Questioning Assumptions about Health Care Systems

Executive Summary
The United States Health care system is the subject of much debate. At one extreme are those who argue that Americans have the best healthcare system in the world, pointing to the freely available medical technology and state-of-the-art facilities that have become so symbolic of our system. At the other extreme are those who accuse our system of being fragmented and inefficient, pointing to the fact that the U.S. spends more on health care than any other country in the world, yet still suffers from a substantial rate of uninsured, uneven quality, and administrative waste (Sultz, 2013). A review of U.S. healthcare expenses by the Institute of Medicine revealed that thirty cents of every dollar spent on medical care is wasted, adding up to $750 billion annually (http://www.iom.edu, 2012). The Institute of Medicine report identifies six major areas of medical waste: unnecessary services; inefficient delivery of care; excess administrative costs; inflated prices; prevention failures; and fraud (http://www.iom.edu, 2012). Americans spend twice as much on health care per capita than any other country in the world. In fact, according to a series of studies by the consulting firm McKinsey & Co, the US spends more on health care than the next ten biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain, and Australia (http://www.mckinsey.com, 2008)
Introduction
Most industrialized nations have single payer systems. Many argue that such a system would eliminate the convoluted paperwork and corresponding costs associated with administrative work. Why has there been such resistance to a single payer system in the U.S.?
The issue of an uninsured population continues to be a major problem in the United States. Throughout every campaign, politicians pledge