The health care delivery system in the U.S.
is characterized as fragmented. There is no centralized authority or a national health program which directs healthcare delivery and this has affected many aspects of health care such as cost, quality and access (Shih et al).The responsibility for health care delivery is shared among various agencies at the state level. Moreover, there is no multidisciplinary coordination among different health care providers in the same hospital or who care for the same clients.
Patients move about various care providers and settings without ample assistance, an experience that is both frustrating and unsafe while poor communication and the absence of accountability measures for a patient among different providers result in clinical errors, duplication efforts and wastage (Shih et al).Moreover, very costly, rigorous medical interventions are better remunerated as compared to long term primary and preventive care or the managing of chronic conditions.The access to health care is facilitated mainly by employer-based health insurance. Although about 80% of Americans have some form of health insurance coverage, an estimated 47 million Americans or 15% of the population are still currently uninsured (ACP).This raises the question of cost and affordability of adequate health insurance. The cost of premiums has risen to more than 25% of the average household income in 2006 with administrative costs as a contributory factor and is a hindrance to employers purchasing coverage for their employees (CED 4).The uninsured and underinsured have lesser access than the adequately insured to preventive medicine, required health care services and regular care by a personal physician (ACP).
As a result, these segments of the population have higher chances of yielding to illnesses that can easily be prevented, will most probably experience related complications or will die earlier.Hence, although national spending for health care has been steadily rising for the past years, there is a lower life expectancy, higher infant mortality and higher proportion of adults with limitations on their activities in the U.S. than in other developed countries (ACP).
Reforms to the current health care system in the U.S. through the institution of a single payer health insurance system are presently being advocated. This system allows for only one government institution to conduct the collection of health care fees and the disbursement of health care related costs drastically reducing administrative expenses (PNHP).Currently, more than a quarter over one-fourth of medical expenses are spent on administrative costs which, according to a Harvard Medical School study, cost Americans over $286 billion (Grumbach 533). This amount is sufficient to purchase coverage for the number of uninsured persons, supply prescribed medications for the elderly and enhance the quality of health care.Single-payer health care allows coverage of all employed Americans. The payment scheme requires employers to pay a 7% payroll tax and employees to pay 2% while a $2 tax for every pack of cigarette will also be imposed (PNHP).
The single payer insurance will cover all medically essential services including long-term, preventive and public health measures (PNHP).Instead of hospital billing, health care facilities will be allotted a yearly lump-sum amount from the government to cover operating expenses while a separate budget would cover expansion projects, acquisition of technology and others (PNHP). Physicians may choose to be paid through a variety of compensation options where government will mainly function as administrator.Essentially, the single payer health care system resolves the issues regarding the disparity in access to health care by permitting universal access to health care coverage at a more affordable cost with the same quality (Grumbach 534).
Further, it gives government greater control over the health care delivery system.
- American College of Physicians (ACP). “Achieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other Countries”. Annals of Internal Medicine 1,148 (2008).
13 October 2008 <http://www.annals.org/cgi/content/full/0000605-200801010-00196v1>
- Committee for Economic Development (CED). “The Employer-Based Health Insurance System is at Risk: What we Must do About it”.
2006. 13 October 2008 <http://22.214.171.124search?q=cache:0Y_CmIWg4eMJ:www.ced.org/docs/report/re port_2007healthcare_ebi.pdf+employer- based+health+insurance&hl=en&ct=clnk&cd=1>