US Healthcare
The Paradox of US Health Care: A Descriptive Analysis of High Spending and Low Outcomes
The United States has the highest healthcare expenditure in the world, yet its health outcomes need to be commensurate with the high spending. This paradox of high spending and low outcomes has been a topic of interest and concern for policymakers, healthcare providers, and patients.
Several factors contribute to the high healthcare spending in the US, including insurance distortions, administrative costs, and overuse of low-value care. On the other hand, inadequate health insurance coverage, social determinants of health, and fragmented healthcare systems contribute to low health outcomes.
This essay provides a detailed analytical analysis of the paradox of US healthcare, its impact on the economy and society, and potential policy options to address it.
One of the significant factors contributing to high healthcare spending in the US is insurance distortions. Specifically, because healthcare expenditures are uncertain, individuals need insurance, which distorts supply and demand market forces [1].
Insurance companies negotiate prices with healthcare providers, leading to higher prices for services and products. Additionally, the administrative costs of the healthcare system, including billing and coding, consume a significant portion of the healthcare spending [2].
Prescription drugs and physician and nurse wages may also contribute to excess health spending in the United States. Overuse of health care, or the provision of low-value or no-value care, is consistently identified as contributing to high costs in the US [3].
Inadequate health insurance coverage is one of the most significant barriers to healthcare access, and the unequal distribution of coverage contributes to disparities in health outcomes [4].
Social determinants of health, such as economic stability, education access and quality, health care access and quality, and neighborhood and built environment, also contribute to low health outcomes in the US [5].
Patients appear to be more dissatisfied with healthcare in more fragmented systems, highlighting the need for better integration and coordination of care [6].
The high healthcare spending in the US has a significant impact on the economy and society. Rapidly rising healthcare spending is considered to lower the growth rate in GDP and overall employment while raising the national debt [7]. Such increases would impact households by directly reducing disposable income or out-of-pocket costs and insurance premiums [7]. Public health expenditure is positively associated with economic performance across the United States [8].
Several policy options can be considered to address the paradox of US healthcare. Three broad strategies for establishing a health insurance system would achieve near-universal coverage, including enacting and enforcing a large employer mandate, an individual mandate, and a single-payer system [9].
Other potential options are improving competition, lowering prices, reducing the use of low-value care, and limiting spending or premiums [10].
Integration, prioritization, contextualization, and personalization of healthcare can also help unravel the paradox of primary care [11].
The paradox of US healthcare is a complex issue that requires a comprehensive understanding of the factors contributing to high spending and low outcomes. Insurance distortions, administrative costs, overuse of low-value care, inadequate insurance coverage, social determinants of health, and fragmented healthcare systems are some of the factors that need to be addressed.
The impact of high healthcare spending on the economy and society is significant, highlighting the need for policy options to address the paradox. The potential policy options include establishing a health insurance system, improving competition, reducing low-value care, and integrating and personalizing healthcare. Addressing the paradox of US healthcare requires a coordinated effort from policymakers, healthcare providers, patients, and stakeholders.
Source:
- Administrative Expenses in the US Health Care System. jamanetwork.com/journals/jama/fullarticle/2785479
- High U.S. Health Care Spending: Where Is It All Going?. www.commonwealthfund.org
- Factors Associated With Overuse of Health Care Within US …. jamanetwork.com
- Access to Health Services — Healthy People 2030. health.gov
- Social Determinants of Health — Healthy People 2030. health.gov
- The Problem of Fragmentation and the Need for Integrative …. www.ncbi.nlm.nih.gov/pmc/articles/PMC2653966/
- Effects of Health Care Spending on the U.S. Economy | ASPE. aspe.hhs.gov
- Healthcare Expenditure and Economic Performance. www.ncbi.nlm.nih.gov/pmc/articles/PMC7237575/
- Policies to Achieve Near-Universal Health Insurance …. www.cbo.gov/publication/56666
- Reducing Health Care Spending: What Tools Can States …. www.commonwealthfund.org
- The Paradox of Primary Care — PMC. www.ncbi.nlm.nih.gov/pmc/articles/PMC2713149
