Multiple, complex factors are associated with the rise of health care spending, and Health Care Delivery in the United States is criticized for being less cost-effective, compared to other developed countries. Though Medicare is a popular health care program with high satisfaction levels among seniors, it is indicated that there is a disparity in Medicare programs from region to region. Only on the basis of research evidence or professional consensus, it will be plausible to identify any service that improves health outcomes. Since the quality of health care is evaluated from the outlook of the individual as well as the community, the principal focus should be quality health care and eliminating disparities within the services provided by the US Health Care Delivery System.
It is reported that “today, the United States spends more than $7100 per person each year on health care services.” (Gibbons et al, pp. 2209-2218). But, unfortunately, 46 million individuals are uninsured, of which over 8 million are children who have limited access to health care because their parents are uninsured. In its report titled ‘Crossing the Quality chasm,’ the Institute of Medicine (IOM) argued that “one of the central drivers of poor quality has been the unsystematic and fragmentary nature of our health care delivery system” (Wennberg, p.1). Dartmouth Atlas indicates that there is a disparity in Medicare program from region to region and it spends considerably more in some high-cost regions as a consequence of inappropriate financial incentives and “supply-sensitive care” under Medicare (Wennberg, p.1).
Multiple, complex factors are associated with the rise of health care spending, of which administrative expenses top the list, as it represents approximately one-third of costs associated with the delivery of health care. Based on two surveys of patients among a nationally representative sample of adults in Australia, Canada, New Zealand, the United Kingdom, and the United States in the first and including Germany in the second, Davis et al (2006) opines that “despite spending more per capita on health care and devoting to it a greater percentage of its national income than any other country, the United States is not getting commensurate value for its money.” (Davis et al). On comparing the per capita health expenditure in Canada and the United States, which was $ 3,003 and $5, 635 respectively, their ranking in patient safety, patient-centeredness, and efficiency were 5 and 6, whereas in timeliness Canada ranked 6th and the U.S 3rd. Inpatient safety, Americans had the highest rate of receiving wrong medication and inefficiency, the U S ranked last among the six countries. The survey also reported that due to the non-availability of regular doctors most sick adults in the US visited the emergency room for a condition that could have been treated by a regular doctor. On measures of choice and continuity, and patient-centeredness Germany was first. On the basis of survey findings, Davis et al suggest that “Disparities in terms of access to services signal the need to expand insurance to cover the uninsured and to ensure that the system works well for all Americans”(2006).
Medicare that covers 41 million people in the US is a popular health care program with high satisfaction levels among seniors. Medicare was enacted in 1965 to provide health and economic security to seniors, which has been expanded in 1972 to cover younger beneficiaries with permanent disabilities. Individuals aged 65 plus are entitled to Medicare (Part A: Hospital and skilled nursing care) if they are eligible to receive Social Security. Medicare represents 13 percent of the Federal Budget. However, it is worth noting that gaps in Medicare coverage are widening, and “annual Medicare beneficiary out-of-pocket drug spending has been rising” (Neuman, Tricia, 2005). Dartmouth Atlas quote that “Medicare Part A and Part B spending per enrollee varied 2.5 fold during the two-year period 2000-01, from an annual average low of $3,346 per enrollee living in the Appleton, Wisconsin hospital referral region to $11,544 per enrollee in the Bronx, New York Hospital referral region. Wennberg et al, 2008). Through securing Medicare financing for future generations, while keeping health care affordable for seniors and beneficiaries with disabilities who rely on the program the challenges facing Medicare can be surmounted.
Research evidence suggests that variation exists among hospital referral regions, from state to state, and from one hospital to another, even among hospitals within the same region of the US health care delivery system. Wennberg, et al (2008) apprise that “most of this variation was not due to differences in the price of care in different parts of the country, but rather to differences in the volume, or the amount of inpatient care delivered per capita.” By removing barriers to affordable health care and preventive benefits, improving the delivery of quality health care, eliminating disparities, and supporting the training of a diverse, skilled healthcare workforce it will be possible to bring healthcare reforms in the United States.
- Davis, Karen., et al. Mirror, Mirror on the Wall: An Update on the Quality of Patient’s Lens. The Common Wealth Fund. 2006.
- Gibbons, Raymond J., et al. American Heart Association’s 2008 Statement of Principles for Healthcare Reform. Circulation. 118. 2008. Web.
- Wennberg, John E. Introduction: Health Care Spending, the Care of Chronically III, and the Problem of Supply Sensitive Care. The Dartmouth Atlas of Health Care 2008.