In America there are so many people who live without healthcare. President Obama has tried hard to change that known fact by introducing and passing his new Obama Care Act. It is very important for people to have proper healthcare coverage, medical care, affordable medications, and for all healthcare services to be available to everyone, whether they are poor, middle class or rich. For most Americans, high quality care generally is readily accessible without long waits but at high cost.
However, the uninsured and, increasingly, the underinsured, the poor, and members of underserved minorities often have poor access to health care and poor health outcomes. The health workforce is well trained, yet the United States faces a severe shortage of primary care physicians. Approximately 45% of the U.S. population has a chronic medical condition, and about 60 million people, half of these, have multiple chronic conditions; the CDC estimated these numbers during a recent survey. 2
Most Americans 250 million (84.2%) have some form of health insurance coverage. But an estimated 47 million Americans (15.8%) were uninsured for a year, as reported for 2006 by the U.S. Bureau of the Census. A survey by the Centers for Disease Control and Prevention found that 43.6 million people (14.8%) of all ages were uninsured at the time of the National Health Expenditure Survey interview in 2006. However, as many as 89.5 million people under the age of 65 years lacked health insurance for a least 1 month or more during 2006-2007, according to a study by Lewin and associates published by Families USA. In addition, another 16 million people can be considered underinsured.
People without health insurance are much less likely than those with insurance to receive recommended preventive services and medications, are less likely to have access to regular care by a personal physician, and are less able to obtain needed health care services. Consequently, the uninsured are more likely to succumb to preventable illnesses, more likely to suffer complications from those illnesses, and more likely to die prematurely.
The U.S. health care system has much potential for improvement. Disparities related to race, ethnicity, and socioeconomic status has pervaded the U.S. health care system. In addition to the large numbers of Americans who lack adequate health insurance, the cost, quality, and utilization of health care services vary widely. Meanwhile, the need for long term care services and care coordination is increasing. Preventive care, cross discipline coordination, and proactive management of long term care might reduce the cost of care, but these services often are uncovered or poorly reimbursed.
Spending on health care in the United States has been rising at a faster pace than spending in the rest of the economy since the 1960’s. According to the Centers for Medicare & Medicaid Services- National Health Statistics Group states that in 2005, national health care spending amounted to approximately $2.0 trillion, or $6697 per person and 16% of the gross domestic product. By 2015, health care spending is expected to reach $4.0 trillion.
People with large medical care cost are often chronically ill, disabled, or poor. Our society’s inability to provide continuous, coherent patient centered care for this group of individuals is one cause of the high aggregate cost of health care and contributes to the cost of public insurance programs. Patients who enter Medicare without previous insurance but with chronic illness will be sicker and more disabled and therefore more costly to that government program.
Health insurance premiums increased drastically since the year 2005. Many have been unable to even afford health coverage. Employer based health insurance has been the basis for paying for health services since 1940, but it is fast eroding under the pressure of relentlessly rising costs of care.
Despite the growing need for coordination of health care services, government and private insures pay for health care services primarily on a episodic, visit related basis with few, if any, incentives for providing comprehensive, coordinated, and continuous care for the prevention and management of chronic illness. Primary care physicians now spend about 20% of their time in unreimbursed coordination of care tasks using the telephone or e-mail.
Despite repeated attempts to rein in federal expenditures for Medicare and Medicaid, federal have continued to increase much faster than inflation in the entire economy. 4
The Medicaid program provides medical benefits to over 52 million people who meet categorical eligibility standards. The federal government and the state share responsibility for funding Medicaid. The success of the VA system in dramatically restructuring itself indicates that major gains can be achieved in the United States in improving health care access and quality while reducing costs. One response to rising health care costs has been the adoption of consumer directed health plans in which the individual takes greater responsibility for paying for care out of pocket rather than the employer or government.
Unfortunately, for those with modest incomes, cost sharing has reduced medically necessary care, such as taking medicines for hypertension. The United States is in such a crisis when it comes to the health care system, yet is very important to see that every one of its citizens is afforded health coverage. People are sickly in this nation, like it is in other countries.
The United States is in the midst of a primary health care workforce crisis that is expected to worsen in the next decade. The population is aging, and baby boomers are at a high, and a large amount of people will soon be over 65 years and at greater risk for needing care for chronic conditions. The United States should continue to work on having national policies introduced to the health care system to help guide training, supply, and the distribution of health care providers to better assist those in need of health coverage. It is very important to make this a reality, because we the people of the United States need to be able to receive medical care, and health coverage, no matter if we are rich or poor in this society.