May 31, 2013
Health care spending has been a debatable topic for decades, spurring a number of opinionated discussions amongst the public and the government. Over the years, a number of changes and revisions have been presented to improve the quality of care at an affordable rate in an effort to maintain a reasonable budget, but none have made enough of an impact to reduce spending. My position on the matter of national health care spending in the United States is that the government is spending more money on minor items and less money on important areas, resulting in higher costs and a lack of supply to meet the increasing demand. The current level of national health care expenditures is at an alarming rate. Our healthcare system is the most expensive the world, with a per capita spending rate of over $8,000 in 2011. “Accounting for differences in national income, the U.S. still far outspent the other countries, dedicating more than 17 percent of its gross domestic product (GDP) to healthcare compared with 12 percent or less in all other countries (Squires, 2012).” There is much debate over the causing factors in the rising healthcare prices, leading to a number of public forums and discussions to address the issue. Increased access to expensive technology, cost of medical supplies and pharmaceuticals, and administrative costs have played a major role in the issue, but not as much as obesity has. “The ‘F as in Fat’ report highlights the current glum picture of the U.S. obesity epidemic in which 35.7 percent of adults and 16.9 percent of children ages 2 to 19 are obese, as the Centers for Disease Control and Prevention (CDC) reported earlier this year (Begley, 2012).” As the number of obesity cases increase, so will the demand for healthcare at an affordable rate and ease of access. In my opinion, the government is spending way too much money on hospital costs and not enough on the quality of care provided. This includes physician services, pharmaceuticals, and home health care. “Hospital care accounted for a steady proportion of aggregate national healthcare expenditures over the past decade – approximately 30% - and is expected to do the same over the next decade (Guerin-Calvert & Israilevich, 2011).” Expensive equipment is partly to blame for high hospital costs. “More than 95 million high-tech scans are done each year, and medical imaging, including CT, MRI, and PET scans, has ballooned into a $100 billion a year industry in the United States, with Medicare paying for $14 billion of that (Kelly, 2009).” Physicians are known for ordering and performing unnecessary tests and procedures, raising healthcare costs exponentially. Many of the MRIs and other imaging procedures were performed without any supporting cause, charging insurance companies and patients for services that would not affect the condition at hand. Fraud is another factor driving healthcare costs up. “The FBI figures that fraudulent billings to Medicare, Medicaid, and private insurers accounts for 3% to 10% of total health spending, and the bureau concedes its estimates may be low (Arnst, 2009).” Extending patient length of stay unnecessarily, upcoding claims, and filing fake claims are just a few of the numerous fraudulent acts committed. Cutting administrative costs and investing all fraud cases will help to reduce spending and increase profitability. It will discourage physicians and billers from committing fraud and reduce the risk of future incidents. Monthly audits of hospital claims by experienced auditors can ensure claims are accurately generated and billed with sufficient supporting data, and save millions in healthcare spending. The healthcare needs of the public are paid for through private and government insurance companies that establish both universal and company specific guidelines for consumers to adhere to.