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Healthcare Delivery in the USA: Unnecessary Care

Abstract

Healthcare delivery is a primary concern for all governments because this sphere is responsible for the citizens’ quality of life. However, it is almost impossible to avoid having some problems with healthcare delivery. Though the healthcare system of the USA has a reputation of being one of the best in the world, an issue of unnecessary care exists in the country. Significant sums of money are spent on drugs and procedures that do not treat patients and can even cause harm (Lenzer, 2012). There are many people to blame for the appearance of the problem, namely physicians who are only interested in receiving financial benefits, aggressive marketing companies that promote the most expensive unnecessary drugs, and naïve patients who are ready to do everything doctors tell them to do (Lenzer, 2012). Therefore, the cause of the problem is complex and the decision should be complex as well. All participants should observe professional ethics, prioritize moral values, find an intermediate level between unnecessary care and overmedication and undertreatment, and focus only on appropriate treatment in each case.

Healthcare Delivery in the USA: Unnecessary Care

It is not easy for any government to implement some reforms in the sphere of healthcare and ruin the system, which functioned in the state for many years. However, these reforms are necessary because health burdens of different diseases increase and people’s expectations grow. Sometimes, a desire to improve the system of healthcare does not bring positive results and leads to unpredictable consequences like the lack of drugs, inaccurate diagnosing, wrong medical prescriptions, violations of patients’ privacy, and others. This paper analyzes unnecessary care as one of the most significant healthcare delivery problems in the USA and determines some participants and strategies to solve the issue.

The healthcare problems enumerated in the introduction are caused by some unreasonable healthcare policies of the American government. However, sometimes the healthcare system cannot be immediately adapted to a rapid spread of some diseases, appearance of new viruses, and changes in the insurance system. The discussed issue of unnecessary care lies in the fact that in the United States very big sums of money are spent on unnecessary treatment and medication, which are not only useless, but can even cause harm to patients (Binder, 2013). Judging by the problem statement, it needs some urgent solution.

Five articles have been chosen to investigate the situation relating to unnecessary care in the United States. Binder (2013) distinguishes and gives a short description to five main problems, which exist in the American healthcare, namely unnecessary care, avoidable harm to patients, wasting budget money on healthcare, distorted explanations of how Americans pay for their healthcare, and lack of transparency. Binder (2013) considers unnecessary care to be the most important issue and supports her point of view with some statistical data: “Overuse and unnecessary care accounts for anywhere from one-third to one-half of all health care costs, which equal hundreds of billions of dollars” (para.4). The article is a valuable material because it gives a concise explanation of the challenges, which the US healthcare faces and places a specific focus on unnecessary care.

The next considered article by Pearl (2015) contains some important data as to why the problem of unnecessary care exists and what people can do to prevent it. The author states that some serious surgical operations, which are currently performed in the USA, can be easily substituted by invasive treatment. “Much of the aggressive and invasive health care we provide in the United States today, compared to time-tested, more conservative approaches, adds little value” (Pearl, 2015, para. 3). The practical examples of treating back pains and other unnecessary surgical interventions described by the author help his readers better understand the essence of the problem. The solution offered by Pearl (2015) is to change the culture of physicians who are initially told that the more they do, the better outcomes they will receive. However, changing this point of view definitely needs further clarification because it concerns medical ethics and education.

Nelson (2015), the author of the next article, supports the opinions expressed in the previous articles. He also gives some practical examples of unnecessary medical procedures and confirms the fact that overuse of treatment can cause harm and lead to unnecessary costs (Nelson, 2015). Nelson (2015) writes that analyzing the system of American healthcare “multiple experts have pointed out the big disconnect between the nation’s top ranking in per capita healthcare spending and only middling scores in a long list of healthcare outcomes” (para. 10). The author also considers medical culture to be one of the main causes of the problem besides aggressive marketing of drugs and tests and defensive medicine (Nelson, 2015). Nelson (2015) states that organizations and societies, which are interested in the problem, have different approaches to solving the issue, focusing either on medical ethics or solely on the improvement of patients’ health through non-aggressive treatment, and cannot reach consensus. The author is correct, recommending all participants to become united and pursue the same goals in settling the issue of unnecessary care.

Unnecessary care problem is so important for the USA that it should be analyzed from different perspectives. Lenzer (2012) writes that the issue of overtreatment and overmedication is not limited only to patients who died because of medical errors, but also covers individuals who have spent significant sums of money on unnecessary treatment and have not received any positive results. The author stresses the fact that American scholars have already made many steps to research the problem and defined the main reasons of unnecessary care, namely “malpractice fears, supply driven demand, knowledge gaps, biased research, profit seeking, patient, demand, and financial conflicts of guideline writers” (Lenzer, 2012, p. 2). The offered solution is writing guidelines by professionals who do not have any conflicts of interest and are ready to share their vision, as well as modify the legislation (Lenzer, 2012). Lenzer’s proposal is reasonable and can be implemented with additional comments on financial interests, which are involved in the problem.

The next article by Mehta, Tribble, and Mehta (2011) gives clear answers to numerous questions related to unnecessary care in the USA. Mehta et al. (2011) write that “Our healthcare system is driven by industry’s desire for profit and patients’ desire for more, though not necessarily better, care” (p. 1). The authors are sure that neither patients, who are sometimes on the verge of death, nor physicians, who are guided only by financial profits, can independently solve the problem. Some common efforts of all participants, including hospitals, marketing agents of drugs and services, and all healthcare professionals are needed to prevent overtreatment and overmedication (Mehta et al., 2011). The solution described by the authors seems to be the most reasonable.

On the basis of the analyzed articles, it is possible to distinguish some effective strategies to face the challenge of unnecessary care in the US healthcare system. These strategies are as follows: (1) change the culture of physicians by encouraging them to do what is right for each patient individually and not to be guided by financial gains only; (2) restrict cooperation between pharmaceutical companies and device manufactures and healthcare professionals to avoid bribing with the purpose to share benefits received for unnecessary care; (3) the state and local governments should change the profile of hospitals from being financial conglomerates to becoming healthcare institutions, which will financially reward their doctors exclusively for high-quality work (Mehta et al., 2011). It will also be useful to carry out psychological work with patients to explain them that to spend money on certain forms of treatment that are inappropriate for their disease means to waste this money and not to receive any positive outcomes. Non-governmental organizations that are involved in solving the problem should clearly determine the aims and use the same vector of movement.

Performing the benefit analysis of the analyzed problem is not so easy as it may seem. On the one hand, patients who may become victims of unnecessary care will significantly benefit from the fact that physicians will apply only necessary drugs and procedures in their treatment and not force them to pay more. The implementation of the enumerated strategies will also help to save life of many people. From the perspective of the government, the solution of the problem will bring significant financial savings because currently the USA spends more than $8,000 per person per year on healthcare, which is more than any other country (Mehta et al., 2011). However, if the question of unnecessary care exists, some participants see additional benefits in this issue.

As it has been stated above, some physicians do not want to participate in solving the problem of unnecessary treatment because of the financial incentives they receive from prescribing certain medications and procedures. However, there are many healthcare professionals and organizations, which are guided by professional ethics and want to clarify who will pay for medical services: the government, a private insurance company, or a mix of the two (Lenzer, 2012). All participants will benefit from implementing the discussed strategies and solving the conflict between unnecessary care and undertreatment, both of which give unfavorable results (Lenzer, 2012). A mutually beneficial compromise will include improving the culture of physicians who should be only guided by a set of single rules for treating a certain disorder and the actions of the government (or insurance companies) to solve the financial aspect of patients’ healthcare and determine the sum needed for corresponding medical procedures.

To conclude, it is important to note that the issue of unnecessary care most probably exists not only in the USA, but in all states that face some healthcare challenges and search for effective strategies to solve the problem. A modern person does not need any specific medical education to understand that the most expensive treatment does not necessarily mean the best. However, patients often forget about this statement when they have serious health problems. They are ready to pay any sums named. The state, as well as insurance and drug companies should unite their efforts and stop inventing the means to receive as much money as possible from patients. Some alterations of physicians’ culture and substantial changes in functioning of healthcare settings and pharmacological companies are needed to solve the issue of unnecessary care in the United States.

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Number of pages
5
Urgency
7 days
Academic level
High School
Subject area
Nursing
Style
APA
Number of sources
5

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