What About The U.S. Health Care System Right Now Seems to Make Sense?

Healthcare spending is at an all time high and only expected to keep growing over the next decade – so why are many people having trouble affording basic medical care if any at all? Healthcare spending is too high, but the quality is not consistent with the hefty price tag. The health care system needs to cut its costs in areas that it can to make it obtainable to the people of this country – this could be done through the pricing of prescription drugs and excessive testing (which results in a bigger bill for the patient).

Also, it is important that there is a shift in the direction towards not only the cost of health care dropping but also one that makes the patient feel like they are receiving a better quality of care, one that they are involved in making decisions about side by side with their physicians.

The cost of health care in the United States has long been the priciest in the world, yet now it is in its own ballpark as it continues to climb higher and higher with each year that passes by.

According to the Centers for Medicare & Medicaid Services, NHE grew 4.3% to $3.3 trillion in 2016 alone, raising the cost of care to over $10,000 a year per each person in the United State. As if that number weren’t high enough, we are nowhere near at an end to the rise – by 2026 the estimation is a growth of 5.5% each year, totaling out at over $5.7 trillion. The spending on health care is astronomical and borderline unobtainable to most people.

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With health care costs this high, people are having to make decisions between getting even the most basic medical care and everyday expenses to survive. This choice should not have to be made in a country that spends over double the amount of money in health care than countries that are similar – proper health care is a basic need.

So, what is contributing to this never-ending hike in price? Two main contributors are the cost of prescription drugs and the cost of testing/treatment, which is sometimes in excess. The pharmaceutical industry has long been a monster that hasn’t been controlled; bluntly put by the AARP when asked why drug prices keep rising, they replied “the simple answer is because there’s nothing stopping them”. With the power being in the hands of the makers of the prescription drugs, they know they have the upper hand in selecting any outrageous price. Unfortunately for the American patient, there isn’t a whole lot of competition or option when it comes to medications they desperately need. With little power to choose between several competing prescriptions that target the same issue, people are forced to pay whatever the cost for a specific drug (usually that ends up being the only one or two that can address a condition) if they want to get the care they so desperately need.

An increase in competition would easily help this scenario; if people have multiple options, they have more power to shop around and not take the first dollar amount thrown at them. Instead, right now, people are forced to make literal life and death decisions, which no one should have to do. While I understand every business is of course looking to make a profit, there is a definitive line between making a profit and absolutely abusing the scenario of people depending on these drugs to survive. No one should ever have to make this choice or the one between necessary medications and whether their family eats dinner tonight. The increase in competition would certainly help but so would regulation and the opportunity for negotiation on prices. Right now, Medicare and other health plans are not allowed to negotiate prices. While for this to change there would need to be work done in Congress, it is a process worth fighting through. This change would put some power back in to the hands of the consumers instead of leaving all of it in the hands of the pharmaceutical companies whom are only going to keep raising their prices.

Besides the high cost of prescription drugs there is also an alarmingly high cost associated with testing and treatment that sometimes is in excess and even wasteful. While of course there is a need for testing and treatment, there are times when there are areas that are not needed in general or maybe just not as often. For example, a patient in the hospital may be unconscious and by the time they surface, comes out to a bill that includes labs and all sorts of bloodwork and scans daily they did not consent to. Of course, physicians are wanting the best care for their patients; but is it really the best for the patient when they are fearful for their wallets and whether this is something they will go into debt trying to pay for? There needs to be a balance in what is necessary and what is preferred. In a perfect word undoubtedly, each person would give the green light to having every scan known to man done as well as daily blood work – in a realistic world, however, it is not feasible.

Lastly, an important addition to the health care system is one that may not seem to directly impact the spending: the quality of health care a patient feels they are getting. Most people look at the costs associated with health care and procedures and are dumbfounded by the numbers but also by what they are receiving for said dollar amount. Patients easily feel like they are not really in control of the decisions made regarding their care. It is important to consider the preferences and concerns of the patients, not just on paper what is the best (and sometimes most expensive) option for them. By addressing this issue, patients will feel more satisfied with the health care system and not like they are by any means being “cheated”. It is important for one to feel like they have options as to what is done not only with their bodies, but with their wallets. Educating the patients and being transparent with costs associated with treatments and tests will help solve this issue.

There are instances where the same test can have such a drastic variation in cost within an area; in Atlanta, Gaynor said, it can cost 600 percent more to have a colonoscopy in one location than another (Lawrence, 2018). As Lawrence goes on to state in her article, “the problem is that patients usually don’t know about local price variations because they’re generally not given cost information by health care providers or insurers”. Combining this idea with the goal of reducing the cost of health care spending would make for a much more satisfied, happier, healthier and more financially sound person. As illustrated above, the spending associated with health care is too high and especially for the quality achieved. The nation needs to work on lowering the cost and raising the quality of care.

This can be done by working on lowering the cost of prescription drugs as well as the cost of testing and treatments. In addition, the excess and wasteful testing needs to be addressed and cut down on. The future of the health care system is an increasingly expensive one that will leave people making decisions between getting medical care and just surviving daily with necessities like housing and food. This needs to be addressed because no one should have to choose between life or death medical care and the basic needs to survive (which one could argue medical care/treatment/drugs also account for). These needs will be lengthier in process rather than in cost; for example, for the prescription drug costs to drop, Congress and laws would need to work on allowing Medicare and other groups to negotiate said prices with the pharmaceutical companies. This will be a battle that will be worth it, and any costs associated with making it happen certainly outweigh the costs the drugs will continue to cost Americans.