American Health Care Essay, Research Paper
The American Health Care system has prided itself on providing high
quality services to the citizens who normally cannot afford them. This
system has been in place for years and until now it did a fairly decent
job. The problem today is money; the cost of hospital services and
doctor fees are rising faster than ever before. The government has
been trying to come up with a new plan these past few years even though
there has been strong opposition against a new Health Care system.
There are many reasons why it should be changed and there are many
reasons why it shouldn’t be changed. The main thing that both sides
heads towards is money. Both sides want to save money just in
different ways.
The movement for changing the Health Care system believes that there
is a need for change because of the problems that the system faces
today cannot be handled. Every month, 2 million Americans lose their
insurance. One out of four, 63 million Americans, will lose their
health insurance coverage for some period during the next two years .
37 million Americans have no insurance and another 22 million have
inadequate coverage . Losing or changing a job often means losing
insurance. Becoming ill or living with a chronic medical condition can
mean losing insurance coverage or not being able to obtain it. Long-
term care coverage is inadequate. Many elderly and disabled Americans
enter nursing homes and other institutions when they would prefer to
remain at home. Families exhaust their savings trying to provide for
disabled relatives. Many Americans in inner cities and rural areas do
not have access to quality care, due to poor distribution of doctors,
nurses, hospitals, clinics and support services. Public health
services are not well integrated and coordinated with the personal care
delivery system. Many serious health problems — such as lead
poisoning and drug-resistant tuberculosis — are handled inefficiently
or not at all, and thus potentially threaten the health of the entire
population. Rising health costs mean lower wages, higher prices for
goods and services, and higher taxes. The average worker today would
be earning at least $1,000 more a year if health insurance costs had
not risen faster than wages over the previous 15 years . If the cost
of health care continues at the current pace, wages will be held down
by an additional $650 by the year 2000. More and more Americans have
had to give up insurance altogether because the premiums have become
prohibitively expensive. Many small firms either cannot afford
insurance at all in the current system, or have had to cut benefits or
profits in order to provide insurance to their employees. Those
problems are just with the system, the main part of the problem comes
from the insurance agencies. Quality care means promoting good health.
Yet, the agencies waits until people are sick before they starts to
work. The agencies are biased towards specialty care and gives
inadequate attentions to cost-effective primary and preventive care.
Consumers cannot compare doctors and hospitals because reliable quality
information is not available to them. Health care providers often
don’t have enough information on which treatments work best and are
most cost-effective. Health care treatment patterns vary widely
without detectable effects on health status. Some insurers now compete
to insure the healthy and avoid the sick by determining “insurability
profiles” while they should compete on quality, value, and service.
The average doctor’s office spends 80 hours a month pushing paper.
Nurses often have to fill out as many as 19 forms to account for one
person’s hospital stay. This is time that could be better spent caring
for patients. Insurance company red tape has created a nightmare for
providers, with mountains of forms and numerous levels of review that
wastes money and does nothing to improve the quality of care. America
has the best doctors who can provide the most advanced treatments in
the world. Yet people often can’t get treated when they need care. The
medical malpractice system does little to promote quality. Fear of
litigation forces providers to practice defensive medicine, ordering
inappropriate tests and procedures to protect against lawsuits. Truly
negligent providers often are not disciplined, and many victims of real
malpractice are not compensated for their injuries. Purchasing
insurance can be overwhelming for consumers. With different levels of
benefits, co-payments, deductibles and a variety of limitations, trying
to compare policies is confusing and objective information on quality
and service is hard for consumers to find. As a result, consumers are
vulnerable to unfair and abusive practices. Insurers have responded to
rising health costs by imposing restriction on what doctors and
hospitals do. A system that was complicated to begin with has become
incomprehensible, even to experts. Each health insurance plan includes
different exclusions and limitations. Even the terms used in health
policies do not have standard definitions. Small business owners, who
cannot afford big benefits departments, have to spend time and money
working through the insurance maze. For firms with fewer than five
workers, 40 percent of health care premiums go to pay administrative
expenses. Administrative costs add to the cost of each hospital stay
with the number of health care administrators increasing four times
faster than the number of doctors. Health claim forms and the related
paperwork are confusing for consumers, and time-consuming to fill out.
Insurance coverage for most Americans is not a matter of choice at all.
In most cases, they are limited to whatever policy their employer
offers. Only 29% of companies with fewer than 500 employees offer any
choice of plans. With a growing number of insurers using exclusions
for pre-existing conditions, arbitrary cancellations and hidden benefit
limitations, consumers have few choices for affordable policies that
provide real protection.
The movement for Health Care reform has created a plan to cover every
American. The plan is called the Health Security plan. The Health
Security plan guarantees comprehensive health benefits for all American
citizens and legal residents, regardless of health or mployment status.
Health coverage is seamless; it continues with no lifetime limits and
without interruption if Americans lose or change jobs, move from one
area of the country to another, become ill or confront a family crisis.
Every American citizen will receive a Health Security Card that
guarantees comprehensive benefits that can never be taken away.
Fundamental principles underlie health care reform, the guarantee of
comprehensive benefits for all Americans, effective steps to
control rising health care costs for consumers, business and the nation,
improvements in the quality of health care, increased choice for
consumers, reductions in paperwork and a simplified system, making
everyone responsible for health care. Americans and their employers
are asked to take responsibility for their health coverage and, in
return, they are guaranteed the security that they will always be
covered under a comprehensive benefit. The Health Security plan
creates incentives for health care providers to compete on the basis of
quality, service and price. It unleashes the power of the market and
puts American consumers in the driver’s seat. Consumers choose from
whom and how they get their care.
The plan empowers each state to set up one or more “health alliances”
that contract with health plans and bargain on behalf of area consumers
and employers. Health plans must meet national standards for coverage,
quality, and service set by the National Health Board. But each state
tailors its approach to local needs and conditions. The Health
Security plan frees the health care system of much of the paperwork and
regulation, allowing doctors, nurses, hospitals and other health
providers to focus on providing high-quality care. It cracks down on
abuse, reforms malpractice law and policy and outlaws insurance
practices that hurt small businesses and imposes the first national
standards for the protection of patient privacy and confidentiality in
medical information and records.
This plan that has been developed by this movement is under serious
scrutiny by the people that don’t want to see a change, mainly
Republicans. Their main argument is that by allowing the states to run
health care insurance agencies will run out of control.. Unfortunately,
reforms have generally relied on increasing government control rather
than expanding market choices. A review of nine states’ reforms
reveals a host of negative consequences: insurance premiums increase;
access to medical care is not improved; jobs are lost; spending on
Medicaid
goes up; insurance companies leave the market; and medical care is
explicitly rationed. The Republicans are completely against state run
health care and are fighting for federal
government health control. The Republican plan allows workers to keep
their health insurance if they leave or lose their job, even if a
worker has a pre- existing condition. Allows the self-
employed to deduct from their taxes 80 percent of their health
insurance premiums . Allows the self-employed and small businesses
with 50 or fewer employees to open tax-free Medical Savings
Accounts to pay for routine medical expenses. In the year 2000, MSAs
will be made available to businesses with more than 50 workers unless
Congress prevents the expansion . Allows tax deductions for long-term
health care, including nursing-home and home-health care. Fights fraud
and abuse in the health care system and reduces burdensome paperwork..
The Republican national health plan that would be funded by the
federal government and administered by the federal government. The plan
would fully cover everyone via a comprehensive public insurance pool,
paid for by taxes from individuals and businesses. The plan has
provisions to limit over-treatment and insufficient care, designed to
both protect patient interests as well as contain costs. Costs would
also be controlled by cutting the current administrative overload and
through health care planning. The plan would not result in an increase
in total health expenditures. The people who are now uninsured will be
insured with funds deriving from massive savings that will occur from
the elimination of the inherent waste in the current system. With more
than 1500 insurance companies and virtually countless payment plans and
policies, our administrative costs have exploded. A single payer system
has a much more basic payment scheme. Doctors would spend less time on
paperwork, and potentially more time with patients. Clinics and
hospitals would need fewer staff members, and would require less costly,
redundant equipment.
The details of the Republican plan are as followed. All essential
care would be incorporated into the plan, including: mental health,
acute care, ambulatory care, long term care and home health care,
prescription drugs and medical supplies, rehabilitation services,
occupational therapy, and preventive medicine. Exclusions would be made
for unnecessary and ineffective procedures. These exclusions would be
determined by expert panels, most probably made of doctors, nurses,
other health care workers, and health planners. Everyone in the U.S.
would receive a national health care plan card, with necessary
identification encoded on it. The card can then be used to gain access
to any fee-for-service practitioner, hospital or clinic. HMO members
can receive non-emergency care through the HMO. As mentioned before, to
implement the national health program, health care costs do not need to
increase. It would however produce a major shift in payment toward
government and away from private insurers and out-of-pocket payments.
Individuals and businesses would pay the same amount for health care,
on average, but the payments would be in the form of taxes. The taxes
contributing to the plan can be found for businesses, for instance, by
adding up the amount spent currently by business for health care. This
would approximately add up to a 9% tax increase for midsize and large
employers . Hospitals and clinics would receive a global sum on a
yearly basis, in addition to allowances for new technology. Funds
would be distributed to physicians and other health care workers in one
of three ways: through fee-for-service arrangements with a simplified
billing schedule, through capitation, paying health care providers on
the basis of how many patients they serve, or through global budgets
established for hospitals and clinics employing salaried health care
professionals.
The debate stands now between letting the states run health care or
continuing control by the federal government. Both make valid points
as to why they are the way to go, but my stance after careful thought
is one of compromise. Let the federal government standardize health
care
while the state governments fund it on a state to state level. With a
national standard to follow prices would be forced to keep the same
through out America. Procedures for problems would not be questioned.
Finally there will be less paperwork. Making the state governments
fund their own health care system at first lance seems to be cost
inefficient. At another look and a explanation I can dispute that.
With the government in total control it had one big pile of money it
had to divide to all the states and no real way to determine how to
divide it. With the individual states involved in funding health care,
they know the size of their population, who needs care in their
population and can do a more efficient job on a smaller scale. Also by
letting the governments on the state level run everything the problem
of the government giving to little to states that need funding and to
much to states that don’t need it
will not occur.
Unfortunately due to the way the government handles major changes
health care reform will most likely be debated for another ten years.
The way the debate is moving it seems to be heading towards the state
controlled health care, but there doesn’t appear to be enough power
behind the movement to get it approved. The dream of universal
coverage s it a dream or is it a near future for all Americans, only
with patience by the people will they find out.