Introduction
The issue of the effectiveness and cost of the US healthcare system has been a major topic of debate for many years. The annual national health budget of over $3.5 trillion sets a world record of 17.9% GDP (Papanicolas et al., 2018). At the same time, in the ranking of states with the most effective healthcare system, the United States takes only 50th place (Shrank et al., 2019). These statistics are far behind most European countries with a more stable position in the medical sphere. Despite the industry’s trillion-dollar budgets, it is stated that between 10% and 15% of Americans do not have any insurance and therefore avoid medical care in every possible way (Papanicolas et al., 2018). In a 2016 Kaiser Family Foundation survey, about a quarter of Americans aged 18 to 64 reported severe problems paying medical bills (Papanicolas et al., 2018). Unfortunately, the statistics have only constantly gotten worse since then.
The Prices for the Services and Medical Debts
Many people around the world may inaccurately assume that the medical sector in the States is flawlessly set. However, despite a large number of highly motivated healthcare professionals, the cost of services and insurance plans makes it unattainable for a middle-income American to rely on the system. Monthly payments for private insurance plans vary from state to state and are calculated based on customer preference, age, income level, and chosen insurance model. An important factor in the price and arrangement of the insurance plan is the presence of chronic diseases. For example, the average cost of premium private insurance for a 30-year-old American would be $483, and for a 60-year-old, it might start from $1,150 (Shrank et al., 2019). Few people in the country can afford such monthly expenses, but the lack of insurance will inflate the total cost of medical services even higher. For example, the average cost of knee surgery for a patient with insurance will be $4-6 thousand. Without insurance, such an operation will cost approximately $30-70 thousand (Shrank et al., 2019). Unfortunately, in such cases, the uninsured American gets a long-term debt for years to come.
The Reason Behind It
Instead of trying to achieve a more affordable cost of medical care, insurers pay clinics and compensate for their costs at the customer’s expense. They are introducing additional options, developing new loyalty programs, selling premium plans, which does not make the case more serviceable. The widespread use of health insurance has caused a domino effect. Hospitals and doctors have quickly adapted to these financial realities. Sadly, nowadays, it is about money chase, not a patient’s financial and physical care. Some physicians in popular specialties such as surgeons or anesthesiologists intentionally quit the staff of hospitals. Specialists unite into separate networks, cooperating mostly with outsourcing clinics. In such cases, the hospital issues a separate bill to the patient or insurance company for the days spent in the medical ward. Medical services and surgeries payments can be organized by the cooperative of physicians at their discretion (Shrank et al., 2019). The division of budgets does not alleviate the case but only increases the cost of services.
Conclusion
An abundance of complex settlements with insurers leads to significant administrative costs, which severely increase the cost of services. Disputes about such enormous amounts of money are taking American healthcare further away from the subject of respect for the interests of patients. All specialists should unite and be ready to debate this issue at all possible levels for immediate elaboration and improvement. Otherwise, it can lead to even more negative consequences and outcomes.
References
Papanicolas, I, Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. JAMA, 319 (10), 1024–1039.
Shrank, W. H., Rogstad, T. L., & Parekh, N. (2019). Waste in the US health care system: Estimated costs and potential for savings. JAMA, 322 (15), 1501–1509.