Table of Contents
I. Cost/Performance ratio 5
II. Accessibility to health care 6
III. Satisfaction with health care system 7
IV. Health and well-being 11
“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
----- Martine Luther King, Jr.
“Onein seven Americans, including more than 8 million children, does not have even basic healthcare coverage.”
----- Dave Reichert
Political figures and insurance companies state that the US has the best health care system in the world, many people however do not agree with this assertion, especially the 46 million people in the US without health insurance. The risingcosts of health care and the lack of access to health care are becoming major issues, and many health care professionals have begun to voice their concerns about a potential future crisis in the US health care system.
How do we know when a health care system is “successful” – that is how well it performs its job – and “fair”, in terms of cost, accessibility, overall satisfaction and heathoutcomes in a population? The World Health Organization (WHO) released a report in 2000, in which it outlined three goals for a ‘good’ health care system: it should make the health status of the entire population as good as possible across the whole country; it should respond to people’s expectations of respectful treatment and client orientation by the health care providers; it should ensure financialprotection for everyone, with costs distributed according to one’s ability to pay.
Cost / Performance ratio
In making comparison of ‘successful’ health care systems, several basic facts emerged: the United States has – by far – the most expensive health care system in the world, based on health expenditures per capita and on total expenditures as a percentage of GDP. The UnitedStates spent $6100 per capita on health care in 2004, more than twice the median, and far more than its closest competitor, Switzerland, who spent $4011 per capita.
The reasons for the particularly high cost of health care in the U.S. can be attributed to a number of factors, ranging from the rising cost of medical technology and prescription drugs, to the high administrative costsresulting from the complex multiple payer health care system. For instance, it has been estimated that between 19.3 and 24.1 percent of the total dollars spent on health care in the U.S. is administrative costs. The growing shift from non-profit to for-profit health care providers, such as the growth of for-profit hospital chains, has also contributed to the increased cost of health care.In addition, the WHO report (WHO, 2000) looked at the degree to which financial contributions to health systems are distributed fairly across the population, and it was found that the US was the least fair of all the OECD countries. This system of financing has implications for much of the population, but especially for those who are uninsured, or underinsured. A paradox of medical costs is thatpeople who can least afford them – the uninsured – end up being charged the most. Insurance companies, with large numbers of customers, have the financial muscle to negotiate low rates from health-care providers; individuals do not.
Accessibility to health care
According to recent figures, 46 million people in the US were uninsured in 2007. This is an embarrassment to politicians,but a matter of life or death to many of these 46 million US citizens. But a shadow problem is facing an additional 25 million people who spend more then 10 percent of their income on out-of-pocket medical costs – they are the underinsured.
1. The Uninsured
Unforeseen accident and illnesses can financially and, possibly, physically rob one who does not have proper health insurance...