Health Care Ethics Essay, Research Paper
Improving Access to Health Care for the Uninsured
For decades, the American system of health care has relied primarily on employer-sponsored insurance programs as a gateway through which individual s access health care services. Gaps have been filled in through public insurance programs such as Medicare, Medicaid, the State Children s Health Insurance Program (SCHIP) and other more locally-based programs to cover elderly, disabled and certain low income populations who cannot access the employer-based market. In addition, the government (federal, state and local) provides certain limited subsidies (e.g., tax deductions for the self-employed) for individuals to purchase insurance policies in the private market on their own.
While this system has worked effectively for many Americans, it has left behind a significant number approximately 42 million who lack any form of health insurance coverage. For these individuals, the country has developed an institutional health care safety net to ensure that they nevertheless receive access to needed care. This institutional safety net is comprised of the many hospitals, clinics and individual providers who serve all who seek their care without regard to ability to pay. Most of these providers receive some support for the uncompensated care they provide through various public programs (on the federal, state and local levels).
America has long relied on this two-tiered approach to addressing the problem of the uninsured: expanding access to insurance coverage while providing financial support to safety net providers serving the uninsured. Some policymakers prefer to emphasize coverage over institutional support for providers, others might tip the balance in the other direction. But the two strategies are inexorably linked: if we do not expand insurance coverage we will need a strong system of safety net providers to serve the higher number of uninsured; conversely, if we do not adequately support safety net providers we will need to ensure that individuals can get care on the private market meaning they will need coverage.
NAPH supports strong public policy in both arenas. We believe that all individuals should have access to health insurance coverage. Universal coverage is and should be the ultimate goal of health policy in this area. However, even under a system of universal coverage there will always be individuals who, for whatever reasons, fall through the cracks and remain uninsured. For these people, it is imperative that a strong and viable system of safety net providers be available to ensure that care is provided even for those without the means to pay.
For America as it enters the twenty-first century, these realities mean that we should be expanding coverage even if incrementally however and wherever we can. And we should be providing financial and other support for our safety net providers so that they may continue to meet the needs of the uninsured. Expansion of coverage and preservation of the safety net these are the dual goals of NAPH policy on the uninsured.