America’s Two Healthcare Systems: The Private and The Poor

Oh, to be on the rich side of US healthcare. We all know that if you have the money, private healthcare and clinics in the US are, by far, some of the best in the world. However, the reality is that only a fraction of the US population can afford private healthcare. So, what’s the difference between the private and what we’re calling the poor? Read on to find out.

The World of Private Healthcare

Most of us can only read about the world of private healthcare in the US. Or, maybe, drive by a private clinic and think, “Oh, that looks fancy.” What lies behind the walls of these exclusive clinics is often seen as both a blessing and a curse. On one hand, it is criticized for being access-limiting and cost-efficient, catering primarily to those who can afford expensive premiums. On the other hand, American private healthcare often stands out for its exceptional efficiency, quick access to cutting-edge treatments, and industry-leading care.

For insured patients with private policies, the advantages are undeniable. They receive fast-tracked appointments, get to choose their doctors, and are treated in modern, high-grade facilities that prioritize comfort and privacy. Some private hospitals, like the Tisch Hospital of NYU, exemplify the level of service available, featuring state-of-the-art technology and financial stability that ensures patients receive timely care. Patients can often get CT scans without prior booking, walk-in for blood tests, or even secure overnight stays without waiting for days, as might be the case in public hospitals.

However, this efficiency comes at a staggering cost. The U.S. healthcare system is notorious for its exorbitant pricing, with more than 18% of the nation’s GDP going toward healthcare expenditures. This makes it one of the most expensive systems in the world, where even those with insurance may face hefty out-of-pocket expenses. This adds to the growing debate about whether this level of care is sustainable for the average citizen.

The Reality of Public Healthcare

Public healthcare is most of our reality. It’s no secret that the system is struggling, spending trillions each year, including on physician recruiter firms and nurse agencies to fill the staffing gap, medical supplies, and extended and unnecessary bed fillers.

Millions of Americans don’t have other alternatives except public healthcare. They tend to be overpopulated, poorly funded, and disorganized. Patients wait to be treated for hours or even days, and some patients leave because they can’t access the car they need. Patients who are either uninsured or on Medicaid tend to disappear into the healthcare system and don’t have the appropriate long-term treatment they need.

Medicaid and Medicare Inconsistencies

Medicaid and Medicare are essential safety nets for low-income and elderly populations, but the availability of these programs isn’t what it should be. The provision of Medicaid coverage expansion per ACA was in the right direction in attempting to bridge coverage gaps, but it didn’t quite get there. States that didn’t opt for the expansion condemned millions of people to lack access to affordable care. While Medicare is certainly a benefit to most Americans, it is often inadequate to cover all of the necessary treatment and prescription costs.

Unlike private insurance coverage, which has a satisfactory reimbursement level for service providers, the level of reimbursement in Medicaid is relatively lower, meaning that several service providers, through the use of accommodation and other incentives, seek to limit the number of patients covered by Medicaid or deny them outright.

The US healthcare system – but so are so many worldwide. Rising population numbers, aging and disease-prone populations, and a lack of staff are causing chaos. That’s for the poor, anyway, the private is thriving.