Johnson Katie Final Essay Nov 29th, 2007
Health care in the United States is too expensive. The skyrocketing price of prescription drugs, the damaged Medicare/hospice system, and how preventive drugs or procedures aren't provided in any health care systems all play a big role on why the health care system needs to change. The United States of America spends two trillion on health care every year. Despite the fact that United States offers the best medical technology and scientific research in the world, the benefits of the American health care system comes at a price that a significant number of the population cannot afford. Contrasting to most the rest of the world, the United States is the only major industrialized nation that does not have government-run or subsidized universal health care. In the United States approximately 84% of citizens have health insurance. The average citizen acquires their insurance through their employer, purchasing it individually or by having it provided by government programs. The remaining percentage of the people who are without health insurance equates to about 47 million people. This in turn causes medical bills to become the most common reason for personal bankruptcy in the United States. The National Coalition on Health Care has found that "one in every four Americans say their family has had a problem paying for medical care during the past year," which is up by 7 percent from over the past nine years. "Nearly 30 percent (of Americans) say someone in their family has delayed medical care in the past year," which is a new high on recent polling. In the following text a brief survey of reasons for the high costs of health care will be reviewed.
According to Blue Cross/Blue Shield, the number one reason behind the high cost of health care is due to the expense of prescription drugs. Over the past few years there has been an increased usage of prescription drugs. In 2004 Americans had 3.1 billion prescriptions filled, or more than ten prescriptions for each citizen. When there is an increase in demand there is an increase in cost. Due to the amount of each citizens need for prescription drugs, the cost for these products has skyrocketed. Also during the last two decades drug companies have gained exclusive rights and protection on brand-name drugs. Allowing them to sell their patented drugs exclusively over a longer period of time, often at significantly higher price. Another reason health care is higher in demand is the increase of advertisements in the media. By promoting specific drugs, drug companies have had a major impact on the consumer demand. By raising public awareness of these medicines, consumers are requesting more for the specific drugs that are advertised. Creating higher premiums and more out-of-pocket costs for the patient. A solution to the increased cost of prescription drugs is to purchase generic prescription drugs rather than name brand prescription drugs. Generic drugs are typically less expensive. Blue Cross/Blue Shield states that "the more you use costly brand-name prescription drugs, the more costs rise. Which means you and your employer ultimately pay more in the form of higher premiums, coinsurance and co-pays." By choosing generic prescription drugs whenever possible you not only save money, but you help the cost of health insurance stay lower. Health care in America has enhanced our every day lives and improved our life expectancies. People are living longer and better due to new technologies and medicines. But health care has yet to help those who are under hospice care. Hospice is a program
that provides special care for people and their families who are near the end of life. Recently those under hospice care are living longer than their life expectancy. Consequently, health care has had a difficult time helping those who are under hospice care. One source of expense for the hospice is that the federal government demand hospices are exceeding the reimbursement limits and have to repay hundreds of millions of dollars owed to Medicare. This creates the problem that in most cases the money has already been spent on salaries, medicine and supplies. The Medicare Hospice Benefit was originally intended for people who had less than six months to live, had cancer or predicted to die fairly quick. But within the last five years, hospice the use has increased dramatically among patients who have less predictable illnesses. For instance, those with Alzheimer's disease and dementia are now the majority of hospice patients, and are predicted to live for about 86 days compared to the 44 of those with cancer. "A hospice's total annual reimbursement cannot exceed the product of the number of patients it serves and a per-patient allowance set by the government each year ($21,410 in 2007)" says Kevin Sack, a writer from the New York Times. Medicare's coverage of hospice has become one of the quickest growing components of the government's fastest growing entitlement. The spending has tripled from 2000 to 2005, to $8.2 billion. Currently 40 percent of Medicare recipients now use the service. By having hospice issue disease-specific guidelines for the program would help cut down the expenses needed to get reimbursed to Medicare. Samuel Uretsky, the author of Health Care in the US, found that the cost of health care is the greatest patient concern in America, particularly for the elderly. In 2006, a Medicare drug benefit plan went into effect, but it offers only limited benefits and does
not cover prescription drugs. Medicare is currently struggling financially. The primary problem is that as the price of health care increases, the ratio of people who work and are pay taxes toward Medicare retirees is decreasing. Currently there are about four workers paying taxes into Medicare for each older American on the Medicare plan. A report by the Medicare Board of Trustees from 2006 indicates that by 2030 the amount of workers will drop to about 2.4 workers for each beneficiary.
A large portion of the American public could lead a longer and healthier life if they were to understand the importance of the early care options and regular screenings that have the potential to prevent or reduce the possibility of future health problems. Many costly and disabling conditions such as cardiovascular diseases, cancer, diabetes and chronic respiratory diseases are linked by common preventable risk factors. Many diseases can be prevented, yet health care systems do not make the best use of their available resources to support this process. Most current health care systems are based on responding to acute problems and urgent needs of patients. According to the World Health Organization "testing, diagnosing, relieving symptoms, and expecting a cure are trademarks of contemporary health care. While these functions are appropriate for acute and other small health problems, a notable difference occurs when applying this model of care to the prevention and management of chronic conditions". Preventive health care is inherently different from health care for acute problems and with the current health care systems.
Given that many conditions are preventable, every health care facility should include prevention support. When patients are systematically provided with information and
skills to reduce health risks, they are more likely to, for example, reduce substance use, stop using tobacco products, practice safe sex, eat healthy foods, and engage in physical activity. These risk reducing procedures can dramatically reduce the long-term burden. It is important that people are aware how to promote a change in thinking in preventive health care. This new thinking will stimulate the commitment and the action of patients and families, health care teams and the community. The World Health Organization suggests that the essential elements to integrate prevention care into the health care system are to "support a paradigm shift towards integrated, preventive health care, promote financing systems and policies that support prevention in health care, equip patients with needed information, motivation, and skills in prevention and selfmanagement and finally to make prevention an element of every health care interaction."
In America today there are approximately 47 million people with out health insurance. The rising costs of health care in the United States will consume everyone unless measures are taken to fix the system. Three solutions to the problem would be to fight the increasing costs of prescription drugs, issue new guidelines as to the use and application of government funded hospice care, and integrate preventive care into the health care system.