Health is the part and parcel of every person’s life. Every person should have information regarding his/her get and should get the best health benefit from the country where he/she resides. Recently the health scenario has changed worldwide. With improving health systems, better diagnosis and patient care, the overall cost of health care systems are rising at an alarming rate. US health care system is one of the best examples of the same.
Shifts taking place currently in the health care system.
In the US the health care system is undergoing the process of metamorphosis or shift. This shift can be broadly explained under three headings:
- A shift in accountability:
Initially, the cost of health care used to be low. The additional cost was distributed to hospital management and the health care providers; so these people used to get less profit. Now, the present scenario has changed completely. Individuals or health caretakers are paying more; in form of health insurance, high premiums, taxes etc. Individuals may more in the name of quality.
2. Shift from acute care to wellness and prevention:
In the health care industry, new companies arise every day. These people view health care with a totally different lens. They consider people as patients, and target all these patients with a totally new landscape. They provide health information, set up health care camps at different places, organize seminars, and provide free health checkups to find out those people from the society who may approach one or the other ailment in near future. After finding out such people, they provide complete medical information to them, along with treatment. So, there is a shift from treatment of ill person to treatment of a person who is approaching illness. This is also understood as prevention of disease.
In this way, they build up lifetime relationship with such people/patients. If this person requires health advice in future, naturally he/she will come up for help to this new entrant only. Gradually, the company will grow with each person who adds up in its group.
- A shift in consumer demand:
Consumers have now become more informative about their overall well-being. So, they demand more from a medical treatment than before. Their demand also increases because now they have to pay more for the same treatment in form of insurance, premiums etc.
Current and potential challenges with the health care system.
- Increasing cost: The most important current and future challenge with health care systems in the US is the cost. In the 1980s, an overall increase in health care cost increase was observed on a national scale. Thereby, an increase has been observed every decade. In the mid-1990s, government and private banks started providing medical reimbursement policies; this reduced the overall medical expenditure of many individuals; but not as a whole.
Experts suggest that these costs will further rise in the next 30 years. The US spends maximum per capita income on health care in comparison to other developed countries. Due to this ever increasing price, the public is unwilling to accept changes in health care system. This concept of ‘shift’ discussed in Part 1 above is failing; in fact, it will convert into crisis if the US government does not find adequate methods to control health expenditure.
- Lack of information: All consumers are not aware of government and non-government policies related to taxes. Therefore, the government and private agencies have to pay an added amount for educating the people regarding various health care policies.
Lack of information also creates reluctance and non-acceptance in the people regarding the changed scenario.
- Competition: The industry faces regular competition in terms of cost, quality, and generation of timely services.
Health care cost for consumers.
In the ten-year time scale from 1999 to 2009, the cost of health care in the US climbed from $1.3 trillion to $2.5 trillion. Even during the recession period, the health care cost rose by 4% percent. 17.6% of GDP is spent on health care cost according to 2009 reports. This was 13.8% ten years back in 1999. These increasing health care costs have more impact on medium income families;
How have the costs for consumers evolved?
Various factors have contributed from time to time to contribute to the evolution of costs for consumers. These factors include:
- Rise in population: Better health facilities result in an increase in the overall percentage of elderly people i.e. people above the age of 65 in the US. This overall results in rising of the population. Rising population always imposes challenges on providing better services, which demand more cost. As a result, US health care system has evolved to become the most expensive health care system in the world. Increases in key health care technologies and related costs;
- Allied health care professions: There are many professions which grow along with health care. These include health insurance service related professions, team leading and team support, analytics, medical information providers etc. All these in a way, contribute to the growth of the overall cost of the health system.
- Discovery of new drugs: With increasing diagnosis and research, newer drugs are coming into the market almost every day. After successful clinical trials, these new drugs come into the market. It is a universal fact, that new technologies are always costlier than old ones; because they are always betterment towards old services. New drugs related to chemotherapy, cancer, HIV, AIDS, vaccines, dengue etc. contribute to the overall cost increase.
- Insurance: with increasing vigilance and cost, almost all families of US try to acquire one or the other health care package. This package is taken with a hope that it will help in medical reimbursement at the time of emergency. So, it is natural that the healthy individual would always be ready to pay an amount which ensures his health at the time of need. This increasing concern has led to increasing increasing cost of individual and family health care insurance.
The following points will explain consumer reaction to the rising cost of health care system:
- Reduction in hospital admissions: People don’t want to go to the hospital. They try to get home treatment and will rush to the hospital only at the time of emergency.
- Increase in outpatient surgeries
- Increase in home care
- Sometimes are trying to adjust themselves to limited choices. They try to take that health care plan that suits their pocket instead of choosing the one which is most appropriate for them.
How the health care system is handling challenges.
The American health care system has handled all its challenges in the most outstanding way. Two best strategies adopted by this system to handle challenges are:
- Affordable Care Act
On March 23, 2010, President Obama signed Affordable Care Act. This act provides Medical aid to millions of low-income Americans. It also extends medical insurance and aid to Americans from time to time. More commonly, this law is known as Obamacare. One of the primary targets of ACA is adults in the age group 19-64. So, to improve overall lustiness of the American citizen, Affordable Care Act was launched. This act makes it compulsory for maximum American citizens to have a health insurance.
This was one of the best answers to the growing challenges of health care system.
- Financial management
Nowadays, hospitals have started hiring of services of doctors. In such a case, doctors visit the hospital part-time; but become associated with the hospital as an employee. So, healthcare organization has to pay an only part-time fee to the physician. This is a good way out to meet the organizational mission without hampering the financial management system.
US health care systems are amongst the most expensive health care systems; which actually accounts to about 3 trillion dollars per year. Shifts in health care policies from time to time have contributed to the same to a very great extent. It is important to evolve a new cost-effective system which fits the pocket of an average American citizen. A set of treatment guidelines should be given to the physicians. Expensive medical treatment should be given to patients only in extreme cases. Every American should be insured. If all these points are followed, then only the target of 100% healthy America can be achieved.
- Lemper, T.A. (2013) “The Supreme Struggle: Obamacare and the new limits of Federal Regulation”, Business Horizons, 56 (6):797-805.
2. Conklin, T.P. (2002) “Health care in the United States, an evolving system”, 7(1): 5-17