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Comparison of Healthcare Between the U.S. and Other Developed Nations
Introduction
The Affordable Care Act is an all-inclusive healthcare reform that became law in March 2010. Before 2010, it was called the Patient Protection and Affordable Care Act, while many Americans refer to it as Obamacare. The law consists of a list of healthcare guidelines targeted to expand access to health insurance for uninsured citizens. It expanded Medicaid eligibility, mandated that people buy or obtain health insurance, created health insurance exchanges, and banned companies from denying individuals coverage due to underlying conditions. It allows kids to be part of the parents or legal guardians plan until they are twenty-six years old.
The Act comprises premium tax credits and cost-sharing reductions to aid in lowering expenditure for low-income earners. The former lower ones health insurance bill every four weeks, whereas the latter minimizes the out-of-pocket expenses for copays, coinsurance, and deductibles. Additionally, cost-sharing deductions reduce the out-of-pocket maximum, which refers to the sum amount one pays annually for covered health costs. This paper aims to discuss the ACA and its impact on healthcare in the United States and comparison with other developed nations on spending, GDP, cost sharing, and healthcare expenditure per capita.
The Affordable Care Act
Before the Affordable Care Act, insurance organizations utilized medical underwriting to establish whether to give an individual coverage, the price and with what limits or exclusions according to their health status. The aim was to guarantee a healthy risk pool by asking individuals to pay premiums that depicted their anticipated medical conditions (Zhao et al., 2020). However, after the ACA came into law in 2010, healthcare improved for people, especially those with disabilities.
For instance, denying coverage due to pre-existing issues was no longer allowed. By removing the lifetime cap on benefits, the Act enabled individuals who are disabled to continue receiving care (Zhao et al., 2020). Additionally, the expansion of health insurance coverage via the Medicaid initiative, the dependent coverage provision, and health insurance exchanges allowed many disabled citizens to get coverage without the need to qualify for supplemental security income. Those with eligibility for Medicaid have since been allowed to access coverage for long term services and supports (Zhao et al., 2020). The Act authorizes federally supported or performed research to gather standard demographic traits of disability status.
With the introduction of the Affordable Care Act, the utilization of the healthcare delivery system has improved. Before, it was organized based on the idea of fee-for-service medicine (Zhao et al., 2020). The model expected patients to pay doctors as well as hospitals for any covered services delivered without regard for patient outcomes, quality, or price. Fortunately, the novel models involve some combination of shared danger amongst providers to improve coordination and collaboration of care to minimize avoidable hospitalizations, emergency department visits, and other forms of unnecessary care. To safeguard against stinting, quality metrics are usually utilized to assess a providers performance (Zhao et al., 2020). Beyond payment approaches, the Act encouraged the narrowing of provider networks and reshaped the delivery of long-term services. It improved support as well, which affects how disabled individuals receive care and documentation of that care in the medical record.
With the introduction of the Affordable Care Act, what remained the same is that the health insurance plans were unaffordable for some people. This is particularly for those who have not qualified for subsidies and find themselves paying for benefits they may not desire. In addition to that, the Act needs improvement in terms of requiring citizens to buy health insurance or be punished by the government through penalties.
Comparison of Developed Nations
Most American citizens are patients of chronic illnesses such as stroke and heart conditions, diabetes, or cancer. According to Zhao et al. (2020), there are more than one hundred million people, fifty-two percent of the population, undergoing treatment for one or more chronic illnesses in the U.S. In comparison to the United Kingdom, where only forty percent or below are infected, the country has serious concerns (Zhao et al., 2020). Additionally, the U.S. differs from other developed nations in terms of hospital-related care where there is absence of universal health insurance coverage (Zhao et al., 2020). Other countries guarantee the accessibility of care via the universal health systems and better ties between patients and the physician practices that act as their medical homes.
In terms of life expectancy, the average at birth amongst comparable nations was 82.1 years in 2020, down six months from 2019. The Centers for Disease Control and Preventions estimates reflect that life expectancy in the United States decreased to 77 years in 2020, down 1.8 years from 78.8 years in 2019 (Venkataramani et al., 2021). Lastly, the mortality rate in the U.S. has declined from 629 deaths per 100 000 population in 1980 to 257 in 2015 (Venkataramani et al., 2021). Comparable nations have declined from 607 to 215 over the same duration (Venkataramani et al., 2021). This means that the U.S. mortality rates are higher than in other developed countries.
The high mortality rates in 2020, showing the first year of the COVID-19 pandemic, resulted in large decreases in life expectancy in most nations, including the United States. Based on the National Center for Health Statistics, life expectancy in the country decreased by almost two years in 2020 (Venkataramani et al., 2021). Given that the pandemic mortality and excess deaths in the U.S. were among the highest worldwide, the drop in life expectancy probably exceeded declines in other places (Venkataramani et al., 2021). Since 2010, whereas life expectancy in other developed nations continued to rise, that of the U.S. remained stagnant and decreased for three consecutive years from 2014 to 2017.
Preliminary proof for 2020 shows that the gap between the United States and other nations widened more during the pandemic. In 2021, research approximated that the life expectancy in the United States decreased by about two years between 2018 and 2020 (Venkataramani et al., 2021). A shocking discovery was the highly racialized state of the decline in expectancy (Venkataramani et al., 2021). It plummeted by 3.25 and 3.88 years, respectively, among the non-Hispanic Black and Hispanic groups compared to 1.36 years for the non-Hispanic White population (Venkataramani et al., 2021). International research reported a large drop in the death count for the United States and thirty-six nations (Venkataramani et al., 2021). However, it failed to examine the outcomes by ethnicity and race.
Economic Comparison
Gross Domestic Product
The gross domestic product refers to a standard measure of the value added created via the production of goods and services in a nation for a particular duration. It determines the income earned from that production or the total spent on final items and services. Based on the International Monetary Fund, the United States is among the top-ranking nations in the world in nominal GDP (Botelho et al., 2022). Compared to other developed countries, it ranks highest, with 20.49 trillion dollars, while China and Japan record 13.4 and 4.97 trillion dollars.
Healthcare Expenditure Per Capita
Healthcare expenditure per capita shows the cost of health relative to the beneficiary populace in the United States currency to aid in comparing. The level of per capita health spending, which covers personal and population health care needs, and how it changes over time, relies on various social, demographic, and economic factors (Botelho et al., 2022). According to Botelho et al. (2022), the United States spent seventeen percent of their GDP on medical care while the United Kingdom spent ten percent. The difference proves that the country has spends more than other developed nations.
Spending Priorities
Medical expenses in the United States were around five thousand dollars more per individual than costs in other developed nations. The spending difference on inpatient and outpatient care was $3,906 per individual, accounting for 76% of the difference in spending between the U.S. and comparable states (Botelho et al., 2022). The American population seems to have prioritized spending on their health. This can be seen from the data that showed the country spent more than its peers.
Cost Sharing
Cost sharing in healthcare means a patient is paying for part of the costs incurred as a result of receiving care. The portion they pay is that which the health insurance has not covered. For example, in the event a plan pays 80% of the service expenses, then the patient pays 20% (Botelho et al., 2022). This often consists of deductibles, copayments, and coinsurance but does not comprise balance billing amounts for non-network providers.
Current Issues and Sustainability
The United States Birth Rates Trends and Growth of the Senior Population
Over the past few decades, there has been enough evidence suggesting the American population is growing older. Fertility rates of younger females fell significantly as there were 116.40 births for 1000 women between the ages of 20 and 24 in 1990 (Jacobs et al., 2021). Three years ago, there were only 66.59 births per 1000 women in that same age range, which is a 42.79% drop (Jacobs et al., 2021). The overall fertility rate dropped due to the jump in birth rates of older females was not enough to offset the drops in birth rates of younger females (Jacobs et al., 2021). Statistics show that U.S. citizens aged 65 years and older may double over the next four decades.
Birth Rates Significance to the Cost and Sustainability of Medicare and Impact of COVID-19 on its Sustainability
Medicare usually covers pregnancy, childbirth as well as some postnatal care. Giving birth enables a woman to get free care from obstetricians and midwives in a birth center or public hospital or subsidized care from a private obstetrician. Since fewer women are giving birth due to less fertility in the United States, Medicare could drop in the next few decades (Jacobs et al., 2021). In the wake of the COVID-19 pandemic, statistics from the Centers for Medicare and Medicaid Services indicate that Medicare spending was less than what was anticipated.
The U.S. Health Disparities
Health disparity refers to a difference that is connected with economic, social, or environmental disadvantage. It negatively affects groups of individuals who systematically experience greater obstacles to medical care due to their ethnic or racial group, socioeconomic status, and religion. In the United States, this can be seen in the higher number of black people possessing no insurance as compared to their white counterparts. According to Zavala et al. (2021), this has led to more blacks dying as a result of lacking funds to facilitate proper care. Research further claims that even among the older population, black people suffer worse symptoms of various chronic conditions than whites (Zavala et al., 2021). Apart from race, it seems financial capability has as well created the disparities existing in healthcare in the United States.
The low-income earners are at higher risk of contracting a condition such as asthma than the wealthy. This is due to their lack of financial capability to receive proper care for an adequate period (Zavala et al., 2021). Apart from inspiring individuals in the low-income areas to acquire skills that will guarantee better wages, it is essential to adopt a better approach in training of personnel. This would end systemic inequities that promote the disparities in healthcare (Zavala et al., 2021). A holistic approach to admissions can help solve the health disparities in the United States. The model helps to identify broadly diverse nursing regulatory bodies. Thus, improving learning for every student and establishes a better prepared medical care staff.
Conclusion
The paper has discussed the Affordable Care Act and its impact on healthcare in the United States, in addition to a comparison with other developed nations on spending, GDP, cost sharing, and healthcare expenditure per capita. The Act aimed to minimize the cost of health insurance coverage for eligible individuals. Before this, insurance organizations used medical underwriting to understand if to offer individual coverage and the exclusions based on a persons status. In addition to that, the paper shows that the American population is believed to prioritize spending on their health more than other matters. A country such as the United Kingdom spends less of its GDP on healthcare than the U.S.
References
Botelho, J., Machado, V., Leira, Y., Proença, L., Chambrone, L., & Mendes, J. J. (2022). Economic burden of periodontitis in the United States and Europe: An updated estimation. Journal of Periodontology, 93(3), 373-379. Web.
Jacobs, D., Huang, H., Olino, K., Weiss, S., Kluger, H., Judson, B. L., & Zhang, Y. (2021). Assessment of age, period, and birth cohort effects and trends in Merkel cell carcinoma incidence in the United States. JAMA Dermatology, 157(1), 59-65.
Venkataramani, A. S., OBrien, R., & Tsai, A. C. (2021). Declining life expectancy in the United States: the need for social policy as health policy. JAMA, 325(7), 621-622.
Zavala, V. A., Bracci, P. M., Carethers, J. M., Carvajal-Carmona, L., Coggins, N. B., Cruz-Correa, M. R., & Fejerman, L. (2021). Cancer health disparities in racial/ethnic minorities in the United States. British Journal of Cancer, 124(2), 315-332. Web.
Zhao, J., Mao, Z., Fedewa, S. A., Nogueira, L., Yabroff, K. R., Jemal, A., & Han, X. (2020). The Affordable Care Act and access to care across the cancer control continuum: a review at ten years. CA: A Cancer Journal for Clinicians, 70(3), 165-181. Web.
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NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.
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