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Is the United States Quality of care directly impacted by the cost of care or by the
access to care?
Quality health care services are important for maintaining health, prevent
diseases, managing diseases, and reduce unnecessary services and premature death.
For more than we can remember, different polls have demonstrated that Americans are
dissatisfied with their current health care system and that it is extremely expensive.
According to Burke and Ryan from “The Journal of Ethics”, the United States cost
positions 26th on the whole planet for life expectancy and ranking poorly on quality. In
other words, the United States health care system is failing and costs continue to
increase faster than what the American can pay for their services, with the quality of
care being also affected. These increase in costs, have driven the possibility to look for
wasteful spending, like Medicaid, but it does not correlate with patient outcome,
capturing the attention of policymakers. Costs are not strongly related to the quality in
the US. For example, the FDA has had approval for new cancer drugs over the years,
which can cost over $100,000 per year but are often expected to extend mortality for
more than a month, but it does not give better quality of life or cure the disease. The
same happens with medical devices that despite of similar survival outcomes, rates of
coronary angiography, angioplasty, and bypass surgery following a heart attack, which
all have different costs for patients, were 5 to 10 times higher in the United States.
This came to the attention of access of care. Access of care is defined “as having
timely use of personal health services to achieve the best possible health outcome.”
(2018). Access of care requires entering the health care system, having access to sites of
care where patients can receive all the services needed to improve their health, and also
find providers and physicians who can meet with their needs and whom patients can
develop a relationship based on trust and communication.
The main purpose for the appearance of Medicaid was to help people obtain
health insurance and improve access to health care for those that were uninsured. To
the present day even with the Obama care installed, which main purpose was to
improve access to health care, the United States still has a poor ranking on insurance
coverage. The Commonwealth Fund conducts an international survey of patients from
time to time and the last time they surveyed was in 2013. Patients were asked if they
could get “same-day” or “next-day” appointments with their provider when they were
sick; more than half said no. But on another survey, patients declared that it was easier
for them to have health care access after regular working hours in the emergency
department but still could not receive the help they needed. The problem here is that
even though patients received the help they needed, some still could not afford health
care because they could not afford the medications they needed or the provider did not
accept their health insurance. The point of this survey is to demonstrate that even
though if health care is available, many factors can contribute to affect ease of access to
it, for example, the availability of providers who will accept a person's insurance could
affect healthcare access, even if they had Medicaid. Also, ease in making an
appointment with a given provider can be a factor of access of care. The ability of a
patient to pay for the care because even though if a patient is insured, due to cost-
sharing copayments and deductibles, they still can’t afford to pay; and also the difficulty
of arranging transportation to and from healthcare facilities could also affect a patient
from accessing health care although they are insured. So even thought Americans have
access to insurance, it does not guarantee access to care for what our health care
system needs a fundamental change or it needs to be completely rebuilt.
Burke, L., & Ryan, A. (2014). The Complex Relationship between Cost and Quality
in US Health Care. Journal of Ethics.
Carroll, A. (2016, October 24). Why the U.S. Still Trails Many Wealthy Nations in
Factors That Affect Health-Care Utilization. (2018, March 1). Retrieved January
30, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK500097/
Pearl, R., MD. (2017, May 25). Mission Possible: How Healthcare Can Achieve
Both Higher Quality And Lower Cost. Forbes.