Lesson+2(American+Healthcare+System)

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The efficiency of American health care system is not high. Because uninsured Americans are less likely to have regular health care and use preventive services. They are more likely to delay seeking care, resulting in more medical crises, which are more expensive than ongoing treatment for such conditions as diabetes and high blood pressure.Uninsured people are less likely than the insured people to receive any medical care after any accidental injury or the onset of a new chronic condition. The uninsured with an injury were also twice as likely as those with insurance to have received none of the recommended follow-up care, and a similar pattern held for those with a new chronic condition. Uninsured patients are twice as likely to visit hospital emergency rooms as those with insurance; burdening a system meant for true emergencies with less-urgent care needs. Jingjian

Of course, the America health care system is the most sophisticated health care system in the world, but there are also many disadvantages of it. Firstly, it is very expensive. Although the government says that the citizens of the US can enjoy their 'universal access', but this is not complete yet. The people who have not bought their medical insurance can not enjoy the health care resources in this system. In this difficult period of time, the number of these people must have increased a lot. Therefore, the government needs to take a lot of measures to stop the deterioration of the whole situation. However, that is difficult. Firstly, the American health care market is a stage where various groups and companies fight for their interests. There is a subtle balance of power in this market: every group, or company, has the power to influence the development of the whole system, but not the power to control the development of the whole system. If the the government suddenly intervene in this balance of power (presently, the US do not have any specific department in the government which manages the whole health care system). Secondly, the groups who provide medical care survices always want to get higher profit. But the government itself will ask them to increase the welfare of people while cutting the price. Moreover, the people are used to high-tech medical service. If the government let them use the relatively low-tech services, they will probably not accept the decision. There are also many burdens in the American health care system, such as the defensive measures to evade judicatory danger. All in all, the imperative reform of the American Health care system is not only a matter of policies, but also a matter of ideology. From Ruoming

**__3P2 Index1-10 group work : Americian Healthcare System__**
__History of americian healthcare system:__ 1) In the past, most Americans had indemnity insurance whereby the cost of health care is split between the patient and the insurance. In recent years, most Americans have switched to managed care plans that provide services and pay the cost of healthcare or patients. This maximized the range of medical care without causing financial problems.

1945- Medicare Medicaid Programmes proposed

1965:Medicare and Medicaid were enacted as Title XVII and Title XIX of the Social Security Act, extending health coverage to Americans aged 65 or above and healthcare services for poor and disabled

This healthcare system helps those who are financially troubled, from elderly to children. This was to ensure not only the rich but all will have the basic medical care.

1973: The HMO Act provided for start-up grants and loans for the development of health maintenance organizations (HMOs)

HMOs are to ensure that private organizations will be able to help the government provide medical care with fixed, renegotiated prices to people under Medicare and Medicaid, on the basis of a contract with the government.

1983: An inpatient acute hospital prospective payment system for the Medicare program, based on patients' diagnosis instead of cost-based payments.

The payments for hospital fees are now diagnosis based, allowing people with a less serious diagnosis but same disease to pay a smaller amount of money.

1986: Medicaid coverage for pregnant women and infants (up to 1 years old) to 100 percent of the Federal Poverty Level was established as a state option

Women are now first involved into the Medicare and Medicaid packages, receiving financial assistance their pregnancy.

1988: Medicare Catastrophe Coverage Act improved hospital and skilled nursing facility benefits, covered mammography and included an outpatient prescription drug benefit and a cap on patient liability

All the health services provided by the healthcare system in US had now more benefits for both the nursing facility and patients. It has helped to ensure that the right people will get the help they need, capping on the patient liability. 1983: - inpatient acute hospital prospective payment system for Medicare program, based on patients' diagnosis ;no cost-based payments. -payments for hospital fees now equalised ->become fairer because no longer cost-based but diagnosis based, -people with less serious diagnosis of same disease pay lesser

1986: -Medicaid coverage for pregnant women and infants (up to 1 years old) to 100 percent of the Federal Poverty Level was established as a state option

Womens now first involved into Medicare/ Medicaid packages, receving financial assistance for medical fees during pregnancy

1988: -Medicare Catastrophe Coverage Act improved hospital/skilled nursing facility benefits: >covered mammography >outpatient prescription drug >cap on patient liability

US Health care system raised to a better standard, More benefits for both nursing facility/patients Ensuring that the right people will get the help they need,capping on the patient liability. 1996: The Health Insurance Portability and Accountability Act of 1996 amended Public Health Service Act, Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to improve continuality and 'portability' of coverage in the large group, small group and individual health insurance markets

By doing this, it allowed the healthcare system to be better able to deal and handle out healthcare services to the people who need it.

1997: -Balanced Budget Act of 1997 (BBA)allows creation of States Children's Health Insurance Program -Revised Putting limits on Medicaid payments to disproportionate share hospitals. -New Medicaid managed care options and requirements for states were established -> to slow down the growth in rate of spending and extending the life of the trust fund for 10 years.

1999: The Ticket to Work and Work Incentives Improvement Acts of 1999 expanded availability for certain disabled beneficiaries who return to work. -To encourage more disabled people to return to work, to help out the economy of US, which was recovering from the effects of the 1997 Asian Economic Crisis

2003- -Medicare Prescription Drug, Improvement and Modernization Act creates prescription drug discount card until 2006 which allows competition among health plans to foster innovation and flexibility in coverage, covering new preventive benefits, and make numerous other important changes

Not only medical care but prescription drug costs also revised


 * Problems in Americian Healthcare System:**

media type="youtube" key="jUV66P5Lr6Q" height="344" width="425" media type="youtube" key="GxE9D6mIO7o" height="344" width="425" These videos shows how the poor in America can't get proper health care treatment,or insurance.Though the government in America pumps in so much money into the health care systems,those poor people living in America cant afford the health care insurances,pills,etc.There was a video i watched which was saying everything was divided into rations,the sick even had to ration their pills,like two people sharing half a pill because they can't afford the whole pill.Therefore,one of the problems in America's health care system is that the poor could not afford the health care,causing a crisis.

__**advantages and disadvantages of the healthcare system:**__ __disadvantages.__ Citizens who are uninsured are mostly unable to pay for it, but the government does not help all of them pay either. This leads to uninsured citizens avoiding regular checkups for financial reasons, resulting in an increase in emergency care. Also, some hospitals in the USA only accept patients of a certain race. The healthcare system has a very high cost. Some insurance from the government or other agencies may not be accepted at some hospitals and patients have to pay their own bills. More is spent on health care in the United States on a per capita basis than in any other nation in the world. However,prices paid for health care services are much higher in the U.S. In 1996, 5% of the population accounted for more than half of all costs. In 2007, the U.S. spent $2.26 trillion on health care, or $7,439 per person. 45 million people lack access to health care.

a system of universal health care has not been implemented nation-wide.

__Advantages__ Many healthcare programs help to provide for people with special needs. Everyone can access emergency services, whether they pay or not The huge sums of money spent on the healthcare system are used for medical research, improving the system Government provides insurance for some people and the insurance in turn covers the hospital bills, so sometimes people get free treatment in the USA. Us government health care system The money spent on the healthcare system in the US is very high, 15.2% of the GDP. Nearly 7.5k is spent yearly on every person in the US. However, it is in need of reform as 45 million people have no access to healthcare.

To top it off, US may have the best health care(e.g. facilities, technologies, resources etc.), however it does not have the best system, or else it would be perfect.

Numerous publicly funded health care programs help to provide for the elderly, disabled, military service families and veterans, children, and the poor, and federal law ensures public access to emergency services regardless of ability to pay. Decreasing birth rates and increasing lifespans due to advances in medical technology pose a problem to the US healthcare system. By 2030, 1 billion people will be older than 65 years. The elderly population is more prone to disease and in need of long-term medical care U.S healthcare expenditure will be even more than it already is. Done By 3P2 index no.1-10
 * __Challenges faced by US healthcare system:__**