Current Issues in Health Policy and Health Reform Term Paper

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U.S. health care system in terms of the current issues prevalent which shape the U.S. health care policy. It addresses two main questions:

What are the activities affecting the U.S. healthcare system?

What is the impact of the specific economic, political, cultural and historical factors on the current U.S. healthcare policy?

Secondary information sources i.e. published text and online sources of information have been used to gather information for the analysis of the healthcare system. It appears that economic factors, medical advancement and universal health access are the most important factors currently shaping the U.S. healthcare system, and needing reforms in these areas. The ultimate goal of health care reform is to keep costs at a level no more than a specific percentage of the economic growth of the country.

Activities affecting the U.S. health care system

The U.S. health care system is influenced by a number of activities in the country notably

Economic

Political

Cultural

Historical

Below is explained how these factors are influencing healthcare system with examples.

Economic factors

The U.S. healthcare system is considered one of the world's most expensive healthcare systems. Currently, the U.S. spends about 2.6 $trillion in healthcare contributing a good 18% of gross domestic product (Appleby, 2012).

Many factors have caused such a drastic increase in the cost of health care in recent years. Two among them are as follows:

Population increase

The population of the U.S. is rising. Also, the percentage of the elderly in the population is increasing who require more health care (Appleby, 2012). The older people need more varied medical attention and treatment giving rise to increased costs. Reforms for a team based and patient centered approach for providing affordable health care to complex patients are being introduced.

New technology development

New drugs, medical technologies and procedures are being developed causing an increase in overall health care costs (Appleby, 2012). Irrespective of whether the new drugs and processes are better or more successful, people seeking medical services ask to be treated with them. Medical advances are good as they give superior treatment and make people get well and delay death, but they require significant spending.

This growth in health spending has caused the authorities to bring reforms, and a change in healthcare policies to cut costs without affecting the quality of services. This is because the U.S. health care has been unable to reap any increased benefits that should have come with increased spending, for example; there has been no lower infant mortality rate, longer lives, improved health care quality and universal access of health care than any other high income country. Freeing up health care expenditure will cause the U.S. To spend the funds on other sectors of economy leading to the country's good. The reforms suggested by the commonwealth fund commission with respect to consumer incentives and system wide reforms will cut health spending by a cumulative 2 $trillion by 2023("The Commonwealth Fund," 2013).

Political factors

Political factors describe how the public can access good quality and safe health care services with affordable cost under government legislation and best practice. Healthcare in the U.S. is expensive, and not all individuals can cover the full costs of the services ("USA.gov," 2013) Two political factors are described below:

Health insurance

Having health insurance allows people to avoid incurring large medical costs while getting the treatment they need. Most Americans are insured under private insurance programs provided by employers, but few are under public programs such as Medicare and Medicaid. While a percentage of the population is uninsured. Medicare is a government insurance program for older people above 65 years of age, and Medicaid is for poor or low income families and Individuals with disabilities. Health care reform ensures that everyone in public is insured irrespective of income and other factors. One reform is the Affordable Care Act which will guarantee insurance to all Americans irrespective of health and earnings. Under this act, people will get comprehensive health insurance, and it provides new rights and protections ("USA.gov," 2013)

Patient safety

Many statistics show how people die due to receiving illegal drugs or faulty treatment. The government is responsible for bringing reforms which ensure best practice, and avoidance of unnecessary deaths caused by a lack of safety measures or carelessness by doctors or other medical staff. One act passed in this respect is the Patient Safety And Quality Improvement Act 2005("Patient Safety," 2008) It is a voluntary and confidential reporting system of events that compromise and adversely affect patient safety. However, many providers of health care are reluctant to engage in quality review procedures since they can incur liability and can result in a loss of reputation.

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Cultural factors

In order to know how culture affects a healthcare system, the definition of culture needs to be considered. Culture is defined as:

"The totality of socially transmitted behavior patterns, arts, beliefs, institutions, and all other products of human work and thought."("The Free Dictionary," n.d.)

Two cultural factors that can affect the U.S. healthcare system are as follows:

Language

The U.S. has racially and ethnically diverse groups of people. The different ethnic groups include White American, American Indian, African-American, Alaska Native, Asian and Native Hawaiian ("United States Ethnic Groups," 2013) These diverse ethnicities mean that there will be language barriers while accessing medical services which can compromise the quality of healthcare in the U.S. Language barriers between an English speaking doctor and a patient who speaks a different language can undermine trust in the quality of care bring received and can also result in faulty diagnosis and treatment (Anderson et al., 2003).

The U.S. has some federal and state laws to reduce language barrier difficulties such as the Civil Rights Act 1964 which prohibits discrimination on the basis of race, color and ethnicity and the Executive Order issued in 2000 improving access to services for persons with limited English proficiency (Youdelman, 2008).

Access to health care

Because the various ethnicities are dispersed geographically, it is often difficult to get the required treatment due to issues such as:

Lack of transportation

Limited presence of medical specialists and advanced diagnostic procedures in these areas

Personal attitudes to health care such as preferring home made treatments than western medicine due to limited education and other socioeconomic factors ("Disparities in access," 2013). Several U.S. states notably California have enacted health reform laws aimed at mitigating racial differences in seeking health care (Youdelman, 2008).

Historical factors

Historical factors shed a light on how health care systems and policies need reforms due to changing times and economic advancement. Two of these factors are discussed:

Evolvement of health care coverage

In the early 1900's, doctors knew little about diseases and did not charge much for the treatments. People were treated in their homes, only a few big employers offered insurance and almost everyone paid funds out of their own pockets. However, as doctors discovered treatments for most diseases and technology developed, they started charging more for diseases, people had to be treated in hospitals with advanced machinery which further rose costs. This caused the development of programs to reimburse patients for their health care costs such as the Blue Cross which helped people pay their bills. Employers then kept offering health insurance as an added benefit to the employment package. Later, government health insurance programs developed such as Medicare and Medicaid for the elderly and the poor. Still, all the public is not yet insured, and there are future programs to provide insurance for everyone in public while containing costs ("Stay Smart Stay Healthy," n.d.).

Medical innovation

Medical innovation is affected by many factors. The requirement for advanced medical treatment comes from consumer demand. As income of the consumers increases with the passage of time, they ask for better and costly medical options that will help them achieve and maintain good health. Consumers get aware of new medical technology through media, internet and advertising. This increased awareness of sophisticated medical treatment options has caused the government and private and public sector organisations to implement advanced, and innovated medical procedures increasing costs such as treatments for AIDS, end stage renal disease, diabetes etc. which were unavailable previously. Medical practitioners also implement advanced procedures to increase the effectiveness of treatment because they are motivated to compete with other providers of health care. In other words, they have a commercial interest in advancement ("Snapshots," 2007).

Conclusions

The U.S. health care system has increased in costs over time significantly, yet the nation still lags behind other developed nations with respect to the health of its public which has not improved in proportion. Reforms to cut costs while providing quality health care have been in place. Steps to provide health insurance to everyone have been enacted so that no one is uninsured. Ethnic and racial disparities are being mitigated through appropriate legislation, and best practices, though not all states are free of this cultural and linguistic discrimination and further reforms are needed. Advancement in medical technology continues to raise costs raising concern for….....

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