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Bringing health care to the public - Essay Example

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Bringing a standard of health care to the public is one of the biggest challenges facing the nation.With an estimated 46 million people without healthcare and millions more underinsured, it is time for the states to take responsibility for covering those that have fallen through the safety net…
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Bringing health care to the public
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Download file to see previous pages Bringing a standard of health care to the public is one of the biggest challenges facing the nation.With an estimated 46 million people without healthcare and millions more underinsured, it is time for the states to take responsibility for covering those that have fallen through the safety net. This will mean restructuring Medicaid to meet the demands of a more central health care system. It will be a task that will take money, planning, public support, and political will. Yet, failure to act will cost more in dollars as well as suffering in the long run. It's time to act to bring health care to the public.There are a few misconceptions about Medicaid and public financing of health that need to be corrected. For one, Medicaid is not a large scale, wasteful system. Rowland (2006) says, "Medicaid is not a failed inefficient rigid bureaucratic program. Medicaid does remarkably well what it is designed to do: fill in gaps in private insurance and Medicare and assist tbe poor and frail with their health and long-term care needs without undue financial burden" (p.70). This is precisely where Medicaid can fit into a state system, by filling the gap between mandated private and the poorest of our population.
States would be required to mandate private insurance for everyone that was employed. Employers would be required to cover a percentage of the cost for the insurance. The people that fell below the poverty line would pay for Medicaid coverage on a sliding scale based on ability to pay. This would bring all of the people under a system of mixed private insurance and Medicaid. Employers would bear a responsibility and those that were able to pay would also bear a cost in the program.
Medicaid insurance would be purchased through the major insurance providers at a negotiated favorable rate. By utilizing slightly higher deductible rates, the insurance would be more affordable and would cover catastrophic situations. Consumers would be given a choice of programs, which would necessitate educating the public. According to Buntin et al. (2006), "the information available to consumers about provider cost and performance, and about the effectiveness of treatment alternatives, is sparse. Cost information in particular is difficult for even assertive consumers to extract from providers" (p.526). A well-educated public would be a first line of defense against waste and mismanagement.
Waste and mismanagement are closely tied to poor quality care. Casalino points out the need for emphasizing quality in the original business model. "During the past few years, a variety have efforts have been initiated to remedy the "profound failure" of the lack of a business case for quality in U.S. health care. Since capitation alone--even when risk-adjusted--does not create a business case, purchasers are realizing that they must reward plans and providers directly for improving quality" (2003). The system will need the support and political will to stress quality.
Still more is needed to operate a large-scale health system with a standard of quality acceptable to the American public. Greater information is needed on hospital success and failure rates, infection rates, and medical errors. "A key component of any solution, however, is the routine availability of information on performance at all levels. Making such information available will require a major overhaul of our current health information systems, with a focus on automating the entry and retrieval of key data for clinical decision making and for the measurement and reporting of quality" (McGlynn 2003 p.2644). Public support will only come through an assurance of a quality program with a high quality of care. By setting modern standards for care these goals can be attained.
The perception of this program will be one that will face the issue of affordability. Cunningham and Hadley (2004) state what the cost would be. "$35-$70 billion, depending on the type of coverage, universal coverage would produce levels of access for ...Download file to see next pagesRead More
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