amc518
Jan 12, 2020
Research Papers / Healthcare costs in America - Peer Review research rough draft. [2]
Living in the united states, the richest country in the world you would not think that we pay the most in healthcare than in any country in the world. In the 1960's the GDP for healthcare was 5% it was recorded at 17.9% in 2017 and projected to be 19% in 2027. This makes this the fastest growing expense for Americans even though the average pay hardly even covers the cost of living ("Why Are Americans"). In my research I have found that there are several ways to lessen the financial burden healthcare has become in America. The top choices are First step was the executive order on improving price and quality transparency in American healthcare to put patients first act, auditing private party and Medicaid/Medicare insurances to find waste, fraud and abuse and lastly cutting drug costs.
In November 2019 President Trump signed the Executive Order on Improving Price and Quality transparency in American Healthcare to Put Patients First act. With this executive order transparency is not only aimed towards hospitals but also forces outpatient centers, insurance companies to make their pricing available to the public. Transparency in pricing will benefit the patient because they can shop around, 90% of the 300 highest-spending categories of medical cases requiring outpatient care were shoppable. ("Executive Order on Improving Price")
Transparency in healthcare costs also further benefit the patient because it protects them from surprise billing, the patient will know exactly what they're expected to be charged at all times.
Waste, Fraud and Abuse is a big problem in both private party and government ran healthcare. Billing for services the patient didn't receive, providing unnecessary services to members, drug diversion. These are all examples of waste, fraud and abuse. Whether it be negligence, fraud or just plain human error the coalition against insurance fraud has estimated that we have lost $487 billion dollars in a single year. Comprising about 1/5th of our total healthcare costs ("why you should care"). Waste comes standard with the fee for service models that dominate healthcare. Recently there has been an industry wide push for value-based care because it encourages usage of evidence-based care focused on reducing variation in treatments. ("why you should care")
Cutting drug costs would also benefit patients by lowering overall healthcare costs. With the GDP for national health expenditures at 17.9% $3,337 billion. $329 billion of which were spent on prescription drugs. U.S is paying more for pharmaceutical's than any other nation. U.S retail prices for commonly prescribed drugs were 5%-117% higher than prices in six other countries included in the study. Streamlining the drug approval process, the process is different for brand name drugs than it is for generic drugs. Expediting the approval process for both could reduce costs, getting these prescription drugs out faster to people who would benefit from them. Eliminating tatics that discourage generic utilization. There have often been obstacles put in place to delay manufacturing of generic drugs. Laws and regulations are being discussed and could be enacted to prevent brand manufacturer's from paying companies to delay generic manufacturing. Allowing prescription drug import would also benefit the patient. This idea has been talked about for years although the FDA cannot guarantee the safety or efficacy of these drugs because they are manufactured in places with less stringent standards than those here in America. ("why you should care").
The federal government is the biggest payer to healthcare costs. Educating our selves on how the billing systems work and voting in the right regulations and bills to lower drug and healthcare costs is something we can all do to start down the path of fixing our healthcare system. Being involved in our government on all levels will be the only way we can stay aware of these issues. We didn't have such inflated costs in healthcare until the government came to regulate it, not we must regulate the government. $329 billion in prescription drugs, $487 billion in waste, fraud and abuse. This is taking its toll on the people who most need the care the most. With the rate of healthcare GDP rapidly growing we need a radical overhaul of our healthcare system.
Work cites
"Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First." The White House, The United States Government, 24 June 2019.
"Why Are Americans Paying More for Healthcare?" Peter G. Peterson Foundation, 15 Mar. 2019.
"Why You Should Care About Healthcare Fraud, Waste and Abuse." Gray Matter Analytics, 9 Jan. 2019.
Healthcare costs in America.
Living in the united states, the richest country in the world you would not think that we pay the most in healthcare than in any country in the world. In the 1960's the GDP for healthcare was 5% it was recorded at 17.9% in 2017 and projected to be 19% in 2027. This makes this the fastest growing expense for Americans even though the average pay hardly even covers the cost of living ("Why Are Americans"). In my research I have found that there are several ways to lessen the financial burden healthcare has become in America. The top choices are First step was the executive order on improving price and quality transparency in American healthcare to put patients first act, auditing private party and Medicaid/Medicare insurances to find waste, fraud and abuse and lastly cutting drug costs.
In November 2019 President Trump signed the Executive Order on Improving Price and Quality transparency in American Healthcare to Put Patients First act. With this executive order transparency is not only aimed towards hospitals but also forces outpatient centers, insurance companies to make their pricing available to the public. Transparency in pricing will benefit the patient because they can shop around, 90% of the 300 highest-spending categories of medical cases requiring outpatient care were shoppable. ("Executive Order on Improving Price")
Transparency in healthcare costs also further benefit the patient because it protects them from surprise billing, the patient will know exactly what they're expected to be charged at all times.
Waste, Fraud and Abuse is a big problem in both private party and government ran healthcare. Billing for services the patient didn't receive, providing unnecessary services to members, drug diversion. These are all examples of waste, fraud and abuse. Whether it be negligence, fraud or just plain human error the coalition against insurance fraud has estimated that we have lost $487 billion dollars in a single year. Comprising about 1/5th of our total healthcare costs ("why you should care"). Waste comes standard with the fee for service models that dominate healthcare. Recently there has been an industry wide push for value-based care because it encourages usage of evidence-based care focused on reducing variation in treatments. ("why you should care")
Cutting drug costs would also benefit patients by lowering overall healthcare costs. With the GDP for national health expenditures at 17.9% $3,337 billion. $329 billion of which were spent on prescription drugs. U.S is paying more for pharmaceutical's than any other nation. U.S retail prices for commonly prescribed drugs were 5%-117% higher than prices in six other countries included in the study. Streamlining the drug approval process, the process is different for brand name drugs than it is for generic drugs. Expediting the approval process for both could reduce costs, getting these prescription drugs out faster to people who would benefit from them. Eliminating tatics that discourage generic utilization. There have often been obstacles put in place to delay manufacturing of generic drugs. Laws and regulations are being discussed and could be enacted to prevent brand manufacturer's from paying companies to delay generic manufacturing. Allowing prescription drug import would also benefit the patient. This idea has been talked about for years although the FDA cannot guarantee the safety or efficacy of these drugs because they are manufactured in places with less stringent standards than those here in America. ("why you should care").
The federal government is the biggest payer to healthcare costs. Educating our selves on how the billing systems work and voting in the right regulations and bills to lower drug and healthcare costs is something we can all do to start down the path of fixing our healthcare system. Being involved in our government on all levels will be the only way we can stay aware of these issues. We didn't have such inflated costs in healthcare until the government came to regulate it, not we must regulate the government. $329 billion in prescription drugs, $487 billion in waste, fraud and abuse. This is taking its toll on the people who most need the care the most. With the rate of healthcare GDP rapidly growing we need a radical overhaul of our healthcare system.
Work cites
"Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First." The White House, The United States Government, 24 June 2019.
"Why Are Americans Paying More for Healthcare?" Peter G. Peterson Foundation, 15 Mar. 2019.
"Why You Should Care About Healthcare Fraud, Waste and Abuse." Gray Matter Analytics, 9 Jan. 2019.
