Inthe Americans mentality, accepting aid from the government it seen likereducing individual freedoms and encouraging the poor to laziness. Other peopleview providing aid to people in need as a social system. The first step inhelping people was trough the Social Security Act after the Great Depression of1929 in order to reduce poverty among elderly, unemployed, women and childrenand was the first welfare in America. To understand how international healthcare systems (Commonwealth Fund countries) compare to the United States. The objectiveof this assignment is to focus on how healthcare system work in the abovecountries, to do so an evaluation of the impact of these system on theirpopulation in the following Care path: the Access to Care, Administrative Efficiency,Equity, and Health system performance according to the report “Mirror, mirror2017”.

Anew study reveals among American workers and youth that: in the United States,your income level defines your accessibility to health care, the quality ofservices you receive and whether you are going to die prematurely because ofthat. This study reveals that The United States also has the worst healthcareamong the high-income countries in the world according to The Commonwealth Fundnotes in July 2017. Using survey data to measure and compare the experience ofpatients and physicians across 11 countries, the study “Mirror, mirror 2017:International comparisons reflect gaps and opportunities for better health carein the United States”. This organization ranks las the United States in overallin providing accessible, high-quality health care regardless of income.Careprocess: this category includes the following areas prevention, care security,coordination and involvement. Overall, the United States is ranked last (11th)on 11 countries and first (1st) in higher health care cost spending.

This is receiving a lot of attention because it’s a potential source of sufficiencyboth in terms of quality of care and cost control. It’s not surprisingly thatPrevention in the United States is poorly ranked. This theme focuses on directprevention actions via the attending physician(smoking, alcoholism, stress ornutrition), the rate of completion of preventive examinations such asmammography for women after 50 years or vaccination against influenza to agedpeople and hospitalization that could been avoided. In Safety of care threeindicators were evaluated through a survey of physicians in medical errors, useof computerized patient records and regular reassessment of the treatments ofpatients taking more than two drug the US is also ranked poorly. The same poorrate also is seen in the Coordination of care means relations between thegeneral practitioner and the hospital. In the involvement of patients andrespect for their choices, especially on the quality of the relationshipbetween patient and his or her physician, which is rather good according topatients in the US (Mirror, mirror 2017)Accessibilityof Care: this mean financial accessibility and timeliness of access care, theUS is ranked 11th. Delays in access to care are quite good in the UScompare to others.

Patients have a reference medical office that respondsresponsively to their requests and the delays in accessing specializedappointments or surgical procedures after diagnosis is very short.AdministrativeEfficiency: the US ranks 10th from the view point of physiciansthere are more time to manage administrative procedures( relations with healthinsurance, reporting of quality indicators, bill recoveries), malfunctions inthe availability of the necessary medical information(results of previousexaminations, unavailability of the medical life).Equity:the Commonwealth Fund reports shows that the United Kingdom, the Netherlands,and Sweden rank highest and the US, French, and Canada ranked lowest and havethe larger disparities between lower and higher- income, a relatively unfairtreatment of people with the lowest incomes.

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Medical practitioners are muchmore familiar with the medical records of the most affluent patients,suggesting a different treatment depending on the socio-economic level. Othersdo not surprise, such as the difficulty of people with the weakest resources topay for the remainder. Low-income people are much more likely to be deniedaccess to affordable care and to suffer and even die from it.Healthsystem performance: the state of health in the US and the results of the healthsystem are bad (ranks 11th) compare to other countries in this report.This analysis is based on infant mortality, chronic diseases and lifeexpectancy at age of 60.

The US perform relatively well on 30- day in hospitalmortality after heart attack (stroke) and breast and colorectal cancer survivalrate. Forty-four percent of low-income people reported facing barriers toobtaining care, compared to 26% for those with higher incomes. In comparison,in the United Kingdom only 7% of low-income people and 4% of those with higherincomes reported that costs had prevented them from receiving care (Mirror,mirror 2017).Thedetailed analysis of the indicators of the US health care system gives less pejorativeview than in the Commonwealth Fund ranking. In addition, in the United States,far more than any other country studied, low-income people are much more likelyto be denied access to affordable care and to suffer and even die from it.According to the study US population as a whole in the last year: 33% hadproblems accessing medical care due to costs. 32% did not go to the dentist orunderwent a preventive examination due to costs.

27% were denied insurancebenefits for care or received less than expected. 20% had serious problemspaying or were unable to pay for medical care.  60% of physicians reported that patients oftenhad difficulty paying for medication or fees. 54% of physicians reported thatthe time spent on insurance claims was a major problem. 54% of physiciansreported that obtaining medication or necessary treatments for their patientswas a serious problem due to insurance restrictions (Mirror, mirror 2017).These problems are worse in the low-income population: 44% of this group had aproblem accessing medical care due to costs and 45% did not go to the dentistor underwent a preventative examination due to costs.

There is also a gap of24% between those above and those below the average income groups who skipped avisit to the dentist because of the high costs (Mirror, mirror 2017). Accordingto Sherry Glied and Stephanie Ma, in Commonwealth Fund reports February 2015, “InJanuary 2014, the Affordable Care Act extended access to health insurancecoverage to an estimated 30 million previously uninsured people. This issuebrief provides state-level estimates of the increased demand for physician andhospital services that is expected to result from expanded access and assessesthe sufficiency of the existing supply of providers to accommodate theanticipated increase in demand.

We project that primary care providers willsee, on average, 1.34 additional office visits per week, accounting for a 3.8percent increase in visits nationally. Hospital outpatient departments willsee, on average, 1.2 to 11.0 additional visits per week, or an average increaseof about 2.

6 percent nationally. Increases of the magnitude likely to begenerated by the Affordable Care Act will have modest effects on the demand forhealth services, and the existing supply of providers should be sufficient toaccommodate this increased demand.” Obamacare’s central goal was to shift thecosts of government and society to the working class, and to ration health caremore and more according to social class. The Commonwealth Fund’s findings onthe state of American health care, particularly mortality, are an indication ofthe preliminary results of this bipartite strategy.

The proposals were towithdrawn Medicaid and give private insurers even more leeway to increaseprofits by offering poor, high-priced coverages. This strategy is to reduceworkers’ life expectancy and get rid of a large number of elderly, sick anddisabled people.Ifthe United States was a politically healthy society, the release of this reportwould have sounded the alarm at the White House and Capitol Hill. Why in the”best country on earth” is the health of citizens in such adeplorable state? What can be done to remedy what can only be described as ahealth crisis? Instead, the publication of the study follows the unveiling ofthe latest version of the Republican Senate’s Better Care Reconciliation Act(BCRA), which proposes to cut $ 772 billion from the program. Medicaid for thepoor and the expansion of Medicaid’s Affordable Care Act. The CongressionalBudget Office estimated that an earlier version of the law would leave 22 millionmore people without insurance starting in 2026 than under current laws. TheAmericans mentality for accepting aid from the government it seen like reducingindividual freedoms and encouraging the poor to laziness seem to be the foundationfor what Americans don’t want to have an universal health care coverage.

       References:SherryGlied and Stephanie Ma. (2015). How Willthe Affordable Care Act Affect the Use of Health Care Services? TheCommonwealth Fund.

ArnavShah, Eric C. Schneider, Dana O. Sarnak, David Squires, and Michelle M. Doty.(2017).

Mirror, Mirror 2017: InternationalComparison Reflects Flaws and Opportunities for Better U.S. Health Care.TheCommonwealth Fund.Agencyfor Healthcare Research & Quality-http://www.ahrq.gov/topics-afforable-care-act.html.