The Hell in Healthcare

Many people see the United States as one of the most significant countries in the world. How can this be when one of the most essential systems, the healthcare system, is not the strongest it can be? Many countries worldwide have a free healthcare system that citizens can access when needed. However, that is not the case in the US. The US healthcare system causes many Americans to choose not to see a doctor due to the unreasonable cost. Many things are implemented to help Americans afford medical attention when necessary, like insurance, Medicare, and places like retail health clinics. Yet, these implementations still have many flaws that come with them. When you or someone close to you becomes sick, the first thing on everyone’s mind is to find a way to get better. However, that is not the case today, whether going to the doctor, getting rest, or just pushing through the sickness to deal with it. Many people prefer not to go to the doctor for many reasons. From the absurd amount of money, these doctors are asking for only a thirty-minute appointment to the accessibility of these doctors to the everyday person. Why should Americans have to worry about the accessibility and money troubles of the healthcare system, while many other countries have free healthcare for all citizens? This is the best option for the US to have free healthcare, but that is not the case and will most likely never be.

The corruption of the US healthcare system is due to many different factors. One is the political aspect of healthcare. To explain simply and efficiently, the government and political parties that have a say in our healthcare system are mostly money-driven. Fees are associated with everything from pharmaceutical companies to general practitioners’ offices.  The economy is considered the most important, so the healthcare system has high costs. These high costs affect ordinary Americans daily, whether through yearly doctor visits or life-threatening surgeries. The article “Examining quality and efficiency of the US healthcare system” by Kumar S, Ghildayal, N.S, and Shah, R.N states, “The US healthcare system is characterized as the world’s most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable.” It can be summarized as a numbers game.  How many patients can we push through an office, and how many scripts can we write for additional costs?  The focus is not on the sick; the focus is on the deepening of the pockets of the healthcare providers. Due to the corruption of the US healthcare system from the political point of view, the costs of necessary doctor visits are being taken away from Americans. 

In comparison to other countries, we need to do better.  In the article US vs. Canadian Healthcare: What is The Difference? states, “Since 1984, the Canada Health Act (CHA) has provided all Canadians with publicly funded healthcare insurance, a program often called “single payer” because all funding and payments come from a single source: the Canadian federal government. The government distributes funds to the provinces and territories, which must each provide care and fulfill CHA requirements for its citizens. Insured health services include inpatient and outpatient hospital care; medically necessary care for maintaining health; disease prevention and the diagnosis and treatment of injuries, illnesses, and disabilities; and medically required physician services.”  Here we can see that a country can sustain and provide this service while not accruing more national debt.  Remember that the system they have created is provided through clearly stated guidelines.  Many of the Medicare costs in Canada come from collected taxes the citizens pay.  This makes sense.   The government uses the money citizens already pay to provide this service back to the public.   Ironically, most of their tax rates are similar if not the same as here in the US. The article goes on to state, “Canada’s health system works pretty well, and it is often cited as a well-functioning example of universal healthcare. But out of 11 high-income country health systems compared in a recent Commonwealth Fund study, Canadian Medicare ranked 10th overall…”  Although this is only one rank ahead of the US, the medical services provided far surpass the US.  Countries like Norway, Netherlands, and Australia rank one, two, and three.  These rankings were based on efficiency, affordability, equity, and outcomes and clearly seen that the American healthcare system falls short in all of these areas.

In understanding why these other countries see success in their healthcare, several factors are taken into consideration.  They are universal coverage and the removal of cost barriers, investment in primary care systems to ensure equitable services, reduction of administrative burdens, and investment in social services, particularly for children and working-age adults.  If our healthcare administration could adopt or replicate this model used in other countries, we could slowly change the view many have on US healthcare.  It seems easier to turn a blind eye and let people (the sick) figure it out as they go.  We, the American Government and Healthcare System, need to do better for our people. 

Many Americans are trying to find another way other than going to their primary doctor for visits, which are seen to cost more than other options that have recently been new to the US. One of these options is urgent care. Urgent care is one of the new and most popular ways Americans today save money when they are sick or need medical attention. Even though urgent care still costs more than it should or is compared to free healthcare in other countries. It is still seen as a better option for many Americans who may have little money or don’t have insurance/access to a primary doctor. Some may say these urgent cares aren’t as good as primary doctors; however, they are becoming increasingly popular. As stated in the article, “Urgent Care Utilization Skyrocketed by 1725% in Last Decade” by Thomas Beaton, “Payers spent an average of $294 for a 30-minute primary care office visit compared to the $255 amount in urgent care centers.” These high costs for a thirty-minute doctor visit are unbelievable. There isn’t much difference between urgent care and primary doctor costs. However, many Americans who go to the primary doctor are not paying the total price. They are not paying $255 for a doctor’s visit because most of these Americans have insurance that covers most of the payment for a doctor’s visit. While most Americans using urgent care do not have insurance, $294 is the best option. Without an insurance plan, this is frequently the only option. Sadly, a lot of the time, it is since many places of business do not offer packages to their employees solely because of the premium costs they are charged for the plans. It simply is not feasible for them to offer their employees a healthcare plan.

Around 15% of Americans don’t even have insurance due to its high costs and the little coverage it gives. Americans who do have insurance are forced to pay high prices since there are not many insurance companies, and because of that, these insurance companies can charge whatever they please. The article “Is our Healthcare System broken?” states, “High costs combined with high numbers of underinsured or uninsured means many people risk bankruptcy if they develop a serious illness.” The high costs of medical attention in the US can have severe and detrimental consequences that come with it.  When it is paying to put food on your table, for your family, or going to urgent care for an antibiotic, a financially struggling person would put food on their table for their families.  This shouldn’t be the case. These adverse effects on Americans can trickle down their lives, causing many different things, like debt. Unlike citizens in other countries, they have to think twice when seeking medical attention for any sickness or injury, mainly due to the financial consequences of seeking medical attention.

Another way the US healthcare system tries to help Americans afford medical attention after age sixty-five is through Medicare. Americans pay for Medicare through taxes until they are sixty-five years old, when they become eligible. Medicare provides help for over sixty million seniors or disabled Americans every day. However, even after paying for Medicare through taxes for sixty-five years, it still has many flaws that come with it. One of the significant flaws of Medicare is the added out-of-pocket expenses that Medicare does not cover. Many Americans with Medicare are retired and no longer have an income so these extra out-of-pocket expenses can cause a burden to these senior citizens. The article “What Are the Pros and Cons of Medicare?” states, “Some beneficiaries may choose to enroll in a Medicare Advantage plan because these plans must include an annual out-of-pocket spending limit. Other beneficiaries may choose instead to apply for a Medicare Supplement Insurance plan, which pays for certain out-of-pocket costs such as Medicare copays, coinsurance, deductibles, and more.” Considering what has been stated, Americans with Medicare need to pay monthly for supplemental plans that will cover the out-of-pocket costs they would have to pay otherwise if they just had Medicare. With this being said, the only pro to this kind of plan is eliminating the surprise out-of-pocket costs that come with the visits for these Americans. However, not all Americans can afford to pay extra monthly for a better insurance plan to cover the out-of-pocket expenses and are forced to pay the out-of-pocket expenses after doctor visits or medical attention. Some Americans may find that the extra plan is unnecessary due to it not constantly breaking even with the amount of money they would have to pay monthly to cover the out-of-pocket costs when they cannot predict how much they would have to spend on out-of-pocket costs.

Furthermore, the article “What Are the Pros and Cons of Medicare?” states, “While Medicare is widely accepted across the U.S., it’s not necessarily accepted by every health care provider.” Therefore, after all of the money spent towards Medicare through taxes and if the American pays an additional amount of money monthly for a supplemental plan, they can still find a disadvantage within the medicare plan of not being accepted by all healthcare providers. This often leads to switching doctors and may have additional costs for various reasons.  Accessibility to the office, relationship with a new medical staff, starting over with the process of treatment/diagnosis, etc.  All are even more difficult when you consider that, in most cases, these Americans are older and may not be as in tune with what is happening throughout the process. 

Additionally, the US healthcare system has retail clinics that can benefit many Americans, but that comes at a cost. Most Americans will go to retail health clinics for affordable prices and time efficiency. Yet, these retail healthcare clinics are only sometimes seen as providing the best care. In the article “Retail health clinics: The pros and cons,” it states, “Geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School, is concerned that the details of a patient’s visit to a retail health clinic might not be sent to her. Although clinics offer this service, not everyone takes them up on it. ‘The risk with that is, scattered care from multiple places can lead to mix-ups,’ says Dr. Salamon. ‘And if people don’t bring their complete medication lists to a clinic, the clinic may prescribe something that will interact with medications they’re taking.” It has been found that these retail health clinics may not be fully treating their patients at their highest capability due to a lack of knowledge. With this occurring, patients who choose this route when seeking medical attention might worsen their health due to choosing to go to a retail health clinic compared to their primary doctor for the low cost or time efficiency of the retail health clinic. “Desperate times call for desperate measures” should not be the motto attached to US Healthcare, yet this is America’s only option in so many cases.  

Although there are many downfalls within the US healthcare system, the US government still tries to find ways to benefit Americans. One of the many ways US healthcare has done this is through urgent care, retail health clinics, and health insurance for those who can afford it. Having these clinics and insurance for the everyday American makes it much easier and less stressful for many people to stay healthy.  It also allows some to have resources when they become sick. 

Urgent care and retail health clinics have many benefits for them. From accessibility due to the many locations of both and the areas in which they are located. Many Americans find these clinics and doctors to be one of the first places they will visit for their sickness. Adversely, Medicare, as stated earlier, could be negatively affected by transportation situations alone. They also are known for their quickness and time efficiency.  Again, this in-and-out mentality could lead to misdiagnosis and further complications.  From personal experience with these places, they are sometimes not the quickest, but they serve well for small things like a cold, the flu, or minor injuries. However, how can the average American get the services they need without insurance when they are forced to go to the hospital for something more significant like a broken leg or sickness? Although there are many avenues for Americans to choose from when they become sick or injured, sometimes the hospital or calling an ambulance is the only option. The average cost of an ambulance ride in the US is around $1,000. That is for both insured and uninsured Americans. Even with insurance, many Americans find themselves only calling an ambulance if it is a life-or-death situation due to the high costs of the ambulance. Treating a severely injured or ill family member is the priority in those instances.  The after-effect of the piling of medical bills begins to happen shortly after.  It is a vicious cycle that many Americans face on a day-to-day basis.   

Taking a closer look at the breakdown of the US healthcare system, every state may vary in cost effectiveness. Again, in the article, US vs. Canadian Healthcare: What is The Difference?, it states, “ In 2023, the nation’s best state health systems were Massachusetts, Hawaii, New Hampshire, Rhode Island, and Vermont. Each of those states incorporates one or more of the Commonwealth Fund secrets to healthcare success. Arkansas, Texas, Oklahoma, West Virginia, and Mississippi were the lowest-ranking state health systems. It does matter which state you call home, but healthcare access and quality in the United States also vary greatly according to race, ethnicity, income, and level of education.”  Our inconsistencies make it that much harder for Americans to find quality healthcare in our own states.  Think about having to relocate for a job.  In your current state, you can receive adequate healthcare at a decent cost.  Moving a few states away could drastically change your cost, quality of service provided, and other incidentals you may not even be aware of at the time of relocation. This is just one of the many downfalls of the US healthcare system.

Urgent care can only provide so much for the everyday American needing a doctor’s visit. It comes down to the costs of a simple checkup compared to something more serious that costs an arm and a leg at the emergency room. This is one of the most significant downfalls in the US healthcare system. Americans without health insurance find themselves in a panic when they have a severe injury or sickness that forces them to go to the hospital or need surgery—leading some who need surgery to leave the country and seek medical services in other places.  It is sickening that a first-world country can not provide for its citizens.  Many Americans have astronomical medical bills due to the high costs of the healthcare system throughout the US. The article, “90% of Americans With Medical Debt On Their Credit Report Face Setbacks; New Rules May Help”, states, “In a survey of 1,000 American adults conducted by Tebra, a medical practice management company, 25% of respondents reported that they’d had unpaid medical bills show up on their credit reports. Of those, 91% reported having experienced financial setbacks as a result.” These medical bills are piling up on Americans who are insured and uninsured. How is this possible with all the great insurance that is supposed to be helping Americans stay healthy, yet it is causing many setbacks? It also states in the article, “…$88 billion in medical debt clogged up Americans’ credit reports, and medical debt is a top source of consumer complaints to the Consumer Financial Protection Bureau (CFPB), any relief should be welcome news to millions of Americans.”  So, we should be thankful for the 88 billion dollars of medical debt across the board for Americans. This is absurd because many other countries have free healthcare that their citizens can access anytime. And so they do not see a national debt in their countries due to healthcare. 

In conclusion, there is no perfect healthcare system.  There are flaws that are very obvious to us as Americans in, or unfortunately not privileged enough to have healthcare.  National funding and dissemination of funds need to be revamped to provide Americans with the healthcare they deserve.  Working citizens pay taxes.  Working citizens get sick.  It is the due diligence of our government to provide us with a service that rightfully deserves, considering what Americans put back into the government, both state and nationally.  I hope in time, there is a change.  As we know and many of us have witnessed, change takes time, but for the millions of people who have waited and are hopeful, this change in a positive direction is so desperately needed in the US healthcare system.

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