Health care leaders proclaim that the US health care system is the best in the world, but studies suggest that it is on the contrary. Despite spending more per capita on health care the benefits are not proportionately matching. An exceptional entity is the US Family Health Plan (USFHP), which has shown a high rate of member satisfaction. Though continuity of care is found to promote interpersonal relationships between patients and caregivers, leading to lesser hospitalization and facilitating cost reduction, studies suggest that the health care needs of older persons are not getting deserving attention.
Comparative study of health status, access to care, and utilization of medical services, as well as disparities in the United States and Canada by Lasser et al (2006), showed that “United States residents are less able to access care than are Canadians.” (Lasser, et al). The United States spends $5,635 per capita for health care, but statistics suggest that “despite spending more per capita on health care…, the United States is not getting commensurate value for its money.” (Davis, et al) Although 60% of health care is being provided by employer-funded health insurance in the US, studies show that “government reimbursement for service for the elderly has not kept pace with their cost.” (Gibbon). A cross-national survey of patients’ views and experiences of their health care system was done by Commonwealth Fund, to assess performance relative to other countries. It was an attempt to enlighten the US health care leaders that US health care is not the best in the world. No doubt, it ranked first on effectiveness, but ranked last on other dimensions of quality, according to the Institute of Medicine’s (IOM’s) framework for quality. Commonwealth Fund’s findings affirm that the US health care system often performs ‘relatively poorly’ from the patient perspective, and it will ‘need to remove financial barriers to care and improve the delivery of care to meet patient’s expectations.
US Family Health Plan (USFHP), established in 1993, is a TRICARE Prime option working as a permanent part of the Military Health System. (Bolyard). It is available to eligible persons—including those aged 65 and over—who are in the Defense Eligibility and Reporting System (DEERS) and live near selected civilian medical facilities on the East, West, and Gulf coasts. USFHP offers benefits to family members of active-duty military, including activated Reservists and National Guard members, as well as all military retirees and their family members, whether they participate in Medicare Plan B or not. Its enrollees must live in specific ZIP codes, near one of the six not-for-profit community-based hospitals and health care networks. The enrollment fee is $230 for a single person or $460 for a family. There is no waiting period for benefits, and the enrollment is transferable to another region. The plan covers medical emergencies as well, and all costs in emergency above co-payment will be covered under the Plan. National Committee for Quality Assurance in its 2006 report states that USFHP’s “national member satisfaction ratings are 22 percent higher than the national average for satisfaction with health plans” (US Family Health Plan). The high rate of USFHP is attributed to: “population-based care, provider-based care, the full risk for care, care management, and disease management, primary care manager, and customer focus” (Bolyard, p.10).
Continuity is “the existence of some thread—individual, practitioner, group, or medical record—that bind together episodes of care,” and it covers clinician continuity, site continuity, and record continuity (Center to Improve Care of Dying). Continuity of care is primarily the relationship between a single practitioner and a patient that is “thought to foster improved communication, greater trust, and a sustained sense of responsibility” (Worral & Knight, 2006). Three continuity types identified are informational, managerial, and interpersonal or relational. Research evidence states that ‘interpersonal continuity seems to be associated with improved preventive care and with lower rates of hospitalization,’ and ‘in the United States adult patients with higher continuity-of-care scores had lower odds of being hospitalized’ (Worral & Knight, 2006). Though “Continuity of care is one of the defining principles of family medicine,” studies suggest that “despite its proven value in the general population, evidence for the benefit of continuity of care for seniors is limited.” (Worral, and Knight) The policy of consumer-directed healthcare (CDH), premised on the concept that Americans are well insured, is criticized as an ineffective remedy, because CDH plans threaten “the old, sick, and poor.” (Himmelstein et al). Available evidence suggests that the US health care approach does not attend to the needs of the old, sick, and the poor, and a fresh start is required to improve its health care delivery system.
Works Cited
- Bolyard, Marshall. US Family Health Plan: Providing High Quality, Cost Effective Healthcare to Military Beneficiaries. US Family Health Plan. 2008.
- Bolyard, Marshall. US Family Health Plan: Providing High Quality, Cost Effective Healthcare to Military Beneficiaries: Reason for Success. US Family Health Plan. 2008.
- Center to Improve Care of Dying: Continuity of Care: The Multiple Dimensions of Continuity. 2008.
- Davis, Karen, et al. Mirror, Mirror on the Wall: An Update on the Quality of American Health Care Through the Patient’s Lens: Executive Summary. The Commonwealth Fund. 2006.
- Gibbon, Raymond J. Special Report Leading the Elephant Out of the Corner The Future of Health Care: Presidential Address at the American Heart Association 2006 Scientific Session. Circulation: American Heart Association Learn and Live. 2007. Web.
- Himmelstein, David U, et al. Ethics in Cardiothoracic Surgery: Consumer Directed Healthcare, The next Disappointment. The Annals of Thoracic Surgery. 2007.
- Lasser, Karen.E.et al. Research and Practice Access to Care, Health Status, and Health Disparities in the United States and Canada: Result of a Cross-National Population Based Survey. American Journal of Public Health. 2006. Web.
- US Family Health Plan. Military.com Benefits. 2008. Web.
- Worrall, Graham, and Knight, John. Continuity Of Care For Older Patients In Family Practice. Can Fan Physician. 52.6. 2008. Web.