Healthcare Affordability in the United States

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Introduction

Access to health care services should be every citizens right in the United States. Affordability promotes the timely prevention of treatable and mild infections, which can be fatal if left unaddressed. Health insurance is a common concept within the United States and other systems across the globe, which promotes adequate planning for eventualities that could put an individuals life at risk. Policy frameworks governing affordability and insurance for medical services can promote equitable outcomes only if the government ensures uniform implementation and endless support to key medical facilities. The following discussion highlights key factors about the current state of the U.S. healthcare system.

The primary argument is that the federal government must collaborate with state and local administrations to reform healthcare policies by ensuring Americans can access free services at a facility of choice. As such, this paper evaluates the U.S. healthcare systems affordability and the impacts of laws that strive to make healthcare services available for Americans.

Cost of Health Care in the U.S.

Health care cost is a key determinant of who can get the services and in which facility. The United States is one of the top global spenders on healthcare services despite the benefits being extremely costly to the citizens (Peter G. Peterson Foundation, 2022). The federal budget for health care in 2022 totaled $4.1 trillion, which implies a $12 500 cost per citizen (Peter G. Peterson Foundation, 2022).

The U.S. Center for Medicare and Medicaid Services highlighted a 9.7% rise in 2022 healthcare costs compared to 2020. Moreover, the expenditure takes up a sizeable chunk of the countrys GDP, rising from a 5% share in 1960 to 18% in 2019 (Peter G. Peterson Foundation, 2022). Holdsworth (2019) compared U.K. and U.S. healthcare expenditures, insisting that both countries engage in resource waste. The latest data on U.K. expenditure by Macrotrends (2022) shows that the government spent $4 313 per capita on health, whereas the U.S. consumed $10 921 Macrotrends (2022). The figures put the American healthcare system at 2.5 times more expensive than the U.K.

Affordability of Healthcare Services in the U.S.

The U.S. healthcare payment structure and responsibilities are one of the most dynamic in the world. The rationale is that, despite coordination efforts, there are several funding sources for the countrys medical services, with the latest data showing that more responsibility lies on individual citizens. California Healthcare Foundation (2022) released a summarized infographic for three major funding sources for U.S. healthcare, showing out-of-pocket expenditures to be the highest for most listed medical services. For instance, dental services in the U.S. cost citizens an average of $142.4 billion each year, with the out-of-pocket settlement catering to $53.2 billion of the total amount (California Healthcare Foundation, 2022).

Other sources of funds are the government and private health insurers. Medicaid caters to $40.2 billion of home healthcare services, a paltry 32% of the annual costs (California Healthcare Foundation, 2022). However, the government should pay for all citizens, which is achievable by reforming Medicaid and Medicare programs to improve citizen contributions and accountable expenditures on medical coverage.

Access to Healthcare: Right or Privilege

Individual access to health is a right that should be accorded to every American regardless of socioeconomic status. The rationale is that good health is critical to other liberties, privileges, and activities concerning economic and social life. Bauchner (2017) observed that the U.S. government should fast-pace the rollout of total healthcare coverage for all citizens. According to Bauchner (2017), the ultimate goal of all U.S. healthcare sector reforms is to expand medical care access and policy frameworks for safeguarding citizens rights. The reason for considering individual healthcare access as a right is that poor health conditions can prevent citizens from working, participating in community activities, or attending school (Bauchner, 2017).

Therefore, the government can safeguard health as one of the rights in line with the World Health Organizations (WHO) Universal Declaration of Human Rights. The Federal government can rally states to declare health care access as one of the fundamental rights.

Design Shortfalls in U.S. Healthcare

Too many funding sources against unsustainable medical expenditures imply acute design shortfalls in the U.S. healthcare system. The average U.S. citizen gets medical access at high costs, despite zero guarantees of service efficiencies. Collins et al. (2022) observed that most Americans are either uncovered or under-covered, increasing the risks associated with public health during short pandemics like COVID-19. There are huge gaps in healthcare coverage; others are insured but underinsured, whereas others decide not to access healthcare, fearing the high costs (Collins et al., 2022).

The system design needs to promote transparency in terms of expenditure disclosure. Considering the disparities in health coverage, I would start an organization that caters to vulnerable community members who cannot pay their medical bills. This would give every community member a fair chance to access healthcare services. Nursing and physician shortages are two design failures that the government can tackle by re-designing the system. The best technique for re-designing U.S. healthcare is consolidating all funding channels to a single source: Medicaid or Medicare. The government can cover all citizens under the new system and ensure adequate staffing and resource stocking for all healthcare facilities.

2010 Patient Protection and Affordable Care Act (PPACA)

Coverage reforms in the 2010 Patient Protection and Affordable Care Act (PPACA) neutralized fraudulent schemes that limited medical coverage for vulnerable populations in America. PPACAs most essential provision was the elimination of lifetime health coverage limitations, exclusions for selected groups such as children, and a prohibition on rescinding coverage unless the user engaged in fraudulent transactions (U.S. Centers for Medicare & Medicaid Services, 2021).

The Act also made insurance more affordable and available to lower-income citizen categories by subsidizing premium attention (U.S. Centers for Medicare & Medicaid Services, 2021). The Act supported innovative medical care delivery, including an expansion to the Medicaid program for covering adults with low income (U.S. Centers for Medicare & Medicaid Services, 2021). The PPACA impact on U.S. healthcare would have been a more consolidated system that subsidizes the economy by encouraging individual insurance to avoid overdependence on the government for short-term emergencies.

Moreover, the PPACA implementation would boost the U.S. economy because readily available healthcare services to citizens will ensure a healthy nation capable of handling their daily activities to earn a living and pay taxes. However, prior discussions have highlighted various design shortfalls in Medicaid and PPACA implementation, implying that the government should reform and rejuvenate actionable guidelines for streamlining healthcare cost management and equitable access.

Accountable Care Organization (ACO): Solutions

Accountable Care Organizations (ACO) can solve some U.S. healthcare design shortfalls like healthcare inefficiencies and high medical costs. The rationale is that ACOs main mission is to consolidate professional service provision by coordinating high-quality care among the members (CMS, 2022). ACO eliminates healthcare service inefficiencies by eliminating duplications in patient care, especially for the chronically ill (CMS, 2022).

Medical error and duplication prevention through information sharing and consultations on client care needs reduce the patients financial burden (CMS, 2022). Therefore, ACO is the best approach for offering effective solutions to poor quality health care outcomes or exorbitant charges because it accommodates diverse programs for improved medical care affordability, such as the Medicare savings program and an ACO investment model. Americans should consider registering with the ACO programs to avoid going through duplicate systems when seeking medical services.

Roles of Registered Nurses

Registered nurses play the most critical role in client monitoring and caretaking throughout recovery. Coster et al. (2018) stated that a registered nurse coordinates patient care through various responsibilities, such as patient education on various health conditions. The registered nurse collaborates with physicians or healthcare professionals on client care provisions, especially information sharing or educational duties (Coster et al., 2018).

Administering patient medicine and further observations on recovery progress, including handling client records and medical histories, makes the registered nurse occupation effective in the U.S. healthcare system. Registered nurses should play other administrative and innovative roles, such as practicing through research and participating in policy-making for healthcare improvements. The National Nurses United is a familiar voice for registered nurses, which can promote further advocacy for R.N. involvement in greater healthcare responsibilities such as research and administration.

The Future of Nursing

The Institute of Medicine (IOM) provided detailed journeys and future insights about the roles of nurses in leading change and advancing the U.S. healthcare landscape for improved service efficiencies. The IOM report clarified that the future of nursing would be on healthcare policy frameworks, revolutionizing the entire system by leading change and advancing healthcare provision (Sullivan, 2018).

I agree with the reports findings that nursing education improvement should match registered nurses current responsibilities and job expectations, giving R.N.s the roles of service improvements and healthcare redesigns (Sullivan, 2018). The reports finding that nurses should be fully engaged through inter-professional collaboration is equally agreeable because interdisciplinary working can eliminate institutional obstacles that restrict nurses involvement in medical care advancements.

Conclusion

Reforms and complex advancements to the U.S. healthcare system should reflect current socioeconomic and pandemic situations, where improved subsidization can promote equitable access to all citizens. The U.S. is spending 2.5 times the U.K.s cost on health care regardless of the quality inconsistencies and fraudulent payment schemes making the nations healthcare one of the worlds most expensive. Therefore, the government must collaborate with states to make individual healthcare access a basic right for the average American citizen.

References

Bauchner, H. (2017). Infographic U.S. Health Care Spending: Who Pays? California Health Care Foundation. Web.

CMS. (2020). Accountable Care Organizations (ACOs): General Information | CMS Innovation Center. Web.

Collins, S., Haynes, L., & Masitha, R. (2022). The state of U.S. health insurance in 2022. The Commonwealth Fund. Web.

Coster, S., Watkins, M., & Norman, I. J. (2018). What is the impact of professional nursing on patients outcomes globally? An overview of research evidence. International journal of nursing studies, 78, 76-83. Web.

Holdsworth, M. (2019). Wasteful Spending in Health Care: A US and U.K. international comparison. Revue Française de Civilisation Britannique. French Journal of British Studies, 24, 1-15. Web.

Macrotrends. (2022). U.K. healthcare spending 2000-2022. Web.

Peter G. Peterson Foundation. (2022). Why Are Americans Paying More for Healthcare?. Web.

Sullivan, T. (2018). Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health. Policy & Medicine. Web.

U.S. Centers for Medicare & Medicaid Services. (2021). Affordable Care Act (ACA). HealthCare.Gov; U.S. Centers for Medicare & Medicaid Services. Web.

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