The American healthcare system is the only one in the industrialized world that does not cover everyone in the country. It is also one of the most expensive in the world, partly because when everyone is covered people are healthier and healthier people cost less. The documentary The Good News in American Medicine is a documentary that discusses why some parts of the country do have full coverage for the population over others. There are many different elements of a good healthcare system, including having an appropriate amount of available treatments, ensuring that different insurers pay the same rates for the same treatment, the coverage of the uninsured, consumer financial responsibility for prescription drugs, and the issue of universal health coverage for every American. These will be discussed in this paper.
One part of a good healthcare system is that it should provide the right amount of treatment and diagnostic procedures for the number of patients in that community. The documentary suggests that when we double the number of treatment centers, for example, twice as many people are referred to those centers whether they need it or not (PBS, 2012). Part of the reason that the American healthcare system costs so much compared with other developed nations is that consumers are receiving more diagnostics and treatments than they need because the system is only limited by the market, rather than by the amount of available funding for the healthcare system across the country like in Germany (Pozen and Stimpson, 2017). If there is only one cardiologist in town then referrals to that cardiologist are likely to be made more carefully than if there are two or more which means that systems that are not limited like the United States will see more unnecessary referrals which pushes the price up.
Another important part of a good healthcare system is the payment for a procedure. Most countries with socialized medicine have doctors on fixed salaries that they received regardless of how many patients they see or what treatments they offer in a session (Pozen and Stimpson, 2017). The documentary also covers this issue. In Grand Junction, the model healthcare system described, doctors receive a flat rate for a certain procedure regardless of who is paying. In other areas of the country, they may get paid differently by patients who are privately insured, uninsured, or on Medicare or Medicaid (PBS, 2012). This can lead to problems because the rates for Medicare and Medicaid reimbursement are much lower, which makes these patients less appealing to practitioners and therefore likely to get behind, resulting in worse patient care.
A hot topic in discussions of the American medical system is coverage of the uninsured. In the United States, many people do not have insurance on an on-going basis because insurance contracts are administered on a year-by-year basis (Pozen and Stimpson, 2017). There are also many people who cannot afford the insurance as they are not covered by their workplace, and of course an insurance plan may not cover every treatment or visit that a person needs. In the documentary, this is dealt with by ensuring that the costs are kept consistent for all of the patients (PBS, 2012). The uninsured are a problem in patient care because they make prices go up – a patient may avoid going to see a doctor until their problem becomes much worse and therefore the treatment will cost more.
The next issue is consumer financial responsibility for their care, particularly in terms of prescription drugs. In the documentary, the patients are encouraged to take generic versions of drugs which are not under patent and therefore are much cheaper than branded drugs (PBS, 2012). This helps to keep the costs low because patients are involved in their own care and are more likely to choose a cheaper drug than if they are just prescribed one by a doctor. The theme of patients taking responsibility and making decisions about their own care is one that can help keep costs low because it prevents them being prescribed unnecessary drugs (Pozen and Stimpson, 2017).
The final issue in American healthcare is the issue of universal coverage. According to the World Health Organization, the aim of every healthcare system is to have everyone covered (Pozen and Stimpson, 2017). The documentary suggests that this is best because healthy populations are much cheaper than unhealthy populations (PBS, 2012). In essence, the best thing to do is to make sure that everyone is covered because this improves the rates of preventative care, which reduces the cost to the service overall. The fact that not everyone has access to healthcare in the United States is one of the main reasons that it is the most expensive healthcare service in the world and reduces the quality of patient care.
Overall, there are many qualities of a good healthcare system that the United States does not have except in some areas as discussed in the documentary. If we improve such measurements as having an appropriate amount of available treatments, ensuring that different insurers pay the same rates for the same treatment, the coverage of the uninsured, consumer financial responsibility for prescription drugs, and the issue of universal health coverage for every American, then the U.S. healthcare system will function much more smoothly and be cheaper for Americans overall. These are areas to work on in future to help equalize and stabilize the American healthcare system.
- Pozen, A., & Stimpson, J. (2017). Navigating health insurance. New York, NY: Jones & Bartlett Learning.
- The Good News in American Medicine | RMPBS Specials. (2012). Retrieved from https://www.pbs.org/
