Health Care in America - Research Paper Example

Health Care in America Formulation and Implementation of Policies Governing Health Care In America Abstract This research paper aims to rate the influence, based on studies in this course, as well as information from other sources, of the legislative bodies, leadership, the justice system, and the Bureaucracy on the formulation and implementation of policies governing health care in America. This essay would also evaluate the influence of the other entities, such as interest groups, political parties, and the media. With the underlying premise that politics is the art of compromise, the essay would eventually show how these entities work together as well as at odds with each other. INTRODUCTION Health care in America faces relevant pressing issues that need immediate attention. With the financial crisis that is affecting the country and other nations on a global scale, the effect on state budgets specifically on education and Medicaid is eminent. (CSL Behring 2009). According to its article on The Economic Downturn and its Impact on Patient Access, “cutting either is politically difficult. However, the reality is that the biggest programs must be cut to produce savings and balanced budgets. Some approaches that governors have proposed are employee furloughs, hiring freezes, suspension of pay raises and layoffs.” (ibid.) The immediate response of the current administration utilizing the Economic Stimulus Package would be to include some provisions regarding Medicaid and COBRA which would cover unemployed or recently laid-off workers. (Medical News Today 2009). These, among other diverse public policy strategies outline the reform in health care presented under the Obama Health Care Plan. It is the objective of this essay to determine if the policy on a universal health care system is the solution to America’s health care crisis. Further, this research paper aims to rate the influence, based on studies in this course, as well as information from other sources, of the legislative bodies, leadership, the justice system, and the Bureaucracy on the formulation and implementation of policies governing health care in America. This essay would also evaluate the influence of the other entities, such as interest groups, political parties, and the media. With the underlying premise that politics is the art of compromise, the essay would eventually show how these entities work together as well as at odds with each other. AMERICAN HEALTH CARE Statistics provided by the AFL-CIO (“What’s Wrong with America, par. 2) reveal that 47 million Americans are without health insurance. Hacker (“Health Care for America”, par. 2) averred that “health insecurity is not confined to one part of the population. It is experienced by all Americans: those without insurance as well as those who risk losing coverage; those who are impoverished as well as those with higher incomes who experience catastrophic costs; those who are sick or injured as well as those who are just one sickness or injury away from financial calamity”. According to a report by the World Health Organization (“WHO Assesses the World Health Systems”, par. 3) “the U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance”. But the report stated that in terms of responsiveness, the United States ranks first due to availability of the country’s resources to immediately respond to health care needs. In terms of health expenditure per capita, the USA ranked first but ranked 72 on level of health and on the overall health system performance, it ranked 37 (World Health Report 2000) out of 191 member nations included in the study. The health care in the United States are administered by private health institutions. There are no public hospitals owned by the government. Health insurance can be availed through a working individual’s employer or through a spouse’s or parents’ employers. Insurance can also be purchased individually. For the uninsured, a study conducted by Hadley and Holalan (“Covering the Uninsured”, par. 44) revealed that “a substantial amount is already being spent on care received by uninsured people. Much of this money flows through an elaborate and often hidden network of grants, indirect payments, and subsidies from a variety of primarily public sources to medical care providers.” When compared to the health care system of Canada, the United States “wastes more on health care bureaucracy than it would cost to provide health care to all of the uninsured” (Himmelstein, “Healthcare Bureaucracy: US vs Canada”, par.1). The difference in health care systems among the two countries lies in the single payment scheme utilized by Canada. “The huge gap in administrative costs between the U.S. and Canada arises from their differing mechanisms of paying for health care.  While Canada has a single insurance plan, or “single-payer”, in each province that pays the bills for everyone, the U.S. has a complex and fragmented payment structure built around thousands of different insurance plans, each with its own regulations on coverage, eligibility, and documentation.” (ibid) The system in the US is so diverse and complicated that the efficiency in delivering health care through utilization of health insurance payments is hampered. With the awareness of this system, plus the 15percent of the population being uninsured, reforms definitely would have to be instituted to improve health care delivery. POLICY IMPACT The budget conditions, proposed reforms in health care, and public support have a direct and relevant impact on the status of health care in the country. The new administration presented reforms in the health care system of the United States which would assure health insurance coverage for every individual (Sage, “The Obama Health Care Plan”, par. 1). To quote Obama’s health care plan, “no one will be turned away because of their medical history and that if you currently have insurance, your premiums will be less” (ibid). The present administration plans to reinforce the universal health care system for all Americans regardless of age, income, policyholder, gender or race. Incorporated in this universal health care plan is a National Health Insurance Exchange which would oversee current private insurance policyholders. Obama realized that the present health care system have several smaller issues that contribute to the major problem. If properly acted upon, these issues would “lead to lower costs and better patient care” (ibid). The flaws in the current system that need to be immediately addressed are: “reimbursing employers for catastrophic healthcare losses, focus on disease management programs, electronic medical records, and lowering prescription drug costs” (ibid). To initiate the implementation of reforms for the health plan, Barack Obama recently utilized the Economic Stimulus Plan as a starting point to revitalize the economy. According to Obama News and Speeches, the Economic Stimulus Plan is “a plan to revitalize the economy in the short-term with a stimulus package that will immediately inject $75 billion into the economy in the form of tax cuts and direct spending targeted to working families, seniors, homeowners and the unemployed. The plan also includes $45 billion in reserves that can be injected into the economy quickly in the future if the economy continues to deteriorate.” (2008) As mentioned earlier, under the Economic Stimulus Plan, “recently laid-off workers could receive health coverage assistance through an $8.6 billion expansion in Medicaid or $30 billion in federal COBRA subsidies, the Washington Post reports. (Medical News Today 2009) With regard to reforms or expanded provisions regarding Medicaid, the following discourse is detailed: “under the proposal, the federal government would pay in full all benefits and administrative costs for all unemployed Medicaid beneficiaries through 2010. The proposal would allow states to choose whether to extend Medicaid coverage to unemployed residents, and it would allow states to determine who would qualify for the program. States would have the option of expanding Medicaid benefits to people using or who have exhausted unemployment benefits, no matter what their income is; unemployed people who qualify for food stamps, which in many states are available to residents whose incomes are too high to qualify for Medicaid; and people who have been laid off and have incomes up to 200% of the federal poverty level who otherwise would not qualify for Medicaid.” (Medical News Today 2009) Likewise, the article presented provisions for COBRA, to wit: “under the COBRA proposal, health insurance premiums would be subsidized up to 65% for one year for recently laid-off workers. According to legislative sources, the level of assistance could change depending on the results of congressional budget analyses, the Post reports.” (ibid.) However, in line of the economic crisis, these proposed reforms would be evaluated in the light of current budget constraints. A concrete example of a policy impact on health care is the one affecting plasma therapies, to wit: “with Medicaid as a major payer for plasma therapies, and especially clotting factor concentrates, where approximately one-third of the bleeding disorders population is on Medicaid, cuts to Medicaid budgets could affect patient access to therapies. The impact also has a ripple effect on manufacturers, group purchasing organizations, physicians, specialty pharmacies and other providers.” (CSL Behring 2009). Finally, the present administration plans to focus on research for on selected medical illnesses and related healthcare programs. The mentioned problem areas which need further research are mercury pollution, lead poisoning, AIDS, and mental healthcare programs. INFLUENCE OF OTHER ENTITIES There are diverse reactions on Obama’s reform policies on health care, specifically providing insurance for the unemployed. “Nina Owcharenko, an analyst at the Heritage Foundation's Center for Health Policy Studies, said that states will feel mounting pressure to maintain the Medicaid expansion when the federal funds run out in two years; otherwise, it's "seen as kicking people off the program." (Medical News Today 2009) A comment from Stan Dorn, a health policy researcher at the Urban Institute, said that “even with the COBRA subsidies, health insurance premiums might be unaffordable for some residents. According to Dorn, 12% to 15% of a small group of dislocated workers eligible for a similar tax credit worth 65% of insurance premiums have taken advantage of the benefit because premiums still are too high. He said that if COBRA subsidies were for the same amount, "there is a very good chance the program will be a major failure." (Medical News Today 2009) Goodman (2008) presented “controversial comments dismissing the nation's uninsured problem. According to the Morning News, to ‘those in health policy or Republican politics, Mr. Goodman have been a prominent figure for decades,’ and some of his ideas ‘have been mouthed by some very powerful Republicans,’ such as President Bush. However, a statement from the campaign of Republican presidential nominee Sen. John McCain campaign said, ‘Mr. Goodman volunteered his advice to the campaign in the past,’ but ‘his philosophy on health care -- and especially on the urgency of the problems faced by 45 million uninsured Americans -- are clearly out of step’ with McCain's views.” (Dallas Morning News 2008) In addition, another opinion on policy formulation regarding health care in the US from newspaper sources were discussed in Dallas Morning News, as quoted: “Michael Foster, commented on Raleigh News & Observer that “lawmakers should ask whether health care spending by the federal government is in the "public interest" and evaluate the role of the government in health care, as the "market for health care services is broken" (Foster, Raleigh News & Observer, 9/14)” (ibid.) ANALYSES The status of health care in the United States needs immediate reforms to make health care accessible and affordable to the population. This is a fact substantiated by various studies enumerated herein. As averred by Keckley (2009), “comparative effectiveness, evidence-based medicine, cost reduction, performance-based payments, consumerism, safety, quality and transparency — they’re all on the table as legitimate action items in the new political structure of Washington, D.C. Agreement of commitment to fundamental reform was echoed by every committee member. Litmus issues — stem cells, abortion rights — were not mentioned. Seemingly, the message to all was clear: The U.S. health care system is broken. It’s expensive, inaccessible to large numbers without insurance and offers highly variable quality.” In a relevant article written on Health Care and Public Policy: What Do Americans Really Want?, a survey was conducted by the Deloitte Survey of Health Care Consumers to determine public sentiments on a variety of public policy issues. When asked about the issue of insuring the unemployed using the administration’s new reforms, a “significant numbers of respondents don’t believe that government intervention is necessarily the cure. The survey reveals that Americans generally support the idea of ensuring that everyone has insurance, but not if it means higher taxes or an individual mandate. Nearly 75 percent outright oppose or are lukewarm to tax increases to cover the uninsured, and 63 percent express concern about forcing individuals to have health insurance. Requiring employers to provide insurance for employees wins more support (53 percent are in favor).” (Deloitte 2009) The important results from the survey are enumerated as follows: “Two-thirds of the survey pool cite opposition or have mixed views on the establishment of a national program of financial incentives for doctors who follow scientifically proven approaches – possibly indicating a lack of understanding about what evidence-based medicine entails. Only four in 10 favor increased government funding and incentives to support adoption of electronic medical records by doctors, hospitals and health plans. Six in 10 consumers endorse the government establishment of standards for how medical information is collected, stored, exchanged and protected – far surpassing the second option of leaving the task to health plans (21 percent). Nearly 60 percent of respondents don’t believe or have reservations that the Food and Drug Administration (FDA) should be allowed to compile information about those who take prescription medications to monitor safety and effectiveness after products have been released into the market.” (Deloitte 2009) The survey revealed that most of the respondents view that the present policies formulated and implemented on health care utilized measures which eventually boil down to spending resources not efficiently appropriated. In fact, “more than half of respondents say 50 percent or more of the amount spent on health care in the U.S. is wasted.” (ibid.) There are issues that are being emphasized by the government but other pertinent health issues are consequently neglected. CONCLUSION A change in America’s health care does not begin or end in knowing the reforms, nor in delegating the action to the administration. As Senator John Kerry averred, “fixing our healthcare system as a whole is our primary challenge, and to make it happen you need to get engaged – to pound the pavement, get your hands dirty, endure real sacrifice, take on antiquated thinking and help lead the public debate.” More importantly, as averred in The Public Purpose (1996), “the most fundamental feature of democratic government is equality under the law. Equality under the law means that none can be viewed as having greater right under the law than others. This principle is captured by the following: What government does for one, it should do for all, and what government does not do for all it should do for none.” The very essence of public policies on health care should exemplify the principle of equality. The proposed reforms, strategies, plans to uplift the status of the delivery of health care in the United States encompass regulations which might undermine the conditions of others. In this regard, the influence of entities and the reviewing public on these reforms should always be encouraged to promote serving private needs. The healthcare crisis of America could be reformed utilizing the present administrations measures focusing on the universal health care plan. Questions on how this system would be made “more affordable and available” than what most Americans can afford are more welcome than status quo. There are opinions that eventually, covering the uninsured might entail paying higher taxes to subsidize this cost. Whatever controversies or skepticism that this plan might face, it is important to realize that America’s health care system needs to be immediately rehabilitated to better address the needs of the population, as a whole. References CSL Behring. (2009). The Economic Downturn and Its Impact on Patient Access. Retrieved on April 9, 2009 from Dallas Morning News. (2008). Influence Of U.S. Health Care by Economist John Goodman. Retrieved on April 9, 2009 from Deloitte. (2009). Health Care and Public Policy: What Do Americans Really Want? Retrieved on April 9, 2009 from Hadley, Jack and John Holahan, Covering The Uninsured: How Much Would It Cost? Health Affairs Web Exclusive, June 4, 2003. Retrieved on April 9, 2009 from < http://content.healthaffairs.org/cgi/content/full/hlthaff.w3.250v1/DC1> Himmelstein, David U., Steffie Woolhandler, Steffie and Sidney M.  Wolfe, M.D. The Cost to the Nation, the States and the District of Columbia, with State- Specific Estimates of Potential Savings. Connecticut Coalition for Universal Health Care. Retrieved on April 9, 2009 from Keckley, P. (2009). The Realities of Health Care Reform: Consumers Want Change but Will They Pay the Price? Retrieved on April 9, 2009 from Medical News Today. (2009). Medicaid, COBRA Provisions Under Economic Stimulus Package Expand Health Care Coverage. Retrieved on April 9, 2009 from Obama News and Speeches. (2008). Barack Obama Announces Plan to Revitalize Economy and Protect American Families. Retrieved on April 9, 2009 from The Public Purpose. (1996). Retrieved on April 9, 2009 from < http://www.publicpurpose.com/pp-pp.htm> What’s Wrong With America’s Health Care.. AFL-CIO America’s Union Movement. Retrieved on April 9, 2009 from World Health Organization Assesses the World Health Systems. Press Release WHO/44 June 21, 2000. Retrieved on April 9, 2009 from < http://www.photius.com/rankings/who_world_health_ranks.html> World Health Report 2000. Health System Attainment and Performance in all Member States, ranked by eight measures, estimates for 1997. Retrieved on April 9, 2009 from < http://www.who.int/whr/2000/en/annex01_en.pdf> Read More