The U.S. Public Health Issues

One issue that should be addressed in our health care system is the rising cost of health care. In 1986, experts predicted that health care costs would reach approximately 14% of the nation’s gross domestic product by the year 2000. In 2001, it reached 14.1% and is expected to drop to 17.7% in 2012. The cost of enrolling in Medicare and Medicaid has continued to rise over the past four decades. It’s estimated that federal spending on both these programs will increase from 5% of the domestic gross product to 20% by the year 2050. Experts however have come up with solutions that can reduce the rising costs of living without incurring any health risks (Orszag & Ellis, 2007).

One approach would be reducing the total health care spending. One advantage of this approach is that it will address the general shortcomings of the U.S health care system. For instance, it will address the issue of choosing effective medical treatments. Little evidence exists about which treatment works best or whether choosing more expensive therapies warrants their extra cost. Treatment choices are often left to the experience and judgment of the physicians involved as well as local practice norms. In most cases, relying on their decisions doesn’t necessarily yield the best treatment results. Experts believe that less than half of all medical care in the U.S is based on firm evidence of its effectiveness (Orszag & Ellis, 2007).

Service providers and patients tend to adopt more expensive treatments and procedures even when their effectiveness is not fully proven. They are both encouraged to adopt these treatments due to the financial incentives offered, that is, as long as the payment exceeds the cost the providers and patients will take up a more expensive treatment option.

One way of dealing with these problems is by expanding research on the comparative effectiveness of treatments. This will include analyzing the overall medical benefits and risks of all types of treatments and weighing them against the costs. The results of the research will provide a way of reducing the ultimate cost of health care spending by changing the behavior of doctors and patients. For instance, instead of choosing services that are more expensive, the two parties should evaluate and choose services that are less expensive but equally effective.

Alternatively, changes in incentives could help to control the health costs. On the health provider’s side, increasing the insurer’s payments to cover all services associated with treatment could result in a reduction in providing additional services that may be of low value. However, one downside to this approach is that providers may face financial risks for costs they may not be able to control and second, incentives may be created for them to provide too little care. On the consumer’s side, those with major health concerns may face financial burdens (Orszag & Ellis, 2007).

It is estimated that more than 79 million Americans have cardiovascular disease, which is the leading cause of death in America. The Division for Heart Disease and Stroke Prevention (DHDSP) is a sub-branch of the Center for Disease Control and Prevention and it provides public health leadership in promoting cardiovascular health. Reaching populations that are affected by cardiovascular disease is currently one of the biggest challenges in the United States. Increasing comprehensive programs that offer risk-reduction counseling and using low-cost policy and environmental interventions effectively reduces the risk of cardiovascular disease.

A program that develops plans and policies to prevent heart diseases should be developed. The main focus of this program will be to control the increase of high blood pressure, high blood cholesterol and increase the knowledge of signs of heart attack and stroke. One of the key goals of the program will be to define the burden of heart disease and stroke and assess existing population-based strategies for primary and secondary prevention of heart disease and stroke within the state. The program will work hand in hand with other programs such as CDC in order to be better able to promote system and policy changes (“Heart Disease and Stroke Prevention Program.” n. d).

The proposed program can be evaluated using The National Public Health Performance Standards Program (NPHPSP). This evaluation tool is used to evaluate the capacity of local public health systems to conduct the essential ten public health services. The proposed program will work hand in hand with local health care centers and therefore this tool will be used to evaluate whether the health care systems are able to meet the ten public health services which are a requirement for the program to be successful (“National Public Health Performance Standards Program” (NPHPSP), n. d).

One such program that has been developed and is currently working is the Rhode Island Heart Disease and Stroke Prevention Program which began in 2007. The project aims to improve the management of high blood pressure, high blood cholesterol and the quality of health care settings by enhancing the existing Rhode Island Chronic Care Collaboration in nine community-based health centers. This project has been able to fund and improve the quality of cardiovascular care for over 5,500 patients (“Heart Disease and Stroke Prevention Program.”, n. d).


National Association of County and City Health Officials (n.d) National Public Health Performance Standards Program (NPHPSP). Web.

Orszag, R.P & Ellis, P (2007) Addressing Rising Health Care Costs — A View from the Congressional Budget Office. The New England Journal of Medicine. Web.

State Of Rhode Island Department of Health (n. d) Heart Disease and Stroke Prevention Program. Web.

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