During the past 20 years, there have been major economic changes in the health care system of the United States. However, addressing the basic problem of cost control still has no solution. The Medical expenditures per capita have risen from 5 to 7 percent per year with health care costs consuming an increasing part of the gross national product. (Relman). The U. S. health care system absorbs a tremendous proportion of national resources. Total spending from all sources was $884 billion in 1993, a sum that amounted to 14 percent of the GDP for the years and average of $3,300 spent for every man, women, and child in the nation.
That share of the GDP has been growing larger: In 1965, medical expenditures were only 6. 2 percent of the GDP: from 1965 to 1993, they grew between 5 and 16 percent every year. Public sources paid 43 percent of the total bill, individuals paid 22 percent directly, and private insurance picked up 35 percent of the tab. These percentages, however, vary greatly with the type of service. For example, direct out-of-pocket payment by individuals for hospitalization represents about 5 percent of the total, whereas direct payment for dental care represents about 75 percent (Health Plan).
Medicare was designed as a supplement to Social Security for elderly recipients, who have more extensive medical needs and expenses than the general population. Medicare is designed to protect this aged population against the risks of medical disaster. It consist of two parts: Hospital Insurance, known as Part A, and Supplementary Medical Insurance, or Part B. Hospital Insurance covers a broad range of hospital and post-hospital services, subject to some deductibles and coinsurance. (A deductible is a set of dollar amount that a patient must pay directly before insurance benefits begin.
Coinsurance is a percentage of the bill that a patient must pay directly after meeting the deductible. ) for a given benefit period, beneficiaries must pay a deductible for hospital care set at the approximate cost of one day of hospital care, $716 in 1995. Medicare pays the entire cost of the first 60 days in the hospital; patient must pay coinsurance of $179 per day for days 61-90. To encourage early discharge from expensive hospital care, Medicare covers certain types of post-hospital care, such as skilled nursing facilities and home health service.
Beneficiaries must pay one-eight of the daily cost of form 21 to 100 days in skilled nursing facility. Thereafter benefits cease. (Hiatt). Part A of Medicare is financed through the Social Security payroll tax. Both employer and employee pay a tax of 1. 45 percent of the employee’s total wage. In addition to the aged, Hospital Insurance since 1974 also covers two other categories: persons who have become disabled, if they have entitled to Social Security disability payments for at least two consecutives years, and those with end-stage renal (kidney) disease.
Health care policy and income support policy are closely linked for two reasons. First, the high costs of health care are primary contributors to poverty or low income for many Americans. Second, the poor and the aged more likely than the rest of the population to be afflicted with illness and high medical bills. Therefore many proposals for reform income support policy include reform of health care policy. Yet, just as with the former, a double bind operates in health care: goals and priorities are in conflict – pursuit of one goal precludes pursuit of others that are equally desirable.
The potential need for health care is unlimited; yet individual and social resources for health care are always limited. Health and medicine are basic concerns of American citizens. Annual expenditures form public and private sources for health care amount to one of every seven dollars of the Gross Domestic Product. Americans each years spend more on health care than on national defense, more for capita for health care than for automobiles and gasoline combined. Malpractice cases and medical-ethical questions, such as euthanasia, abortion, and experimentation with new forms of life, claim an increasing share of judicial attention (Ydstie).
The power of physicians to affect lives grows because of new medical technologies and the public’s great fear of serious disease. Conditions once handled by the moral, religious, or criminal systems, such as alcoholism, sexual deviations, gambling, overwork, child abuse, and family violence, now tend to be classified as sickness to be treated by mental- or physical-health professionals. The interest in jogging, health food, body building, and other physical fitness activities signals of growing concern for health (Dolbeare).
How a society deals with pain, the meaning and value assigned to it, reveals much about its fundamental beliefs and commitments. Pain and death are basic concerns of medicine, but they are also experiences that address the meaning of life, the value of the body, and the significance of the human spirit. Health care policy is fundamental because the resources and attention given to health care, the institutions that deliver it, and way it is received affect the shape of social relations (DiNitto et al. )