The United States Health Care System
Moving from a fragmented to a unified health care system requires that individual units recognize their dependence on each other and the importance of collaboration. The model must include “processes,” such as doctor examinations, laboratory tests, follow-up visits by nurses, and medication administration. The model must also explain how each process relates to the delivery of health care and the interactions among processes.
Many prominent single-payer proposals base their benefit packages on newsink categories of essential health benefits. The requires insurance plans to cover a variety of services, including ambulatory care and hospitalizations. It also requires insurers to cover specialized areas. In order to meet these requirements, all insurance plans must cover a comprehensive range of services, from preventative care to rehabilitative care. Ideally, the benefits package should also include the cost of non-emergency transportation services and early and periodic screenings.
In addition to addressing individual patient needs, health organizations need to support the development of clinical care teams and wikireports. To accomplish this, organizations must invest in information/communications technologies, systems engineering tools, and the associated knowledge. In addition, organizations must provide the necessary material, managerial, logistical, and technical support to ensure integrated, patient-centered care. This is challenging in an extremely fragmented care delivery system.
In addition to these elements, the health care system is also subject to the political and economic environment. It is shaped by a variety of keek, including the federal government as the largest purchaser of health care services, principal regulator, and principal research patron. These actors shape the health care market and influence the direction and quality of care.
While the United States leads the world in health care spending, it lags behind peer countries in terms of coverage and value. A large percentage of Americans lack health insurance, and many face cost-related barriers to care. Employer-sponsored health insurance is less common than in the past, and public insurance programs have trimmed benefits and increased deductibles. Furthermore, the United States spends more money on health care administration than peer nations, which detracts time from patient care and frustrates clinicians.
The United States health care system needs to transform its model of care delivery. It needs to place a greater emphasis on coordinated primary care. Current resources must be redirected and new ones isaimini be allocated to achieve this transformation. Moreover, payment policies for health care providers should reflect a greater emphasis on primary care. And, Congress should enact comprehensive legislation to promote the change.
ACP supports single-payer and public choice models. The organization also supports standardization of billing and quality measure reporting. These changes could reduce administrative burdens on physicians, which increase the risks of medical errors. There is a need for rigorous research into these aspects of the health care system. Its members are ready to take on this challenge.
ACP endorses the idea of rational tinypic of health care resources by incorporating value statements and cost-effectiveness analyses into price and coverage decisions. Its position on cost-effectiveness is reflected in its guidelines and practice. Further, the American College of Physicians calls for policy changes that will slow down health care spending growth and make the health care system more efficient.
In addition, the ACP believes that universal coverage is essential to improve health care delivery. However, critics of universal coverage argue that such a plan would ration care, increase out-of-pocket costs, and lower physician pay. Furthermore, there is no guarantee that patients will receive quality care. Furthermore, research has shown that patients without health insurance have a higher rate of preventable mortality. In short, a comprehensive health care system must prioritize primary care and emphasize affordability as a key component of health care reform.
Lastly, a single-payer system is disruptive and could put a strain on the federal budget. It would require taxation of health insurance premiums. Further, it would eliminate or severely limit the role of private insurers. As a result, it may prove to be too expensive and unattainable for many people. However, the single-payer model can be structured to address public concerns and provide universal coverage. For example, the federal government could provide funding for coverage and set minimum standards, while states could oversee supplemental plans offered by private insurers.