Essay On Health Care System

The United States, like every nation seeking to better its health care system, faces a set of dilemmas known as the “iron triangle of health care.” The three vertices of the triangle represent three dimensions of each health care system: access, cost, and quality.The dilemmas stem from the fact that attempts to improve any one of the three dimensions are likely to create pressure on one or both of the other two.This essay, written for readers unfamiliar with the details of American health law and policy, portrays the essential features of the battle for health reform in the United States and of the law that survived the battle: the Patient Protection and Affordable Care Act (PPACA). The political and legal conflicts leading up to and following PPACA’s enactment are described.

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In the early months of his presidency, Obama made overtures to congressional Republicans in an effort to reach agreement on the outlines of a bipartisan consensus health reform program. Former Republican vice-presidential candidate Sarah Palin characterized the reform proposals as creating government “death panels” to determine whose life is worth saving and whose should be sacrificed to save money.

At town hall meetings across the country, “tea party” activists denounced health reform as a government scheme for “socialized medicine.” The health reform debate took on larger overtones symbolic of what some have called a “culture war” between proponents of different visions of America’s future.

Cost-control success cannot be predicted with confidence. What is less well known is which segments of the population lack coverage, and how the high-cost care that does reach the public results in many respects in mediocre health outcomes.

Myths about American health care are pervasive, and factual correctives are needed.

Perhaps the most important structural reason contributing to America’s excessive health care costs is that the amount of payment providers receive for their services depends chiefly on quantity, not quality.

Since physicians control most health care purchasing decisions, and they are not constrained in most health care settings by cost considerations, incentives for excessive diagnostic procedures are built into the system.

In the author’s view, for advanced, specialized treatments at selected hospitals, the U. For what Americans pay for their health care, too often they fail to get their money’s worth.

And the unceasing growth of health care costs is unsustainable.

The percentage of total health care expenditures spent on administration and insurance in the U. (7.7% in 2006) is almost double that reported in Canada (4.1%), and more than triple the level in Japan (2.3%).

The Institute of Medicine, a prestigious research entity, estimated that almost one-third of U. health care spending goes to waste on billing and excess administrative costs, duplicative x-rays and other diagnostic tests, and unnecessary or ill-advised procedures.


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