The Vital Role of Healthcare
The importance of healthcare in any country is uncanny as it plays an important part in the well-being of each individual. It is not only limited to providing basic health needs but also preventive care, and health education to individuals and communities.
A country’s economic and political situation does affect the Quality of Healthcare but is not limited to that. One of the things that matter the most is how well-administered Healthcare Facilitation is.
A Complex Tapestry: The US Healthcare Landscape
Below down we will discuss the US Healthcare key points and how they work:
The US healthcare is a complex and not well-administered structure with a mix and blend of public Programs like Medicaid and Medicare and Private Insurance. Despite having advanced technology and Infrastructure challenges like Fragmented Care High costs for care and inaccessibility to healthcare are faced often.
Unlike many developed countries the US healthcare does not have universal health coverage and there are multiple reasons for that.
Involvement of Several Groups like Hospitals, Physicians Insurance Companies Pharmaceuticals, and Government Agencies, and one of the most important is:
A mix of Private and Government Sectors.
For this to better understand we need to know roots that go back to the 20th century when there was a labor shortage, and employer-based health insurance began to emerge rapidly. Moreover, during that same time Private sector’s growth was also observed on a large scale which created a dominance of Private Hospitals and Physician practices in the Health sector in the USA.
In Year 1965 Medicare and Medicaid were established to provide Healthcare facilities to the public specifically Elderly People Low Income Individuals and People with Disabilities.
Even though there was wide acceptance of this, still the dominance of Private Hospitals and Facilities could not be reduced.
For Now, the United States is the only Developed Country that has no Universal Health Coverage even though the US spends a lot on their Healthcare according to an estimate American Government spent around $4.9 Trillion between 2023 and 2024.
The United States spends more on healthcare than any other country still outcomes are inadequate and several factors come into play such as
High-Cost labor:
High-cost labor is one of the important factors that contributes significantly to the overall expense of the system and there are multiple reasons such as expensive training programs shortage of staff and so on.
Expensive prescription drugs:
High Drug Prices impact both patient and overall healthcare expenses and there are numerous reasons for them to be expensive in the USA Regulatory and Compliance Costs Insurance and Pharmacy Benefit Managers Patent Protection and Exclusivity are some of the reasons other obvious Research and Development.
Pay for service:
Is also an important factor that can result in increased healthcare costs overutilization of services and much more.
Complexity in the Medical Billing Process:
Medical Billing is very complex as there are multiple insurances each with their rules and regulations specific codes for billing and different types of paperwork are required and when it comes to coding it can be very confusing as minor details matter accordingly. This process combined with other protocols makes it hard to ensure that billing is done correctly for the processing of payments. Also, new updates could add to the confusion in the billing process.
In recent times efforts have been made to improve the accessibility and delivery of healthcare to the general public.
Many Reforms have been made like
ACA Affordable Care Act:
The Affordable Care Act was introduced by President Obama in 2010 which aimed at increasing the accessibility of Health to the General Public expansions were made the goal was to provide subsidies helping Low-Income Individuals to get Health Coverage it also focused on regulations to prevent Insurance from denying health coverage due to pre-existing conditions.
Reforms to Reduce Prescription Drug Prices:
The Inflation Reduction Act 2022 allows the Federal Government to negotiate for certain High-cost drugs covered under Medicare and the intention is to lower the cost for beneficiaries and a perspective for Broader Price Negotiations also in some states pharmaceutical companies are required to disclose the pricing information and justify price increases through which excessive price hikes are intended to be controlled and transparency would be observed.
Cost Control Measures:
Reforms are being implemented to control the cost new rules mandate that insurance cover a wide range of treatments and Medications, reducing financial strains for patients.
Recently Out-of-Pocket caps have been introduced which means that after spending a certain amount or reaching a treatment under Medicare customers will not have to pay further for even high-cost treatment and Medication.
Even After all the reforms the US Healthcare is still in need of urgent further reforms due to factors like unequal access and escalating costs overall, Issues like Access and Coverage Administrative complexities, and Treatment over Prevention need to be addressed.
Also to overcome staff shortages reforms like training and education expansion should be implemented, grants and subsidies should be provided and scholarships and programs like loan forgiveness should be improved for student facilitation.
Conclusion
Despite all the challenges, it is also a fact that the United States has a world-renowned infrastructure for healthcare, advanced treatments, and innovations, and satisfaction is reported highly in Americans regarding the efficiency of treatment and delivery of specialized care.