Urrent Status of the U.S. Health Care System

Current Status of the U.S. Health Care System

Explain the current status of U.S. health care in terms of costs, service levels, equity, access and resource inputs.

Compare the status of health in the United States with other developed countries.

Module 3: Assignments

U.S. Health Care System Paper

Write a research paper of 500 words, addressing the following:

Compare the U.S. health care system to another countrys system with the focus of Why another country can achieve better health outcomes for less money?”

A minimum of three scholarly sources must be cited. Remember that Wikipedia is not considered a scholarly source

Lecture notes from the chapter below:

In Module 3, we present the demand side of health economics and its relation to use of services. In addition, we discuss the U.S.s relatively high level of expenditure in relationship to the countrys health outcomes as compared to other developed countries.

Demand for Health Services

As discussed in previous weeks, economics is concerned with the consequences of resource scarcity, and health economics is concerned with resource scarcity in the health care industry. The main tool of economic analysis is built on the supply and demand curve.

The intersection of the supply and demand curves establishes the equilibrium price at which the good or service will be sold. A price below the equilibrium level demand exceeds supply, which causes prices to increases. A price above the equilibrium level supply exceeds demand, which causes prices to decrease. However, health economists have identified various differences between health care and other sectors of the economy. The main difference is uncertainty of demand for health care. An individual does not know when he/she may become ill, for how long, and at what expense.

Another area that causes the demand for health to be unlike other goods is that individuals allocate resources (money, time, etc.) in order to both consume and produce health. As noted in your readings this week, the Michael Grossmans 1972 model of health production sees the demand for health as an investment decision by individuals. In other words, using Grossmans model, health care is not a consumer good, but an input into production of the capital good a the stock of health (Dewar, 2010).

U.S. Compared to Other Countries

In a recent article titled U.S. Health Care Overhaul: Five Lessons From Abroad by Alexandra Marks of the Christian Monitor, which was presented in an ABC News broadcast, the following points were made to highlight the difference between the U.S. health care system and the health care systems of other developed countries:

In Singapore, hospitals publish the cost of every treatment, from hip replacement to dengue fever, so consumers can choose medical options as if theyre buying jeans.

In Germany, people suffering from fatigue or back pain can get a three-week stay at a Wellnessretreat in the mountains all paid for by health insurance.

In Taiwan, people who go to the hospital swipe a card that gives doctors their basic medical information, which is one reason the country has among the lowest health care administrative costs in the world.

Almost every country in the developed world ensures that all its citizens have access to some kind of care when they need or want it. The U.S. is the exception.

Most countries also manage to provide that health care for about half the cost of the U.S. and with better overall health outcomes, such as lower infant mortality rates, as well as with greater overall patient satisfaction.

According to Karen Davis, president of the Commonwealth Fund, a non-profit research foundation that focuses on health care, Its not likely that the U.S. will adopt another countrys health care system but it is important to look at some of the innovative things other countries are doing. The U.S. spends more than twice what other [major industrialized] countries do and are the only one that doesnt provide universal coverage.”

In a recent study, Docteur and Berenson (2009) examined data from several health systems and highlighted the role of health care quality in the midst of the current U.S. debate, which is focused on improving quality and access. Recent surveys show that the majority of Americans believe that, despite spotty coverage, high costs and other problems, the U.S. health care system and the quality of health care delivered is the best in the world. But is it really?

The study examined health care system research conducted during the past 10 to 15 years and found there was No hard evidencethat U.S. health care quality stands out across the board. What was revealed that the quality of care in the U.S. differs dependent on the services. The U.S. does well in the area of cancer care but not in mortality from treatable and preventable conditions. Docteur and Berenson (2009) concluded their report by saying that our nations pending health care reform could be an opportunity to systematically improve quality of care. The researchers noted that their study A¬¶provides an opportunity to build on strengths and correct weaknesses in the U.S. health care system, working towards aims for improvement that the care provided is safe, effective, patient-centered, timely, efficient and equitable.”

Redesigning the Healthcare System

According to Borkowski (2008), due to the many problems associated with the overuse, underuse or misuse of care, there have been public calls for redesigning the U.S. health care system. For example, in 1999 the Institute of Medicine (IOM) Committee on Quality of Health Care in America published To Err is Human which implied, based on previously published research findings, that between 44,000 and 98,000 individuals die each year as a result of medical errors that could have been avoided. The major points made by the IOM report were that the cause of medical errors is not an issue of clinicians competence or incompetence but to faulty system factors, such as, Unrealistic reliance on human memory, poor communication systems, unrealistic demands on human vigilance, too little respect for the consequences of fatigue, reliance on handwriting in a computer age, and so on(Berwick, 2002, p. 84). IOM related that these systems must be redesigned and patient safety must become a national priority.

Less than two years later, the IOM committee followed up with a more comprehensive report, Crossing the Quality Chasm, which analyzed the needed changes in the U.S. health care system at four different levels: the experience of the patient (i.e., patient-centered care); the functioning of the small units of care, such as a cardiac surgical team, the night shift in an emergency department, etc. (Microsystem”); the functioning of the organizations that support the microsystems (Macrosystems”); and the external environment that affects the operations of the macrosystem (i.e., policy, payment systems, regulations, accreditation, etc.) (Berwick, 2002). The IOM identified six aims or goals for improvement of the U.S. health care system:

Safe: avoiding injuries to patients from the care that is intended to help them.

Effective: providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit.

Patient-centered: providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.

Timely: reducing waits and sometimes harmful delays for both those who receive and those who give care.

Efficient: avoiding waste, including waste of equipment, supplies, ideas, and energy.

Equitable: providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.


We discussed the Grossman model