Healthcare in America is provided by a number of different entities both profit and non-profit, publicly funded and private. 59.5% Americans receive their health care insurance through employers, which can be fatal if a medical crises mounts, and about 9% attain it privately while 27.3% are covered by the government.
Two of the most financially successful and largest health insurance organizations in the United States are WellPoint and the UnitedHealth Group.
Both are managed health care companies; the term “managed health care” is used for a variety of different health insurance programs which are “…intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases.
The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.”-1 Managed care was exclaimed by the US medical industry as a way to battle inflation but managed care has not been successful in defeating it. Nor has there been any change in the managed care program and surprisingly both of the two top companies are managed care.
The Unites State currently spends more, both in terms of GDP and per capita basis, than any other nation in the world. Current Estimates put US healthcare spending as the highest in the whole world. As of yet the American public seems quite happy with its country’s health care system, people regard it as “excellent” and “effective”.
Yet all may not be as well as it seems. The healthcare system has its own drawbacks and has been criticized and general public opinion may not necessarily reflect the current state of affairs that the United States Healthcare system is in. The government relies on private companies such as WellPoint and UnitedHealth Group to cover as much of the American public as it can.
WellPoint is coined as one of the top medical insurance company in the United States, and is an independent licensee of the Blue Cross Blue Shield Association.
Blue Cross is itself a non-profit organization but due to past failing financial status of Blue Cross California, WellPoint was established to handle the managed care programs. Since then WellPoint has risen to its peak.
UnitedHealth Group on the other hand had always been a private company. It was recently involved in an investigation into the conduct of its management and directors, which led to the resignation of its CEO. Apparently major stock holders have also filed lawsuits against UnitedHealth Care due to this investigation.
Both companies deal in managed care which ironically has not able to hold off the medical inflation for which it was made for, in fact it looks as if the program is used to make more profits, which is evident in the rise of WellPoint and UnitedHealth Group in the shares market, rather than curtail the rising medical expenses.
As mentioned before nearly 60% Americans receive their healthcare through employers who in turn go to private healthcare insurance companies. This can be the very reason of rising healthcare prices. If the healthcare system was single-player that is the United States Healthcare was in the hands of only the government the crises that could ensue, if private healthcare were to collapse, could have been eliminated completely without its ever starting.
Yet the expenditures would have been greater and so would have been the tax and due to being a public venture the healthcare doctors and facilities would have given poor performance and quality as is the fact in most government-run systems. In a way employer sponsored insurance and private healthcare companies have helped in the rise and coverage of healthcare greatly yet this sole dependence can become a serious downfall.
The government should have maintained its two tier health care system with both the government and the private companies running around hand in hand but private insurance was allowed to rise to the extent that it covers more than half of the population. Now though, it seems as if it is too late. The private health care industry is too much lodged into the healthcare system as it covers more than half of the insured public.
Both WellPoint and UnitedHealth Group have been so successful that they are now deeply entrenched in two government health care programs, Medicare and Medicaid.
Thus there seem to be no reason to convert to a single player health system as the private sector has already flourished and taken more into its grasp than the government will be able to handle if a single player system conversion were to take place. A nationalized, single-payer system would be difficult to implement, for one thing.
The bureaucracy and procedures alone would be dauntingly complex, especially when many of the systems are already in place in the private sector-2.Therefore the government has to keep on running on a two tier based system. But that in its own terms is filled with more problems like some of the population going around without any insurance at all.
To eradicate uninsured people a program named Medicare, as mentioned before, was developed by the government.
Yet Medicare faces continuing financial issues. In its 2006 annual report to Congress, the Medicare Board of Trustees reported that the program’s hospital insurance trust fund could run out of money by 2018. Such observations have been made in the past but this was the worst one yet. The fundamental problem is that the ratio of workers paying Medicare taxes to retirees drawing benefits is shrinking at the same time that the price of health care services per person is increasing.
1. National Library of Medicine. Wikipedia Contributors. Managed Care.
2. Jonathan R. Laing, “Good Prognosis For WellPoint, SMARTMONEY.com, May 7th 2007.
3. Luksik Actions “Health Care -Problems And Solutions”.