An Introduction to the US Health Care System - Case Study Example

Literature Review with Respect to the Health Care Reform in U.S. Table of Contents Introduction 3 Literature Review 3 Health care system in US 3 Problems in the System 5 Health Care Reform in US 5 History 6 Current Issues 8 Conclusion 9 References 10 Bibliography 11 Introduction Health care system is undoubtedly one of the most significant social systems. In every nation, health care system is given special attention by the respective authorities. According to World Heath Organization, health care system is the one which takes into account all the activities which are responsible for promoting, maintaining or restoring health (Kotler, et al. 2010). The definition also says that the system includes patients, their family members, caregivers in the community as well as within the organizations, health care workers and most importantly the environment in which all the activities that are related to health take place. Health care reform is considered to be an important responsibility of any government. In simple terms, health care reform refers to the reform in the health care system and/or in some parts of this system. This paper is developed to serve the purpose of providing a clear review of the literatures that are available with respect to the Health Care Reform in U.S. In the process of doing so, the paper includes a brief history of health care system and reforms in the context of US. Furthermore, it also contains the present situation of health care reform in the country. Literature Review Health care system in US It is important to review the literature regarding US health care system before reviewing the literature regarding US health care reform. Significant volume of literature can be found related to US health care system. Steven Jonas, Karen Goldsteen and Raymond Goldsteen in their “An introduction to US Health Care System” have opined that the health care system in US is very similar to the systems of the other nations where ‘allopathic medical model’ is mainly followed (Jonas, Goldsteen & Goldsteen, 2007). However, it has several features that are unique in nature when compared to the health care systems of other countries. While providing a brief overview of the Unites States health care system, Jonas and Goldsteens have said that an important aspect of the US health care system is that it is significantly fragmented and decentralized (Jonas, Goldsteen & Goldsteen, 2007). Its main function and role are significantly focused on the production of outcomes. It remarkably emphasizes on the profits and power of the service providers. In US, health care is provided but it does not come at a low cost. High end education and researches that are related to health care are provided and funded. Surely there are loci of control and power. In the US as such there is no central Ministry of Health. The system allows physicians to earn significantly huge amount of money by means of private medical practices. It has been observed that since 1980, US has become one of the main venues for generating profits for the corporate from the provisions of various health care services (Jonas, Goldsteen & Goldsteen, 2007). Lillian E. Forman has taken an attempt to illustrate health care reform in the context of United States. In the process of describing the current situation of health care system, Forman has said that everyone believes that it requires to be changed. However, there is significant lack of consensus about how the system may be changed. Karen Davenport who is the writer of “Covering America: The US health care system and the 2008 election” has found that the US health care system is hybrid in nature. It is found that in the year 2008 almost 53% of the country’s total population was covered by the private insurance policies which were actually offered by their employers. On the other side public insurance policies were able to cover only 26% of the nation’s population. Problems in the System According to Lillian E. Forman, the effectiveness of US health care system has gone down remarkably during the last decade as it has experienced number of critical problems. She has identified several such problems in her book named ‘Health Care Reform’ (Forman, 2009). One of the most crucial one among these problems is significant increase in the spending related to health care. In 2007 the total costs of health care went up to $2.3 trillion – cost to per individual was $7000. It was an increase by almost 7% from the previous year’s statistics. It was predicted that the costs to increase more and reach the figure of $3 trillion by 2011. Such an increase in the spending is the reflection of ‘inpatient hospital care’ and rising costs of drugs that are prescribed. Furthermore it is also the result of increased usage of the various health care services. Moreover, there is a continuous increase in the number of people who are uninsured. These people has tendency of postponing the decision of seeking medical help. As a consequence when they visit a doctor their physical conditions are found to be more difficult to treat and this in turn raises the expenditure (Forman, 2009). Health Care Reform in US The information found while researching the literature regarding US health care system shows that there are several possible ways in which reform can be done in the system. Over the past few years many proposals have been made by the experts and governments. For instance, former president George W. Bush said that “we share a common goal: making health care affordable and accessible for all Americans. The best way to achieve that goal is by expanding consumer choice not government control” (Forman, 2009). However, there is no significant consensus regarding these proposals and hence the best proposal is yet to be found. The literature regarding health care reform in the United States can be portrayed in two different sections which are History and Current Issues (Forman, 2009). History During the past few decades medical science has gone through some significant advancements and modifications. However, it has been observed that only a certain proportion of US citizens have received the benefits from such advances. Researches show that medical expenses have increased remarkably with the improvement of medical technology. The system that is responsible for delivering has been becoming more and more exclusive. Records of nineteenth century shows that both poor as well as rich were treated equally by the public hospitals. Such centers were not supposed to make profits. Patients used to pay what they were capable of paying. During mid of nineteenth century, important substances like chloroform, ether and morphine were discovered. With the time medical practice became a profitable profession. Patients who are capable of paying high were started to be provided special treatment. Hospital officials started to investigate the charity instances for fraudulent claims (Forman, 2009). It is found from Forman’s ‘Health Care Reform’ that initial ideas related to reform of health care system came in the early 1900’s. In that period, social reformers identified the relation between poverty and health. They started to push for modifications in the law and their main purpose was to force the employers for paying their employees a ‘living wage’. The principle aim was to give workers the opportunity of earning enough income so that they can maintain good health. Leaders of labor union joined the reformers as they realized that healthy workers can be more productive as compared to their unhealthy counterparts (Forman, 2009). According to Forman, there were reformers who realized that it would be quite complicated to convince Congress for passing a bill that is required to force the employers to increase wages so that the workers can cover the cost related to health care. They looked for alternatives and went for the concept named Public Health Insurance. In 1912, the issue was further raised by the American Association of Labor Legislation. By 1916, the committee on Social Insurance developed a bill regarding health insurance that was supported by the tax system. However, it was never implemented as the private insurance players made objection to the government. Even the physicians were afraid as they felt that they might loose control which in turn may adversely affect their earnings. American Medical Association stated that there should not be any government interference in the profession of medical practices (Forman, 2009). Although the plan was not implemented, it raised the requirement of reform in the country’s health care system. A significant move came in when Medicaid and Medicare were brought in by the president Lyndon B. Johnson in 1965. Medicare enables the elder people to access health care services using taxes that are on individual income. On the other side, Medicaid is basically a health insurance program which is mainly designed for the poor. It is funded by both state as well as federal government. During 1965, ‘Universal Health Coverage’ program was tried to be implemented by the then president Nixon. By 1972, over 40 plans for reforming the health care system were proposed to congress. However, most of them including the ‘universal health coverage’ were not passed due to certain difficult circumstances (Forman, 2009). In 1976, a new plan named ‘Health Security’ was presented by Jimmy Carter who was the president of the country. Representative Henry Waxman and Senator Kennedy developed another plan in the name of ‘Health Care for All Americans Act’. Both the plans were not adopted. During the period of 1980 - 1990 political leaders and presidents were more focused to the cost of health care. Universal Health Care was revived in 1993 by the president Bill Clinton. Forman stated that during the presidency of George W. Bush Medicaid and Medicare faced critical financial problems. However, President Bush tried to help citizens by introducing new laws that would make the health care more affordable. For instance, a bill which was related to Medicare was passed. This would allow people to have ‘health savings accounts’. Such accounts assist people to “supplement their Medicare coverage with tax free accounts for health care expenses not covered by Medicare” (Forman, 2009). Bush also made recommendation for the development of ‘association health plans’. As a result of such development, associations of employers would have purchased the health insurances without any intervene from the state boundaries. Current Issues Barack Obama who is the current president of US has made health care reform one of his top priorities. Information provided by the renowned news papers like BBC reveals that on 21st March, 2010 the most significant bill regarding health care reform was passed by the House of Representatives (BBC, 2010). It was proposed to challenge the two-three main problems that were identified in the health care system in US. These are huge cost and large number of people who are either uninsured or under-insured. A report which is developed by Congressional Research Service on health care reform says that there are mainly three main areas that are matter of main concern. These are ‘coverage’, ‘quality’ and ‘cost’ (Lyke, 2009). Recent health care reform bills that are proposed by the Obama government offer to make regulations tougher for the insurers. Establishing individual mandate and setting insurance exchanges are two other important proposals that are proposed in the bill. It has also been decided that a significant cost of reform programs would be recovered from the waste of the famous Medicare program (BBC, 2010). Conclusion There is no second view that the current system of health care in US must be changed and reform is something that is immediately required. However, there is no broad agreement over the ways in which changes should be made and how they should be executed. Steps taken by the present president and his government have failed to draw enough appreciation from the opposition leaders as some of them believe that the government’s strategies would make the entire system more expensive as well as more bureaucratic (BBC, 2010). Even there are people in ruling party who disagree with the proposals that are put forward by the government. Considering all the above mentioned aspects it can be said that at present the main concern for the authorities should be to bring in and execute effective reforms for the betterment of the country’s health care system and its main stakeholders. References BBC, 2010, Q&A: US healthcare reform, BBC NEWS, Retrieved from http://news.bbc.co.uk/2/hi/8160058.stm on April 25, 2012 Forman, L. E. (2009). Health Care Reform, ABDO Jonas, S. Goldsteen, R. L. & Goldsteen, K. (2007), An Introduction to the U.S. Health Care System, Springer Publishing Company Kotler, P. et al. (2010). Strategic Marketing For Health Care Organizations: Building A Customer-Driven Health System, John Wiley & Sons Lyke, B. (2009). Health Care Reform: An Introduction, Congressional Research Service, DIANE Publishing Bibliography Jacobs, L. R. & Skocpol, T. (2010), Health Care Reform and American Politics: What Everyone Needs to Know, Oxford University Press Kronenfeld, J. J. & Kronenfeld, M. R. (2004), Healthcare Reform in America: A Reference Handbook, ABC-CLIO Sultz, H. A. & Young, K. M. (2010), Health Care USA, Jones & Bartlett Learning OECD, (1999), Regulatory Reform in the United States, OECD Publishing Read More