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Healthcare mostly in the US is provided by separate legal entities and the facilities of the healthcare are mainly owned by the private sectors. Evidence has shown from the scorecard taken in 2008 that the care keeps on deteriorating year by year. The overall health system is completely off the track as the performance keeps on decreasing year after year. For many years, politicians and insurance providers have claimed that the US residents have the best healthcare in the world but their citizens have failed to agree by this assertion. From the recent statistics, it has been proved that more than 42.6 million people living in the US do not currently have health insurance and this has led to a big crisis because there are those citizens who cannot manage the costs in the healthcares (Porter 2006: 78). There have been more input on the search for the solutions but there have been no clear cut solutions apart from just short term solutions that pop up to solve the upcoming crisis. The best way to know if healthcare in the United States is at its best is by involving thorough research if the current healthcare is good and fare and later comparing it with other developed countries. It is the result of this research that will give us the way forward on how best the healthcare should operate. In the year 2000, a World Health Organization released a report of their findings about what a good health system should contain and in their findings, good health, responsiveness and fairness in financing was among their key factors (Porter 2006: 98).

According to WHO, a healthcare is only seen to be good and fair if and only if; it has overall good health; good health is fairly distributed; the overall responsiveness is at a high level and fair; financial healthcare is fairly distributed. From their analysis, it was realized that US has the most expensive healthcare system in the whole world. This was based on the expense incurred per capita against the gross domestic product. This increased profits in for- profit hospitals from 24.5% in the year 1994 to 34.0% (Porter 2006: 9). The US was compared with other developed countries like Switzerland, Norway, Germany, Canada, Luxembourg, Denmark, France, Australia, Japan, Italy, Sweden, Finland and U.K. All the countries had less expenditure and UK had much less expenditure but US had a big difference and in fact, the difference between US and UK was by 2117 dollars. It is not what we spend on the society but what return is the whole national population receiving is the most important. To address this, it is important to analyze the healthcare outcomes in the US.

Healthcare outcomes In US

America is the only country among the developed countries that do not provide healthcare services to all its citizens. This is an embarrassment because this is a matter of life or death and the policy makers are not saying any thing about this. In the year 1999, about 42.6 million people living in America were not having health insurance cover and a good number could not afford the rising bills in the hospitals especially in the intense care unit (Porter 2006: 17). According to the American College of physicians, it was discovered that people without the health insurance cover became sick regularly and majority die at a very tender age thus making the pattern of the population to be irregular by having more elder people in the society than younger people. The infant mortality rate stands at 7.2 for every 1000 lives. Even though this is lower when we compare with the world but when we narrow down to the selected high income countries, US stands out and it has the highest figure compared to its counterparts (Kotlikoff 2007: 97).

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Compared to other developed countries, United States has the most expensive health care system. When analysis was done on the expenditure per capita, and the gross domestic product, United States spends $ 4178 per capita on healthcare (Porter 2006: 61). This was more than twice when it was compared with Switzerland. This was due to the expensive prescribed drugs, increased costs of medical technology and increased administrative costs. The shift from non profit hospitals to for profits hospitals is rapidly increasing having an impact on the healthcare costs.

Finance fairness:

There is unfair distribution of finance in this sector and the people who suffer most are those at the lower level as lack of financial protection simply sends them deeper to poverty. The people in America are not satisfied with the healthcare system in the United States and from the research, only 40% of the total population is satisfied with the system (Kotlikoff 2007:7). This means that the policies regarding healthcare needs to be reviewed and make possible adjustments. The people in the United Kingdom had 60% of its people who were either satisfied completely or fairly satisfied yet this is a country which has been having persistent problems for a long time with their national health services. Analyzing the performance of the health systems using the scorecard, efficiency remains low and here, there is a need for national leader to come and add value to the devoted healthcare.

Unlike UK and other developed countries, US does not provide healthcare to all its citizens. There should be a basic provision of healthcare to all the citizens to avoid this common problem of some people being unable to pay their bill. This only creates the gap between the poor and the rich. When this is put in place, it does not mean that the private insurer will be out of context but this will only reduce the costs and ensure that everyone gets access to the healthcare.

Basing on World Health Organization's analysis, America was the first in the category of responsiveness among 191 member countries. People with no insurance or have less access to health care have more problems in getting the responsive caregivers compared with those with adequate degree of private coverage of health insurance.

Health Care system satisfaction:

The most important aspect is the satisfaction and all the people are supposed to be satisfied with the system that is in place and if not then the system must be changed. U.S from statistics had only 40% of the whole population who were satisfied with the services provided (Kotlikoff 2007: 7). This means that the services provided has widely depreciated and needs to be amended. Because people are paying for the services, there is a need for them to be satisfied with the kind of services they are paying for it. This will greatly improve the live hoods and decrease mortality rate in the country.

There are so many factors that affect the healthcare of the United States and they need to be ironed out. Some of these factors have been discussed and in a nutshell they include; high costs in the healthcare providers, fairness in the service providers and effectiveness of the services. There is however other factors which has contributed to be healthcare crisis. Patients no longer have a choice of the kind of treatment they prefer, the insurance companies continue increasing their limits and patients cannot now access the healthcare freely. The quality of the service provided is rapidly depreciating as most of the nurses are shifting fro their careers and moving to other professions. It is becoming so obvious and clear that this dilemma will not be easily solved unless there is a creative overhaul placed in our current systems. Even though, the managed care companies and the insurance companies have managed to limit political choices when it comes to the healthcare reforms, there are proofs of an increasing extensive based support in America. There is need to have a single payer in the healthcare systems to ensure we completely eradicate these issues of fairness, cost effectiveness and access (Armoni 2000: 198). When this policy of having a single payer will be implemented, it will not only be feasible economically but it will have an enormous improvement in the whole country compared to what is in existence at the moment. When the idea of a single payer is put in place, it is not going to rule out the private insurers as this will only provide healthcare at the basic level.

In the year 1991, the Congressional Budgeting Office and the general Accounting Office produced a report saying that it was important to have a single payer like that of Canada. This will ensure there is universal access to healthcare and will also reduce the administrative costs. It will also increase the Income per capita by ensuring there is a decreased expenditure per capita. There has been documentation by Massachusetts about the healthcare policies and they assert that it will be vital if the idea of single payer is adopted as it will ensure economical feasibility. There is also a need to expand on the current Medicare. Currently, the Medicare cost is at 2% implying that there is a need to intensify on the Medicare (Armoni 2000: 198).By doing this, we may be able to meet some of the challenges that are currently faced in the healthcare.

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