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National Health Care Spending Essay

Introduction
Health care in the United States is provided by many distinct organizations. Accordingly, the US Census Bureau (2010) reported that health care facilities are largely owned and operated by private sector businesses. While sixty-two percent of hospitals are non-profit, 20% are government owned, and 18% are for-profit. Furthermore, 60–65% of healthcare provision and spending comes from programs such as Medicare, Medicaid, TRICARE, the Children’s Health Insurance Program, and the Veterans Health Administration. Most of the population under 67 is either insured by themselves or a family member’s employer, buy health insurance on their own, and the remainder are uninsured. Health insurance for public sector employees is primarily provided by the government.

Still, the United States has a life expectancy of 78.4 years at birth, up from 75.2 years in 1990, and is ranked 50th among 221 nations, and 27th out of the 34 industrialized countries, down from 20th in 1990. Of 17 high-income countries studied by the National Institutes of Health in 2013, the United States had the highest or near-highest prevalence of infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, homicides, and disability. Together, such issues place the U.S. at the bottom of the list for life expectancy. On average, a U.S. male can be expected to live almost four fewer years than those in the top-ranked country (NIH, 2013). Thesis Statement

As dismal as the statistics are, in recent years, policy makers as well as leading economists have focused a considerable amount of attention on aggregate spending increases in health care and how health care spending impacts the United States economy. Thereby, specific emphasis has been given to identifying and examining distinctive factors that have contributed to spending growth, and proposing solutions for reduction. Seemingly, factors that have contributed to spending growth encompass changes in health care utilization, population demographics, price inflation, and advances in medical technology. Thus, as more and more advanced scientific technology is developed the costs associated with providing quality health care increases.

With that said, according to the World Health Organization (WHO), the United States spent more on health care per capita ($8,608), and more on health care as percentage of its GDP (17.2%), than any other nation in 2011. Yet, the United States ranked last in the quality of health care among similar countries, and notes United States care costs the most. Similarly, in a 2013 Bloomberg ranking of nations with the most efficient health care systems, the United States ranks 46th among the 48 countries included in the study. The U.S. Census Bureau reported that 49.9 million residents, 16.3% of the population, were uninsured in 2010 (up from 49.0 million residents, 16.1% of the population, in 2009).

In addition, a 2004 Institute of Medicine (IOM) report said: “The United States is among the few industrialized nations in the world that does not guarantee access to health care for its population.” Further, “with the exception of Mexico, Turkey, and the United States, all of the other countries had achieved universal or near-universal (at least 98.4% insured) coverage of their populations by 1990;” and recent evidence demonstrates that lack of health insurance causes some 45,000 to 48,000 unnecessary deaths every year in the United States. In 2007, 62.1% of filers for bankruptcies claimed high medical expenses, and 25% of all senior citizens declare bankruptcy due to medical expenses, and 43% are forced to mortgage or sell their primary residence.

On March 23, 2010, the Patient Protection and Affordable Care Act (PPACA) became law, providing for major changes in health insurance. The medical system has been forced to change normal procedures to meet federal regulations. The law includes a large number of health-related provisions to take effect over the next four years, including expanding Medicaid eligibility for people making up to 133% of FPL, subsidizing insurance premiums for peoples making up to 400% of FPL ($88,000 for family of 4) so their maximum “out-of-pocket” pay will be from 2% to 9.8% of income for annual premium, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage and denial of claims based on pre-existing conditions, establishing health insurance exchanges, prohibiting insurers from establishing annual spending caps and support for medical research.

The costs of these provisions are offset by a variety of taxes, fees, and cost-saving measures, such as new Medicare taxes for high-income brackets, taxes on indoor tanning, cuts to the Medicare Advantage program in favor of traditional Medicare, and fees on medical devices and pharmaceutical companies; there is also a tax penalty for citizens who do not obtain health insurance (unless they are exempt due to low income or other reasons). The Congressional Budget Office estimates that the net effect (including the reconciliation act) will be a reduction in the federal deficit by $143 billion over the first decade. Conclusion

In conclusion, in contrast to the argument that rising health care spending at the Federal and State level decreases economic growth, and employee health care costs decreases job growth, a reasonable argument, could also be made that rising health care spending has important benefits, often outweighing the increased costs. I submit that improvements in quality may produce a cause and effect whereby, the cost of medical care is decreased. Subsequently, increased health care spending improves increases in access to new technologies, providing both new options of treatment and treatment for a greater number of individuals; which provides for healthier employees. Moreover, health care spending growth is more likely to create health care jobs, increases wages for health care workers, expands local tax revenues, and increases demand for related goods and services.

We, as Americans, profess to be the richest, strongest, and greatest country, yet we stand by and watch homeless citizens sleeping on the streets, children going to bed at night hungry, and citizens dying because they lack health insurance. The Affordable Care Act is a good start, however we must keep legislators who oppose the bill from chipping away at it. Health care should be a human right, not a privilege. For example, in May 2011, the state of Vermont became the first state to pass legislation establishing a Single-Payer health care system. The legislation, known as Act 48, establishes health care in the state as a “human right” and lays the responsibility on the state to provide a health care system which best meets the needs of the citizens of Vermont. The state is currently in the studying phase of how best to implement this system.

Of the 26.2 million foreign immigrants living in the US in 1998, 62.9% were non-U.S. citizens. In 1997, 34.3% of non-U.S. citizens living in America did not have health insurance coverage as opposed to the 14.2% of native-born Americans who do not have health insurance coverage. Among those immigrants who became citizens, 18.5% were uninsured, as opposed to noncitizens, who are 43.6% uninsured. In each age and income group, immigrants are less likely to have health insurance. With the recent healthcare changes, many legal immigrants with various immigration statuses now are able to qualify for affordable health insurance. We need to push for more. The cost for individuals that use emergency rooms as port of entry to medical care far exceeds obtaining a primary care provider.

References

Institute of Medicine (2004). Retrieved from http://.www.institutesofmedicine, May 09, 2014.

National Institute of Health (2013). Retrieved from http://.www.nationalinstituteofhealth, May 10, 2014.

U. S. Census Bureau (2010). Retrieved from http://.www.uscensusbureau, May 10, 2014.

World Health Organization (2014). Retrieved from http://.www.worldhealthorganization, May 10, 2014.

www.healthcare.gov (2014). Retrieved from http://.www.healthcare.gov. May 10,
2014


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