Healthcare Issues With the Provision

Healthcare

Issues with the Provision of Healthcare in the United States: An International Comparison

The issue of healthcare reform in the United States is in the news constantly right now, as the two houses of Congress attempt to hammer out a national healthcare plan that will guarantee more complete coverage to millions of Americans while attempting to appease, to some degree, worries about budget deficits and government intrusion into private medical matters. These media-friendly issues only touch the surface, however, of the underlying problems in the United States healthcare system. There are many other problems with the healthcare system in the world's largest economy that fail to receive such attention due to their complexity and, in some cases, their obscurity. An examination of healthcare systems in other countries can illuminate some of these issues in the United States healthcare system.

Healthcare in the United States

Despite the lack of true primacy of the healthcare issues that have received popular media attention in the United States, it is not unreasonable to begin an investigation of the problems of the system with these areas. The intrusion of the government into private medical matters has long been a contentious issue in the United States, but it is clear that the government is becoming more involved so this issue is essentially moot. The issue of cost and deficit, however, is indicative of some of the deeper problems already present in the healthcare system. The expense of care in this country has been prohibitive to many in receiving adequate care, which is the reason government intervention is needed.

The central problem with the United States' healthcare is not the cost of providing healthcare, but rather the deeper reasons that result in such high costs. These deeper reasons have been identified differently by different scholars in their assessment of the healthcare system, attributing larger healthcare issues alternatively to a lack of physician input and control, a lack of integration of the various agencies and offices involved in providing care, and simple (yet profound) organizational problems that emphasize centralization rather than responsiveness (Squires 2009). What this essentially means, of course, is that a massive reorganization of the healthcare system is needed that takes into account all of the players -- insurers, patients, providers, and the government (Squires 2009). There is one complex and underlying problem that must be addressed before this can be accomplished.

Successful Healthcare in Other Countries

Cuba's healthcare system clearly illustrates what this underlying problem is. Though the complete nationalization of the healthcare system is not desired nor required in the United States, the move to a similarly population-based healthcare system rather than a market-driven system such as what currently exists in the country will likely provide the first major step towards a more responsive and more adequate provision of healthcare to American citizens (Offredy 2008). There are certainly issues with the Cuban government and the question of liberty and choice, even in the healthcare system (Offredy 2008). A market driven healthcare system will necessarily be controlled by the entities making the greatest investments (and the greatest profits) from the system, but a population-based system will address true needs.

There are definite problems with so-called universal care provided by a single payer (i.e. The government) such as what takes place in Cuba, however. The United Kingdom ran into financial difficulties and inefficiencies in providing care in this manner; the amount of costs to the government and lack of costs to patients created a heavy strain on the system (Wan & Wan 2010). For this reason, the healthcare system in China is being looked at as a possible model for future large-scale healthcare systems. In their move from a completely government-paid and -- operated healthcare system to a fees-based approach, the Chinese have greatly improved the efficiency, availability, and efficacy of their healthcare system (Wan & Wan 2010). This suggests that a combination of perspectives, rather than the market or single-payer perspectives that form so many healthcare systems, is most effective.

There are also, of course, healthcare systems that have developed in the same period as those mentioned above, but with far more negative results. The South African healthcare system, though effective in combating certain specific conditions, has many of the same failings as the United States' system, only on to a far more apparent degree. A lack of organization and responsiveness, exacerbated by an attempt to exert highly politicized and highly centralized control over healthcare provision, has plagued South African efforts to combat AIDS and many other problems the country -- and the continent -- is facing (Sewankambo & Katamba 2009). Lack of provider and patient input on the system, and of the responsiveness of the system to changes in medical needs, are largely reflective of problems the United States healthcare system is facing, according to some (Squires 2009).