The US health care is based on a private insurance system, which allows people to decide on the necessity of health insurance. However, according to statistics indicated in the video, the US spends about 3.8 trillion dollars on health care every year, which has a massive impact on the economy (PBS NewsHour, 2021). Still, its efficiency is questionable, while these statistics show that the US HC System is not very efficient financially and has a higher death rate than other high-income countries. Even having health insurance, a considerable number of the US citizens cannot afford a needed treatment.
Does America Have the Best HC in the World?
A COVID-19 situation had perfect real-time evidence of the difference in the efficiency of nationalized and private insurance health care systems. The pandemic had critical consequences for many people dependent on safety net programs, largely underfunded during the outbreak (Saloner et al., 2020). While American HC depends on employment, some countries abrogated such relation. Observing how the US HC failed to support the population in a pandemic and the relevant success of other countries’ systems, such as Australia, New Zealand, Canada, and European countries, explains essential differences in these systems.
Advantages and Failings of the U.S. Health Care System
The advantage of the U.S. HC system is the independence of health medical institutions from the government in financial means. The government allows a diversity of medical institutions and allows them to set the prices they consider appropriate. Moreover, people see advantages of the U.S. HC in that every person can choose if they need the insurance or not, how much they want to pay, and what should be covered. Meanwhile, the single-payer health care system makes medical institutions dependent on the government’s decisions and makes people pay high taxes whether they like it or not. However, there are distinct disadvantages to the nationalized health care, mainly affecting on population with low incomes. Many states propose to call “for sweeping changes across the health care system and aim to improve access, quality, and cost containment” (Liu & Brook, 2017, p. 9). When it comes to a necessity, but not a choice or desire to pay for insurance, the U.S. government provides almost no guarantees that a person will be treated. The health insurance system does not allow such people proper medical care, and the health insurance cost is too high.
Arguments For and Against Nationalized Healthcare
The NHS allows all people to be treated, not depending on their income level since medical care is funded through taxes. The statement, “there’s no cost attached with going to see a doctor…and that’s a real game changer,” belongs to Dr. Sam Everington and refers to the effectiveness of the NHS in the UK (PBS NewsHour, 2021). This system can be considered more socially responsible and caring for people in need of treatment. Existing illnesses sometimes require far more money than a person on an average income can afford, not to mention people with social status of need. There are charity organizations and local fundraising initiatives in the US, but often they are not enough to save a patient with a specific disease. For patients with more common diseases, charity organizations do not usually fund such treatments. By neglecting all citizens’ medical care needs, the state sentences the seriously ill to death if they cannot afford the costly treatment on their own.
However, there are arguments against nationalized health care due to its rationed services that limit timely treatment when the disease is not life-threatening. Lack of NHS funding leads to the necessity of paying for additional health insurance to avoid the long waiting list for medical care. Referring to Dr. Jha’s statement can negate this argument because the US HC also represents rationing based on the paying ability of the citizens (PBS NewsHour, 2021). Single-payer HC supporters appreciate the feeling of protection by the government even though the taxes are higher than in the US. Even considering that nationalized HC requires some insurance payment besides taxes, it still has the advantage over the US HC in offering various financial treatment solutions. While the NHS ensures the population can survive, the government saves money and prolongs general life expectancy in the country.
Alternatives to the U.S. Health Care System
A hybrid health system model could become a suitable replacement for the U.S. HC, which combines both public and private systems. This model gives people the opportunity to choose which system suits them more and shows more freedom and independence from the government, which generally U.S. citizens aim. Hybrid systems “emulates the individual variability of patients and health professionals while retaining the complex, aggregate behaviour” (Cassidy et al., 2019, p.3). The downside of this system is the choice ability for younger people of using it or not. It leads to some financial issues for insurance companies since it is the young population that brings their income.
Only using some applications borrowed from other countries’ HC systems can improve the U.S. HC system. First, the government should provide a treatment guarantee for people who cannot afford health insurance. It does not have to be implementing compulsory insurance but a subsidy for low-income citizens to help afford this insurance. Such practice exists, for example, in Switzerland and Germany and has a high level of support from the population.
Safety Net Program
There are several health care services in the US that give people an opportunity for treatment when their income is lower than the required care cost. All people with low incomes, and those with a civil status that does not allow them to get health insurance, can take advantage of safety net programs. They include charitable institutions, several special programs at community medical centers and public hospitals.
Several of these programs exist for a few decades, among them are MediCal, Medicare, and Medicaid. MediCal works for a broad group of people with low incomes, the elderly, people with disabilities, foster families, pregnant women, and people with certain illnesses such as breast cancer, HIV/AIDS, and tuberculosis. People over 65 years of age and some people with disabilities whose parents are retired, disabled, or deceased can access Medicare. Medicaid is designed to help people with legal civil status whose income does not exceed the official poverty line. The central part of the program members is people with disabilities, the elderly, and children from disadvantaged families. The scholars state that “Medicaid finances nearly a fifth of all personal health care spending in the US, providing significant financing for hospitals, community health centers, physicians, nursing homes, and jobs in the health care sector” (Rudowitz et al., 2019, para. 1). Another program orienting children’s health is Children’s Health Insurance Program (CHIP). CHIP provides health insurance coverage to children of families who have incomes above the Medicaid eligibility threshold but do not have private health insurance opportunities.
These programs are well-known in the US through their high importance for particular social groups in need. Their effectiveness identifies a necessity of implementation through other social groups, which do not suit to listed above programs requirements but still need help from the government. Scholars state that preventive services are practical in preventing more “serious illnesses that are costly to treat or potentially deadly” (Ng et al., 2017). More attention is paid to those social groups for which none of these preventive services can provide help. Possibly the state should consider introducing subsidies for such groups or additional safety net services.
Based on the video, it is possible to conclude that reform is indeed more costly for the state, but it brings economic results in the end. With lower efficiency results and higher healthcare costs and expenditures, the US healthcare system shows a necessity in reorganization and improvement measures. Some particular social groups in need already have access to such preventive services as MediCal, Medicare, Medicaid, and CHIP. It will not be easy to achieve fast changes, and probably it will not be possible to implement another HC system due to the different political approaches of the US. However, implementing some features of hybrid, universal, and nationalized HC may have a good effect on the general health picture of the US. Increasing the life expectancy and standard of living has vital importance both in the health of the population and in the economic aspects of the country. That is why the state needs to reduce the cost of medicine and increase its efficiency, taking care of the citizens’ needs.
Cassidy, R., Singh, N. S., Schiratti, P., Semwanga, A., Binyaruka P., Sachingongu N., Chama-Chiliba C. M., Chalabi Z., Borghi J., & Blanchet K. (2019). Mathematical modelling for health systems research: A systematic review of system dynamics and agent-based models. BMC Health Services Research, 19(845), 1-24. Web.
Liu, J. L., & Brook, R. H. (2017). What is single-payer health care? A review of definitions and proposals in the U.S. Journal of General Internal Medicine, 32(7), 822–831. Web.
Ng, B. P., Jensen, G. A., & Fritz, H. (2017). Effects of Medicare coverage of a “Welcome-to-Medicare” visit on use of preventive services among new Medicare enrollees. Journal of Aging Research, 2017, 1–9. Web.
Rudowitz, R., Garfield, R., & Hinton, E. (2018). 10 things to know about Medicaid: Setting the facts straight. KFF. Web.
Saloner, B., Gollust, S. E., Planalp, C., & Blewett, L. A. (2020). Access and enrollment in safety net programs in the wake of COVID-19: A national cross-sectional survey. PLoS ONE. Web.
PBS NewsHour. (2021). Health care: America vs. the world [Video]. YouTube. Web.