Keith Epstein (2002) has presented the issues of uninsured patients which normally are comprised of young adults (p. 524) and minorities (p. 529). Epstein touched three major issues in which is comprised of the question weather the United States can afford health insurance for all; if Medicare should cover the prescribed medicines for the marginalized senior people; and if small businesses could band together to apply for the insurance of their employees in order to reduce its costs. The fist issue was addressed by Epstein by arguing that since the passing of the Balance Budget Act of 1997, there has been a huge cut back on medical costs.
Medicare has cut on reimbursement and some states have also cut on Medicaid payments. However, Young (President of the Health Insurance Association of America) as cited from Epstein, claimed that the United States can do afford insurance for all if it only has the will power. Young emphasized that the uninsured has already been subsidized due to the increase of costs in insurance payments and also for hospital services because initially, these insurance companies and hospitals are adding up their costs in order to cover for uninsured patients.
Solutions in subsidizing the uninsured in terms of taxes are also one of the solutions that he presented (p. 526). The issue in subsidizing the marginalized seniors’ drug prescription has also been tackled as could be resolved by having the government subsidize a certain percentage of the price by those seniors of having the salary cap of less than $13,000. However, part of the issue is the lack of funds or the possible soar of the taxes in order to subsidize such a change.
The third issue is with regard to the passing of a bill which would allow small companies across states to band together in order to apply for insurance for their employees and consequently to reduce costs. Such an idea according to Lehnhard, (Blue Cross Senior Vice President) would only provide temporary savings on the end of these small companies because since the associations will not be regulated by the state rules, it is possible that such companies would engage in discriminatory underwriting.
An example that was given is that there might be some cases wherein the program would encourage health people from joining, and unhealthy people from not joining (p. 530). A more recent article which emphasized the relevance of the law in order to cater to the needs of the uninsured is those of Owcharenko (2006). Owcharenko provided three major recommendations in which the government could do to solve the growing number of uninsured population in the country.
The first is to offer the uninsured “direct subsidies in the form of a refundable tax credit, to lower-income working individuals and families for the purchase of private health care coverage” (p. 95). Owcharenko emphasized that enormous tax breaks are normally given by the government to those high-earning individuals, rather than to those who have relatively lower incomes. The tax exclusion also provides more generous health care coverage to those individuals belonging in big companies.
In addition with this, those people who don’t have any health coverage at all does not enjoy any tax break at all, thus they are left with no choice rather than to use after-tax dollars to purchase their insurance. Owcharenko emphasized that if a new and robust system of individual health tax credits will be given to low-income families, these people will have the buying power to secure their own private insurance rather than opt to rely to Medicaid which is relatively spread on a small number of population.
The Health Savings Accounts (HSAs) that was enacted on 2003 was perceived by Owcharenko as a good program for the government because it allowed people to “purchased a high-deductible insurance plan to establish a tax-preferred savings account that allows carryover of unspent funds” (Owvahrenko, 2006, p. 96). This plan however needs certain changes in order to function more proficiently. Owcharenko focused on the use of the flexible spending account (FSA) and the health reimbursement arrangements (HRAs) such according to her would allow patients to exercise more autonomy on choosing their heath care.
Such a step would allow the patients to gain more control on determining the amounts which they want to contribute and significantly decide how they wanted to apply these funds. The recommendation is for the government to allow federal contributions to be used in order to improve the health status of every state. Consequently, the state should be able to provide a feedback on the effectiveness of their reforms by “reducing the number of the uninsured, improving access, and remaining fiscally visible”.
The research of Young et al (2004) focused on the life saving health care of undocumented children. Undocumented children are off springs of paperless immigrants which consequently forms a huge percentage of the population for the uninsured. Undocumented children often times did not have an access to health services as they don’t have any contact to any insurance other than the Emergency Medicaid that was given by the Federal Government in 1986.
However, the Emergency Medicaid could only be used in severe cases wherein a patient experiences severe amount of pain (p. 1316). In addition, Medicaid can only pay for a portion of the hospitalization costs, which is why some hospitals needed to seek support either from various organizations or individuals or from the country of the immigrant himself. Such an attempt of some hospitals although noble, may prove to further increase the costs of the treatment because of the delay of the latter.
Young et al. claimed that such prolonging could result to a long-term morbidity and a high risk of death (p. 1318). Young emphasized that immigrants served a relevant part of the society. They do jobs that could highly affect a huge number of the population if by any case they acquire communicable diseases. In relation with this, failure to immunize their children and treat their sicknesses could also result to a significant impact in the society.