Healthcare Policy in the United States, Essay Example

While some Americans believe that their healthcare system is one of the best in the world, the majority agree that the quality of U.S. healthcare is worse than in many developed countries. Under the circumstances of rising costs, up to 18% of GDP expenditures on healthcare, and U.S. spending 2,5 times more than average OECD expenditure per individual, the health of the U.S. population suffers from uneven quality of healthcare delivery, bigger amount of health-related problems, and lower than average OECD life expectancy. Indeed, U.S. life expectancy is lower than OECD average (whereas average is 79.5, the one that is fixed in the States equals 78.2), infant mortality is higher, as is the number of potential years of life lost (“Health at a Glance: OECD Indicators”). Besides, in the United States the rates of disability are quite high, as well as the rates of lung and heart disease, teenage pregnancies, infections that are sexually transmitted, and injuries (National Institutes of Health Committee on Population).

The major challenge of the healthcare policy in the United States is its market-based approach and lack of effective prevention programs. Currently, the U.S. supports free market system in healthcare services delivery. In other words, healthcare facilities in the country are generally owned and run by business entities and by private sector. It means that the private element dominates the public or governmental element. To receive adequate healthcare, a person must be insured. While nearly all elderly Americans are insured through the government-run Medicare, which provides for the majority but not all health services, others have to buy health care insurances themselves or get employer-sponsored health insurances. These health insurances include private health insurances administered by private providers and have varying benefits. Very poor individuals are insured through Medicaid, but they actually have difficulties finding a provider, since the reimbursement rates are rather low. More than 16% of the overall population remains uninsured in the United States (2010 data). This number exceeds the figure of 49 million citizens (with reference to the non-elderly population, the percentage is significantly higher: namely, 18% back in 2003) (Kaiser Commission on Medicaid and the Uninsured) (Figure 1).

Figure 1

Under these circumstances, it is clear that the U.S. healthcare system should undergo major changes. First, it should be altered following a different program: either a government-run system of healthcare, or a mixed system. Second, the government should regulate prices on healthcare, which are inflated for most healthcare services in the States compared to other countries (Figure 2). Third, consistent preventative measures should be done to make people change their life habits and improve their health condition. Fourth, the government should fight the issues that contribute to the rising rates of diseases and mortality with the help of taxing policy. While federal-induced measures such as insurance policy improvements are often quite hard to launch, preventative measures, which may be taken either on a governmental or on a non-profit private basis, are the easiest to implement; besides, as research shows, they can be highly successful.

Here are several more justifications of application of preventative measures. While the adoption of the Affordable Care Act has brought some positive changes to the state of health care delivery in the United States, current processes in its implementation (for example, Obama administration’s recent decision to hand authority “back to states to develop their own essential health benefits standards”) evidence that the problem needs to be solved in another dimension simultaneously (Levey 663). Specifically, Affordable Care Act does not seem to justify the hopes of many Americans who otherwise hoped to be entitled to free state-sponsored healthcare services. Therefore, in a situation when it seems unwise to rely on measures of dubious effectiveness, other ways to improve health of the American people should be sought.

The American society suffers from smoking-related diseases to a great extent. Data provided by the U.S. Centers for Disease Control and Prevention evidences that every pack of cigarettes which is sold on the territory of the United States costs the American society $7.18 in higher costs of health care as well as in lost employee productivity. If added, the cost exceeds $150 million annually. This results in $3,400 per smoker every year (McEachern 108). Although the rates of tobacco consumption as well as rates of smoking-induced diseases and mortality in the U.S. are considerably lower than in some other countries (for example, in China, nearly 67% of men and 4% of women are smokers, of whom 18% are in their teens), measures should be taken to further reduce the number of smokers (Zhang & Cai 17). 19.3% of U.S. population still smoke, so these measures should target them directly (Centers for Disease Control and Prevention). Consequently, one of the priorities of health care improvement should be fight against smoking and smoking-related lifestyle. The next part of the paper provides an overview of how the problem of smoking-related diseases, especially cancer, and smoking-related mortality could be solved with the help of federal action.

Figure 2. U.S. hospital procedures quasi-prices (U.S. dollars) in comparison with other countries within OECD (Adapted from Koechlin et al).

Major trends of the U.S. public policy aimed at reduction of tobacco consumption have been laws restricting cigarette trade and banning smoking in public places, tax increases in various U.S. states, health warning labeling campaigns, restrictions on cigarette sales by age, and restrictions on advertising of tobacco products. First of all, numerous states within the U.S. have adopted laws that restrict or ban smoking in public places. According to a recently published report by American Nonsmokers’ Right Foundation, as many as 81.3% of Americans are subject to a ban on smoking – namely, in “workplaces, and/or restaurants, and/or bars, by either a state, commonwealth, or local law” (American Nonsmokers’ Right Foundation). 60 major cities in America have smoking legally banned from food facilities.

Next, some states raised taxes on tobacco products and thus made them unaffordable for the most vulnerable population of smokers – teenagers. Specifically, California has been running a comprehensive tobacco-control program based on a raised cigarette tax for over two decades. This measure has produced the desired effect: per capita consumption has considerably declined in California; number of smoking-related deaths has considerably dropped (Warner 103). Even a greater impact has been produced by the Obama Administration action, in particular, by the cigarette tax increase fixed on the federal level. Based on the recent statistical data, the number of young smokers significantly dropped in 2012 in comparison with 2011.

The foregoing measure was enhanced by an accompanying restriction on cigarette sales to minors which was also imposed on the federal level. Teenagers sensitive to changes in price and deprived of the opportunity to purchase tobacco products based on age limit have been found to smoke considerably less. A research group from the University of Michigan’s Institute for Social Research conducted a survey back in 2012, which allowed discovering a statistically significant decline in the number of smoking teenagers in 8^th, 10^th, and 12^th grades. In the period from 2011 to 2012, the smoking rates fell particularly significantly among the 8^th graders: from 6.1 to 4.9 per cent. Coupled with the findings for the remaining age groups, the data demonstrate a record decrease in the number of young smokers for 38 years (Johnston et al, “Decline in teen smoking continues in 2012” ).

Two other measures within the public policy campaign were labeling cigarette packs with health warnings and imposing restrictions on tobacco sales advertisements. First labels that contained warnings were placed in 1966. The 1989 data by U.S. Department of Health and Human Services evidenced the positive impact of the campaign. The campaign proved to be effective in California, where coupled with increase in the cigarette tax, it contributed to a 5% decrease in cases of lung cancer among females despite the fact that the incidence of this cancer rose 13% in the rest of the United States (McEachern 108). As for advertising restrictions, these proved to be tremendously effective back 1967-1970 when due to the Fairness Doctrine every 3 minutes of smoking advertising aired on television was accompanied by a 1-minute broadcast that informed the audience about the hazards of smoking. Warner reports that per capita consumption of cigarettes was falling throughout all those four years. However, when smoking was totally banned from the television and radio, and anti-smoking broadcasts stopped, the smoking rates rose again (Warner 101).

In conclusion, the American public policy in the sphere of healthcare clearly needs to be enhanced. At the same time, efforts to improve the healthcare system on the federal level, as research shows, are made slowly and will take additional years to produce visible effects. It means that alternative solutions should be sought to raise the level of health quality among Americans. One of the most effective, as evidenced by the reputable research data, is anti-smoking policy.

Specifically, it is recommended that the taxes on cigarettes be further increased. Also, a comprehensive education campaign is highly needed that will involve broadcasting information about health hazards of smoking on television, radio, and, most importantly, in the social media. In addition, a federal ban on smoking in public places should be initiated which will ensure that no American state finds itself left behind the anti-smoking campaign. Overall, the tobacco policy in the United States could be a good example of how an important improvement in the health of U.S. citizens may be achieved before the questions related to healthcare insurances, politics, and changes in the system are resolved.

Works Cited

Americans for Nonsmokers Rights’. “Summary of 100% smokefree state laws and population protected by 100% U.S. smokefree laws.” 1 Oct 2012. Web. 4 Apr 2013. < http://www.no-smoke.org/pdf/SummaryUSPopList.pdf >.

Centers for Disease Control and Prevention (2012) “CDC Factsheet.” CDC. 14 Mar 2012. Web. 4 Apr 2012. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/ .

Health at a Glance 2011: OECD Indicators. Why is health spending in the United States so high?, pp.1-6.

Johnston, L., O’Malley, P., Bachman, J., & Schulenberg, J. “Decline in teen smoking continues in 2012.” University of Michigan News Service. 19 Dec 2012. Web. 4 Apr 2013. http://www.monitoringthefuture.org.

Kaiser Commission of Medicaid and the Uninsured. Current population survey. Mar 2004. Web. 7 Apr 2013.

Levey, Noam. Passing the buck – or empowering states? Who will define essential health benefits? Health Affairs, 663-665.

National Institutes of Health Committee on Population. US health in international perspective: Shorter lives, poorer health. The National Academies Press.

McEachern, William. Microeconomics: A contemporary introduction. Cengage Learning, 2008.

Print.

Warner, Kenneth. “Tobacco Policy in the United States: Lessons for the Obesity Epidemic.” In Lynn B. Rogut et al (Eds) Policy Challenges in Modern Healthcare. Rutgers Unibersity Press, 2005: 99-114. Print.

Zhang, H. & Cai, B. The impact of tobacco on lung health in China. Respirology, Mar 8 (1) 2003, 17-21. Print.