Cost and Quality in U.S. Health Care

Health care, as one of the basic needs, is quite an essential element for human kind and as such, it should be readily available and at the same time affordable.Research indicates that health care costs in the United States are relatively high. It is even more tragic since despite the fact that the cost is high; the quality is way poor compared to other nations based on some outcomes and indicators that are related to performance.This piece of paper will give an in depth analysis and discussion of the link between cost and quality of health care in the United States. In addition, the manner in which the Patient Protection and Affordable Care Act (PPACA) tries to minimize costs and enhance quality will be highlighted. PPACA’s success level in this will as well be outlined.

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Cost and quality of health care should go hand in hand. When an individual pays heavily for a certain product or services, it is expected that the quality is equally good. Nonetheless, this is not the case when it comes to the quality and cost of health care in the United States. This can be understood by the fact that cost is not the sole determinant of care but rather one out of the many factors. For instance, availability of services also influences accessibility. There is a shortage in supply of health care services compared to the demand in the United States. This is as a result of shortage of physicians as the population rapidly increases at a higher rate compared to the number of individuals that venture into the medical field. In as much as there is a need to increase the number of physicians in the United States, other measures also have to be looked at. For instance, there is need for the United States to change the manner in which health care is used, delivered as well as finance (Hussey, Wertheimer &Mehrotra, 2013)

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Compared to other countries, the cost of health care in the United States is quite high. According to Potyraj (2017), the United States expends more than 50 percent more on health care compared to other developed nations. Compared to the rest of the Organization for Economic Co-operation and Development (OECD), research indicates that the United States spent the highest per capita on health care between 2000 and 2013. The sad thing is that the Centres for Medicare and Medicaid Services predicts that the cost of health care in the United States is bound to continue rising in the next decade. Despite the fact that the United States has one of the highest gross national incomes, this does not justify the amount of health care spending. This is more so since the rising costs do not in any way benefit the Americans especially because they do not translate to better quality of care.

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Some of the nations that could serve as positive examples with regard to reduced spending on health care as well as enhanced services include Australia and Germany. They represent effective use of health funding. In Germany for example, the government takes care of health care costs for the citizens who are unemployed. In addition, there are limits to expenses by those who are employed. The more money one earns, the more one has to pay and vice versa. The fact that there no deductibles allow individuals to seek medical services whenever they are unwell, without worrying of high costs (Potyraj, 2017). Accessible and affordable health care is essential and every nation should strive to provide this to its people.

Burwell (2015) asserts that despite the fact that United States spends more money per individual on health care compared to other nations, there is adequate evidence that the Americans do not really get the care they need. For instance, there is a mistake of underutilizing preventive care, an aspect that results in higher spending on advanced and complex illnesses. Patients suffering from chronic illnesses such as diabetes fail to get appropriate treatments to allow them to manage their conditions effectively. This affects the under-insured, the uninsured as well as the insured. There is also a challenge of lack of coordination of care for those with chronic illnesses. Another problem that could be attributed to the ineffective health system is lack of payment support for health care providers as well as tools needed to cooperate and enhance patient care.

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The PPACA has been a tool that has greatly tried to offset the balance between quality and cost of health care in the United States by reducing the cost and improving the quality. This is mainly by making health coverage more accessible. The PPACA achieves this by creating entities referred to as American Health Benefit Exchanges, through which small businesses and individuals are in a position to purchase coverage. Larger employers will also get a chance to purchase the coverage. PPACA is also a positive unit when it comes to enhancing accessibility to quality health care by all since it places conditions on given employers to offer coverage, and offers some subsidies that work towards encouraging the expansion of employer-based coverage. In an effort to make coverage more accessible for low and middle income people and families, the federal law has some provisions that in one way or the other limit the premiums and lower cost sharing responsibilities. This includes deductibles and copays that may be charged to those who buy coverage. There is also the issue of PPACA imposing different new standards on health insurers. A good example is where the law necessitates that insurers should provide and renew coverage on a guaranteed issue basis (Rak& Janis Coffin, 2013). This means that an insurer has to accept all applicants for coverage with given exceptions. It is also worth noting that through the expansion of the Medicaid program, PPACA offers low income individuals greater access to health coverage. Individuals with pre-existing health conditions will also be in a position to purchase coverage through a temporary high-risk insurance pool.

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To a great extent, the PPPCA has been successful in its aim of enhancing quality while at the same time reducing cost of health care in the United States. The Act has already achieved numerous important accomplishments. These include significantly reducing the ranks of the uninsured, an aspect that translates to better access to health care by a majority. Also, public health care expenditure growth has considerably slowed. This shows that the reform has extended beyond the economic patterns linked with the Great Recession. The American medical care is safer and better now than in the past based on aspects such as preventive care, hospital infection and avoidable hospital readmission. This can be attributed to the incentives and new payment plans enacted under PPACA (Jost and Pollack, 2015). This shows that although all is not perfect, the efforts by PPACA can never be underrated.

There is need to reduce aggressive health care which is not cost effective. Nonetheless, it is advisable that utmost caution is taken so that the cost-cutting does not in any way compromise patient outcomes as well as quality of health care. Reforming the health care delivery system in the United States to enhance the value and quality of care is vital in addressing the poor quality and increasing costs. Access to the right care at the right time and in right place should be encouraged. Preventive care should also be emphasized.

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From the above discussion, it is apparent that there has been a mismatch between the quality and cost of health care in the United States. This is more so when the outcomes are compared with other countries. This makes most individuals not to be in a position to access health care services. This is a worrying trend since health care is one of the basic needs that ought to be readily available and affordable for all. Nonetheless, there have been efforts to balance the equation or rather reducing the costs while at the same time enhancing the quality of health care. The establishment and implementation of PPACA is one of the efforts that are geared towards making the situation better and to a greater extent, it has been successful. This gives hopes not only to the current but also the future generations.

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