What determines the best healthcare system is how much the country spends in the quality of the health care provided and what are the outcomes of that spending. Moreover, it depends on the availability of healthcare services and obviously how effective it is at keeping the country’s populous healthy. At what cost, and what consumers are required to pay and how employers are contributing to it.
Increasing cost for healthcare services is among some of the major problems in the U.S. healthcare system. There are countries in the world that are ranked higher than the United States like United Kingdom, Australia, Netherlands, New Zealand, and Norway – and for having best healthcare system at a much lower cost than the United States. Despite being providing the best health research, technologies, and most qualified healthcare providers.
There are some major problems in the U.S. healthcare system that is pulling the U.S. down the list.
Expensive to afford
We hear it all the time that Americans pays more for healthcare than any other country. Why is a free market styled healthcare system is so bad at controlling the cost of healthcare in the U.S.? If we analyze the data we would find that the U.S. spends highest in pharmaceuticals and other operational costs. In a similar way, the average physician earning in the U.S. is almost double than the rest of the work. Then the question arises that when we are spending the highest in healthcare, using best technologies, backed by the top researchers of the world then what are those problems with the U.S. healthcare system that are pulling us down in the list of world’s top countries in healthcare quality list.
First, we have to see why healthcare delivery in the U.S. is expensive.
With the advent of the unified electronic healthcare system, the cost of care delivery has increased for physician practices. Physicians are now required to hire highly trained IT resources to manage the new EHR and EMR systems. Not only that, but the transformation from the old system is also expensive. Although, many government-run programs have incentivized the switch from paper records to electronic health record system it has, in fact, increased the operational cost.
Rising technology cost
Physician practices are now required to install new computers with EHR solutions. To maintain the software, sometimes they have to pay for subscription charges on monthly or one-time subscription fee to the vendors. Besides, training and induction of the IT trained staff is also increasing the operational cost.
Healthcare system in the U.S. is different from other countries. Unlike Canada where practices are only required to submit the claims to one entity; in the U.S. there are multiple payers of healthcare reimbursements which require an advanced level of medical coding and billing experience or you would get back the claims with objections. To achieve this level of accuracy and skill, physicians are required to hire trained and highly paid staff.
Expensive diagnostic procedures
Diagnostic procedures are also expensive in the U.S. Physicians don’t take the risk of being sued on wrong diagnosis and treatment. So they ask for more diagnostic tests as compare to other countries which increase the care delivery cost.
If someone has no insurance then nobody is negotiating on their behalf. They have to pay the charges upfront from their pockets. One study found that the hospitals charge uninsured patients more than patients with insurance coverage. That is not the case with other countries and is one of the problems with the U.S. healthcare system.
Healthcare vendors market
In the U.S. the idea that you are a consumer and you will reach out to the best seller to buy the best product in your budget doesn’t work with the healthcare system. Because neither the consumers nor the government is negotiating the vendor price. It means that vendors can charge increase price in the absence of a strict price control entity.
This is why; the U.S. healthcare system is so expensive than by other countries and is among some of the major problems in the U.S. healthcare system. Medical bankruptcy is common in the U.S. almost 650,000 Americans go bankrupt every year because of high medical bills.
Insurance companies are not in business to make the patients pay less; instead, they are in business to reimburse from what they get from the employers or government. The government of the United States is spending on healthcare programs of Medicare and Medicaid about the same size as other countries where the government runs the whole healthcare system.
The absence of transparency
The lack of transparency is a major problem. The lack of cost transparency in the healthcare system is endemic. It all comes down to codes and the upcoding is the most common type of fraudulent activity reported. It’s a widespread malady in the healthcare system because it is really hard to track down. If an insurance policyholder wants to find out the cost of medical procedures he had, it is very unlikely for him to get the concrete answer. The insurance companies are also business focused, they try to get good premiums from the employers but tighten the noose when required to pay back to insurance policyholders. This looks good for business but bad for consumers who solely depend on a system that is beyond their control.
The high cost of prescription drugs
Pharmaceutical prices in the world are rising, but Americans are paying even more than the rest of the world. The government of the United States is doing little to control the price of prescription drugs and due to limited competition among major vendors; the price of prescription drugs is higher in the U.S.
On average, patients in the U.S. are paying more to buy prescription drugs. This causing issues for the unemployed or uninsured citizens who are to pay out of their pockets. According to Centers for Disease Control and Prevention (CDC), patients in the U.S. are paying 3 times more the price than other countries and this is why almost 1 in 10 Americans can’t afford medications.
This is why most of the patients belonging to low waged income group ask the physician to prescribe the drug which is less expensive or are taking the substitute treatments that are less expensive and less effective. That eventually leads to recurring visits to higher medical bills because of the recurring visits.
High-priced medical equipment
The medical equipment is mostly overly priced in the U.S. and the companies keep increasing the price every year. The government encourages the product to use but makes no effort to reduce the price. This overpriced medical equipment is also increasing the cost of care delivery.
Although the healthcare system is best in the U.S. in many aspects the cost of care delivery is creating problems for the consumers. High ranking healthcare systems around the world are mostly government controlled where the government has strict control over the vendor pricing. However, in the U.S. the price is mostly controlled by the open market competition.
Currently, the healthcare system in the U.S. is under transformation phase which is causing discrepancies at various levels. Due to which the healthcare system looks more broken than by comparison to other countries. However, government agencies like Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services (HHS) are working vigorously to control the problems with the U.S. healthcare system and to set the path right for the better future of healthcare delivery in the United States.