Healthcare In The United States Essay

1905 words - 8 pages

Healthcare in the United States is rooted in the private sector. The private sector directly funds 56% of the expenditures through private health insurance, household expenditures and copays, and other private expenditures. (CMS, 2014) The US healthcare system can thank the private sector for providing much strength such as new diagnostic technologies, innovative treatments and procedures, and dynamism. American hospitals and physicians are regarded internationally as being of high quality. Americans can also be proud that the physician- patient relationship is among the most trusted and valued relationships in the country. By allowing the private sector to take a lead role in the healthcare system, the United States values individual responsibility and freedom of choice. Despite all of the problems with the healthcare system, 82% of Americans rate their healthcare quality as excellent or good. (Mendes, 2012) Patients can choose their preferred doctor to provide care and physicians can choose where and how to practice medicine. The private sector orientation of the US healthcare system provides its strengths.
Despite these strengths, the United States healthcare system also has many weaknesses. Healthcare delivery is fragmented. Specialists often do not work in concert with Primary Care Providers. (Cebul, et al, 2008) When patients are transferred between providers, often there is little to no coordination of care. (Cebul, et al, 2008) On average, Medicare patients see two primary care physicians and five specialists per year. (Elhauge, 2010). Medicare patients with chronic illnesses see thirteen physicians per year. (Elhauge, 2010). Each of the many physicians focus only on one specific illness or the body part of their specialty. The patient is left trying to put the pieces together and to make sense of their condition. (Elhauge, 2010). Fragmentation leads to duplication of tests and effort. Often, physicians do not have test results and notes from prior treatments. This results in wasteful duplication of efforts. Fragmentation leads to unplanned hospitalizations. Approximately 20% of discharged Medicare patients are re-hospitalized within thirty days. (Jencks, Williams, Coleman, 2009) It is estimated that only 10% of those readmissions are planned. (Jencks, Williams, Coleman, 2009) Patients can receive better continuation of care if their doctors coordinated better, if there was better discharge planning and incentives for providers to control costs after the patient has been discharged.
A patient centered medical home (PCMH) could integrate patient care. A patient centered medial home is a team of healthcare providers coming together to improve the health of a specific population. A PCMH is designed to integrate primary care and specialists into improve care coordination, safety and quality.(Stange, et al 2010) A PCMH would also improve physician training and development to provide a commitment to treat the...

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