Healthcare Essay, Research Paper

The American Health Care system has prided itself on providing high quality services tothe citizens who normally cannot afford them. This system has been in place for years and untilnow it did a fairly decent job. The problem today is money; the cost of hospital services anddoctor fees are rising faster than ever before. The government has been trying to come up with anew plan these past few years even though there has been strong opposition against a new HealthCare system. There are many reasons why it should be changed and there are many reasons whyit shouldn t be changed. The main thing that both sides heads towards is money. Both sides wantto save money just in different ways. The movement for changing the Health Care system believe that there is a need for changebecause of the problems that the system faces today cannot be handled. Every month, 2 millionAmericans lose their insurance . One out of four, 63 million Americans, will lose their healthinsurance coverage for some period during the next two years . 37 million Americans have noinsurance and another 22 million have inadequate coverage . Losing or changing a job oftenmeans losing insurance. Becoming ill or living with a chronic medical condition can mean losinginsurance coverage or not being able to obtain it. Long-term care coverage is inadequate. Manyelderly and disabled Americans enter nursing homes and other institutions when they would preferto remain at home. Families exhaust their savings trying to provide for disabled relatives. ManyAmericans in inner cities and rural areas do not have access to quality care, due to poordistribution of doctors, nurses, hospitals, clinics and support services. Public health services arenot well integrated and coordinated with the personal care delivery system. Many serious healthproblems — such as lead poisoning and drug-resistant tuberculosis — are handled inefficiently ornot at all, and thus potentially threaten the health of the entire population. Rising health costsmean lower wages, higher prices for goods and services, and higher taxes. The average workertoday would be earning at least $1,000 more a year if health insurance costs had not risen fasterthan 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 2000ii . More and more Americanshave had to give up insurance altogether because the premiums have become prohibitivelyexpensive. Many small firms either cannot afford insurance at all in the current system, or havehad 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 theinsurance agencies. Quality care means promoting good health. Yet, the agencies waits untilpeople are sick before they starts to work. The agencies are biased towards specialty care andgives inadequate attention to cost-effective primary and preventive care. Consumers cannotcompare 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 aremost cost-effective. Health care treatment patterns vary widely without detectable effects onhealth 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 averagedoctor’s office spends 80 hours a month pushing paper. Nurses often have to fill out as many as19 forms to account for one person’s hospital stay. This is time that could be better spent caringfor patients. Insurance company red tape has created a nightmare for providers, with mountains offorms and numerous levels of review that wastes money and does nothing to improve the qualityof care. America has the best doctors who can provide the most advanced treatments in theworld. Yet people often can’t get treated when they need care. The medical malpractice systemdoes little to promote quality. Fear of litigation forces providers to practice defensive medicine,ordering inappropriate tests and procedures to protect against lawsuits. Truly negligent providersoften are not disciplined, and many victims of real malpractice are not compensated for theirinjuries.Purchasing insurance can be overwhelming for consumers. With different levels ofbenefits, co-payments, deductibles and a variety of limitations, trying to compare policies isconfusing and objective information on quality and service is hard for consumers to find. As aresult, consumers are vulnerable to unfair and abusive practices. Insurers have responded torising health costs by imposing restriction on what doctors and hospitals do. A system that wascomplicated to begin with has become incomprehensible, even to experts. Each health insuranceplan includes different exclusions and limitations. Even the terms used in health policies do nothave 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 thanfive 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 careadministrators increasing four times faster than the number of doctors. Health claim forms andthe related paperwork are confusing for consumers, and time-consuming to fill out. Insurancecoverage for most Americans is not a matter of choice at all. In most cases, they are limited towhatever policy their employer offers. Only 29% of companies with fewer than 500 employeesoffer any choice of plans . With a growing number of insurers using exclusions for pre-existingconditions, arbitrary cancellations and hidden benefit limitations, consumers have few choices foraffordable policies that provide real protection. The movement for Health Care reform has created a plan to cover every American. Theplan is called the Health Security plan. The Health Security plan guarantees comprehensive healthbenefits for all American citizens and legal residents, regardless of health or employment status. Health coverage is seamless; it continues with no lifetime limits and without interruption ifAmericans lose or change jobs, move from one area of the country to another, become ill orconfront a family crisis. Every American citizen will receive a Health Security Card thatguarantees comprehensive benefits that can never be taken away. Fundamental principles underliehealth care reform, the guarantee of comprehensive benefits for all Americans, effective steps tocontrol rising health care costs for consumers, business and the nation, improvements in thequality of health care, increased choice for consumers, reductions in paperwork and a simplifiedsystem, 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 acomprehensive benefit. The Health Security plan creates incentives for health care providers tocompete on the basis of quality, service and price. It unleashes the power of the market and putsAmerican consumers in the driver’s seat. Consumers choose from whom and how they get theircare. The plan empowers each state to set up one or more “health alliances” that contract withhealth plans and bargain on behalf of area consumers and employers. Health plans must meetnational standards for coverage, quality, and service set by the National Health Board. But eachstate tailors its approach to local needs and conditions. The Health Security plan frees the healthcare system of much of the paperwork and regulation, allowing doctors, nurses, hospitals andother 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 andimposes the first national standards for the protection of patient privacy and confidentiality inmedical information and records. This plan that has been developed by this movement is under serious scrutiny by thepeople that don t want to see a change, mainly Republicans. Their main argument is that byallowing 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 marketchoices. A review of nine states’ reforms reveals a host of negative consequences: insurancepremiums increase; access to medical care is not improved; jobs are lost; spending on Medicaidgoes 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 federalgovernment health control. The Republican plan allows workers to keep their health insurance ifthey 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 theself-employed and small businesses with 50 or fewer employees to open tax-free Medical SavingsAccounts to pay for routine medical expenses. In the year 2000, MSAs will be made available tobusinesses with more than 50 workers unless Congress prevents the expansion . Allows taxdeductions for long-term health care, including nursing-home and home-health care. Fights fraudand abuse in the health care system and reduces burdensome paperwork.. The Republican national health plan that would be funded by the federal government andadministered by the federal government . The plan would fully cover everyone via acomprehensive public insurance pool, paid for by taxes from individuals and businesses. The planhas provisions to limit over-treatment and insufficient care, designed to both protect patientinterests as well as contain costs. Costs would also be controlled by cutting the currentadministrative overload and through health care planning. The plan would not result in an increasein total health expenditures. The people who are now uninsured will be insured with fundsderiving from massive savings that will occur from the elimination of the inherent waste in thecurrent system. With more than 1500 insurance companies and virtually countless payment plansand policies, our administrative costs have exploded. A single payer system has a much morebasic payment scheme. Doctors would spend less time on paperwork, and potentially more timewith patients. Clinics and hospitals would need fewer staff members, and would require lesscostly, redundant equipment. The details of the Republican plan are as followed. All essential care would beincorporated into the plan, including: mental health, acute care, ambulatory care, long term careand home health care, prescription drugs and medical supplies, rehabilitation services,occupational therapy, and preventive medicine. Exclusions would be made for unnecessary andineffective procedures. These exclusions would be determined by expert panels, most probablymade 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. Thecard can then be used to gain access to any fee-for-service practitioner, hospital or clinic. HMOmembers can receive non-emergency care through the HMO. As mentioned before, to implementthe national health program, health care costs do not need to increase. It would however producea major shift in payment toward government and away from private insurers and out-of-pocketpayments. Individuals and businesses would pay the same amount for health care, on average, butthe payments would be in the form of taxes. The taxes contributing to the plan can be found forbusinesses, for instance, by adding up the amount spent currently by business for health care. Thiswould approximately add up to a 9% tax increase for midsize and large employers . Hospitalsand clinics would receive a global sum on a yearly basis, in addition to allowances for newtechnology. Funds would be distributed to physicians and other health care workers in one ofthree ways: through fee-for-service arrangements with a simplified billing schedule, throughcapitation, paying health care providers on the basis of how many patients they serve, or throughglobal 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 bythe federal government. Both make valid points as to why they are the way to go, but my stanceafter careful thought is one of compromise. Let the federal government standardize health carewhile the state governments fund it on a state to state level. With a national standard to followprices would be forced to keep the same through out America. Procedures for problems wouldnot be questioned. Finally there will be less paperwork.. Making the state governments fund their own health care system at first glance seems tobe cost inefficient. At another look and a explanation I can dispute that. With the government intotal control it had one big pile of money it had to divide to all the states and no real way todetermine how to divide it. With the individual states involved in funding health care, they knowthe size of their population, who needs care in their population and can do a more efficient job ona smaller scale. Also by letting the governments on the state level run everything the problem ofthe government giving to little to states that need funding and to much to states that don t need itwill not occur. Unfortunately due to the way the government handles major changes health care reformwill most likely be debated for another ten years. The way the debate is moving it seems to beheading towards the state controlled health care, but there doesn t appear to be enough powerbehind the movement to get it approved. The dream of universal coverage s it a dream or is it anear future for all Americans, only with patience by the people will they find out.