The price of health care is the most important factor behind U, S. Health care costs, accounting for 90% of spending. These costs reflect the cost of care for people with chronic or long-term illnesses, the ageing of the population and the rising cost of new drugs, procedures and technologies. Getting ready to turn on the grill? Become a Pro with Matt Abdoo's Burger and Steak Recipes Today, all it takes is a surprise medical bill to send a patient into bankruptcy.
So, what exactly makes healthcare in the U.S. UU. So expensive? Health insurance prices? Government regulation or lack thereof? The pharmaceutical industry? TMRW spoke to experts about different aspects of the health care system, who pointed out five general reasons. The most prominent reason is that U, S.
Health care is based on a for-profit insurance system, one of the only in the world, according to Carmen Balber, executive director of Consumer Watchdog, who advocates reform in the health insurance market. In the U.S. On the contrary, many other countries have some element of something private, but there is a basic understanding that health care is a right, not a privilege, Balber said. The underlying motive for making money has a domino effect that increases prices, he continued.
For example, insurance companies spend a tremendous amount of money on utilization review, the process that determines if a medical service is covered by a particular plan, adding that the goal is not to pay consumers for the care they thought they were insured for. In the same way, the. Georges Benjamin, executive director of the American Public Health Association, pointed to the lack of universal health care, in which everyone is guaranteed access without suffering financial hardship, as the main reason for the high costs. Health care exists in a system where patients are charged based on the services they receive, yet another reason why almost everything is more expensive here, Dr.
Harlan Krumholz, a cardiologist and professor of health policy at Yale School of Medicine, told TMRW. As a result, there is less use of primary care, Benjamin said, because the pay-per-service model encourages overuse. Balber argued that pay-for-service creates a perverse incentive to provide more procedures, rather than helping patients be healthier, so that the nation as a whole needs fewer procedures. Benjamin also spends less than other countries on social support systems and long-term care.
For example, a recent study found that private insurance companies paid almost two and a half times what Medicare would have paid for the same medical service at the same facility. To make things more expensive, the United States,. The government does not regulate what most healthcare companies can charge for their services, whether it's insurance, medication or care itself. The health system itself may be fragmented, in many parts of the country, there are only one or two companies that provide health insurance or health care.
This means that, again, there is little or no incentive for them to reduce costs, as patients don't have many options. In addition, healthcare providers are paid, on average, much more in the U.S. That in other countries, both Benjamin and Krumholz highlighted. Maura Hohman is a staff writer and reporter for TODAY Digital based in Brooklyn, who joined the team early in the coronavirus pandemic.
While she happily writes on a variety of topics, from pop culture to politics, she has a special interest in in-depth health coverage, especially research on COVID-19, women's health, and racial health disparities. This finding provides a new explanation for why U.S. spending is so excessive. According to researchers at Harvard's Chan School, what marks the U.S.
Apart from that, there may be inflated prices across the board. Hospital services and diagnostic tests cost more. And much more money goes into planning, regulating and managing medical services at the administrative level. In other areas, despite conventional wisdom, there seems to be less discrepancy between the United States,.
And other countries that are commonly thought of. Experts have previously suggested that high utilization rates could explain the high spending in the US. However, by looking at hospital discharge rates for various procedures, such as knee and hip replacements and different types of heart surgeries, the researchers found that the use of care services in the U.S. It's not that different compared to other countries.
In fact, compared to the average for all nations, Americans seem to go to the doctor less often and spend fewer days in the hospital after being admitted. Expert groups such as the Brookings Institute have suggested that low social spending could also be partly to blame, as funding programs to help low-income families, the elderly and the disabled would mitigate the demand for health care. But then again, researchers didn't find a substantial difference in the U, S. Spend less than average but not much.
Another popular argument is that the US system has an unnecessarily high number of specialists, who usually earn more than general practitioners, and that increases spending. However, according to this report, the ratio of primary care physicians to specialists was similar between the United States and other high-income countries. The real difference between the US health care system and overseas systems is pricing. Meanwhile, administrative costs accounted for 8 percent of total national health expenditures in the United States.
For the other countries, they ranged from 1 to 3 percent. Health professionals in the United States also reported a higher level of administrative burden. A survey showed that a significant proportion of physicians consider the time they waste on matters related to insurance claims and the presentation of clinical data to be a major problem. Even so, they conclude, it is not clear whether innovation justifies high levels of spending.
On wages, high incomes can improve performance, and studies have suggested that some countries do not pay their health professionals enough. In addition, high salaries in the U.S. It may reflect the time and greater amounts of money that American health professionals must invest in their education and training. In general, researchers believe that prices in these areas should be analyzed and cut whenever possible.
It continues to struggle with high spending on health care, it is essential that we make progress in reducing these costs, said author Irene Papanicolas, visiting assistant professor in the Department of Health Policy and Management at Harvard's Chan School. One of the most notable findings of this report is that, at least in some areas, the quality of health care in the U.S. Long waiting times for treatment, for example, aren't as much of a problem for Americans as they are elsewhere. In the treatment of heart attacks and strokes, the U, S.
In fact, he had the best record in any country. Therefore, contrary to previous findings, quality of care may not be much worse in the US. But the nation's health system has been shown to remain the least accessible. An estimated 22 percent of the population missed a visit because they couldn't afford it, according to the report, compared to an average of 11 percent among the eleven countries.
The percentage of the population with health insurance has increased since the Affordable Care Act was passed, the report said. Even so, a substantial proportion of people would benefit from coverage but would remain uninsured in the United States. The report sheds a new vision on how the U.S. The health care system compares with its peers, and the fact that the cost of labor, pharmaceuticals and administrative organization seems to be driving spending.
It also points out that, despite this level of spending, too many of its citizens are still uninsured and without coverage. Spend more on healthcare than all other rich democracies in the world. But despite all that spending, life expectancy in the United States lags behind that of its counterparts. And many Americans struggle to pay for health care.
One of the reasons for the high costs of health care in the U.S. Is that the country never sets limits on payments for new treatments, such as MRI scans, organ transplants or new drugs. Another driver of rising costs is that the healthcare system became more complicated, as insurance companies require patients, doctors and hospitals to work harder to demonstrate that particular treatments are needed. Frakt said: “Behind the scenes there is a huge army of people who are managing how the hospital and doctors will be paid for those services.
And that's extremely complicated, because the exact way they're paid depends on our particular insurance. And my insurance is different from yours. A third reason for high U, S. Health care costs are due to health care industry, insurance companies and hospitals becoming more consolidated.
Referrals are usually to specialists within the HMO organization, who then decide on additional treatments. Due to the complexity of the system and the lack of fixed prices for medical services, providers are free to charge what the market will bear. Customer saves out-of-pocket costs, but forgoes choice between providers and treatment options. One of these women had excruciating headaches; the doctor assumed she had stopped her psychiatric medication until a CT scan found a brain tumor the size of an orange.
I could try the role of the AMA (American Medical Association) in all of this, but I'm not that brave. It has made us obsessed with medical advances and turned this country into the world's research laboratory. Today, it is urgent to reduce overspending to help stretch medical and hospital resources to cope with pressure on the overall system. What separates Maloney's story from the others is that she also has a privileged view of the healthcare system, having worked both as an emergency room (ER) technician and later as a medical writer and project manager for a pharmaceutical company.
In the case of Medicare and Medicaid, the government reimburses doctors and hospitals at rates far below what private insurers pay. Half of the country lives on medical debts and nearly a third of Americans report skipping health care because of cost, sometimes with detrimental health outcomes. In the United States, the federal and state governments are the main payers of health care costs through the Medicare for the elderly and Medicaid for low-income families, but the government plays a very small role in the employment of care providers and the operation of hospitals. Those experiences allow Maloney to open the curtain on the inner workings of the system, such as how much hospitals can bill insurance for patients who die in the emergency room and how uncomfortable medical students can be when they learn to talk about patient care in front of the patient.