The United States’ health care system is one of the most expensive in the developed countries. This is because the country’s healthcare system is rife with private insurance companies which make it difficult for the low-income, disadvantaged, and minority groups to access adequate and quality health and medical care. Many scholars have called for the reformation of the US healthcare system, for instance, by adopting a universal system like the one currently implemented by Canada. Healthcare reform has become one of the most significant and controversial policies of the Obama Administration. In one of his speeches, President Obama stated that “healthcare reform cannot wait, it must not wait, and it will not wait another year,” (The White House, 2009, para.1).
The costs incurred by the US government, healthcare organizations as well as individuals and families have skyrocketed in the past decade to an extent where health care has become more expensive than food or housing. Indeed, the US spends more than twice the amount spent on health care by other developed countries. As a result, Americans are forced to spend less on other basic needs and more on healthcare. Additionally, the high costs of healthcare hurt the competitive edge of American companies because they have to compete with companies whose costs of delivering healthcare services are significantly lower. To reform the American healthcare system, the Obama Administration has vowed to undertake several measures which include: reduction of healthcare costs for the government and businesses; protection of families from debt that arises from the high healthcare costs; voluntary choice of healthcare providers and insurance plans; investment in preventive health services and general wellness; enhancement of patient safety and quality of healthcare; affordable health insurance for Americans; and guarantee of insurance for people with pre-existing health conditions (White House, 2009, para.5).
The Congressional Budget Office (2008) also concurs with the argument that the American healthcare system has long been an issue of concern to many policymakers. Despite the higher percentage of gross domestic product that is spent on healthcare as compared to other nations, the quality of healthcare in the US remains deficient. Indeed, the high cost of healthcare in the nation has led to inefficiencies in the system hence the great need to enhance the US healthcare system’s efficiency. The Veterans Health Affairs, Medicaid, and Medicare are three of the biggest healthcare programs that are funded by the federal and state governments. These programs make up the greatest portion of total healthcare costs in the US and affect the delivery of healthcare in the wider healthcare system. As a result, modifications in these programs would have a significant impact on the broader healthcare system.
Medicare is largely funded by the federal government through standardized policies on insurance and funding. Due to the uniformity that characterizes Medicare, it is easy for the government to create and assess plans to minimize the costs incurred by the program and to enhance the quality of care provided to the beneficiaries. Several current Medicare schemes, such as Hospital Compare, make it possible for the government to gather data from the providers and assess their performance. Medicaid on the other hand is mainly funded by the state governments. This creates different policies in the execution of the program because each state adopts the policies that govern the program. Therefore, reforming Medicaid poses a great challenge. However, states have put up measures that can enhance the quality of care provided to the beneficiaries of Medicaid. The difference in the measures pursued by different states implies that the effectiveness of Medicaid differs from state to state (The Congressional Budget Office, 2008, p.129).
Approximately forty-seven million Americans lack health coverage (Smedley, 2008, p.448). Of these 47 million, close to fifty percent are people of ethnic, racial, and language minority communities. The American healthcare reform should therefore take into consideration the social, cultural, and language barriers that affect Americans’ access to quality health and medical care. This can be achieved in several ways. First, the government should encourage equitable and fair sharing of the costs of healthcare. Health coverage plans that require high premiums and out-of-pocket fees harm members of the low-income and minority groups. Equitable healthcare initiatives consider this and try to lessen the unequal effect that these cost-sharing plans have on access to healthcare. Second, effective healthcare reform would promote cultural and linguistic competence among healthcare professionals. This is necessary because the majority of healthcare professionals are members of the dominant ethnic communities. This makes it difficult for healthcare professionals to provide quality and accessible health and medical care to patients from minority groups due to language and cultural barriers. Besides the promotion of cultural and linguistic competence, effective healthcare reform should promote diversity among healthcare professionals.
Smedley (2008) states that “greater diversity among health care professionals is associated with greater access to and satisfaction with care among patients of color,” (p.449). Fourth, effective healthcare reform should enhance and restructure the public health insurance enrollment process. This is because the members of the racial and ethnic minority communities are not well represented in public health insurance programs despite acceptable eligibility rates. Participation of minority groups in public health insurance programs can be enhanced by states by instituting and maintaining forceful outreach initiatives and by restructuring enrollment, with meticulous notice to the needs of the racial and ethnic minority groups (Smedley, 2008, p.450).
A major concern of any healthcare reform is the distribution of healthcare resources across the different regions of the country. The resources can be distributed either through a centralized or decentralization strategy. Decentralization increases the autonomy of the lower levels of government (state and local governments) which in turn possess a greater influence on the appropriation of funds to the healthcare sector. The disparity inability to produce and to use resources combined with different local preferences will most probably generate different levels of funds and provision of healthcare services across lower levels of government (Okorafor and Thomas, 2007, p.419). For most countries, the result of the healthcare sector – access, equity, and quality – is of paramount importance. In countries that run a fiscal federal system, the central governments exert a significant influence on the functioning of the lower levels of government to ensure equitable allocation of resources and provision of healthcare services throughout the nation. This helps to lessen the power and autonomy of state and local governments and to ensure that these lower-level governments comply with the national policies of healthcare reform (Okorafor and Thomas, 2007, p.420).
Congressional Budget Office. (2008). Budget options volume 1: Health care.
Okorafor, O.A. and Thomas, S. (2007). Protecting resources for primary health care under fiscal federalism: options for resource allocation. Health Policy and Planning, 22, 415-426.
Smedley, B.D. (2008). Moving beyond access: Achieving equity in state health care reform. Health Affairs, 27(2), 447-455.
White House. (2009). Health care reform.