Why is health care reform in America a necessity? PART ONE
When any government makes any type of effort at health care reform the following criteria are usually used as a procedural guide:
- Broaden the population that receives health care coverage through either public sector insurance programs or private sector insurance companies
- Expand the array of health care providers consumers may choose among
- Improve access to health care specialists
- Improve the quality of health care
- Decrease the cost of health care
According to the US Census Bureau, as of 2008, 87.6 million of the U.S. population are without health insurance coverage. Our country currently spends 15.3 percent of the GDP on health care. Almost TRIPLE what the rest of the world spends on health care and surprisingly our health care quality is lacking compared to many nations!
We need to broaden the population that receives access to health care. According to the United States Census Bureau and the Kaiser Family Foundation approximately 85% of Americans have health insurance; nearly 60% obtain insurance through an employer while 9% purchase insurance directly. Since 2001 premiums for family coverage have risen 78%, while wages have only risen 19% and inflation has risen 17%.
There are many differences in premiums among private insurance carriers and if someone has pre-existing conditions forget it; either the premiums are way to high or the chances of coverage and treatment are little to none. We need to expand employment-based coverage by requiring employers to ofer coverage or contribute to insurance pools; though controversial and subject to some side effects, this reform is the most effective way to expand coverage with-in the private employer-based insurance system. It requires:
- Establishing purchasing co-operatives for small firms or "buy-ins" to existing group plans such as FEHBP or state employee health plans
- Providing subsidies or tax credits to vulnerable employers
- Providing direct subsidies or refundable tax credits to low-income workers to help them afford their share of employer sponsored coverage, and to low-income people purchasing COBRA coverage.
Improving access to health care mean increasing enrollments to eligible populations into government funded insurance programs by:
- Conducting outreach through public awareness campaigns
- "Out-stationing" eligibility workers in a variety of community sites such as health clinics, childcare centers, schools, religious institutions, and social service agencies;
- Holding eligibility workers accountable for erroneously denying benefits, and providing incentives to promote appropriate enrollment;
- Simplifying the application process and providing information and application forms in multiple languages
- Computerizing the application submission and response process to reduce human bias and error, and speed turn-around;
- Instituting a 12 month Medicaid eligibility, "presumptive" eligibility, and single insurance cards that do not denote source of payment.
Our nation also needs to expand government-funded programs and develop new insurance products. For example, expanding eligibility for existing government insurance programs such as Medicaid, Medicare, and CHIP (eg, extending CHIP eligibility to parents and allowing people with incomes above current cut-offs to "buy-in" to Medicaid or CHIP on a sliding-scale basis; instituting a "buy in" to Medicare for retirees). An example already6 in effect is Blue Cross Blue Shield of Massachusetts Foundation's Connecting Consumers with Care grant program, which supports community-based organizations, community clinics, and some hospital programs as they assist low-income residents to obtain public coverage; navigate the health care system and provide on going relations with health care providers.
December 29, 2009 at 3:14 PM
I am not for the current form of health care reform because I don't think people should be forced to buy insurance or penalized if they don't have it.There are threats of fines and even jail if you don't buy healfh insurance.If the government wants to reform the health system it should start with the elimination of waste and corruption in the system as it is now.I don't want my taxes to increase and still be forced to pay for insurance so everyone is covered.People who have medical,phyiscal and mental disablities have recourse for coverage already.People who are unempolyed decause they don't want to work can also get insurance.There is no need to expand government to better the system.Give people a better choice by allowing them more insurance companies to choose from.That would help lower the cost of insurance.Cover preexisting conditions.Pay doctors a fare fee and pay them in a timely manner.If people don't want to buy health insurance they can either pay for services they get or apply for the current forms of government insurance.The government waste too much of our taxes for me to think they would not abuse a system where they have control of the health care system of the country.I don't agree with the premise that the rich should pay more because they have more.They pay more now.Eliminate the tax loop holes that some some people use to avoid paying their rightful share and there won't be a need to raise taxes on people who really can't afford a higher tax burden.To support the current proposed reform everyone who works will have an increase in taxation not just the rich.If the government wants to cover more people it can change is eligibility standards for medicaid and medicare,help low income people pay for employer sponsered insurance.
December 30, 2009 at 3:04 PM
The problem with medicaid is that there are people such as myself who are covered by medicaid and yet it only pays for three perscriptions a month, I have more than three. Also for people who need help with mental health programs Medicaid only cover 30 visits to a psychiatrist per year and that does not include intensive therapy that many people need. Simply giving some one drugs and putting them back out into society does not fix anything, it only prolongs issues.
Lastly if we were to cut the administrative overhead in the private insurance industry and go to a single payer system while still allowing these companies to operate as normal $200 billion dollars would open up; take $54 billion of that and filter it into the medicaid system you would create more revenue for doctors, drug companies, hospitals, and lower the cost of health care for everyone else because more health care would be availble: meaning more bills would be paid and cost would come down.