The modern American healthcare culture is characterized by the shift of focus from disease treatment to prevention. Indeed, it is much easier and less expensive to prevent a disease or minimize the extent of its severity than to cure it. For example, nowadays, technological developments enable doctors to detect cancer at its early stages when it is still curable. At the same time, healthcare providers dedicate less attention to investigating the history of diseases. This transition toward prioritizing high-technology solutions to preventable health issues illustrates that American healthcare philosophy has become prevention-oriented and less focused on developing the insurance system (Sultz & Young, 2017). Overall, the transition to prevention-oriented culture is not necessarily bad; it is just a matter of fact provoked by the technological and scientific progress of humanity in the second half of the 20th century.
As it has already been mentioned above, one of the characteristics of medical care culture that encourages high-technology solutions to preventable problems is the focus on the prevention of diseases. Another characteristic of such a culture is the increased investments of physicians in “laboratories, imaging centers, medical supply companies, and other healthcare businesses” (Sultz & Young, 2017, p. 19). This point is understandable because most people trust scientific developments and strive to receive the best care possible. Hence, hospitals have to invest in high technologies not to go bankrupt. From this, it could be inferred that modern medical care culture is oriented not only on the quality of treatment and satisfaction of patients but also on revenue. As Latifi (2019) puts it, hospitals invest their resources in quality that attracts more patients who generate more revenue that enable a hospital to invest more in quality. In other words, the vicious circle described by Latifi (2019) is based on high technologies that are applied to solve preventable health issues.
Another inference from this circle is that the medical care culture has become characterized by the increased possibility of conflicts of interest. These conflicts appear because hospitals attract investors that would ensure their ability to provide high-technological solutions to the patients. It was also noted by Sultz and Young (2017) that “physician-owned laboratories, for example, perform more tests per patient at higher charges than those in which physicians have no investment” (p. 19). Overall, the changes in the characteristics of medical care culture could not be regarded as entirely negative. Instead, these characteristics are the outcome of technological progress.
Financial Solvency of Hospitals
In the era of high technologies, financial solvency has become necessary for hospitals to survive the market competition. This, in turn, strongly affected the health care system of the US. The practitioners invest in purchasing innovative equipment that boosts the quality of care and the effectiveness of treatment and diagnosis of diseases. To cover the costs, healthcare provides have to raise prices for the services. Since the US government does not provide the population with free and equal access to medical services, a significant share of Americans cannot access them. For example, according to the survey conducted by Berchick et al. (2018), every 10th American citizen living in the US is uninsured. Consequently, the absence of medical insurance means that they have to pay for health care services by themselves.
Since hospitals are increasing the price of services to be financially solvent, it is becoming harder for uninsured people to check their health regularly or even visit primary care providers. From this, it could be inferred that investment in technologies and installations of the most innovative equipment raises the quality of the provided services and cause the growth of the price of these services. This turns into a problem for people who cannot afford insurance or do not want to purchase it.
The ongoing pandemic of COVID-19 has significantly damaged the solvency of American hospitals. As a result, more than 400 facilities in rural areas are in danger of being closed (Boserup et al., 2020). From one point of view, this means that the pandemic filtered out hospitals that could not adapt to the changing circumstances. From another point of view, a considerable share of rural citizens became deprived of choice due to the decreased number of operating healthcare facilities. The problem is that even though the pandemic one day will be over, the probability that the closed hospitals will open again is low. From what is written above, it could be inferred that the focus on financial solvency forces hospitals to constantly improve the quality of the provided care to attract more clients. At the same time, in pursuit of monetary profits, hospitals tend to raise the price for the services and, hence, put people without insurance into a challenging position. This means that the need for hospitals to stay financially solvent drives the development of healthcare and simultaneously contributes to the growth of inequality in access to various medical services.
Single-Payer Healthcare System
A single-payer healthcare system means that every citizen of a country receives equal basic medical coverage that does not depend on his or her paying capacity or employment status. The costs for the essential medical services are covered by a single public system. Such systems are employed in the United Kingdom, Canada, Japan, and several European Union countries. In the US, the single-payer system is exemplified by the Veterans Administration (Sultz & Young, 2017). Nonetheless, this system is not applied to all American citizens.
A single-payer healthcare system has a lot of advantages, including less insurance paperwork and provision of medical assistance to the under-served people. This means that such a system reduces the number of people who cannot access medical help and lowers administrative costs (Ivers et al., 2018). In turn, this system improves the overall state of health of the entire population and allows businesses to reduce their spending on employees insurance. In spite of the existing benefits, the US still has not adopted this system. The possible reason for this lies in the systems disadvantages.
The adoption of the single-payer healthcare system is detrimental to the market of healthcare services. Currently, in the US, there are numerous healthcare facilities that have to constantly ensure good quality of care and implement innovations not to lose the market competition. When a single payer covers the costs, the facilities have no motivation to compete and, therefore, do not develop. More importantly, this system is a burden for the federal budget. To cover the costs of healthcare, the government has to reshape the budget and, thus, allocate less money on the development of infrastructure, defense, education, and various international projects.
References
Berchick, E. R., Hood, E., & Barnett, J. C. (2018). Health insurance coverage in the United States: 2017. United States Census Bureau. Web.
Boserup, B., McKenney, M., & Elkbuli, A. (2020). The financial strain placed on America’s hospitals in the wake of the COVID-19 pandemic. The American Journal of Emergency Medicine, 45, 530–531. Web.
Ivers, N., Brown, A. D., & Detsky, A. S. (2018). Lessons from the Canadian experience with single-payer health insurance: just comfortable enough with the status quo. JAMA internal medicine, 178(9), 1250-1255.
Latifi, R. (Ed.). (2019). The modern hospital: patients centered, disease based, research oriented, technology driven. Springer.
Sultz, H. A., & Young, K. A. (2017). Health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett.