*** Please discuss the effect of the characteristics of the US health care system on (1) access to health care, (2) health seeking behaviors of the population, and (3) provider behaviors. Please be sure to answer the questions from the perspectives of at least TWO of the characteristics identified in the module home page. *** Some Americans say that we have the finest health care system in the world, while others think it’s astonishing that as a world leading country, we don’t have universal health care.
Whichever side of the fence a person is on in regards to our country’s new health care reform bill, I think all can honestly say there is something wrong with our system. For the most part, American’s health care is based on having insurance. This means that unless you have insurance, you will have to pay out of pocket for treatment. Since most people cannot afford this, and some can’t even afford health insurance, this leaves people uninsured and without medical coverage.
With that said, Americans with or without insurance focus on the quality of their medical care, and expect nothing short of the best. I don’t disagree with them, but doctors are not miracle workers. Here I will look at these two characteristics of the health care system in the U. S. , and explain how they are related to the access of care, the health seeking behavior of the population, and health provider’s behavior’s towards their patients. Access of care refers to the ease of a person getting the required medical attention they need (Rand corporation, http://www. and. org/topics/health-care-access. html). Ease of access is a great comfort to anyone who has any medical concern that requires being seen by a provider. It’s also a necessity to people with chronic health issues, or someone who suffers a traumatic injury. The U. S. has many emergency departments that are equipped and ready to see people with life threatening injuries and illnesses, whether or not they have insurance. Private offices on the other hand, have an option to see someone or not based on that patients insurance plan.
People with a good insurance plan are usually not afraid to go see a doctor. They know that their plan will provide for most, if not all expenses, in return for their or their employer’s monthly contribution. On the other hand, Americans without insurance are understandably more reluctant to seek treatment. Medical care is expensive, and can lead to financial hardship. In fact, over 60% of bankruptcies in America are directly connected to medical expenses (Science Daily, 2009, http://www. sciencedaily. com/releases/2009/06 /090604095123. htm).
I know what the financial issues of not having insurance can bring. Before my wife and I were married, she was uninsured for a brief period. It so happened that she needed a surgery during this time, and we are still paying off the bills 4 years later. With these things in mind, I can understand the reluctance of uninsured people seeking help for medical conditions. People who will be crushed by medical bills would clearly not believe that they have an easy way to obtain access to care. However, whether people are insured or not, all people want the best medical treatment available.
I think in most cases, Americans tend to want the best of everything, not barring the outcome and quality of the treatment provided. I have worked in a number of hospitals as a Paramedic student, and I can’t count the number of times I have heard something along the lines of, “ Nothing was done for me”, or “I didn’t even get any medicine”. People who don’t understand medicine sometimes assume that just because a doctor sees them, that they will automatically be cured. This couldn’t be further from the truth.
In a lot of cases, nothing needs to be done, or what can be done is the burden of the individual (eating healthier, exercise, not using intravenous drugs, etc…). Just because most people in the country have high expectations of outcomes from their hospital visit, doesn’t mean that it’s automatically going to happen. Considerations of carrying insurance, and the expectation of quality of care in America have an impact on the health seeking behaviors here. All competent and conscious adults in our country have the choice of whether or not to be treated, or seek treatment.
There are a multitude of things that might determine someone’s health seeking behavior including: ethnicity, age, gender, financial status, and location. Another big determining factor can again be traced to whether or not one has insurance. While there are a number of studies outlining these other factors, I think that if a person has good medical coverage, they are more likely than not to seek out care. People with limited or no coverage are more likely to put off any routine treatments or surgery, and certainly are not going to visit a doctor for something as minute as a common cold.
For the people that do seek medical help and make it to a doctor, they will expect the results to be positive. As stated before, as a people we’re known for having high expectations of medical outcomes. Let’s now take a look at the provider’s behavior, and how they are related to access based on insurance coverage, and the focus on quality that comes with treatment. There are many aspects of a health care provider’s behavior that can influence a patient’s thoughts on not only their own health, but the opinion of their individual doctor.
I have had doctors that were fantastic, told me everything I needed to know, and spend an adequate time doing it. I’ve had others that were frank, to the point, and not helpful at all. Typically, when a health care provider has a positive attitude and is knowledgeable, I feel better when I leave their office, and am motivated to take care of my own health. Considering that I am a very healthy person, I can only assume that this provider behavior has the same effect on others.
The only negative account that I have witnessed where having insurance made a difference in provider behavior was in a certain large South Western city. I was doing my Paramedic internship, and a particular doctor referred to several uninsured families in the waiting room as the “Medicaid parade”. This was an obvious insult to the families being from a lower income bracket. Had those patients overheard him say this, they, like anyone else would know that this is unacceptable behavior of any health care provider.
From the patient’s perspective, provider behavior can greatly influence the outcome of the visit. If they get a good doctor, then they are going to do more for themselves than if they leave the office not knowing what just happened. In a study conducted about African Americans’ perceptions of physician attempts to address obesity in the primary care setting, wording and behavior had a great deal to do with how the patients felt afterwards. One of the main findings was the “importance of the physician’s manner and timing when discussing weight” (Ward, Gray, & Paranjape, 2009).
The patients in the article were much more motivated to help themselves with their obesity when the doctors were positive and constructive. When this was the case, patients had a higher expectation of their individual outcomes. As we can see, our model of health care in America isn’t perfect, no individual country’s is. There are always factors that can be adjusted in any system, from people feeling they can only have access if they have insurance, to the sometimes overly high expectations of their outcomes from doctor visits.
With a few things tweaked, and some health care reform we might be able to provide for more people, and give better service to all patients as a whole. Everyone in our country should feel that they have easy access to care when they need it. People will feel more confident in seeking out the care they need if they don’t feel scrutinized over their insurance plan, or their socio-economic background. Lastly, if we can ensure that our doctors and other health providers give patients the care and attention they need, more people will be willing to do what they can to provide for themselves.