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LA&S Senior Seminar

Literature Review
11 February 2022
Discipline 1: Medicine

Literature Review #1: Is the US Healthcare System Worth the Cost for Patients?

Many people think that the healthcare system in the United States is the best in the world.

That’s the main reason why many people accept the ludicrous costs that US citizens must pay for

a basic human right. It’s seen that the United States pays the most GDP per capita than any other

country, so that must mean the healthcare system is good right? Wrong, this is a byproduct of

capitalism gone to the extreme where the free market is only isolated to private third parties. This

means the transactions of goods and services are not between the consumer and producer.

Moreover, Research Dr. Sarpel found that there are intermediaries which get the goods

from the producer and sell the products and services at a higher price for the consumer. Dr.

Sarpel also finds that the quality of the healthcare system is not that good from his research.

Likewise, researcher LaPierre compared the quality of the US healthcare system and the

healthcare system in Canada. She found that the overall patient outcome and quality was higher

than the US healthcare system, and the Canadian healthcare system is much cheaper to run than

their counterpart the US healthcare system. Furthermore, it was found by Dr. Shrank that the

main culprit of wasteful spending was due to these intermediaries. Researchers Daemmrich and

Moharity compared the expenditure done by the United States and compared it with China’s

expenditure on pharmaceuticals. It was found that both countries are involved with extremely

high in their spending to create more brand products to increase profits, rather than reducing

prescription costs for patients with cheaper alternatives. With all this in mind, is it seen that the
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patients’ health is a number one priority or is the healthcare system’s priority to make as much

money of off their patients. Ironically, Researcher Khan found that the US healthcare system

results in higher mood disorder, this classified as bipolar and depressive symptoms, due to the

costs of the healthcare system weighing down on them mentally. With the healthcare system

focused on monetary gains does this result in a healthcare system which prioritizes patient care

above all?

In Dr. Sarpel’s research paper where he debunks common myths about the US Healthcare

system, it seems that the patient is not the priority. One key things Khan found was that

insurance the reason there’s a growing number of uninsured people in the United States is that

the cost of health insurance has been increasing (Sarpel et. al, 2008). Since these citizens are no

longer able to afford health insurance, they cannot access to the healthcare system that is

“praised” for its unequivocal care it provides, which is caused by their high spending and costs.

This results in these people to avoid the hospital and healthcare system all together, the last thing

they want to be doing is using a healthcare system they cannot afford. Furthermore, even though

these uninsured individuals seek to avoid the healthcare system, there are times where

emergencies occur, and they need to use the healthcare system. It was found that these uninsured

individuals were treated with “too little medical care [or received] it too late (Sarpel et. al,

2008).” Dr. Sarpel’s perspective on this issue within the healthcare system is due to the

complexities and intermediaries involved. Since, the goods are distributed through private

sectors these third parties can then upcharge the patients for health insurance and using the

emergency room so they can drive a profit. This healthcare system is not used to benefit the
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patients, rather the system is used to benefit the healthcare admins, insurance companies, and

pharmaceutical companies.

On the contrary, it’s seen that the Canadian healthcare system is much more affordable

for its patients. Research LaPierre analyzed multiple studies to compare the patient outcomes and

perspectives on the US healthcare system versus the Canadian healthcare system. LaPierre states

that “one could justify the high cost of health care in the United States if it led to superior health

outcomes… Canada has a higher life expectancy and a lower infant and maternal mortality than

the United Stats (LaPierre, 2012). This showcases that the price tag that the US healthcare

system is not worth it for the patients due to a worse patient outcome than their universal

healthcare counterpart. She further states that the reason the US has poor health outcomes is due

to the number of uninsured people in the country which is ever growing (LaPierre, 2012). Dr.

Sarpel and LaPierre’s studies intertwine with each other because they both validate their

arguments regarding the patient outcome of the US healthcare system. The World Health

Organization found that the United States ranked 32nd for infant survival, 24th for life expectancy,

and 54th for fairness (Sarpel et. al, 2008). This depicts the disparity of the US healthcare system

present in the country which results in worse patient outcomes. Furthermore, an interesting

finding Harvard School of Public Health found was that “45 percent of respondents felt that the

United States has the best health care system in the world (LaPierre, 2012).” This depicts the

unawareness and the myth Dr. Sarpel found was that the “United States Healthcare System is the

Best in the World” which should justify the price of the healthcare system, no? Though, that’s

not the case both researchers found that the patient outcome in the United States is much worse

when compared to other countries.

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Both researchers Dr. Sarpel and LaPierre believe that there is a lot more to be improved

upon in the US healthcare system. They are in consensus that the US healthcare system does not

prioritize the patient’s wellbeing rather their focus is increasing the amount of profit they can

extract per patient. This results in a toxic system where low to intermediate socioeconomic status

are unable to fully access the healthcare system the US must provide due to economic burden the

US healthcare system imposes on them. Whereas high socioeconomic status people pay the least

amount of money for health insurance and can reap the benefits of the US healthcare system, that

should be implemented for all. LaPierre found that the Canada was much more successful at

delivering cost effective care to their patients which the US fails to do so. What results in such

high maintenance of the US healthcare system?

Researcher Shrank analyzed the waste of the US Health Care system, and why it is such an

expensive system to maintain. The costs of the healthcare system were measured from a variety of

parameters ranging from failure of coordination to fraud. What was found was that the amount of wasted

money in the healthcare system ranged from $760 billion to $935 billion, where the most expensive

parameter was the administrative complexity which was between $191 billion and $286 billion (Shrank

et. al, 2019). This showcases the amount of unnecessary spending resulting in overall a more expensive

system for working class people to utilize. Dr. Shrank found that the second major contributor to waste

was pricing failure, which is related to pharmaceutical spending, over-priced ER rooms, and other

expensive hospital facilities (Shrank et. al, 2019). This supports the idea that the healthcare system

although expensive, isn’t built to result in the best patient outcomes. It’s seen in the previous studies that

the US healthcare system fails to meet certain standards, though the US spends around 18% of it’s GDP

on the service (Shrank et. al, 2019). Dr. Shrank’s perspective on this issue is that if they can reduce the

overhead costs of the healthcare system for the hospitals it will then result in cheaper healthcare for the
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everyone. Though this is not necessarily true, because it is seen in the past that the US healthcare system

prioritizes its profits over the patient outcome. The results of an extremely expensive healthcare system

one may need to rely on is an extremely taxing event, especially when these people are barely getting by

economically.

Dr. Khan analyzes the psychological burdens the healthcare system has on people, due to its

obscene cost. The healthcare system itself results in higher depressive and bipolar disorder symptoms as

the cost of healthcare of patients increased (Khan et. al, 2020). The system in theory created to care for

patients only results in higher stress and psychological strain on the patients trying to afford to access said

system. It was seen that spending on prescription medications resulted in higher mood disorders for the

participants tracked (Khan et. al, 2020). This ties back to Dr. Shrank’s study which showcases that

pharmaceutical spending is a major contributor to the costliness of the healthcare system in the United

States. In Dr. Khan’s perspective, with the increasing costs of the healthcare system it results in higher

mood disorder for patients, which overall lowers their health outcome. Patients are being negatively

afflicted by the healthcare system mentally when not even actively participating in it due to the costs of it.

In addition, Dr. Shrank finds that if the healthcare system becomes less wasteful in its expenditure this

would result in lower costs for the healthcare system. And with the lower economic burden on the

patient’s, it would result in lower mood disorders for them. Furthermore, with a cheaper healthcare

system the overall patient outcome could increase because more people are able to afford insurance.

In conclusion, all these researchers found from their studies was that the economic burden of the

healthcare system taxes the health of the patient. Although, the United States may spend the most money

on the healthcare system, they are unable to provide the best care for their patients, as they have large

disparities in their mortality rates in comparison to their universal healthcare counterparts. The amount of

wasted money which pours into the healthcare system results in a higher overhead costs for the system to
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run. Furthermore, with these higher overhead costs causes a higher economic burden on the people in the

system mentally because they need to afford the system to survive for worst case scenarios. It is seen

across all these studies is that the healthcare system prioritizes the amount of profit per patient rather than

the amount of positive health outcome resulting from the system. What is the solution to this problem? To

reduce the costs of the healthcare systems, which will then allow people to have less mental stress on

themselves and people will be able to afford health insurance so they can receive better health outcomes.

Though this is a lot easier said than done, because this will need major reform in the US healthcare

system which is manipulated by lobbying parties to prevent actual change. At the end of the day, it’s seen

the that the costs healthcare system for the people of the United States of America do not pay for the

quality care they expect. Rather, they are being used as financial tools to fill the pockets of other more

influential people.
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Works cited:

Khan, Hammad A., et al. “Direct Incremental Healthcare Costs Associated with Mood Disorders in the

United States, 2007–2017.” Journal of Affective Disorders, vol. 273, 2020, pp. 304–309.,

https://doi.org/10.1016/j.jad.2020.03.127.

LaPierre, Tracey A. “Comparing the Canadian and US Systems of Health Care in an Era of Healthcare

Reform.” Comparing the Canadian and US Systems of Health Care, Oct. 2012.

Sarpel, Umut, et al. “Fact and Fiction.” Annals of Surgery, vol. 247, no. 4, Apr. 2008, pp. 563–569.,

https://doi.org/10.1097/sla.0b013e318159d566. 

Shrank, William H., et al. “Waste in the US Health Care System.” JAMA, vol. 322, no. 15, 2019, p.

1501., https://doi.org/10.1001/jama.2019.13978.