Americans nowadays face a serious problem when it comes to health care. As the country develops, population increases and ages, and our state population grows, health care also becomes expensive. A positive future American economy signifies good quality jobs with superior benefits and financial access to the finest and most advanced health care. The key elements to have a sound economic system and achieve prosperity, a long and healthy life ought to be possible for all Americans. What is more, this aspiration is within reach if Americans can enjoy an affordable health care.
This possibility to have an affordable health care must consider two things, first, people must have a clear understanding of what an affordable healthcare coverage is, and people must require proper financial accountability from the federal government. Health care reform has been at the center of health care debates and arguments for a number of years. The three vital factors when it comes to examining and assessing health care system are cost control, access to care, and health care quality.
Despite the fact that managed care has been able to control costs for most people, now it is apparent, at least in terms of the premiums that those costs were very low and are on the rise. Many people are becoming uninsured and access to quality care is harder to obtain. Quality of care has always been a worry for patients, and consistent with the records of thousands of medical errors, quality concerns are hard to resolve. There are debates regarding Medicare drug benefits, unionization of doctors, and medical errors.
These issues need solution and the best way is to consider having a universal health care and having national health insurance. Health care costs in the United States are escalating uncontrollably. Approximately, each person spends more on health care than on housing and food. What is more, premiums on insurances are increasing much faster than prices of commodities, which delay economic development since businesses opt not to hire more workforces. Even though the availability and quality of health care in the U. S. ontinues to be among the best medical care worldwide, it would be better to have a universal government-controlled health care system.
Relative to this aim, this paper intends to propose a health care coverage plan, the administrative processes, and strategies for public health organizations and other array of inter-organizational structures and institutions involved in the process. Health Care in United States In most developed countries, there is universal health care for all. Heath coverage is definite from birth of a person until his death.
Patients receive health care in accordance with their needs, not with their paying capacity. They receive “free” treatments or they need not shell out money, from simple immunizations to critical operations. Every person has the right to enjoy whatever care is necessary since the government is shouldering the costs. Not known to everybody, the United States, even though considered as one of the most developed country in the world, has no governmental program concerning guarantee of financial access to health care services to its populace (Starfield, 1998).
Compared to other industrialized nations, US ranks poorly in health care in spite of having the best-trained health care providers and having the best medical infrastructure and advance medical technology of any industrialized nation. One of the necessities nowadays is insurance. Insurances, particularly health insurances, greatly lessen the burden in times of contingencies or unforeseen events such as death, disablement, or sickness. A health insurance refers to insurance intended to compensate the costs associated with health care.
Specifically, health insurance plans pay the bills from hospitals, physicians, and other providers of medical services. Through this action, health insurance safeguards people from financial adversity attributable to considerable or unanticipated medical bills. People may get hold of health insurance either from private organizations or from government agencies. Unfortunately, in the US, there is no government-funded national health insurance system or Universal Health Care for every American.
At present in the United States. those privileged to have financial access to health care do not have the assurance that they will get good quality care. One type of health care or also known as managed care is a prevalent practice in the U. S. This kind of practice has promoted the selection of a doctor, yet, these physicians do not give assurance of a first-rate primary care or services. Some managed care seeks only profits, thus, neglecting their true mission, which is to provide quality care (Starfield, 1994). These physicians have the option to lessen the services or care that they can offer instead of increasing or delivering quality services.
Next, the necessity to ensure there will be a long-term relationship between a client and his doctors is far from possibility because of aggressive managed care. In managed care, the employers have the option to change the contracts of their employees annually, thus, changing the selected primary care physicians as well (Starfield, 1994). According to studies, in order to build a strong and mutual relationship between a doctor and his client, they must see each other for two to five years (Starfield, 1994).
In addition, the aim of offering quality services is not achievable since managed care organizations frequently leave out or exclude particular services. Furthermore, managed care organizations do not give guarantee that they are finding ways to improve organization or management of services. The United States spends more on health care than any other country in the world. However, millions of Americans still do not enjoy free health care for the reason that they do not have insurance coverage.
Unlike most industrialized countries, United States does not have a national health insurance system that answers for all the medical expenses. U. S. government realized the need to provide a medical care for everyone. In fact, the United States Congress set up and expanded health-related programs designed to offer medical access to everyone. On successful example would be the Medicare. This health program covered approximately 38 million people over age 65 and disabled people in 1997. One more effective health program was the Medicaid.
The Medicaid is a federal-state program that is available to low-income people. Relative to these programs, Congress also took into consideration establishing a national health insurance system or broaden government health care assistance to more people. Unfortunately, this health program did not push through for the reason that it entails a lot of money. Public Health and Public Health Organizations Public Health stands for the protection and development of the health of the whole populations by means of community-wide measures or actions, mainly by governmental agencies.
The objectives of public health are to stop the spread of human diseases, prevent damage, and disability; safeguard people from environmental health perils; encourage behaviors that bring about good physical and mental health; inform the community on the subject of health; and guarantee accessibility of high-quality health services. The present public health organization is in numerous ways a product of its distinctive historical improvement and its position within the existing economic, political, and technological environment.
Public health organizations are also outcomes of the current philosophical and ethical beliefs that stimulate contemporary public health initiatives. Public health practice includes organized efforts to make the health of communities better. The targets of the public health prevention strategies are the populations rather than the individuals. All through history, public health effort embraced the goals of controlling transmissible diseases, reducing of environmental dangers or hazards, and safeguarding the food supply.
The historic importance on safeguarding communities from transmittable disease and environmental hazards or threats is now getting bigger to counter risks from behaviors and lifestyles that bring about chronic disease. On an international scale, the World Health Organization (WHO) coordinates public health. WHO coordinates worldwide disease prevention and control measures or efforts, and is involved in teaching medical personnel, educating, or informing world populations on the subject of public health issues such as widespread diseases, population control, nutrition, and the advantages of environmental sanitation.
United Nations membership dues and contributions, as well as voluntary donations from public and private sources fund WHO and all of its programs. In the U. S. , the Department of Health and Human Services (HHS) supervises public health and safety all over the nation. American citizens fund it by means of taxes. The Public Health Service, a part of HHS, is the major federal agency concerned with public health. The Public Health Service consists of numerous individual agencies that concentrate in various aspects of public health.
The National Institutes of Health, the medical research arm of the Public Health Service, carries out biomedical research and keeps 25 institutes and centers of health and the National Library of Medicine. The center that examines and put a stop to epidemic of diseases, keeps up national health statistics, and oversees several of the public immunization programs in the U. S. refers to the Centers for Disease Control and Prevention (CDC).
Meanwhile, the agency that ensures the safety of food, cosmetics, pharmaceuticals, and medical devices by way of legislation and licensing programs refers to the Food and Drug Administration (FDA). Every state in the U. S. has its own department of health and nearly all local communities have a city or county health department. State and regional public health departments operate with national agencies to oversee public health programs or projects. Other government agencies, particularly environmental protection departments, might as well have some responsibilities for public health.
Scores of private or voluntary health organizations play a part to overall community health by means of enlightening the public on the subject of good health practices and prevention of cancer, heart disease, and other conditions. In 1798, Public Health Service, an agency of the U. S. Department of Health and Human Services, came into being under the conditions of congressional legislation consenting to marine hospitals for seamen in the merchant marine. Successive legislation greatly increased the extent of the agency’s activities.
These days, it is the principal health agency of the federal government. The Public Health Service has the main task of promoting or encouraging the highest level of health achievable for every American and working together with foreign governments in health projects or agendas. It imparts financial assistance or aid for the improvement and delivery of community or local health services, for research in medical sciences, and for education in the health professions. Among its other tasks are defending the population against hazardous food and drugs and preventing or managing transmissible diseases.
The service, governed by an assistant secretary for health, consists of the following most important units: Alcohol, Drug Abuse, and Mental Health Administration; Agency for Toxic Substances and Disease Registry; Centers for Disease Control; Food and Drug Administration; Indian Health Service; Health Resources and Services Administration; and the National Institutes of Health. Universal Health Coverage Proposal Since there is a need to have a Universal Health Insurance, President Bill Clinton, proposed an important revamp of the U. S. health care system in 1993.
He wanted to have a system that would offer universal health insurance. The health care revamp commenced with a federal free vaccine program wherein the people need not pay for the vaccine. This healthful move mirrored some of the concerns that motivated the health care proposal. In the meantime, AIDS and tuberculosis are persistently spreading. In addition, a new transmittable disease transpired that, though often serious, did not endanger to match the public health challenge presented by tuberculosis and AIDS, since it does not spread from person to person.
Furthermore, serious outbreaks of diseases that led to deaths happened brought about by ordinary tap water and chain restaurant foods, particularly, hamburgers. In view of this, the U. S. Food and Drug Administration permitted drugs during the year that guaranteed to aid people with two immobilizing illnesses, particularly, multiple sclerosis and Alzheimer’s disease. In October 1993, President Clinton passed to Congress a bill intended to assure wide-ranging health insurance coverage for all Americans and to regulate runaway medical costs.
President Clinton must propose a Universal Health Coverage. The health care proposal would be a federally operated and supervised system. Whatever the case may be, Congress would significantly amend the final measure of the universal health care system. Administrative Processes and Strategies The supervision and implementation of public health in the U. S. take in an extensive and evolving range of activities (Mays, 2000).
A comprehensive array of institutions and organization structures provide for the delivery and administration of public health services in the health system of the U. S. Even if the primary objective of the Universal Health Care System is for the common good of all Americans, the set of organizations related to public health administration is multifaceted and unstable. According to Mays (2000), the organization of the public health delivery system is comprised of governmental health agencies and nongovernmental organizations as well. These organizations take important parts in delivering public health at regional, state, national, and international levels.
What makes the delivery system more complicated is the variety of public health activities among communities, regions, and nations. In the U. S. , two government agencies, the Congressional Budget Office and the General Accounting Office (GAO), carried out far-reaching studies on the cost of giving health care to every one. Both agencies brought to a close that the conversion of the present patchwork of public and private health insurance programs into a universal health care system would put aside $100 billion savings on paperwork alone.
In fact, there would be extra savings conditional on how the plan is organized. The GAO came into a conclusion that the savings produced by switching to a national health system would likely give comprehensive health care for all Americans. Not known to all, paperwork or having to abide by with the requisites of a large number of insurance companies for documentation, determination of eligibility, billing of patients, and subsequent payments or collections, comprise roughly one-fourth of health care expense in the United States.
Because of the present complex payment system in some hospitals, trying to reorganize who will pay for the medical care of a patient calls for large number of administrative staffs to take care of the dealings and processes of a variety of insurers. In addition, what makes the matter more complicated is that the current system presents an inadequate, high-priced, and inefficient form of universal health coverage by demanding hospitals to make emergency care available to the uninsured. This kind of care, the emergency care, is the most costly form of health care in the United States.
On the average, medical doctors in the U. S. presently complete paperwork for numerous insurance companies approximately an hour a day in order to receive payment for services they have rendered. As a result, patients often go through long waiting hours or delays in receiving care for the reason that the physician has to process paperwork first. Under several health plans, insured patients ought to shell out money as initial payment for medical care, and then forward a request to their insurance provider to have the necessary reimbursement.
If everyone were under the same health plan, the requirement to monitor whom among the patients had health plan or insurance would no longer happen. A patient need not present insurance information before having or receiving medical care. Everyone would merely bring a health card that would promise easy access to the health care considered necessary and present the needed information for reimbursement to provider hospitals and physicians for care. Universal Health Care Coverage or Single-payer System One promising universal health proposal is the single-payer system.
This model would take the place of private and public health plans with a government-controlled trust that would compensate or pay for medical expenses and health care needs. Having a single-payer system presents a number of advantages. This single-payer system of health care financing assures physicians and their patients to deliver and receive quality health care. The word single-payer illustrates a government-sponsored program or in this case, a form of health-care financing wherein a single insurer, that is, the government, answers for all of the hospital and medical bills.
The basis of costs or payment made to the hospitals in a single-payer system the costs the hospital incur in working for a population, and not by every individual patient admitted. Moreover, the hospital need not present a bill for each medicine or dressing that each patient received. The basis for the sum that every hospital collects from the government is on its costs from the prior year added to the cost of inflation. The existing billing and reimbursement system would still be the one to allocate the funds. This, however, would be closely monitored and regulated.
This method of payment refers to global budgeting. The idea of global budgeting for hospitals lets the population in the community and government agencies to formulate plans that will enhance the health of the populace and put a stop to illness. What is more, by concentrating on precautionary medicine or those things that make people stay in good physical shape, universal health care endows in procedures such as immunizations to avoid diseases, movements against smoking, and mammograms to discover breast cancer in its first stages.
A highly developed health policy includes benefits for public health and as well as government budgeting. This step of making the populace health-conscious would not be that easy and uncomplicated. This, of course, requires a systematic process and an array of strategies concerning health awareness and medical information. What would greatly help this advocacy is conducting information dissemination, health consciousness/awareness seminars, trainings, etc. An improved concentration on preventive medicine will make general health conditions better and help out prevent scores of expensive medical measures in the future.
The use of high-priced resources for individual patients would decrease, as care will move to other venues for example, outpatient clinics and community care. Additionally, the outpatient setting permits health-care professionals to concentrate on preventive care. The establishment of outpatient clinics and community health centers has trimmed down the incidence of pregnancy complications. The payment for physicians and clinics will be the same with the rates paid to preventive care and education.
Likewise, these clinics and centers aim to enhance the treatment of chronic illnesses, particularly, diabetes and asthma, leading to remarkable savings on health or medical costs. However, at present, the setting in the U. S. is far from having a Universal Health Coverage. Actually, the government offers health insurance only for the underprivileged or poor, elderly or citizens over the age of 65, and disabled people under the Medicaid and Medicare programs. These health programs answer for less than half of all Americans.
Most of the uninsured are working people and their families. Several employers do not offer health care as a benefit to their workers, or they require the employees to shell out for such a large fraction of the premium that employees do not have enough money for it. The single-payer system of health care is not the only potential way to offer universal health care; nevertheless, it would most likely bring about the least problem. In another health plan option, the National Health Service, every physician, and nurse are employees of the government and gets flat salaries or wages.
A national health service gives reasonably priced and all-inclusive care, but lessens the independence of health-care professionals or physicians. Additionally, the single-payer system is better suited with the delivery system of health care in the United States. If the U. S. takes on a single-payer system, the price of care will be built-in or included in taxes rather than the payroll deduction most people shell out to cover their health insurance premium at work. The working people who possess insurance owing to their employment would not suffer an increase in taxes.
Rather, the money now subtracted from their salaries to pay for their health insurance would go to the government to aid cover the price or outlay of universal health insurance. The proposal to have a Universal health Coverage received many criticisms. Some critics argue that greater government participation in health care will cause ineffectiveness and declining quality. Yet in a single-payer system, it is not required for hospitals to be government-owned, or for physicians and nurses to be government employees. In fact, government participation in actual medical care is not that big.
Single-payer is only a system to support universal health coverage. The government’s major role is merely to accumulate money and pay bills, a responsibility that the government can accomplish successfully and competently. What is more, the single-payer system lets people to make a decision as to where they would want their health care received. For several people in the current system, particularly those covered by Health Maintenance Organizations (HMOs) that limit choice, the single-payer system would give far more choices concerning who they could visit for their care and what type of care they could get.
The existing system often does not permit people to have long-standing contact with a doctor for the reason that coverage plans change frequently that patients never get the chance to become acquainted with their doctor. Several people worry that if the U. S. takes on a single-payer form of health-care financing, troubles with waiting lists might commence here. Without a doubt, patients in some countries where everybody has access to health care, for example, in Britain and Canada, must wait for particular types of elective care. To add, in these countries, patients with emergency problems obtain care right away.
In Canada, where waiting lists exist, governments are working on running the systems better. What is more important is that, in these systems, the basis of care given is the medical need rather than the paying capacity. Those patients who need care the most receive the best care first. Likewise, it is of great importance to be aware that in any system, inadequate financing causes blockages when people attempt to gain access to insufficient resources. The dilemma of waiting lists crops up because of inadequate funding, not from any basic problem with assured health care.
A significant difference between the U. S. and other developed nations is the sum of money the U. S. allocates on health care, which is more than twice s much per person on health care compared to the next closest country. The U. S. expends almost 14 percent of its gross domestic product (GDP), or the total cost of goods and services generated within a country, on health care, while most nations use up only 6 to 9 percent of their GDP on health care costs. To note worthwhile, the U. S. is surely spending an adequate amount of money.
Nevertheless, over and above the amount used up on paperwork, much of this money transformed into profits for insurance companies and large for-profit managed care agencies. In the U. S. health care system, care undergoes allocation; however, the basis for distributing care is in accordance to the paying capacity of the patient rather than to his need. In most industries, particularly in the economic set up, free-market competition would likely boost the quality and reduce the price of goods and services, but this trend does not pertain to health care.
More than 125 studies have confirmed that people who do not have health insurance experience more sicknesses and die earlier for the reason that they fail to get preventive care and obtain health care only when their conditions are more advanced. Organizational Structure The federal government would serve as the operator of the system proposed. This single-payer universal health care system would be applicable to all states and communities.
The federal government would provide the funding and over-all supervision; the provincial governments run the hospitals, and have doctors in private practice enter into contract with the government for fee-for service payments. Conclusion/Recommendations A bright future for the U. S. economy signifies good employment records with quality benefits and privileges such as access to excellent and most modern healthcare that numerous medical resources in the U. S. have to offer. Having a good health is indeed important to have a strong and firm economy. This vision is possible if all Americans can avail to have quality health care services.
One important factor in ascertaining a sound and firm economy and prosperity Americans yearn for is ensuring reasonably priced healthcare coverage for all. This aim is within reach, however, two essential steps on the road to improvement call for rethinking the message concerning affordable healthcare coverage and insisting to have true fiscal accountability from the federal government. Having a health care coverage for all Americans involves an extensive and evolving range of actions, which might cause complications that eventually bring about failure.
A good health care coverage plan must have the aims of providing affordable and quality health care and at the same time, cutting the public health costs. The Single payer universal health care promises lower costs than the present US system owing to lower administrative costs. Currently, the U. S. spends 50 to 100% more on administrative costs than single payer systems. Through reducing these costs on administration, the U. S. would have the capacity to give universal health care, without managed care, foster benefits and still save money.