Introduction
A country’s healthcare system is critical to the well-being of its population, which explains why governments across the world spend billions of dollars improving the sector. However, it is important to acknowledge that several issues are affecting the functionality of healthcare, including social, economic, and political elements. Examples include high-technology advances as firms in the industry compete against each other, financial issues, and the efforts by the government to introduce a single-payer system in the country. This paper will focus on the technological developments and the healthcare culture encouraging them, financial solvency, and the opposition to the single-payer system.
Medical Care Culture for High-Technology Approaches
Healthcare planners could be more efficient and effective if they adopted the concept of the natural history of disease and designed services that address the weakest links. However, the current pathway is that of high-technology solutions to preventable problems. An argument can be made that the medical care culture that supports this approach is characterized by competition and desire for profit by the healthcare providers. According to Young and Kroth (2018), the first half of the 20th century saw massive improvements in healthcare as the focus was on the prevention and cure of infectious diseases. The second half was accompanied by technological developments that brought about massive profit potential. The new devices resulted in a scenario where entities extravagantly competed with each other in the development of lucrative services through capital investments in such equipment. Therefore, it can be argued that the focus of healthcare planning may have switched from healthcare improvements to profitability and innovation in patient care.
As new technologies and devices emerged, many entities purchased and used them to provide care for their patients. The technological paradigm shifts have included the rise of an information era that led to the emergence of newly-designed services whose key features included effectiveness, personalization, and patient-centered focus (Patricio et al., 2020). The firms with better equipment and services could attract customers and charge better prices. Therefore, the development of new drugs, creative surgical approaches, and life-extending and life-enhancing medical solutions have been fueled by profit-centered competition in the American healthcare industry. According to Patricio et al. (2020), technology has been intended to enable people-centered approaches, which are considered more efficient in the diagnosis, rehabilitation, and treatment of patients. However, most of the innovations have been made to offer healthcare facilities an edge in the industry, including the opportunity to make vast profits.
Another characteristic of medical care that encourages high-technology approaches is self-service. As explained by Young and Kroth (2018), many players in the industry pursue selfish interests geared toward profit maximization and risk reduction. Young and Kroth (2018) argue that physicians, hospitals, and nurses can be viewed as self-serving, as seen in their political efforts in influencing healthcare reforms in the country. Besides the self-service nature of the industry, it can be argued that Americans have developed a technology-oriented culture where people believe that more dramatic technologies are more effective in improving their lives. In the healthcare industry, the same culture can be manifested through the consumers’ preferences for providers claiming to have the best technologies and equipment. Since the firms have developed a culture of profit-driven competition, it follows that the survival of many entities relies on their ability to innovate and handle competitive pressure.
The Need for Financial Solvency
Hospitals and other healthcare organizations, both voluntary and for-profit, are under severe market pressure to remain financially solvent. Their success and survival depend on this bottom line, which has changed the nature of the American healthcare system. Under normal circumstances, the primary focus of these institutions should be to improve the health and well-being of consumers. However, the need for financial solvency has meant that all their operations are geared towards profitability and cost control. An argument can be made that the situation has been the result of unsuccessful government legislation or the inability of the government to assure healthcare organizations’ financial safety. For example, the 1997 Balanced Budget Act was designed to reduce the payments for Medicare patients below the treatment cost (Young & Kroth, 2018). This legislation caused massive havoc as a result of rising costs and checks kept on hold by managed care organizations. Many hospitals resorted to cost-cutting measures to avoid financial ruin, including laying off staff (Young & Kroth, 2018). Therefore, the external environment has played a critical role in shifting the focus of healthcare entities from care delivery to financial stability.
Whether non-profit or for-profit, hospitals need to be well-funded for them to deliver care to patients, the source of these funds remains a contentious issue in the United States as debates of who should pay for healthcare do not seem to find the right answer. Implementation of healthcare regulations, including funding the organizations, becomes a challenge for the government, which means that the organizations have been left to find alternatives to their financial well-being. The result of such an approach is a scenario where care services are offered only if they are financially viable. The problem mostly manifests itself in private hospitals where cases of patients being turned aware due to financial reasons are on the rise. Diedrich (2020) paints a clearer picture of this situation using a study that established that ambulances with patients deemed to be poor are turned away by private hospitals. Even public and voluntary facilities will face challenges admitting patients who cannot afford the services and lack insurance since the treatment costs must be met.
The new bottom line is that the American healthcare system is inequitable, as only the patients with higher incomes can afford the services. Even the insurers operate on a similar basis, which means that high-risk individuals are also left out of the health insurance systems. The problem is made worse by the fact that hospitals have to make huge capital investments, especially in new technologies, to remain competitive. The investments cannot be feasible or successful without financial health. The resulting scenario is a profit-focused healthcare system where services are not equitably distributed. The thriving private facilities, which often offer the most profitable services, mean that the healthcare system has adopted a commercial nature. All players have to consider the fact that their survival depends on their financial solvency.
Resistance to Single-Payer System
Most developed countries have adopted a single-payer system that helps to eliminate the complex insurance burdens and frees funds that can be used to support care for the under-served. In the United States, such is not the case, as there exists strong resistance to a single-payer system. The debates for a single government program have often been done along political lines, with both democrats and republicans having different opinions on the matter. However, it is important to acknowledge that the resistance hardly comes from the public as there is massive public support (Oberlander, 2019). The question of why the resistance remains can be answered by considering the influence of the private sector on the healthcare industry and the profit-driven culture of the players. A simple argument can be made that what has been considered costs are revenues gained by a stakeholder in the healthcare system. If the opposition is meant to allow private insurance companies to thrive, then it becomes apparent that the opposition to a single-payer system is intended to allow insurance companies to maximize their profits.
A single-payer, either the government or a private entity, may be beneficial to the patients. However, it would eliminate the use of private providers, which means that all the insurance firms would be out of business. Additionally, it can be argued that many people believe that under-served people can be better served through improving such frameworks as the Affordable Care Act (ACA). According to Young and Kroth (2018), the fierce resistance from the private sector is the main reason why the United States does not have a comprehensive national healthcare system. The private sector often comprises stakeholders with vested interests and organized medicine organizations that would prefer a freer market. Even the ACA, which should be a national framework, has left many people uninsured. Therefore, the ACA fails to function as a national healthcare system.
Conclusion
The American healthcare system can be described as chaotic due to the lack of a central framework to govern the delivery of care. The influence of the private sector is manifested through the fierce resistance to such developments as a single-payer system, which should offer massive benefits for patients. The culture that has developed can be described as a profit-centered competition among firms as each attempt to make heavy capital investments to gain an edge. The current approaches to care involve high-technology solutions where new technologies and equipment are used to gain a competitive edge. However, the trend has also been influenced by the consumer base who believe that the more dramatic the technology, the better the treatment outcomes.
References
Diedrich, J. (2020). Some hospitals turn away ambulances when the patients are more likely to be poor, a study finds.Journal Sentinel. Web.
Oberlander, J. (2019). Lessons from the long and winding road to medicare for all.American Journal of Public Health, 109(11), 1497-1500. Web.
Patricio, L., Sangiorgi, D., Mahr, D., Čaić, M., Kalantari, S., & Sundar, S. (2020). Leveraging service design for healthcare transformation: Toward people-centered, integrated, and technology-enabled healthcare systems. Journal of Service Management, 31(5), 889-909. Web.
Young, K., & Kroth, P. (2018). Sultz & Young’s Health Care USA: Understanding its organization and delivery. Jones & Bartlett Learning.