The United States Healthcare Paradox: Spending More and Achieving Less (Essay Sample)

The United States Healthcare Paradox: Spending More and Achieving Less
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The United States Healthcare Paradox: Spending More and Achieving Less
The high cost of healthcare is a significant concern in the United States. The United States spends a larger proportion of its GDP on healthcare, outpacing other countries with similar income levels. According to Squires and Anderson (2015), the United States spent 17.1 percent of its GDP on health care compared to 11.6% of France, the next highest spender, followed by 8.8% of France. However, despite its high spending on healthcare, the United States population had worse health outcomes than their international peers. For instance, the United States had the lowest life expectancy of 78.8 years in 2013 compared to the average of 81.2 years and the highest infant mortality rate of 6.1 deaths per 1000 lives compared to the average of 3.5 deaths in OECD countries in 2013 (Squires & Anderson, 2015). Other measures of illnesses also showed that Americans have very high obesity rates, heart disease, diabetes, and chronic lung disease. This essay argues that the United States fails to have a healthy population despite spending a lot on healthcare because of conflating health with healthcare, consequently erroneously thinking that investing in healthcare would result in healthy populations.
The Real Determinants of Health
The United States is undeniably one of the best healthcare providers globally. The American healthcare system has invested heavily in medical research and equipment. For instance, the United States has 38 MRI units per 1 million people (Papanicolas, Woskie & Jha, 2018). Similarly, it prides having the highest quality kidney transplants, knee replacements, and higher cancer care (Squires & Anderson, 2015). Therefore, Americans have higher chances of getting high-quality treatment than other countries in the world. However, Bush (2018) posits that healthcare only contributes about 10% of a person's health. The remaining 90% is determined by several factors, including 20% of social/environmental factors, 30% of genetics, and 40% of individual behavior. Therefore, aside from genetics and healthcare, 60% of the factors determining a person's health are within the social, environmental, and behavioral context. The social and environmental determinants include whether a person lives in a safe neighborhood, has adequate housing, access clean water, food and air, quality education, employment status, and social support. These social/environmental factors directly impact individual behaviors such as stress and chronic illness management, substance abuse behavior, level of exercise, and amount of sleep.
Reasons for the United States Healthcare Paradox
Social services significantly help prevent a country's population from becoming sick on the onset. Social services include employment programs, job training, income support, supportive housing, family assistance, nutrition support, and a host of other social services that exclude healthcare benefits. The United States population experienced poor health outcomes because of spending a lot of tax money on healthcare and allocating fewer resources to social services that have a more significant impact on health. According to Bradley, Sipsma, and Taylor (2016), for every 1 dollar the United States spent on healthcare, they spent 90 cents on social services between 2000 and 2011. On the contrary, other high-income countries in the same level as the United States, such as England, France, Sweden, Scandinavia, and Denmark, spent more tax money on improving social services than healthcare. For instance, for every one dollar OECD countries spent on healthcare, they spent about 2.5 dollars on social services in the same period (Bradley, Sipsma & Taylor, 2016). These countries experienced lower infant mortality, fewer low birth weight babies, fewer premature deaths, and longer life expectancy. Consequently, the ratio of GDP on social services to that spent on healthcare made all the difference between the United States and other peer countries in terms of having a healthy population.
Similarly, the phenomenon of medicalization in the United States also significantly contributes to high healthcare costs and poor health outcomes. Medicalization places more emphasis on healthcare as a solution to health problems leading to less focus on the social, environmental, and behavioral factors (Bradley & Taylor, 2013). There are two perspectives of medicalization which include the supply-side and demand side. On the supply side, the healthcare system forces people to take more medical care than they need. Therefore, medical professionals such as physicians suggest a more costly treatment plan instead of a less costly and safer alternative (Bradley & Taylor, 2013). The American healthcare system has a more profit-based payment approach, and physicians might try to force expensive treatment plans on patients to make more money. On the demand side, the public seeks to feel healthier and strive to get medications they don't need (Bradley & Taylor, 2013). The patients and their families feel they need to get a more sophisticated treatment plan and spend a lot of money on unnecessary medication and tests for a simple health problem (Sabbatini, et al., 2014). When the two aspects of medicalization are combined, they create an inflating situation making Americans spend a lot on healthcare even though the root cause of their illness might be social or environmental.
Moreover, the separation of healthcare and social services as different sectors in the history of the United States significantly contributes to high healthcare costs and poor health outcomes in the American population. Unlike in Western Europe, the healthcare and social services sectors grew independently in the United States. For instance, healthcare became professionalized over time, fit in the market, and became a valuable commodity that the middle class could buy and feel good (Bradley & Taylor, 2013). On the other hand, social services were initially conceived for the poor. The poor were considered outcasts because they could not afford to pay taxes. Consequently, social services were perceived as a responsibility of charity organizations and the government. The separation of healthcare with social services creates a situation where social workers encounter challenges while doing their jobs because of a disconnect with healthcare (Bradley & Taylor, 2013). Similarly, healthcare professionals feel their recommended treatment would not be effective because some of the causes of the patient's illness are ass