HW 30

Healthcare has been one of the biggest topics for debate over the years, as it is one of the most essential things that people need. Somehow we still find that a large population of the country is insured and those that are insured are not being provided substantial care. It is obvious that the US has the money to provide healthcare for all, so how come our healthcare system still has so many flaws. By studying the spending on healthcare a greater understanding of why our healthcare system is not effectively taking care of our population medically.

The US is the wealthiest country in the world at the moment(1). It would only be logical for one to think that they would have the best resources for their citizens. However, this doesn't seems to be the case. According to the World Health Organization, the US ranks 37th in the world for it's healthcare system(2). One would think that wealth and the quality of a countries healthcare system would correlate, but we see they do not. The US spends approximately 2.2 trillion dollars a year on healthcare(3). This is a little over 10 percent of our entire economy(3). It is obvious that our government is funneling an ample amount of money into the system, but how this money is spent is a different story.

Approximately one third of the governments healthcare budget is allocated in administrative costs(4). This means that over 600 billion dollars of our countries healthcare budget is not being spent on medicines, doctors, and any other forms of actual care for the people who this system is supposed to serve. The reason for this enormous expense in our budget is insurance companies. Insurance companies have been able to exploit the people of this country. By having people pay high premiums and denying as many claims as possible they have been successful in increasing their profits incredibly. The downfall to this is of course worse coverage for their clients which in turn leads to a worse healthcare system. As Michael Moore showed in Sicko the more denials an insurance company makes the more profit they make. Most insurance companies are privatized businesses whose sole motive is profit. Therefore, what they are essentially trying to do is make their clients pay in as much as possible on their monthly payments while minimizing the amount that they have to pay for care.

Insurance companies seem do whatever they can to avoid paying for healthcare although that is the service that they are offering. Whether it be denying people because of pre-existing conditions or whatever other reason they can find, they try their hardest to take your money with our reciprocating any services. Michael Moore's documentary SICKO provides a very good example of this. Laura is a middle aged woman who got into a head on collision while driving. The crash knocked her unconcious and she was taken by an ambulance to the hospital. She did have health insurance however they denied her coverage for the ambulance ride, an expensive ride, because it was not pre-approved. Although she was unconscious her ambulance ride was denied because she did not call to get it approved. Stories like this show the unhumane nature of the insurance companies our healthcare system revolves around. However, a third of our entire healthcare budget goes insurance companies like the same ones that denied Laura coverage on an ambulance ride. We are obviously not spending our money as efficiently as we can.

So now it is understood where a third of our budget is allocated, but where does the rest go? Ten percent of our budget is spent on prescription drugs(5). A little bit over 20 percent is spent on physician services, and a bit over 30 percent is spent on hospital care(5). These are the most substantial expenses as all other expenses do not surpass 10 percent of the budget. Spending a large amount on hospital care and doctors makes sense but the culture of healthcare in our society reveals a different story and provides some implication as to why our medical system is ranked so poorly.

Our government is not spending an ample amount on prevention. Therefore, a large amount of our money is going to hospital care. This means we are paying to help people after they get sick rather then taking effective cautionary steps to try to prevent sickness. We have very little programs that teach prevention and in turn we have fallen into a system that is focused on helping the sick after there sick, which is very important, rather than helping people not get sick. This culture not only leads to a massive amount of spending on hospital care but coincides with the grotesque amount of money being paid for administrative services. If less people got sick less administrative services would have to be paid. By increasing the allocating of our budget in the prevention category, which is now a measely 3 percent of our budget, we would not only decrease the amount of people getting sick but we would cut the amount needed to spend on taking care of the already sick, which is of course our biggest expense. Ken Thorpe, a professor at Emory University stated it quite well "Seventy-five percent of what we spend in health care is linked to chronically ill patients; less than 3 percent [is spent] in prevention, we do a great job of taking care of people after they're sick, we do a mediocre job of preventing people from getting sick."(6) Although it is questionable whether we do a great job taking care of the already sick it is obvious that we have too little focus on prevention.

Our country has the money, we have the resources, yet we still don't have an adequate healthcare system. We are spending more than enough money, but we are spending it inefficiently. It is our healthcare culture that is our biggest downfall. We are focused on fixing the problem after it has happened rather then trying to prevent the problem from happening in the first place. It is essential that we make an effort to prevent sickness as it is the only way we will really provide effective and efficient healthcare for all.



1.(International Monetary Fund, World Economic Outlook Database, october 2010, Nomial GDP list of countries)
2. The world health report 2000 — health systems: improving performance. Geneva: World Health Organization, 2000.
3. President Obama's Fiscal 2010 Budget, Transforming and Modernizing America’s Health Care System, Whitehouse.gov
4. Costs of health administration in the US and Canada, woodhandler, september 21
5. US healthcare costs, Kaiseredu.org
6. US cancer costs in 2020, Lauren Cox