The Past, Present and Future of Health Insurance in America - Term Paper Example

The Past, Present and Future of Health Insurance in America   History of Health Care Efforts in the US: It took centuries for some form of government health care policy to being formed in the US. Other developed countries by that time did have their own unique health care system, some European countries started with compulsory sickness insurance for workers. Benefit societies that cared for labour were formed. So in one way or another concrete platform for government healthcare was already laid in Europe while in America policy makers still faced hurdles. Originally the idea of proving healthcare to workers was a manipulative one as it was in exchange for the seeming power that could be had over them. US did have some funds for health purposes but there was no regulated law or policy in place. During President Roosevelt’s time some initiation did take place because of his belief in making the country strong, however the leaders that followed Roosevelt delayed any sort of law to be formed. In 1906, American association of Labour legislation finally started a campaign for health insurance. A model bill was drafted years later in 1915 and was only limited to the working class health costs. The private insurance industry opposed this proposal as for them it would prove to be harmful to their own business. When WW1 started, people denounced this compulsory health care policy as a German socialist agenda. They associated it with communism and declared that it was not in accordance with American values. This put an end to the debate till 1930s. But after that medical costs for workers increased. As more and more middle class people started using hospitals, the costs of the business increased and opportunists realized how much money can be made out of this. Concerns over medical costs and health insurance led to the formation of Cost of Medical Care (CCMC). It was a privately funded group made by philanthropic organizations. Their contribution was a research report that showed how important the need for medical care is. The debate between compulsory or voluntary health insurance still existed. However this document was used as basis to bring about change. Just as the AALL campaign ran into WW1 the same happened with the new movement as WWII began. The bill that changed health care was The Wagner-Murray-Dingell bill. This bill called for compulsory health insurance. The political opposition for this bill was immense which is why the bill never became a law. President Truman was a big supporter of the health care issues, and during his tenure he greatly focussed on this. But this was during the cold war period and the opposition used it to full advantage citing that this too was a communist agenda that cannot be acceptable in America. Thought Truman’s plan came with several reforms the opposition never took to it and again the health care reform faced major hurdles. In 1945 AMA again put a lot of resources into lobbying for the bill but they faced defeat again. But now they changed their mindsets and started working on something more basic, hospital insurance for the seniors and Medicare. Finally in 1958 a new proposal was introduced by Congressman Aime Forand. It contained covering of hospital costs for the elderly on social security basis. The AMA introduced a voluntary ‘eldercare plan’ against this, and in response the government expanded its legislation and Medicare and Medicaid were formed. Framework of U.S. Healthcare: U.S is the only developed country except South Korea that does not provide health care for all its population. Also the private sector dominates the public one. How the system is organized is discussed below: Private health insurance: Employer sponsored insurance: This is the main way common Americans receive insurance, through their employees. This is a part of their benefits package and is administered by both for profit and non profit organizations like Blue Cross/Blue shield etc. Some companies also self inure which means they pay for the health costs directly by choosing a third party insurer. This plan is also contribution based part of it the employer provides and the other is contributed by the employee. Individual health insurance: This covers the individuals whose health insurance is not provided by employees. They are self employed or retirees, they also pay the full health insurance premium. Public health insurance: Medicare: This program is provided by the federal government which covers individuals aged 65 and above. It is funded through income tax and premium payments. And covers hospital services, doctor services and drugs benefits. Medicaid: This program is for low-income individuals and the disabled. This is compulsory in nature as the state is required by law to provide coverage for children, elderly, and pregnant women. Although technically this program should benefit all it has its own problems due to lack of funding and high costs of medical expenses. Other public systems: This includes insurance for veterans and S-CHIP, which covers children whose families earn too much to qualify for Medicaid but still not enough to afford high quality insurance. Issues faced: The problems faced by the government during recession have also greatly affected the healthcare system. Emergency rooms are filled to the breaking point, there are long waiting lists. Few statistics from ABC News, Science Daily and the National Coalition are mentioned here: The U.S. has the world’s most expensive healthcare system but still one-sixth of Americans are not insured. Surveys indicate that the high cost of premium is the major problem for backing out. One third of adults and 54% of children do not have a primary doctor. Another shocking statistic is that someone files for bankruptcy every 30 seconds because of health concerns. Ironically U.S. spends six times more on health administration than Western European nations which insure all of their citizens. The total expenditure on the uninsured citizens in 2004 was more than the combined expenditures of Iraq war and war on terror programs. These are just of the few issues that are faced by the U.S. healthcare system, but the magnitude is scary. These problems have to be solved so that the population can be satisfied. A nation cannot progress further while so many of its population is uninsured and does not have access to proper medical care. Many experts provide different theories for solutions; they want universal health care system that has been in place for decades in European countries. The other solution is providing Medicare to the whole population, and some propose capitalist solution to the problem to let market forces dictate the way. One of the underlying issues is that why do so many people need medical care so frequently at such pace? Few people say that the root cause of the problem should be solved rather than addressing the symptoms. There should be health programs that enable people and make them aware of the responsibility they have towards themselves of keeping in shape, eating the proper diet and living spiritually. Current issue in Community Based Healthcare: The current issue that will be analyzed in this paper is the passing of the Affordable Care Act. This new law contains the most radical changes to the health system in decades. It will extend insurance to the currently uninsured by 2019, but it will also affect the costs and behaviour of insurance buyers. From 1999 to 2009, health insurance premiums grew at a higher rate than the wages and cost of living. The cost of a family insurance plan grew from 12 to 22 percent of a family’s income. Small businesses that had to provide health care to their employees were especially hard hit and this is why a lot of small companies did stop offering health insurance. The Affordable care act increases insurance companies’ accountability by setting standards. Thousands of early retirees and uninsured people will now get relief from this law to avoid unaffordable premiums. The problems are analyzed below: 1999 – 2009: Relentless Health Insurance Premium Hikes and Fewer Choices Premium growth in employer-based insurance: Both employers and individual insurance markets felt the higher cost of insurance. Premiums that had to be provided to families doubled in cost. Even a single worker signing up for coverage experienced the same rise as a family one did. As far as the private industry was concerned health insurance costs taking into account inflation greatly reduced disposable income, while the salaries also dropped from 73 to 70.8 percent. Small businesses were the hardest hit as they had to cover a lot of costs which their profits could not cover. Insurance companies also take advantage as they increase their premiums even if a single worker falls ill. Which is why a ripple effect was created and many companies stopped offering health coverage all together. Individual market insurance trends: Individual market premiums grew rapidly by 10 percent over this decade. These rate increases have led to a stagnation of growth in this market as more and more people are reluctant to get insurance. A survey found out that 75% of the people who were looking for a health plan never bought it due to the high premium cost. The pre research of a client is also very discriminatory in this market, if a person is found to have a pre existing condition they were not offered a health plan. Fewer insurance choices: People now have fewer and fewer choices has the insurance industry has become concentrated. Due to market forces the fewer the insurers, the higher the market premium. Research shows that the market share of the four largest firms has grown from 60 percent in 1998 to over 70 percent in 2005. Little transparency or oversight: There is no competition which increases the power of the few companies that exist. There is no standardized format to provide consumers with easy information. They usually don’t have the basic information about insurance and are not aware of hidden liabilities. Affordable care Act enacted: Affordable care act signed into law on March 23, 2010 by Barack Obama has changed the landscape of health reforms. They have been the most invasive reforms in generations and have started to reap results. Consumers are now more in charge of their health care and companies are now made to be more transparent and accountable. This will help in improving the quality of care provided while simultaneously lowering the costs. One of the problems mentioned above was that customers don’t get all the information available and they either get an expensive plan or don’t get one at all. Transparency is increased as government has launched a web portal called HealthCare.gov. It contains all the information about different plans and future customers can compare prices and premiums and then make an informed decision. For small businesses that were the hardest hit, a tax credit is now provided that helps them to cover the costs while expanding their businesses. More than four million small business owners are eligible for this tax credit. Early retirees who are not yet eligible for Medicare can now have health plans. Also the uninsured Americans who previously could not afford insurance are now able to have access to affordable insurance. Another discriminatory policy that screened applicants who had a pre-existing medical condition has now been changed. People with existing medical conditions are now given access to another plan option that has no rate-ups, waiting lists, or denials. The future: The act contains a set of policies that will be implemented in 2014. This will lead to lower premiums and more choices. The implementations are: Government exchanges will begin to give individuals and small business funds that provide purchasing power to get private health insurance at lower premiums. As customers will have access to clear precise information, the cost of medical underwriting will be reduced. Due to this act every individual has a choice; at least two state plans will be available throughout the nation. Other private health plans will also be on the table. This competition will increase quality and lower costs. Savings for individuals and families Savings for businesses Savings in the long run Major opinion in general population is that the health care problems in America are difficult to solve. Americans want less insurance costs and better healthcare services. And for the government and private companies it is important to find out ways to provide that while lowering their own costs. It is important to formulate frameworks that meet all these objectives. The point of universal health care is that everyone should have enough income to be able to afford it. The government provided healthcare would be free to all and a patient can go whenever in need. This kind of universal healthcare system is already in place in a lot of European countries especially Sweden has had this system for ages. What critics argue is that even though the system is in place there are a lot of repercussions for this. The quality of healthcare is not top-notch, there are vague waiting lists and it is not necessary that you can get treated at a government facility. In fact you do end up paying for private facilities just to get healthcare. This kind of universal health care system will always be unfinanced as there is no proper framework. There is no connection between what you pay and what you eventually get when you need it. This system is also extremely socialist that has no place in America, their economy been founded on the capitalist principle you get what you are able to buy. Considering all the issues the Affordable Care Act does provide all the solutions to the problems that are discussed above. Changes in statistics can be seen in the present and the situation will only be better in the future. REFERENCES: Alex Blumberg, A. D. (2009, 10 22). Accidents Of History Created U.S. Health System. Retrieved 10 27, 2011, from NPR:http://www.npr.org/templates/story/story.php?storyId=114045132 Earl L. Grinols, J. W. (2009). Health care for us all: getting more for our investment. New York, NY: Cambridge University Press.  Kallberg, J. (2010). How Socialized Health Care Will Radically Change America. Railhead Press.  Palmer, K. S. (1999, 04 01). A Brief History: Universal Health Care Efforts in the US. Retrieved 10 27, 2011, from PNHR: Physicians for a National Health Program: http://www.pnhp.org/facts/a_brief_history_universal_health_care_efforts_in_the_us.php?page=all United States. (2011). Health insurance premiums: Past high costs will become the present and future without health reform. Washington, D.C: U.S. Department of Health and Human Services,. Farrell, R. R. (n.d.). America’s Healthcare Crisis – Is There a Solution?. The Real Truth - A Magazine Restoring Plain Understanding. Retrieved November 23, 2011, from http://www.realtruth.org/articles/090203-005-health.html Read More