Healthcare Issues Country How Solve Ongoing Problem Essay

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healthcare issues country. How solve ongoing problem Medicare Fraud Abuse government sufficient effective regulation enforce. If, resolve problem? recommendation ? It Economics Healthcare economically sound.

Economics of healthcare

The population of the modern day society is faced with incremental pressures, but also incremental challenges, and these new issues impact all aspects of life, including the provision of healthcare services. For instance, the more and more technological developments made within the medical and pharmaceutical industries improve the quality of the medical services and as such the life expectancy of the patients. Then, the sustained academic research conducted also improves the quality of the services and the overall quality of the medical act.

In spite of the developments made, it must also be noted that the provision of healthcare services in the United States is a complex situation, with numerous ramifications and challenges. On a first note, it is revealed that the population of the modern day society is facing an incremental rate of heart and blood pressure diseases, as well as cancers. These put additional strains on the healthcare system, its financial administration and are linked to an unhealthier life style of the population. Then, it is also noted that the generation of baby boomers is starting to retire, meaning as such that as they come of age, they would require more services, but also that there are fewer individuals in the workplace to support the expenses of the medical care sector.

Overall, the healthcare system in the United States is challenged and continues to encounter numerous difficulties. The scope of the current endeavor is that of assessing the issues which currently face the system and the means in which the government deals with them. Based on the analysis conducted, several recommendations would be made as to how the issues could be approached and the general healthcare system could be improved.

2. Issues with healthcare in the United States

The healthcare system in the United States is weak and it has gradually transformed into a social and national problem. Ezra Klein (2007) forwards several reasons for the dramatic state of the current healthcare system. According to the author, the main problems of the medical system are pegged to the following:

High costs, actually the highest medical care costs in the world

Low wages for the medical staffs

High levels of population not getting treatment

People do not have a regular physician

The medical doctors seldom fully listen to what the patients have to say

The population faces high rates of chronic conditions, which are, sadly enough, not adequately treated

The population often falls victim to medical, medication or laboratory errors (Klein, 2007).

From a historic standpoint, it is noted that the healthcare system has improved, but it still appears as insufficient when compared to the needs of the current population. The table below reveals the evolution of healthcare and the adjacent problems since the 1850s through today, and estimates for the future.



1900 to World War II

World War II to present


Predominant health problems

Acute epidemic infections

Acute trauma, infections

Chronic diseases: cancer, stroke

Chronic diseases: emotional, behaviorally related

Technology available

Virtually none

Beginning rapid growth of medical sciences, technologies

Explosive growth of medical science, technology

Continued growth and expansion of technology, with attempts to repersonalize the technology

Social organization; Policy

None; individual resources or charity

Beginning societal and governmental care for disadvantaged

Health care as a right; government responsibility to organize and finance care delivery

Greater centralization in federal government; organized systems of health and financing

Source: Cunningham, 2003

The issues encountered by the American healthcare system today are affecting the entire population and they as such cause concern and raise interest for the entire population. From an analytical standpoint, this means that opinions about what is wrong with the healthcare system are issued by all, from the people on the streets, to the individuals in the media and the very politicians. But the problems are complex and not to the full comprehension of all.

In order to create some light into the issues which to impact the American healthcare system, the lines below point out to some of the more stringent issues, as revealed by reliable sources. In a succinct enumeration, these issues refer to the following:

High number of uninsured individuals

Lack of flexibility with the employer-based insurance

High levels of bureaucracy

Lack of emphasis on the quality of healthcare

Fraud and abuse of the Medicare, and last

Insufficient governmental efforts to regulate and improve the system.

a) Uninsured

A primary problem is posed by the large number of people who do not have medical insurance. In 2010, it was estimated that 50.7 million Americans did not have medical coverage, and the figure was following an ascendant trend, which is expected to maintain its course unless immediate action is taken (Wolf, 2010).

The reasons as to why so many people remain uninsured are unclear, with some being represented by the high costs of medical insurance, the fact that not all employers offer it, the high unemployment rates among the population or the acceptance of the people to work illegally and as such not benefit from insurance. All these problems have worsened with the commencement of the economic crisis in 2008 and continue to worsen and pose new threats.

b) Employer-based insurance

Today, medical insurance is provided by the employer and the quality of the medical care and coverage depend on the employer and their company related scopes. And in the age of capitalism, employers will often seek the minimum cost medical insurance policies in order to preserve profitability. Aside from the employer, medical insurance is also offered by the Medicare, a social system implemented by the state through which specific categories of citizens -- such as those with disabilities or those older than 65 years -- are entitled to medical care. In both cases however, the individual has no control over the type of medical care coverage they receive.

c) High levels of bureaucracy

Another problem which currently characterizes the health care system of the American population is represented by bureaucracy, which in turn creates administrative inefficiencies for both insurance firms, as well as medical staffs. This ultimately impedes the efficient provision of medical services and creates patient dissatisfaction, and even jeopardy for the heath of the patients.

d) Emphasis on healthcare quality

The American healthcare system is currently found at an advanced level of degradation, where the medical staffs come to place less and less emphasis on the quality of the services, but simply focus on ensuring that these services are provided. The quality of the medical act is as such not assumed as a criterion for improving the sector, nor is it integrated as an element in the decision making process (Garson, 2000).

e) Fraud and abuse of Medicare

As it has been mentioned throughout the previous lines, a major problem of the American healthcare system is represented by the fact that it registers tremendous costs. And these costs are not always pegged to actual services, but the abusive and fraudulent use of the Medicare service.

"Medicare fraud is purposely billing Medicare for services that were never provided or received. For example, your Medicare number can be used to bill Medicare for services and supplies you didn't need or want, services and suppliers your doctor did not order, services and supplies you can't even use and services and supplies you did not receive" (California Health Advocates).

This virtually means that the state budget and/or the private insurance companies pay money to medical institutions for services that were not delivered to the patient benefiting fro the respective insurance package. In essence, while the medical institution bills the insurer (private or public), the patient does not benefit from the services, and the costs for the respective patient still increase. This false generation of costs deepens the financial problems of the healthcare systems and prevents it from recovering.

"Medicare fraud costs Medicare billions of dollars every year. It can cost you higher Medicare premiums, deductibles and co-payments. Losses due to fraud may also prevent Medicare from offering more services and better coverage" (California Health Advocates).

f) Governmental efforts

The government of the United States of America has long recognized the problems of the healthcare system and has developed and implemented measures and legislations in dealing with the problem. Nevertheless, these measures have proved insufficient as the issues of the healthcare system deepened. As more and more Americans become uninsured and possess fewer capabilities of medically providing for themselves, the federal institution is at a loss and requires assistance (Gratzer).

3. Recommendations

The main recommendation to improving the healthcare system in the United States is that of making it more flexible. This flexibility refers to the fact that the system would become more easily adaptable to features which impact the economy and the society, and would as such create an opportunity for the American citizens to receive better healthcare services.

At a more specific…[continue]

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