Health system and policy (public health)

Factors influencing health spending in the United States

The healthcare services in the United States are very expensive, and these high costs reduce access by low-income earning populations in the states. The unaffordable costs of healthcare services have led to increased cases of mortalities among the American population. The Journal of the American Association (JAMA) study revealed a 50% contribution from health services intensity and prices (New Study Explains Why US Health Care Spending Increased $1 Trillion, 2017). The journal stated some reasons to increase expenses, such as the increasing United States population and the increase in the aging population.

Population growth

The rising population results in increased expenses on healthcare services and funds. The growing population requires increased end extensive healthcare service provision, thus stretching the healthcare resources and services. This results in excessive spending and rising costs in healthcare services. The increase in population size in the United States resulted in an increase in healthcare spending by 23% (Dieleman et al., 2017). The higher the population, the higher the utilization of the various healthcare services.

Increase in the aging population

The rise in the older/ aging population results in increased demand for specialized care. This is due to the terminal and chronic illnesses associated with old age and palliative care needs by geriatric individuals. This increased spending by 12%, increasing service intensity and prices. In addition, the increased variety and complexity of services provided in the healthcare system resulted in increased expenditure by 50%. As a result, the rise in services in the healthcare system, such as outpatient and inpatient services, rose by 85% and 59%, respectively, between 1996-2013 in the United States.

Changes in disease incidence and prevalence

The changes in the disease incidence and prevalence in the United States have led to increased spending. For instance, new illnesses such as COVID-19 resulted in increased expenditures in the new condition’s treatment, admission, and management. This results in excessive utilization of healthcare services and overstretching with the rising need for expansion. In addition, the rising cases of chronic illnesses result in increased expenditure due to rising costs of medications such as diabetes medications. The management of these conditions and the associated effects such as depression requires a lot of expenses in the healthcare system.

Rising insurance costs

The rise in healthcare insurance costs resulted in increased spending on healthcare services. Healthcare services, insurance policies, and services are increasingly becoming unaffordable in the United States due to rising costs. The increase in the demand for medical services through the development of government programs such as Medicaid and Medicare has resulted in the rise of healthcare services prices (Why Do Healthcare Costs Keep Rising? 2022). These programs caused increased utilization of the healthcare services among the American populations, hence increased prices.

Technology growth

The technology growth and development have resulted in innovative new treatment modalities. These technological advances have led to increased spending in the healthcare setting in the United States. In addition, the change in the market power, that is, the increase in healthcare services consumption by the American population, has resulted in continuously rising costs and spending in the healthcare system. The population’s rise in healthcare needs demands results in a rise in spending by the healthcare delivery system (Dieleman et al., 2017).

How health care costs affect the American population

The rising costs in the American healthcare services have resulted in disproportionate effects among its population. These changes in costs adversely affect the uninsured adult population, low-income populations, and the Hispanic and the Black adults in the American population. These groups among the American population experience difficulty affording the healthcare services in the United States. This is due to the continuously rising costs in healthcare services. This results in increased mortality rates, inequality, among other effects in the American population (Mazurenko et al., 2018).

The high employer-provided healthcare insurance results in decreased wages and job destruction. This results in the replacement of good, well-paying jobs with low-paying jobs. The low-income generation from the employees results in decreased income for meeting individual and family needs. These low incomes make it difficult and unaffordable to acquire healthcare services for uninsured family members. This also results in the unaffordability of the uninsured health care services.

The high healthcare costs have made it difficult for a large population to afford medical services. The difficulty in paying medical bills due to high costs is associated with significant difficulty in settling household bills. 12% of 26% of American families with sick member(s) in 2019 reported a major impact of the medical bills in their families and meeting of household needs. Some individuals in America have skipped or delayed seeking healthcare services due to the high costs of these services. Reports revealed that approximately 51% of the adult population in the United States delayed or didn’t receive some medical care services due to high costs (Mazurenko et al., 2018).

The rising costs in medical and other healthcare services in the United States have resulted in widespread and growing inequality among the American population. The majority of the affected populations are from low-income households and insured individuals. These individuals face hardships in acquiring healthcare services. Therefore, these populations have poor living conditions and poor health status. This results from the inability to meet the healthcare needs and families’ daily needs incurring healthcare and medical bills.

The skipping or inability to acquire medical services increases mortality cases among the sick populations. Individuals with chronic illnesses who cannot seek medical care may compromise their health and die at a younger age. The high costs result in increased involuntary hospitalization and admissions (Stokes, 2021). This increases the healthcare workers’ workload due to an increase in the size and the number of sick populations and communities. Overstretching of resources results due to increased ill populations.

Reasons behind lower healthcare costs in other Asian countries

The healthcare costs in other Asian countries are lower than the United States’ costs. The United States has the highest costs in healthcare service delivery. However, the United States is among the most developed countries globally. The developing countries spend lower costs on the healthcare system than the developed countries. Urbanization and high urban population increase healthcare expenditure in countries (Vogenberg & Santilli, 2018).

Other Asian countries have low urban populations as compared to the United States. The low urban population is associated with low incidences of illnesses that result from urban life and environmental exposure. On the other hand, urbanization, globalization, and industrialization are associated with increased air pollution and other environmental pollution, thus a rise in health issues among populations. This, therefore, results in low costs due to low consumption and utilization of healthcare services. On the other hand, the United States is highly developed with improved technology. Therefore, the technological advancement in the healthcare system results in increased prices of healthcare services.

The population in some Asian countries majorly consists of a younger population than that of the United States (Li et al., 2021). The rise in the aging population is higher in the United States, thus high costs in healthcare. The presence of the young population in other Asian countries is associated with low costs in the healthcare system. This is due to low cases of chronic illnesses and the need for specialized care such as palliative and geriatrics. The majority of young populations are healthy and do not consume a lot in the healthcare system.

Asian countries such as Malaysia have a low market and demand for healthcare services due to the low population in the countries. The larger the population in a country, the higher the consumption rates of the healthcare services. Some developing Asian countries receive donor funding to support their healthcare system, resulting in lower costs in healthcare services provision. The United States does not receive healthcare donor funds; however, some funding companies are from the states. The donor funds explain the low costs of healthcare services in other Asian countries.

Ways in which the American government can lower the Health care costs/ insurance

The United States government can put in place some strategies to reduce the costs of healthcare services and insurance. These strategies include competition promotion among the public and the private health provider sectors in the states. In addition, the provider competition efforts such as transparency in prices help enhance lower costs in the healthcare setting. The government should also set policies to ensure equal Medicare payments regardless of the location of the care acquisition site for its population. Finally, the development of policies to guide healthcare costs and spending across the country should also be done by the government.

Development of commissions to support the nation’s policy goals. This helps the government to develop and implement its policies effectively. State commissions support pro-competitive policies. This provides hearing for anticompetitive practices and policies, which can be used to develop anticompetitive behavior in the health sector. The government can set policies to regulate the prices of healthcare services in the healthcare sector (Dieleman et al., 2020). This includes setting limit prices for specific healthcare services to prevent hiking of prices by the public and private health sectors. This helps reduce the rising costs of healthcare services.

The government of the United States can improve the insurance through adequate funding of the Child Health Insurance Program. Provision and implementation of free maternal healthcare policies help reduce healthcare costs. The expansion of the Medicaid programs to cover a larger population helps reduce the costs of healthcare services. Increased coverage of larger populations in the United States increases the population’s ability to afford and access healthcare services. This reduces the costs of healthcare services and reduces the inequalities in the United States. The government can increase Medicare coverage by expanding the Affordable Care Act (ACA) (Papanicolas et al., 2018).

Other methods of government involvement in healthcare cost reduction include addressing healthcare workers’ shortages. This helps improve healthcare access and provision through having enough trained healthcare workforce. In addition, the promotion and utilization of technological healthcare trends such as telehealth and telemedicine help promote easy access to healthcare services. These trends in healthcare make healthcare services affordable and easily accessible.

The United States government can reduce healthcare service costs by reducing the overpayments in the Medicare Advantage. This is made possible through adjustment of payments to reduce the differences in coding intensity, diagnostic reporting. This helps the healthcare sector improve its efficiency and quality in service provision. The government can also reduce the costs through hospital price capping. This is possible by reducing commercial payments to healthcare facilities (Dieleman et al., 2020).

Effects of low costs on the healthcare quality

According to data from the Harvard Business Review, reducing healthcare costs may result in poor performance in the care provided by the hospitals and other healthcare facilities. However, in some countries like the United States, the costs of healthcare services are not associated/ related with the healthcare services quality. Healthcare services are costly in the United States; however, this doesn’t mean that these services provided are of high quality (Papanicolas et al., 2018). Furthermore, the reduction in maternal healthcare costs has decreased maternal mortality rates. There has been a decrease in maternal mortality rates by approximately 50% since the 1990s. Free maternal services have increased maternal health and a reduced maternal mortality ratio.

The reduction in costs of healthcare services reduces the income generated from the healthcare sector. This, therefore, reduces the ability to improve the quality of services produced in healthcare facilities. The income generated from the healthcare sector can be used to hire more healthcare workers. Therefore, a decrease in income generation results in the inability to hire more workers; thus, staff shortage comes in. The availability of few staff results in increased workload and reduced efficiency and productivity among the healthcare workers. This, in turn, results in decreased quality of healthcare services.

Reduced or low healthcare costs make healthcare services easily affordable and accessible to the public (Stokes, 2021). This results in a high number of populations seeking care in healthcare facilities. However, increased admissions result in overstretching and depletion of healthcare resources. The healthcare facilities may acquire cheap resources to curb the shortage due to excessive consumption and depletion of the healthcare resources. However, the cheaply acquired resources may not provide quality services, therefore poor health care provision.

Conclusion

Healthcare service delivery in the United States is continually rising every year. This is due to the increasing globalization and urbanization in the states. The growing population also causes the overutilization of the resources in the country. The population growth and aging results in increased expenses on the healthcare services. This rise in healthcare cost has affected the American population in various ways, including inaccessibility of healthcare services. This has resulted in continued inequality in the nation.

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