US Healthcare System
America's health care system is neither healthy, caring, nor a system ― Walter Cronkite
image by: Marco Verch
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We’re Already Paying for Universal Health Care. Why Don’t We Have It?
There is no shortage of proposals for health insurance reform, and they all miss the point. They invariably focus on the nearly 30 million Americans who lack insurance at any given time. But the coverage for the many more Americans who are fortunate enough to have insurance is deeply flawed.
Health insurance is supposed to provide financial protection against the medical costs of poor health. Yet many insured people still face the risk of enormous medical bills for their “covered” care. A team of researchers estimated that as of mid-2020, collections agencies held $140 billion in unpaid medical bills, reflecting care delivered before the Covid-19 pandemic. To put that number in perspective,…
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The Business of Healthcare Is Business
Hmm, that headline doesn’t seem right, does it? I mean, shouldn’t the business of healthcare be, well, health? Or, at least, caring? Actually, shouldn’t the business of healthcare be patients? After all, everyone in healthcare says it’s all about patients. Everyone says they’re patient-centered, whatever that means.
The problem with American health care is the care
Our health care system hasn’t caught up with the evolving face of disease in America. It is still mostly a workforce of doctors and nurses who dutifully treat patients in hospitals with expensive drugs and high-tech medical devices. If we could reconfigure health care to detect and address the root causes of costly illness, health reform would be a true success.
Health Care Reform Facts: How Does U.S. Actually Stack Up Against Other Countries?
The question often arises, "What is heath care reform and why do we need it?" The answer is almost always something like: The U.S. spends more than any other industrialized country on health care, but gets worse-quality health care. And, the U.S. is the only country that doesn't provide universal coverage to all of its citizens. Each of these claims is technically true, but also very misleading. When you look at the data, the picture gets far more nuanced. And the alleged advantages foreign countries have over the U.S. start to dissipate.
The Fractured State of American Health Care
The quality of your coverage increasing depends on whether you live in a red or blue state.
The most screwed-up employee perk in America (and the man who just might fix it)
Gawande, who has been writing and speaking on the problems of the US healthcare system for most of his adult life, has long bemoaned the field’s resistance to innovation. As an influential book author, New Yorker contributor, and public speaker, Gawande has become one of the foremost champions of change in healthcare delivery and policy. His ideas are about to be put to their biggest test yet.
The next health care wars
Forget the Affordable Care Act: The future of our health care system will be shaped by a much bigger and broader fight — one that will likely culminate with a 2020 choice between private markets and an authentic government-run program in the form of a Bernie Sanders-style Medicare for All.
The Worst Patients in the World
Americans are hypochondriacs, yet we skip our checkups. We demand drugs we don’t need, and fail to take the ones we do. No wonder the U.S. leads the world in health spending.
We Should Treat Everyone Like We Treat HIV-Positive Patients
Don’t look to Canada, France, or Singapore for a world-class health care system. You can get the best health care in the world right here in the United States, for free. But there’s a catch: You have to be HIV-positive. Through a combination of federal and state funding, plus some very clever implementation strategies, Americans infected with HIV are eligible for incredibly comprehensive care, even if they are uninsured or underinsured. It’s amazing the program doesn’t get the attention it deserves. In fact, it should be a model for how we treat all patients.
What the U.S can learn from the U.K.’s National Health Service
At first glance, the struggles of NHS England appear to embody conservative arguments against the kind of single-payer health care system that many progressives in the U.S. have rallied behind as a way to expand health insurance to all Americans. In this view, the troubles of NHS England clinch the case that universal health insurance is a fool’s errand. Not so fast.
A Brief History: Universal Health Care Efforts in the US
The campaign for some form of universal government-funded health care has stretched for nearly a century in the US On several occasions, advocates believed they were on the verge of success; yet each time they faced defeat. The evolution of these efforts and the reasons for their failure make for an intriguing lesson in American history, ideology, and character. Other developed countries have had some form of social insurance (that later evolved into national insurance) for nearly as long as the US has been trying to get it.
A history of why the US is the only rich country without universal health care
When did the country diverge from other industrialized nations and, rather than offering universal health coverage, built up a system that relied on private insurance?
A physician’s response to Jimmy Kimmel’s monologue
Most importantly, Mr. Kimmel put a face on the importance of health insurance and the inhumanity of not providing it to those who need it most: those with pre-existing conditions. He suggested that without good insurance, Billy would have been abandoned by the health care system.
America's Health Care System Kills People—But It Doesn't Have to Be This Way
In Australia, vital services like cancer treatments are free; in the US, countless people struggle to even get screened. We spoke to cancer patients in both countries about the drastic difference single-payer health insurance can make.
As Health Care Changes, Insurers, Hospitals and Drugstores Team Up
Former adversaries are banding together, girding against upheaval in a rapidly changing health care environment. They are also bracing for the threats posed by interlopers like Amazon eyeing a foray into the pharmacy business or tech companies offering virtual medical care via a computer or cellphone.
Drug overdose deaths were so bad in 2017, they reduced overall life expectancy
The CDC blamed the increase in drug overdose deaths, as well as a continuing increase in suicides, for a drop in life expectancy in 2017, making that year the third in a row in which life expectancy fell or remained flat.
How American Health Care Killed My Father
Over the next five weeks in the ICU, a wave of secondary infections, also acquired in the hospital, overwhelmed his defenses. My dad became a statistic—merely one of the roughly 100,000 Americans whose deaths are caused or influenced by infections picked up in hospitals.
How Republicans Can Fix American Health Care
The future of health-care cost-cutting in America is top-down cost-cutting, not bottom-up. It’s the providers who will have to be squeezed, not the consumers.
Is Canada the Right Model for a Better U.S. Health Care System?
For many critics of U.S. health care, the Canadian system of universal health care has long been viewed as an alternative, superior model for the U.S. to follow. Canada’s single-payer system is mostly publicly funded, while the U.S. has a multi-payer, heavily private system. While dissatisfaction with the U.S. health care system is widespread among Americans, Canada’s health care system enjoys high levels of satisfaction among its own population. Much of the appeal of the Canadian system comes from the fact that it seems to do more for less.
Is Singapore’s “miracle” health care system the answer for America?
The Singapore model shows how liberal and conservative ideas can fuse.
Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally
The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance.
Paying Till It Hurts
In her series on the costs of health care, Elisabeth Rosenthal of The New York Times examines the price of medical care in the United States, interviewing patients, physicians, economists, and hospital and industry officials. In each installment, readers were invited to share their perspectives on managing costs and treatment.
The Fake Freedom of American Health Care
What passes for an American health care system today certainly has not made me feel freer. Having to arrange so many aspects of care myself, while also having to navigate the ever-changing maze of plans, prices and the scarcity of appointments available with good doctors in my network, has thrown me, along with huge numbers of Americans, into a state of constant stress. And I haven’t even been seriously sick or injured yet.
The real reason American health care is so expensive
What we don’t talk about as much is why. Americans don’t consume more health care than the Germans or the Japanese. We actually go to the doctor less often. The real reason American health care is so expensive compared to other countries is that the prices are higher. We pay more for everything from angioplasties to C-sections, from hip replacements to opioids.
The state of American health care, in 5 charts
If you've been following Vox at all, you know we love charts. So here are five to help you make sense of where US health care stood in 2016, before the Trump administration and these new health pursuits got underway.
Think the NHS is in poor health? Try being ill under the US system
Thanks to decades of lobbying by the US health industry, Americans pity Britain for our ailing hospitals and overworked doctors. But it’s the astronomic cost of US treatment that is truly sick.
This is how America rations health care
Patients are starting to fight back. Morton is part of a class-action lawsuit that argues these insurers must make good on their contractual promise to pay for "medically necessary" services. The complaint is unique — and the eventual ruling could have national consequences as more expensive new drugs come onto the market.
U.S. Has the Worst Health Care? Not By a Long Shot
A new Commonwealth Fund report is the latest to indict U.S. health care. It pegs the American system dead last in a survey of 11 developed countries. But like virtually every other study that trashes the U.S. healthcare system, Commonwealth's rankings rely on questionable assumptions, like giving weight to those systems that treat people equally rather than well. At the same time, Commonwealth ignores the problems that countries with socialized healthcare systems have actually treating people once they're sick.
U.S. Health Care from a Global Perspective
Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions.
U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries
t’s fairly well accepted that the U.S. is the most expensive healthcare system in the world, but many continue to falsely assume that we pay more for healthcare because we get better health (or better health outcomes). The evidence, however, clearly doesn’t support that view.
U.S. Healthcare: Most Expensive and Worst Performing
In a new international ranking, the United Kingdom ranks first, while the U.S. performs poorly across almost all health metrics.
Unspeakable Realities Block Universal Health Coverage In America
Americans with good jobs live in a socialist welfare state more generous, cushioned and expensive to the public than any in Europe. Like a European system, we pool our resources to share the burden of catastrophic expenses, but unlike European models, our approach doesn’t cover everyone.
US health care system: A patchwork that no one likes
Almost all parties agree that the health care system in the U.S., which is responsible for about 17 percent of our GDP, is badly broken. Soaring costs, low quality, insurance reimbursements and co-payments confusing even to experts, and an ever-growing gap between rich and poor are just some of the problems.
What's Actually Wrong With the U.S. Health System
A new report shows why American health care performs so poorly compared to its rivals—and suggests the Obamacare replacement proposals aren’t the way to fix it.
When Social Needs Are Medical Needs
Health is more about what happens outside the clinic. So why aren’t our high-tech health care systems better at addressing it?
Why an Open Market Won’t Repair American Health Care
We need such a conversation — not just about how the market fails, but about how we can change the political realities that stand in the way of fixing it.
America’s Health Rankings
The 2017 America’s Health Rankings® Senior Report provides a comprehensive analysis of senior population health on a national and state-by-state basis across 34 measures of senior health.
My Stupid Elbow and the Crisis in Health Care
A lingering hockey injury forces a science writer to reconsider his criticism of American medicine
The New Business Of Health Care
Health care is in the midst of a seismic shift, from a model that rewarded providers for the volume of care to one focused on the value patients receive from that care. This is in response not only to rising costs but to legislative mandates from the Affordable Care Act and Medicare. Providing patients with quality care at lower costs so they can lead healthier lives is a trend that’s accelerating for a reason: because it works.
What You Need to Know About 4 New Healthcare Delivery Systems
New delivery systems are rapidly changing the face of healthcare, and staying abreast of new developments can be a constant challenge.
American Health Care Is Broken. Major Hospitals Need to Be Part of the Solution
It’s time to use that wealth and that clout to tackle the social drivers of health. Hospitals and health care systems must mobilize to treat—and ultimately, prevent—diseases caused by poverty, inequality, racism, and loneliness just as aggressively as they mobilize to attack a cancer with sophisticated drugs and surgeries.
How the US health-care system works — and how its failures are worsening the pandemic
It is impossible to understand the US health system without considering America’s ideological and political context.
Why Healthcare Needs A Civil Rights-Style Movement
There will come a time in the not too distant future when we look back at the healthcare system as it is today with shame and embarrassment. We’ll wonder how anyone got the right kind of care and rue the policy and clinical decisions that have made oursystem unaffordable, inaccessible, wasteful, and inferior to our peer nations.
Accidents Of History Created U.S. Health System
It turns out there never was any central logic at work. The evolution of the American health care system began in the 1920s, when choices boiled down to which crazy cure you preferred.
America is a health-care outlier in the developed world
The only large rich country without universal health care.
How Health Care In The U.S. May Change After COVID: An Optimist's Outlook
For example, the use of telemedicine skyrocketed, and many think it's an innovation that's here to stay. Patients like the convenience — and for many conditions, it's an effective alternative to an in-person visit.
How Healthcare Costs Hurt American Workers and Benefit the Wealthy
Americans spend vast sums on health care. Certainly, health care is expensive all over the world, and it makes good sense for rich countries to spend large amounts to extend their citizens’ lives and to reduce pain and suffering. But America does this about as badly as it is possible to imagine.
Reducing Administrative Waste in the US Health Care System
The US health care system is famous for its expense and its waste. In a 2019 study, Shrank et al1 estimated that about 25%, or $760 billion to $935 billion, of the $3.6 trillion the US spends on health care annually is potentially wasteful.
Taiwan’s single-payer success story — and its lessons for America
In the 1990s, Taiwan did what has long been considered impossible in the US: The island of 24 million people took a fractured and inequitable health care system and transformed it into something as close to Sen. Bernie Sanders’s vision of Medicare-for-all as anything in the world.
The American healthcare system is only making COVID-19 worse
The United States is at greater risk than other industrialized countries from the COVID-19 outbreak, he says. Why? “We have a really bad social safety network.” Things like universal access to healthcare and paid sick leave mandates are just two of the things that could improve it, he says.
The Changing Face Of The Healthcare Industry
Before the pandemic, the healthcare industry often relied on people’s ability to move around and meet face-to-face. Everything was based on patients being able to get to a clinic or a hospital to participate in a clinical trial or speak to their doctor. The pandemic forced us to acknowledge that the industry needs to be able to do much more remotely.
The coronavirus exposes our health care system’s weaknesses. We can be stronger
Acoronavirus is so tiny that 1,000 of them could be stacked in the thickness of a sheet of paper. It is an invisible threat, and it is making vivid the shortcomings of our health care systems.
What can Italy teach the rest of the world about health?
Italy's healthcare system isn't perfect, but the people who live here are some of the healthiest in the world. Other countries can learn a lot from its example, writes Susan Levenstein, an American doctor in Rome.
Why Americans Have Been Deceived About Canada's Health Care System
For decades, the health insurance industry has been scaring Americans about Canada's health care system. We hear from a whistleblower about his role in the disinformation campaign.
We’re Already Paying for Universal Health Care. Why Don’t We Have It?
Coverage needs to be free at the point of care — no co-pays or deductibles — because leaving patients on the hook for large medical costs is contrary to the purpose of insurance. A natural rejoinder is to go for small co-pays — a $5 co-pay for prescription drugs or $20 for a doctor visit — so that patients make more judicious choices about when to see a health care professional. Economists have preached the virtues of this approach for generations.
Three reasons the US doesn’t have universal health coverage
Why isn’t universal coverage through a national health insurance system even being considered in America? Research in health policy points to three explanations.
3 Things U.S. Medicine Can Learn From A Global Humanitarian Nonprofit
The recent legislative debacle in Washington, D.C., tells us the biggest problems facing American medicine are unlikely to be solved in our nation’s capital. We must, therefore, seek solutions in unexpected places.
9 things Americans need to learn from the rest of the world’s health care systems
Universal health care is hard, but it should be possible — and eight more things I discovered from visiting other countries.
Commonwealth Fund Ranking
The U.S. health system is a mix of public and private, for-profit and nonprofit insurers and health care providers. The federal government provides funding for the national Medicare program for adults age 65 and older and some people with disabilities as well as for various programs for veterans and low-income people,
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