Healthcare: –
Healthcare spending in the United States occupies an increasingly large portion of the federal budget and will continue to grow at an alarming rate if measures are not taken to reform the sector. Pharmaceuticals, hospitals, and insurance providers combine with heavy federal and state regulations to create a complex, fragmented delivery system that ultimately confuses and masks true costs from the general population. Incentivized by the current payment system, the sector focuses on disease care rather than preventive care. There continues to be a lack of national consensus as reflected by the difficulty Congress faces in finding a solution to the healthcare debate, which can delay, dilute, and even dismiss any momentum for meaningful change. This stagnation will drive additional mandatory federal spending at the expense of discretionary programs critical to national prosperity and security, including investments in diplomacy and defense necessary for an effective foreign policy. Ultimately, the complexity of healthcare in the United States creates exorbitant inefficiencies which inflate costs, reduce access, and place value on quantity over quality. Consequently, through extensive field investigations and academic research, this report examines the current status of healthcare in America along with future constraints and opportunities, then provides realistic and achievable recommendations to target improved population health and healthcare value.
Healthcare in the United States is costly and complex. With mandatory healthcare spending currently at 25 percent of the federal budget for Fiscal Year 2017, federal obligations are anticipated to increase as the population ages and economic inequalities continue to grow. While the time appears favorable for a system-wide overhaul, there is a clear lack of national consensus as reflected by the difficulty Congress faces in finding a solution to the national healthcare debate. Regrettably, while discord and stagnation limit meaningful reform, healthcare expenses continue to rise at an unsustainable rate. This growth drives additional mandatory federal spending at the expense of discretionary programs also critical to national security and economic prosperity, including investments in diplomacy and defense necessary for an effective foreign policy.
While many Americans question whether healthcare is a right or privilege, their true objective may be how to achieve health equity. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) describe health equity achievement when “every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of the social position or other socially determined circumstance.” Other nations achieve health equity by providing healthcare at much lower prices than the United States; the American system stands in stark contrast to the rest of the developed world. Health insurers play an intermediary role, confusing patients with fee-for-service bills coded in nearly indecipherable alphanumeric sequences. Furthermore, healthcare payments incentivize quantity, making the United States system more about caring for disease rather than preventing it. Not only does the United States lack health equity, but it spends more per capita on healthcare while experiencing less favorable outcomes. The nearly $3 trillion invested annually – 75 percent of which represents spending on preventable conditions like diabetes and heart disease – reflects this motivation. The popular 2004 documentary film, Super Size Me, demonstrates the deleterious health effects of America’s fast-food culture. While director and star Morgan Spurlock explores the consequences of this culture in an extreme and personal fashion, the film effectively underscores the American appetite for unhealthy behaviors and sedentary lifestyles. Yet, the United States remains a global leader in healthcare innovation, from training and educating providers to developing the next miracle drugs. This seemingly paradoxical relationship demonstrates the complexities of a heavily regulated, segmented system.
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