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The Patient Protection and Affordable Care Act (PPACA) which was signed into law by President Obama on March 23, 2010 is an effort to solve America’s biggest domestic issue. The issues of cost, the large number of uninsured, and quality of care are the catalysts leading America toward universal healthcare.

First, while insurance companies are recording superfluous profits, insurance premiums are averaging 10% to 20% of families’ budgets (Abelson 3). In addition to having to pay large premiums, high deductibles have risen sharply. In 2010, 10% of people covered by their employer had a deductible of at least $2000.00 (Abelson 1). These high deductibles discourage people from receiving routine medical care because they are paying out of pocket until their deductible is reached. This practice has a reverse effect with people putting off care until they absolutely need to, which results in higher costs. An estimated 18,000 people in the U.S die each year prematurely because of not having affordable healthcare (Toner 5). A byproduct of this age of large premiums and deductibles is deceptive marketing practices by insurance companies leading people to believe they are covered while the small print excludes them from coverage, selling people essentially fake insurance.

The small print jargon can be so confusing even hospital representatives can be fooled. In one case, Lawrence Yardin had a policy, which seemed to indicate $150,000 a year in hospital care. After looking at his policy, St. David’s, where he went for two separate heart procedures, estimated his portion of his bill to be a few thousand dollars. He and the hospital were surprised to learn his coverage was mostly for room and board. The policy coverage for “other hospital services” was capped at $10,000, which excluded him from nearly all-routine care including medicine (Abelson 1). Mr. Yardin ended up with a hospital bill of over $200,000, forcing him into bankruptcy. This is one example of people being pushed into personal bankruptcy by medical problems who actually had insurance when they got sick, which is now estimated be 75% of people filing for bankruptcy. The excessive cost of healthcare in America has also created a new industry called “medical tourism”.

This is the practice of going to such countries as Thailand, India, Singapore, and Costa Rica to receive elective medical treatments. With heart valve replacement costing as much as $160,000 in Boston, the same procedure can be as little as $8,000 in India. A hip replacement costing $43,000 in New York can be done for $12,000 in Thailand (Shilan 1). In 2008, Hannaford supermarkets added an international option for hip replacement surgery where the cost is $10,000 to $15,000, compared to more than $40,000 in the U.S. An employee would pay $2,000 to $3,000 out of pocket for the procedure stateside. If the employee goes to Singapore, he or she has no out of pocket expenses and the company pays up to $10,000 for airfare and lodging for the patient and a companion (Shilan 2). Healthcare costs forcing Americans to foreign countries for procedures, going into bankruptcy, and foregoing preventive care have put America on the course for universal care.

            Second, although the perception in America is that our healthcare is the best in the world, the U.S. ranks only 37 th in healthcare performance among 191 members of the World Health Organization (Davidson, p. 3). A dismal statistic considering America spends more on healthcare per capita than any other country in the world. “Quality healthcare means doing the right thing at the right time in the right way for the right person and having the best results possible” (Docteur 1). A recent study finds 81% of Americans have concerns that quality of care will diminish if the U.S. adopts universal healthcare. Americans have come to assume they have the best healthcare in the world, maybe out of ignorance. The United States is not among top performers in terms of life expectancy, and rank among the lower third of developed countries in life expectancy at birth (Docteur 3).  In addition, in a recent study among 19 countries, the United States had the highest rate of death from conditions that could have been prevented or treated successfully.

The Canadians, who have had a universal health care system for years also seem to be receiving better quality of care. From 10 studies that included statistical adjustment and enrolled broad populations, five favored Canada, two favored the United States, and three showed mixed results (Docteur 7). When looking at these studies it is clear that the United States is not the best provider of health care in the world, offering another reason for the push toward universal care.

Moreover,  according to (Patel & Rushefsky182) and the findings of a research carried out by RAND HEALTH on the quality of heath care in America, it was established that on overall, adults receive nearly half of the recommended health care. In addition, the findings further postulates that the quality of care across metropolis was similar. It also points out that the quality of care varied across conditions, as well as across communities in respect for the same condition, for instance, cares for diabetes varied from 39% in Little Rock to 59% in Miami. However, the care for cardiac problems was also inconsistent with 52% in Orange County and Indiana to 70% in Syracuse. The findings further revealed that no single community had the worst or the best health care in relation to chronic conditions, and that all socio-demographic groups were at risk for poor health care since race, financial status, as well as gender makes a negligible difference as far as receiving recommended health care is concerned. This measures the extent in which the quality of health care in America vary, and as such, the need for a universal care will help improve the situation.

Finally, the other factor pushing America toward universal care is number of uninsured in America. The Census Bureau reports the number of Americans now at an all-time high of 49.9 million, an increase of 900,000 from 2009 (Pecquet 1). Since 2001, the number of Americans with employer-provided insurance has declined from 179.9 million to 169.2 million, partly from employers no longer offering coverage, but also from employees who could no longer afford the premiums (Kunerth 1). In 2010, in regard to the adult population 16.4% are un-insured, 11.2 % are get insurance from means such as buying their own insurance coverage, 25.3% get health coverage through government plan, and 45.8% getting employer-based coverage. However, this percentage has been on a decline, hence increasing the number of uninsured. With the economy not doing well many families have had to make the decision between health insurance and food on the table. Those without insurance have been classified as either involuntary uninsured or voluntary uninsured.

The involuntary uninsured comprises of school dropouts, young, low-Income, immigrants, unemployed, as well as those who are single and have no children. These demographics indicate the variation in health coverage. The number of uninsured in America has been tolling, and research indicates that 1 in 5 adults below the age of 65 and approximately 1 in 10 children are without insurance. As such, individuals without insurance are exposed to more health risks compared to those insured. The gap that exist between those insured and those without insurance in terms of effective health care access and health care needs have resulted in needless suffering, illness and even death. In addition, the levels of uninsured in America in 2010 still remains high with 38.9% of Hispanic Americans continuing to be uninsured, whereas 3 out 0f 10 low-income Americans staying without insurance. On the other hand, 28% of youths below the age of 26 are still without insurance. The high number of uninsured means that, those uninsured will be potentially vulnerable, and again it will add to the collective cost of healthcare that Americans pay.

A Center for Disease Control (CDC) report points out the falling economy as one of the contributor to the soaring number of the uninsured. Many people during the economic downturn loss their job, this implies that they also loss the accompanying insurance coverage. The report findings indicates that out of the 68,000 Americans surveyed, more than two-thirds are considered to be in good health, but the number is far much below what it was a decade ago. As such, the need for a healthcare reform is indispensable.          

Based on the documented studies, the healthcare system of America is on a crisis. Therefore, necessary action must be taken, and as such, the appropriate action should be through a healthcare reform where all the American citizens will be eligible to health insurance coverage. This will help in reducing the variations that are prevalent in health care needs and access.

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