this group, 24.4 percent were near poor, while 23.8 percent were poor. Other significant contributors to low health coverage in the U.S. include the trends of race and ethnicity. It is estimated that a considerable number of Blacks and Hispanics have no health insurance plan in the U.S. For instance, Cohen et al. (2018) indicate that 14.1 percent of Hispanic black, 8.5 percent, and 7.6 percent of non-Hispanic white and non-Hispanic Asian respectively aged between 18-65 years did not have health coverage. Reports from various health stakeholders do not comprehensively address issues of race and ethnicity in the health insurance sector; hence, more research would be required to reveal the current trend.
Although the American healthcare system is criticized due to systemic failures, it has several positive attributes witnessed during its implementation. Firstly, the healthcare systems have an advantage of excellent professionals both in practice and in research, making it among the most competent sectors across the globe. Center for Disease Control and Prevention (CDC) has provided solutions to global health challenges due to its infrastructural capacity in research and development. Secondly, the American healthcare system is majorly controlled by the private sector, making it efficient with limited political influence (Cockerham, 2017). Thirdly, highly qualified and experienced physicians, nurses, and other ancillary professionals support the healthcare industry with quality services. The professionals operate in all levels of healthcare service provision from the primary healthcare phase to the consultant stages. Therefore, the U.S. government can enhance the healthcare system’s capabilities by improving and implementing related policies.
Despite the institutional capability and economic power of the U.S., the healthcare system experiences several challenges. Firstly, the ineffective oversight and limited control of the government limit the access to care and service provision for citizens. Secondly, since more than 30 million Americans are not covered, their access to healthcare is challenged by high costs, making the entire system non-responsive to their health needs. Thirdly, high competition between hospitals and physicians interferes with service delivery (Cockerham, 2017). Given that the U.S. has such global influence and economic prowess, it has to develop efficient measures, mitigate weaknesses, and deliver effective and comprehensive healthcare for its citizens.
The future of the American healthcare system is likely to be defined and influenced by technology. The developments witnessed through medical innovations, especially disruptive technology, are expected to gain control of the healthcare system (Cockerham, 2017). For example, the sensor technology can help to gain data related to different organs’ states and address symptoms promptly. The growth of telemedicine might replace the need to visit a health facility. Notably, the intense expectation for nurses and clinical staff to offer service for inpatients at night is expected to improve through the adoption of healthcare robotics. The robots are programmed to deliver drugs and offer the right doses devoid of human limitations, such as weaknesses in judgments. Remote monitoring is also expected to improve efficiency in complicated procedures, including organ transplants and stem cell technology. Therefore, the system is projected to experience improved development through the adoption of medical technology.
The current healthcare system in the U.S. has not been effective due to its inability to meet specific and essential health needs. Poverty levels, ethnicity, and race-based discrimination limit the achievement of comprehensive care for the citizens. As an essential basic service, health should attract the government’s attention since it affects all citizens and the county’s economy. Therefore, it is significant to mainstream the issues of comprehensive healthcare, especially for individuals without health insurance plans. The government should also endeavor to acquire reasonable control of health services to protect citizens from exploitation by the private sector.
American Hospital Association. (2018). The American Hospital Association conducts an annual survey of hospitals in the United States. The data below, published in 2018, are a sample from the 2016 AHA Annual Survey (FY 2016): Facts on U.S. hospitals, 2018. Advancing Health in America. Retrieved from https://www.aha.org/statistics/fast-facts-us-hospitals.
Cockerham, W. C. (2017). Medical sociology (17th ed.). New York, NY: Taylor & Francis.
Cohen, A. R., Zammitti, P. E., & Martinez, E. M. (2018). Health insurance coverage: Early release of estimates from the National Health Interview Survey 2017. Division of Health Interview Statistics, National Center for Health Statistic. Retrieved from https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201805.pdf
Rampell, C. (2009). Bill Clinton on health care, 1993. The New York Times. Retrieved from https://economix.blogs.nytimes.com/2009/09/09/bill-clinton-on-health-care-1993/
Statista. (2018). Number of active physicians in the U.S. in 2018, by specialty area. Statistica Portal. Retrieved from https://www.statista.com/statistics/209424/us-number-of-active-physicians-by-specialty-area/
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