Running Head: RESEARCH PAPER 1

Senior Citizens in the United States Struggle to Pay for Healthcare Cost amongst Other

Countries

By [Name of Student]

Course

Professor

[Name of Institution]

October 19th, 2019

Contents
Introduction .................................................................................................................................................. 3
Background of the Study............................................................................................................................... 4
Healthcare in the United States .................................................................................................................... 4
Reasons for High Costs of Healthcare in the US ........................................................................................... 5
Challenges Faced by Senior Citizens in the US.............................................................................................. 8
Comparison of the US Healthcare for Senior Citizens to Other Countries ................................................. 10
How to Reduce Healthcare Charges for American Seniors Citizens ........................................................... 10
Conclusion ................................................................................................................................................... 12
References .................................................................................................................................................. 13
Running Head: RESEARCH PAPER 3

Introduction
Senior citizens or people who are aged above 65 years of age in the United States (US) go through

tons of issues and experience loads of issues when it comes to paying and taking care of their

health costs as compared to other developed economies of the world. Senior citizens in the US do

have access and availability of insurance services and health care programs but having said that

they still suffer more from medical issues and sickness issues primarily because of affordability

issues when compared to other countries which are as much of economic power as the US

(Anderson, 2003). Many surveys and researches have shown and proven with numbers that the

majority of senior citizens in the US who face health and sickness issues are because they cannot

afford health care services. Research done previously has also shown that health care issues in the

US are majorly faced by senior citizens. It is in clear evidence that some health care and medical

treatments or procedures are very much high in cost as compared to other countries and these are

the treatments that only the wealthy can afford (Med, 1993).

Senior citizens in the US who are not that wealthy enough don't have that much capacity at that

age to raise or earn much money to get these treatments and required procedures. Because of this

constraint of not being able to afford the required treatment, the sickness rate is very high in the

senior citizens of the US (Garber, 2008). Other developed countries and economic powers like the

United Kingdom, Australia, and France, etc are way ahead in providing the right care to their

senior citizens as compares to the US. The lack of financial power of senior citizens to acquire

health care in the US makes their healthy life in these senior years very hard to manage. Why

senior citizens are not able to afford the required health care in the US as compared to other

countries is the issue that will be highlighted and discussed in this paper (Danzon, 1992).
Running Head: RESEARCH PAPER 4

Background of the Study

The senior citizens in the United States go through challenges in raising enough money to cater to

their medical costs. But why do they need so much money to get the required medical treatments

as compared to senior citizens in other developed economies is the issue (Homedes, 2005).

Previous researches and surveys have shown that about one-quarter of senior citizens in the US

skipped going to a doctor or skipped recommended treatment or getting prescribed drugs due to

the reason of not being able to pay the costs of all that. On the other hand, researchers found out

that in other developed economies of the world like the United Kingdom, France and Sweden, not

more than 5% of their citizens complained about not being able to get the required health care

because of costs (Magnussen, 2005).

Healthcare in the United States

The US as compared to other developed economies of the World is seen as the poorest state with

a high income in giving its senior citizens proper and timely health care which causes its senior

citizens to be more ailing then from other senior citizens in developed countries. The health care

system in the US is such that it becomes unaffordable for the majority of the senior citizens which

causes them to skip medical treatments, procedures, checkups, and drugs (Hoffman, 2011). Despite

having access to medical insurances and health programs senior citizens in the US still face

challenges in acquiring the medical assistance they need because of financial issues. This is

because medical services are of very much high cost in the US and senior citizens find it hard to

pay the bills especially those who are retired from work and have no paychecks coming their way

(Legis, 2015).
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All these healthcare challenges in the US are primarily because of the high cost of medical facilities

and the drugs as compared to in other countries. The United States health care system is one of the

most costly systems in the world. Just in 2017, it was reported that the US spent almost $3.5 trillion

on health care. The major cause of so much spending on health care is the increase in prices and

health care prices have increased the most in the US economy as compared to other services in the

past 20 years (LDickman, 2017). The consumer price index for health care shows an increase in

prices of 3.5 percent annually which is more than any other price increase in the economy. The

health care systems of the major developed countries or economies of the world are regularly

ranked by the Commonwealth Fund. Last year the Commonwealth Fund ranked the USA as the

lowest performer when it came to health care systems and the USA has been getting this position

consistently for the past 20 years. This stands behind the fact that life expectancy in the US has

been going down in a recent couple of years along with US senior citizens being sicker and ailing

when compared to other developed countries (Anderson, 2003).

Reasons for High Costs of Healthcare in the US

As mentioned before about the health care system pricing in the US, it is twice as expensive when

compared to the other economies of the world. The high cost of medical expenses is related to

them as much high expenditure of the US on health care. For example, just in 2016, the US took

17.8% of its domestic growth product to pay for all its medical bills (Danzon, 1992). Regardless

of this money being spent on health care, trillions of it, the health care system in the US has been

ranked 37th in the world by the World Health Organization (WHO) even though the US is one of

the most developed countries of the world. Going a step ahead, the Commonwealth Fund placed

the US the last among the 11 countries when it came to health care systems. All this is mainly due
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to the high costs of the health system in the US. The reasons for such high costs can be described

in 5 major reasons (Garber, 2008).

The number one reason for health care costs in the US being so high is administrative costs. It is

reported that about one-quarter of total health care cost is given to cover up administrative costs.

Administration services include stuff like reporting and making data for clinical studies,

negotiating and talking with investors and payers like private insurance companies, government

programs, etc, doing the process patient bill along with all the other payments, recruiting staff like

nurses, doctors, surgeons, and other staff, and marinating all the information system (Hoffman,

2011)s. Stuff like this all comes under the administrative costs and as mentioned before almost

one-quarter of the health care budget goes into managing the administrative costs and thus the

citizens have to pay for all those expenses and costs which makes health care expenses in the US

(LDickman, 2017).

The second major reason for the increased health care cost of US citizens is the costly pricing of

all the medical drugs. In the majority of countries, the governments negotiate and talk over the

drug prices with all the drug companies for the drugs being sold in their country (Legis, 2015).

The US, on the other hand, does not do any negotiation with the drug dealers regarding the prices

and gives a free hand to the pharmaceutical companies in setting whatever prices they want.

Because of this, the prices of all medical drugs are quite expensive when compared to prices in

other countries and US citizens especially senior citizens don't have the financial power or liberty

to get the medical drugs required regularly which makes them remain sicker (Magnussen, 2005).

The third reason for the high costs in the US health care system is the fact that doctors tend to

practice a lot of defensive medicine in the US. Defensive medicine means being extremely careful
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in confirming a diagnosis and starting treatment of it by rechecking it again and again through

different tests and procedures which increases the costs unnecessarily (Med, 1993). This is

basically because of the fact that doctors are afraid of being sued in case of any little error in

diagnosis which pushes them to order multiple tests which wouldn't be medically necessary before

actually confirming the diagnosis although they would be sure of what it is or just to keep the

patient satisfied in order to avoid chances of being sued. This fear in doctors is upheld by the fact

that almost 34% of doctors have been sued for medical liability at least once in their careers.

Though this practice of defensive medicine does protect the doctors from being sued and patient

litigation but it drastically increases the costs of health care as well. The Gallup survey in 2010

stated that an estimated amount of $650 billion could be saved annually if the majority of doctors

stopped practicing so much defensive medicine (Homedes, 2005).

The fourth reason for health care is expensive in the US is that doctors and practitioners tend to

use a mix of expensive treatments as compared to other countries. For example, the USA in the

latest data available performed the second-highest number of most MRI's in the world which meant

118 MRI's per 1000 patients (Anderson, 2003). The price of the MRI is the US is also the highest

as compared to other developing countries. MRI in the US costs $1119 as compared to the prices

in New Zealand which are $811, the second-highest after the US. Also, citizens in the US are

treated mostly by a specialist, that is just how the US health care system is that more specialist is

everywhere dealing with citizens who just need primary care. This automatically increases the cost

because specialists generally have a higher wager. In other countries, the same treatment to those

citizens is being done by primary care doctors who demand a way lesser wage than a specialist

(Danzon, 1992).
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This brings in the 5th reason for the US being the most expensive in health care. The US is known

for paying doctors, nurses and medical staff very high wages as compared to all the other

developed countries in the world. High wages and high staffing automatically increase the costs

of health care. A health care professional earns more money than all other health care professionals

in the world (Garber, 2008). It was reported in 2016 that an average health care professional in the

US earned $218,713 annually which is twice the pay in other countries with nurses and other staff

also earning more. The supply of doctors in the US is pretty low as compared to other countries in

the world which prompts doctors and medical staff in the US to demand more wages and there is

no option but to give them more because they are needed. This makes the costs of going and seeing

a doctor so much more of American citizens', especially senior citizens (Hoffman, 2011).

Challenges Faced by Senior Citizens in the US

There are countless challenges faced by senior citizens in the US when it comes to getting health

care. The US health care system has failed in providing timely and quality affordable services to

its senior citizens over the years (Homedes, 2005). The major problem in US public hospitals is

an expensive treatment, expensive doctors and expensive drugs which are unaffordable for senior

citizens. As discussed in detail above, highs costs of the medical care system in the US is the major

challenge faced by the senior citizens there in acquiring the health care that they need (LDickman,

2017).

These observations are backed up by various data from surveys and researches. In surveys of recent

years, it was reported that almost 31% of senior citizens in the US reported that they skipped going

to a doctor or getting a recommended test and drugs due to financial affordability reasons (Legis,

2015). In 2013 a research report 19% of US senior citizens claiming high costs of medical care as
Running Head: RESEARCH PAPER 9

obstacles for them to getting the health care they wanted. This was the highest rate in the world

with the second-highest rate of senior citizens complaining of health costs as an obstacle was 10%

in New Zealand. Higher costs of the health care system are thus one of the major challenges that

an average senior citizen in the US faces (Magnussen, 2005).

What is interesting here is that access to health care insurance isn’t much of an issue. The medicare

program of the US government gives health insurance to everyone above 65 who is in the senior

citizen category. But regardless of the medicare program being there, health care is still very costly

for senior citizens (Magnussen, 2005). Despite the health care program, 19% of senior citizens

have stated that they skipped their health care requirements due to affordability issues because

they didn't have the luxury to do out of the pocket expenses on health as they were more concerned

on meeting their other expenses like food, rent, etc. In comparison to other countries like the United

Kingdom and France, not more than 5% of senior citizens complained of costs being an issue of

skipping health care needs although the UK and France also have government-funded health

insurance programs (Med, 1993).

An example of a loophole in the Medicare insurance program which doesn't help senior citizens

the US as much as it should in terms of cost is that the medicare part d does not give medicare the

right to use its program to negotiate the prices of medical drugs for its users. This keeps the costs

of medical drugs higher for all the senior citizens under medicare thus the complaint of costly

health care even with this insurance plan being in place because the structure of medicare is as

such that it has a lot of out of the pocket expense which the senior citizens cannot afford (Anderson,

2003).
Running Head: RESEARCH PAPER 10

Comparison of the US Healthcare for Senior Citizens to Other Countries

As stated above in this paper, the US compared to other developed countries in the world has been

ranked very low when it comes to providing a good affordable health care system to its citizens.

This observation is proved by the stats discussed above in this paper of how the percentage of

senior citizens of other developed countries being satisfied with their health care is very high than

of senior citizens of the US being satisfied with their health care (Anderson, 2003).

The major reason for this dissatisfaction of US senior citizens as compared to other countries is

the difference in the health care systems of the US and all these other major developed countries.

And the real difference between them is pricing. The difference in costs can be seen by several

figures in different departments (Garber, 2008). For example, the average annual salary of a doctor

in the US was reported to be $218,713 in 2016 while in other countries like Sweden and Germany

the annual earning by salary for doctors ranged from $86,607 to $154,216. Administrative costs

caught a total of 8% of the total expenditure in health care in the US while for all these other

countries it ranged from just 1% to 3% (Hoffman, 2011).

Other treatment tests and procedures like MRI, CT scans, etc are also very highly-priced as

compared to other developed countries. As mentioned before prices of medicines are also very

costly as compared to other developed countries because the USA has given a free hand to the

pharmaceutical to set prices and even the medicare insurance program does not cover the drug

costs like in other countries (LDickman, 2017).

How to Reduce Healthcare Charges for American Seniors Citizens

There are several ways and policy changes through which the government can reduce the health

care charges for American senior citizens. It can start by cutting off its administrative costs as the
Running Head: RESEARCH PAPER 11

US spends the most on administration as compared to other countries. It can opt for a single-payer

rather than having multiple ones to do this as it would help save almost 15% of health care costs

(Med, 1993).

Secondly, the government can make such policies that they ensure that all physicians practice ways

of cost-effective medicine and not defensive medicine. Unnecessary tests and procedures and

majorly performed in fear of malpractice suits (Anderson, 2003). The government should do

reforms in malpractice law and remove this extra consciousness from the doctors and encourage

them to practice cost-effective medicine and only do tests and procedures where necessary.

Because of this $600 billion can be saved annually (Hoffman, 2011).

Thirdly the government can change its policy of having given a free hand to pharmaceutical

companies to set prices as they wish and start controlling costs of prescription drugs through

negotiating with them etc (Legis, 2015). If not that then the government should at least give the

power to their senior citizen health care program Medicare to negotiate the prices of drugs which

are to be sold to the people covered in that program so that at least the cost of buying drugs is

reduced and covered in the Medicare program for US senior citizens (Med, 1993).

The Utilitarian ethical theory applies to the solutions given above for the problem. The Utilitarian

is that theory which talks about right and wrong focusing on what the outcome is. Utilitarian theory

supports the fact that most ethical choices and actions are those who in their outcome will end up

giving a lot of good and benefits to a large number of people (Hoffman, 2011). The solutions given

above might not be that beneficial to US medical and pharmaceutical industry and might even

cause issues in the huge investments coming to it but generally the outcome of the actions proposed

as solutions will give a huge number of population of US, which are the senior citizens, tons of
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benefits like good, less costly health care which would help them live a healthy comfortable life

in these old age years without having to worry about getting the right health care (Homedes, 2005).

Though there are also other ethical theories which can be applied to the justification of the costly

US health care system. The Kantianism theory can be applied to this situation as this theory does

not decide right or wrong on the outcome of actions but it focuses on right and wrong depending

on weather the duty is being fulfilled or not. An applying Kantianism theory to the US healthcare

system, it is practically fulfilling its duty towards its citizens of providing easy access to quality

health care in quick time (LDickman, 2017). It is also fulfilling its duty towards senior citizens in

the form of medical insurance programs like medicare. So regardless of the outcome, the duty is

being filled. The justification of the socialism theory can also be applied to this situation as USA

is socialist society and economy with free hand to industries and businesses, which somewhat

justified the free hand US has given to the pharmaceutical industry there which brings in returns

tons of investment in the country inducing on research and developments on new cures and

medicines (Hoffman, 2011).

Conclusion
In conclusion, it can be seen through various observations, surveys, data, and researches that the

health care system for senior citizens in the US is full of challenges and problems and the senior

citizens are not satisfied with it as compared to other countries. With the above-given solutions,

the US government can remove these problems to quite an extent and make their health care system

and insurance program much more affordable and satisfactory for their senior citizens like it is in

the other developed countries.

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References
Anderson, G. F. (2003). Its the prices stupid; why US is different from other countries. Health Affairs,
22(5), 89-105.

Danzon, P. M. (1992). HIDDEN OVERHEAD. Health Affairs, 1-23.

Garber, A. M. (2008). Is American Health Care Uniquely Inefficient? JOURNAL OF ECONOMIC

PERSPECTIVES, 22(4), 56-76.

Hoffman, B. (2011). Health Care Reform and Social Movements in the United States. merican Journal of
Public Health (AJPH), 3-5.

Homedes, N. (2005). Why neoliberal health reforms have failed in Latin America. Health Policy, 71(1),
83-96.

LDickman. (2017). Inequality and the health-care system in the USA. The Lancet, 389(1077), 1431-1441.

Legis, H. J. (2015). The Wide Range of Challenges Facing Seniors. Hein, 34-43.

Magnussen, L. (2005). Comprehensive Versus Selective Primary Health Care: Lessons For Global Health
Policy. Health Affairs, 23(4), 2-4.

Med, A. J. (1993). Reforming the Health Care System: The Universal Dilemma. Hein, 2-12.