Health Care Policy in the USA - Essay Example

?Health care policy in USA Importance to the health care has been the prime duty of the most of the countries of the 21st century. The basic structure of health care system deals with individuals, groups who thrive to dedicatedly work for the promotion of overall health of people all around. The general structure of health system in a society comprises of private health service providers, occupational health and safety legislation, health insurance organizations, and presence of any unit working for the education and promotion of health. World Health Organization and other international health regulating body have been specifying the needs for better health facilities to be provided to the citizens all around the world. In this context it is necessary to study the health policies incorporated by the developed countries like the United States of America. A study of the general condition of the health policies is USA is undertaken and analyzed to identify some of the limitations of the health care system. The US healthcare: The overall healthcare system in the United States has taken a rapid progress over the century. The formalization of the US healthcare system occurred in 1990s when medical licensure was incorporated by the government. Hospitals started serving the public in the 1920’s. However the accreditation of the hospitals was started much later after privately owned heath insurance evolved in the market. The effective participation of the government in the US heath care policy was evident when the government started sponsoring the Medicare and the Medicaid policy back in the year 1966 (Greenwald 22-25). The participation from the government also came into picture when the government started providing benefits to the diseased children belonging from low income family. US maintains a variety of health policies, however the overall marginal benefit arising from the health care services is often very small. An initial surgery in cancer does not cost much to the patients but the cost of radiation and chemotherapy involves a greater expense which reduces the overall benefit the patients receive from the health care facilities. The additional treatments which patients had to incur are not covered by the heath policies and the overall utility which the patients receive becomes hugely insignificant. The disadvantaged people are also not on the receiving ends of high end facilities The criteria for eligibility under the disadvantaged quota is a matter of concern ,and most of the undocumented immigrantsare barred from the service. However the immigrant’s forms a greater part of the US population and the government should also try their best to deliver for their cause. The overall heath care costs in the country are borne by the taxpayers, health insurance agencies, and various other government agencies. However over the past decade the general consumers have borne a large part of the tax. In recent times various participants in the US healthcare policies have tried to shift the cost among each other This has lead to the increased resistance from various groups for receiving higher health care without much increase in the overall cost towards the service. The increase of cost in the health care system has endangered the condition of the poor section of economy.The healthcare system and policies in USA is of voluntary in nature and it has two definite purpose of taking the care of the health system in USA, through the preferential pricing and also at the same time it provides a financial protection from unprecedented increase in the overall cost of healthcare. The heath care policy also looks after the benefits of the doctors and the insurance providers by providing financial stability in their business. (Greenwald 22-25) Health care policies in US: The US government follows three-tier health system, which are National Health Service (NHS), social health insurance (SHI), and private health insurance. In matters of publichealthcare, the US government has three popular policies which are Medicaid and Medicare and State Children’s Heath insurance program. Medicare heath policies: The Medicare program is one of the popular programs in the United States which is being funded by the US government. The health insurance program is aimed for the senior citizens of the country. The facility is also applicable for the physically challenged citizens of the country. Other than providing benefit to a considerable portion of the US senior citizens, it also sponsors the training programs of the physicians of the US. The Medicare facility comprises of four parts which are hospital insurance, medical insurance, Medicare advantage plans, and plans for the prescribed drugs. The hospital insurance covers some part of the charges of the patients excluding the fees for the doctors. The Medicare facility covers the charge of the hospitals for 100 days out of which the first 20 days are fully sponsored by the policy and the rest 80days are paid in part. Thus the hospital insurance under the Medicare facility does not provide a substantial benefit for the patients who need to be admitted for a longer period of time as they are liable to receive only 10days of free treatment in the hospital. However the part B of the Medicare facility covers medical insurance for the patients in terms of their diagnostic charges and it also covers the fees for the doctors and the nursing services. The medical insurance part also covers charges, which the patient had to undertake towards the purchase of their equipment required for the treatment process. The Medicare advantage plans provide option for the policy holder’s to receive the benefits of the Medicare with the help of the private heath insurance plans. The medical drug plan under the Medicare facility covers the drugs which are required by the patients for the treatment. The policy holders need to enroll themselves in the standalone prescription drug with the Medicare advantage plans so that they may receive the benefit of the prescription drugplans. The administration of the Prescription Drug plans is done by the privately owned heath insurance organizations (Patel & Rushefsky 134-136). Medicaid heath facility: Medicaid Heath facility provided by the US government is aimed at serving the people who have low incomes and belongs to the lower middle class of the society. The Medicaid facility covers the whole family of the low income group people. The main criterion for the enrolment in the policy is that the people from low income groups should have the US citizenship or poses legal permanent resident ship in the country. The Medicaid facility provides considerable amount of service towards the HIV AIDS affected people. The Medicaid policy also provides special attention to the children and also have special reimbursement rate for the dental check ups for thechildren. (Smith & Moore 15-25) State Children’s Health Insurance program: Another vital health policy maintained by the Federal government is the State Children’s Health Insurance program which looks after the children belonging from modest family whose overall income is greater to be qualified under the Medicaid facility. The policy aims at covering all the expenses incurred for the treatment of a child enrolled under the policy (Ewing,99). Apart from the government intervention, a large part of the US healthcare facilities is also maintained by the privately owned enterprise. Most of the Americans who do not belong to the senior citizen groups receive the health insurance services through their employers. However the cost of the premiums, which they have to pay to maintain their policies provided by their employers are very high which often prevents them in the purchase of the health policies. Individual health insurance is not popular in USA. Though the US government spends much potion of their revenue in providing healthcare benefits, but only 27.8 percent of the population is covered by the government health policies (Musgrave 95-99). A significant portion of the total population in USA does not receive any heath insurance programs either from the government or from the employers. The absence of heath care facility to this sector of the population underlines the limitation of the health care facilities provided by the US government. These portions of the citizen generally comprises of the unemployed youth and the unskilled labors who work on a part time basis. The uninsured people face serious heath issues as they generally delay to visit a clinic and get the necessary treatment. This portion of the US population also does not undertake regular health check up and restore to the use of precautionary healthy service which further contributes in deteriorating their situation. Overall situation of the US healthcare: The Federal government of United States has always aimed at providing the best of the healthcare facilities to the American citizens. The government has provided their focus on three aspects of the healthcare facilities which are cost, quality and the access of the proper medical facilities. However the proper control of all the three aspects has never been maintained by the government. The control over one of the elements has resulted in the exacerbation of the other factors. Though the government successfully implemented the Medicare and the Medicaid policies, which provided immense help to the senior citizens and the lower sections of the economy, it resulted in the growth of the expenditure along with the degradation in the overall quality of the health care facilities. The overall extension of the healthcare facilities provided proper medical help to the considerable number of people, but it has also given rise to a wide variety of clinical tests, and a large number of procedures involving high cost which are also questionable at times (Sultz & Young, 39). However in the year 2010, The US president Barrack Obama, announced a new healthcare policy to address the needs of the US people who don’t have any health policy. The universal healthcare system was incorporated to provide quality health care to the people at an affordable cost. The universal healthcare system was aimed at expanding the facility of the Medicaid and subsidizing the rate of the insurance for the poor section of the society. The new healthcare system also encouraged the health insurance exchange programs for the US people. It was aimed to prevent the denial of coverage and claims by the insurance companies citing the reasons of pre-existing conditions. The new heath care reform aimed by Obama will drive away the private insurance agency from the market. However if the new policy is implemented carefully then it will benefit the cause of an innumerable Americans. Conclusion: US healthcare system has been one of the vital sectors of the US economy. Every year the government allocates a larger portion of the revenue towards the maintenance of the healthcare. The study of the US healthcare policies underlines the facilities which are being provided to the US citizens. Various limitations are also reflected which includes non coverage of a significant number of US citizens under the healthcare facilities due to a variety of reasons. Some policies provide partial benefit to the policy holders. A critical evaluation has been made which signifies that the government faces a challenging task in the simultaneous maintenance of the quality of the healthcare and in regulating the cost. The overall access to the healthcare system is also a problem for some sections of the society. Though the overall facility of the current US health care system is enormous, but its utilization is not done in the proper manners. (Askill, 2009) Letter to the US official: Respected Sir/ Madam Sub: Aspects of the US healthcare policies. I would like to bring your kind attention to the present condition of the US healthcare and the underlying heath care policies. It is evident that the US government spends a considerable amount of revenue towards maintaining better healthcare facilities for the citizens of the privileged nations. Healthcare policies like Medicare and Medicaid and the State Children's Health Insurance Program indeed benefits a considerable number of people. The policies aim at providing the best of the healthcare facilities at a cheaper cost for the senior citizens, underprivileged sections of the society and towards the children respectively. However various limitation have been observed in these policies as they policies often fail to cover all the medical expenses and the associated cost towards the treatment. Another notable fact observed is that the employers also play a major part in providing healthcare policies towards the employed mass, but often their premiums involve high costs which discourage to people to enroll in such policies. The absence of any suitable heath policies for the unemployed youth in the country is also noticeable, which is also a matter of concern. The efforts of government to increase the quality of healthcare along with a decrease in cost have not produced substantial results and greater participation is required from all the units working towards the promotion of heath in US. Hence the government also needs to monitor the working of the privately owned healthcare facilities, so that they do not maintain any discrepancy. Thanking You. Bibliography: Askill, E, M, (2009), Obama outlines plan for universal healthcare system in US, guardian, available at: http://www.guardian.co.uk/world/2009/jun/11/obama-administration-universal-healthcare-reform (accessed on 17 December 2011) Ewing, T, Mary, State Children's Health Insurance Program (SCHIP), New York: Nova Publishers, 2008 Greenwald, Howard P. Health Care in the United States: Organization, Management, and Policy, New Jersey: John Wiley and Sons, 2010 Musgrave, Frank W. Economics of US health care policy, New York: M.E. Sharpe, 2006 Patel, Kant& Rushefsky, Mark E.Health care politics and policy in America, New York: M.E. Sharpe, 2006 Smith, David & Moore, Judith D. Medicaid Politics and Policy: 1965-2000,New Jersey: Transaction Publishers, 2009 Sultz, Harry A, & Young, Kristina M, Health Care USA, Massachusetts: Jones & Bartlett Learning, 2010 Read More