By Abhinita Mohanty:
Intense debate is going on in certain circles with regard to the American healthcare system and its efficiency. Being the most developed place, its healthcare system is popularly perceived as one of the best with huge amount of money spent on healthcare of the citizens. But although US spend the highest in terms of healthcare, there are has been large scale allegations of fraud, inefficiency and unstructured ways which is the ‘bone of contention’ of such a debate. The US healthcare system has certain uniqueness that need to be known. The private sector dominates the US healthcare system, rather than the public. Most of the insurers which coverÂ ‘healthcare aspects’ are private players. In a country which spends the highest in healthcare in relation to its GDP, a large section of its population remain uninsured. Commonwealth Fund published in Health Affairs estimated that 16 million U.S. adults were under-insured in 2003.
Some of the healthcare programmes of the US government include ‘medicare’ (completely federal govt. funded, covers elderly and disabled), ‘medicaid’ (jointly funded by federal and state govt. for lower income groups and disabled), and other few public programmes that are directly financed by the government. Most of the other healthcare funding or financing is done by either the corporate businesses for their employees or by the private insurance companies. So, the US healthcare system is financed jointly by federal govt. and the private sector.
As private sector gains an upper hand, frauds by healthcare and insurance companies have become a matter of concern in the US. Many American people are involved in various cases relating to their insurance companies with regard to non-payment. Many US citizens remain uninsured. A free market oriented approach to cover public healthcare is doomed to be inefficient. Nations whose healthcare is funded by the public sector remain efficient and spend much more than compared to ‘market oriented’ healthcare. Many of the companies that cover the health of their employees also often face trouble in terms of competitiveness.
‘The Patient Protection and Affordable Care Act (PPACA), commonly called the Affordable Care Act (ACA) or “Obamacare” requires insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or sex’ (Wikipedia). But the popular ‘Obamacare’ programme has worsened the situation by cutting funds for the ‘medicare’ scheme and taxing middle class Americans. As a result, the citizens (including those who are uninsured) will have to pay more taxes and the elderly population covered under the ‘medicare’ will also decrease. It also increases the US govt. financial deficits.
It is also believed that the American physicists prescribe expensive and branded drugs. The federal govt. does not negotiate with the pharmaceutical companies regarding the ‘pricing’ of such drugs and powerful guild of lobbyists very often influences the Congress. These further adds up costs to the working class and the uninsured, building profit on the back of such a population.
The challenge that the US faces is to ensure adequate health care for all, at the same time also taking care of their fiscal deficits in this matter. Also, many US companies bear the burden of taking care of their employee’s health which often puts them at a disadvantage. As the US population has started ageing to a large extent, a well structured healthcare system seems to be the only way to ensure the working dividends of its population and to keep itself at the helm as the ‘undisputed superpower’.