The US Healthcare Mass Debate

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https://www.commonwealthfund.org/public ... irror-2024

The functioning of the U.S. health care delivery system also suffers from multiple deficits. First is the lack of investment in primary care. Years of neglect and undercompensation for primary care have resulted, predictably, in nationwide shortages of the clinicians who play a vital role in managing chronic illness and reducing the need for costly and sometimes unnecessary emergency, specialty, and hospital care services. The acquisition of primary care practices by health systems and private equity investors is further disrupting an already fragile primary care capacity, with uncertain short- and long-term consequences. The fragmented nature of the U.S. health care system makes it difficult even for many well-insured patients to access convenient and effective care.

A second area for improvement is administrative inefficiency. With thousands of health insurance products, wide variation in benefits, and complex utilization management policies, U.S. health care can be a nightmarish maze for patients and care providers alike. Adding further to the delivery system’s dysfunction have been recent trends in ownership and control. Massive consolidation through hospital mergers or hospital acquisitions of physician practices, among other examples, has enabled large providers to negotiate higher prices from private insurers — a key factor in the overall higher costs of care in the U.S.28 No other country relies to this extent on the unregulated private market to allocate vital health care resources.

Beyond the financing and delivery of services, social policies and influences outside health care strongly affect Americans’ health and put added stress on the health system. Gun violence and drug overdoses, for example, take a huge toll in morbidity and mortality, especially among young males.

After all these years the insurance companies cannot agree on a single claim form.