Some prominent reasons strongly support that healthcare in the U.S. needs to be reformed. The skyrocketing price of healthcare, the need for improvement in the healthcare quality, 25% of Americans having no or little health insurance, and the economic costs of health care fraud are some valid reasons to reform healthcare. Around 2 million people have been affected by medical bankruptcies, and the rising health care costs may consume the entire federal budget. This has also made preventive care unaffordable to many. With low-income families often turning to the emergency room due to lack of access to proper healthcare, the cost of healthcare rising even higher. This has made the health care system in the U.S. twice as expensive for individuals compared to any other developed country. Consequently, in 2019, health care expenditures contributed 12% to gross domestic product and 17% of all personal consumption expenditures.
Healthcare remains a significant aspect of the national conversation, and it is encouraging to hear politicians, policymakers, opinion leaders, and even normal people discussing how the nation can offer the highest-quality and affordable healthcare to patients. It is a truth that every American should have access to affordable and meaningful coverage. The country needs to build on its current coverage system provided by the government, employers, and individually selected plans so people can largely benefit from choice and competition. People should have the option to choose the health plan that best fits their needs. Reforming payment and delivery processes is an essential aspect to completely cover the costs of care and ensure practice sustainability.
Reasons behind Rising Healthcare Costs
Increased Life Expectancy
Due to the advancement and progress in the healthcare sector, the life expectancy of the elderly has increased, but these innovative and advanced medical procedures are expensive and yet not guaranteed. This creates doubt whether the expensive medical procedures that have a low chance of success should be carried out or not. In U.S. such procedures are carried out despite the poor prognosis.
In the healthcare sector in the U.S., there is less price competition compared to other industries. The reason being people in the U.S. don’t pay for their healthcare, as they only pay a set fee or co-pay, and the rest amount is paid by the insurance company. Thus, people do not price-shop for medical procedures, lab tests, or for doctors as they would for other products.
Another reason behind the high health care costs is an increase in malpractice lawsuits. Doctors are often seen conducting over-test suggesting several colonoscopies and MRIs. The doctors advised these tests even if these were not required at all. The doctors mostly do this to protect themselves from getting sued because of not advising a particular test to a patient.
Ways to Improve U.S. Healthcare
To determine the best way for the world’s largest healthcare system, the government should recall the ethical imperative and fix the imperfections of the ACA and primarily focus on extending the health coverage to the uninsured, without affecting the existing coverage enjoyed by the majority of the Americans today. The nation’s health reform law, the Affordable Care Act, was enacted in March 2010 to reform both private and public health insurance systems. Since its enactment, this act has helped 20 million people get health insurance. This law comes with many benefits like increase benefits and lower costs for consumers, providing funding for public health and prevention, boost health care and public health workforce and infrastructure, boost innovation and quality in the healthcare system. However, the ACA needs to be strengthened to improve the healthcare system in the U.S.
Some of the measures that can be adopted to make the ACA more affordable for individuals and families include:
- While retaining the ACA’s current formula, enhanced tax credits offsets should be offered to young adults.
- The effort to expand Medicaid eligibility to 133% of the federal poverty level should be supported at the state level.
- Tax credits eligibility should be expanded to premiums to five times the federal poverty level.
- Threshold determining whether the employee’s premium is affordable or not that affect subsidies to buy coverage on exchanges should be lowered.
It is essential to take measures to correct the flaws in the ACA’s individual-market risk pool, where younger and healthier people are often reluctant to participate. The efforts of the states to adopt individual mandates should be backed while expanding outreach efforts to convey to patients about financial incentives they can receive to purchase coverage on the exchanges. The ACA paved the way to extend health insurance to everyone and now it is the time to strengthen it to ensure that comprehensive and affordable coverage is made available for all Americans.
To reform the U.S. health system, care should be taken that individuals having health insurance should not lose their coverage. Instead, reform in healthcare is required to provide health coverage to millions of uninsured people who lack access to proper healthcare at the right time that will help them live long and healthy lives. Though the number of uninsured people was significantly reduced after the implementation of the ACA, but millions still remain without coverage, so efforts are required to offer health insurance for all Americans. Some of the measures that can be adopted for the reform of healthcare include:
- Ensuring proper and adequate funding to Medicaid, the Children’s Health Insurance Program, and other safety-net programs.
- Strengthening and stabilizing the individual insurance market
- Coverage for pre-existing medical conditions.
- Young adults covered under parental plans.
- Guaranteed issue of health plans regardless of the individual’s status.
- Lowering regulatory burdens that increase costs and detract from better care.
Different strategies need to be initiated to lower the nation’s uninsured rate that includes improving health insurance affordability so that people can afford to buy health plans from the health insurance exchanges. Even the premium tax credits can be increased to 500% of the federal poverty level from 400% so that young adults eligible for premium tax credits become insured.