U.S. Health Care System

The U. S. spends more money on health care than any other country in the world, yet most Americans do no receive adequate health care. Many factors have contributed to this problem.

One major factor is cost. The price of health care has risen tremendously in the previous years and is expected to continue to rise in the years to come. Some reasons for the high cost of health care are technology, administrative costs, unnecessary care, and patient complexity. Technology plays an important role in the increasing health care costs, because it gets more and more expensive as new drugs, procedures and equipment are created.

Administrative costs, which include paying physicians, hospital bills, enrollment, marketing, and determining eligibility, also add up to a large sum of money. According to Peter Conrad’s The Social Organization of Medical Care, cost administrative costs accounted for about 25% of the $738 billion health care expenditure in 1990, and the estimated savings in administrative costs for some proposed health care reforms is $31 billion to $67 billion. Although it is difficult to define which procedures are necessary and which are not, unnecessary procedures add to the cost of health care.

These procedures take away from the money needed to perform life-saving and emergency procedures. Also, it seems as though and more patients are seeking treatment with serious, life threatening conditions. Although not a major contributor to the cost of health care, complex surgeries and treatments begin to add up. In 1965, Lyndon B. Johnson created Medicare and Medicare to help benefit people who could not afford health insurance. Medicare, created to aid the elderly, and Medicaid, created to aid the poor, both help in a few ways, but in reality neither one covers enough to really benefit these people.

Medicare, which covers all adults age 65 and older, takes care of hospital costs, skilled nursing facilities, hospice and a few others. Unfortunately, many elderly people need prescription medication, orthopedic shoes, eye exams, dental work, and hearing aids, which Medicare does not cover. Medicare was created mainly for those with acute illnesses; therefore, those people who require long-term care, such as a nursing home, cannot afford the proper care.

The program does offer a supplemental plan in addition to the basic care it provides, but even though people may receive more care from the plan, it increasing yearly and it only pays for 80% of reasonable cost, which may not be enough for some of the older or poorer people. Medicaid covers under-privileged people. It allows those below and slightly above the poverty line to have access to the health insurance that they cannot afford. One immediate downside of Medicaid is for those who cannot afford their own health insurance, but make too much money to qualify for Medicaid.

Those people usually end up falling through the cracks, because they end up with no health insurance at all. Like Medicare, Medicaid only covers a limited amount of services, leaving off some potentially crucial procedures and treatments. Both the federal and state governments pay for Medicaid, which also causes problems. The state decides which people receive Medicaid, and which people don’t, so when the state cannot afford Medicaid, it lowers the line and people are turned away. Unlike Medicare, Medicaid covers long term care, but it is extremely expensive.

It also covers prescription, which Medicare doesn’t. Many doctors refuse to treat people with Medicaid because of the hassles they have to deal with when trying to get paid for their services, and when they finally get their payment, it is usually less than they expected. Some doctors work pro-bono, because they would rather do work for free than deal with Medicaid. There have been quite a few attempts to reform the health care system both comprehensively and incrementally. Early in the Clinton administration, Hilary Clinton propped idea to totally reform the health care system for the entire country.

Initially it failed, because the public did not want the government to get involved, but soon the public changed its mind. They went back to the government for help, and laws began to get passes. Slowly change began to happen. Each problem was dealt with separately. Many people believe that dealing with each problem separately won’t work, but some states have already improved the state of their health care system. Hawaii, for example, passed a health care pact in 1974 that was based on employment. As long as people work 20 hours per week, they are entitled to health insurance.

They receive a basic package and the employer pays most, if not all, of the premium. In 1984 the plan was extended to part-time workers, seasonal workers, and the unemployed. When a company did no spend all the money allocated for health insurance, they were required to put the extra toward the insurance of the unemployed. When the program was first implemented, some business went out of business, but after a few years, everyone was settled into the program. Hawaii had since kept the program and in the late 1990’s only 2% of the population was without health care coverage.

Another state to take health care into their own hands was Oregon. In 1989, the Oregon Plan was proposed, and in 1993 it was passed. The goal of this plan was to increase the number of people of Medicaid recipients. An employer mandate was made, which said that anyone who worked a certain amount of hours per week were entitled to health insurance paid for their employer. They also went out into the public and surveyed the people for three years on what they thought was the most important procedures and treatments.

After compiling all the information, a list was created ranking the most important to the least important. Medicaid would cover as much as it could starting with the top of the list. After this plan was installed, over 100,000 people were added to Medicaid. Other states have also come up with their own plans, and Congress has encouraged other states to be creative in coming up with ways to deal with the health care crisis. Having one of the worst health care systems in the world, the United States constantly looks to other countries for ideas.

Canada is always looked at because of the similarities to the U. S. , and it’s very successful health care plan. The federal government grants the provinces 40% of the cost s of medical care. The provinces receive the grant as long as their health insurance covers all citizens, covers all conventional hospital and medical care, is accessible, is recognized and accepted by all other provinces, and is controlled by a public non-profit organization. Annual meetings between the federal government and the provincial governments are held to determine budgets and the allocation of money.

Under Canada’s health insurance program everyone gets covered and everyone shares the same risks and costs. This policy is not job related. People can go to the doctor of their choice, but must see a primary care physician in order to be referred to a specialist. Although Canada’s health care program is exemplary, it has a few problems that often arise. Even with an appointment, someone may be put on a waiting list and wait for hour before being seen by a doctor. There is also a very high income tax, which is the price the Canadians pay for such an excellent system.

I think that the best way to change the problem with health care in the United States is thorough incremental, state-by state change. Each state should for a Health Care Reform Committee whose only goal is to get health care to all those who cannot afford it. One way of doing this would be for the state to conduct a survey. Like the census, this survey must get to every person in the state. In the survey, people would answer questions about their current financial status, their financial history, whether they have insurance or not, what kind of insurance the have etc.

From the data collected, the Health Care Reform Committee would examine would meet and discuss the problems and patterns they see from the survey results. The committees must then come up with different ideas for health care reform that meets to needs of their state. Different states have different needs, so each state’s committee must come up with a plan that works best for them. After discussing and creating ideas, the committee should implement the plan in which they have decided on.

If it looks like the plan is working, they should stick with it, but if not, the committee will have to go back to the drawing board and come up with a better idea. Like any health care proposal, this idea had its downsides. One major one is the time that will be needed for this process to occur. There would not be any visible changes for quite a few years. Also, once the plan had been tried, it may not have a positive effect and all the past years spent working on it would have been a waste. Another problem is that like the census, it is not definite that every person living in the states will be surveyed.

The committee will have people doing door-to-door and seeking people out, but there is always a chance that people can get overlooked. The United States health care system is in a horrible state that is only getting worse as time goes by. The current plans are semi-helpful, but still do not cover nearly as many people and problems that the country has. The United States needs to follow in the footsteps of our neighboring countries or the states that have taken upon them selves to make change. Whether it is a national change or small state changes, our country needs to do something to better the health care system…