Commonwealth Fund, a New York-Based

¶ … Commonwealth Fund, a New York-based foundation, released survey results from a number of physicians in eleven countries. That survey found that the United States lags far behind other developed nations on quality and use of information, health care access, and a general view of overall care. In fact, sixty percent of U.S. doctors said that quite a large number of their patients had trouble paying for medication, preventative care, and out of pocket expenses. (Casale, 2009). Ironically, the United States spends more per capital on healthcare than any other country in the world. Despite having such a large economy, the percentage spent to the quality and services provided is out of whack. This is particularly true because of technological shifts, changes in healthcare policy, and a general inefficiency in the way the government interacts with HMOs, Medicare and Medicaid (Kaiser Family Foundation, 2007).

Direct comparisons between countries are difficult, due to GNP and other demographic and psychographic factors. However, countries that have a less high-tech approach, more preventative and general practioner care (e.g. Scandinavia, for instance), tend to have both a higher degree of customer satisfaction with their healthcare, and in fact, a healthier population. Preventative care, while seemingly low-tech and expensive, actually saves money in the long run, by providing a long-term health model for disease prevention early in life, inoculation, and the ability to receive care when needed rather than sporadically. Additionally, by adopting a more generic wellness model allows the GP to get to know the individual and that individual's health concerns; often alleviating the need for expensive and invasive testing (Kaiser).

Part 2 - The American system of healthcare is, admittedly, fractured. There are hospitals, clinics, outpatient rehabilitation centers, private practice doctors, and more -- yet due to economic constraints, employees are moving in the direction of providing limited care packages in which the burden of healthcare coverage is on the employed. When one adds the market costs (e.g. pharmaceuticals, technology, real estate, human resource salary and benefits, etc.) to the bill, we find that prices are growing in healthcare faster than wages. In our capitalistic market, however, someone must share the cost burdens associated with care. One of the challenges is that many pharmaceuticals are non-subsidized and must therefore experience a profit while in the United States so that they can then fund more Research & Development. The "bottom line" fiscal situation has become exacerbated by been the proliferation of HMOs, Health Maintenance Organizations, or managed care insurance plans. There is a huge debate regarding these services, their focus on costs and, some feel, not on care; the level of money spent on the bureaucracy of health care as opposed to patient advocacy, and yet, in most cases, HMOs are able to alleviate some of the burden, but also contribute to a more intense and expensive bureaucracy (Getting to the Real Issues in Health Care Reform, 2009).