Healthcare System in the US - Term Paper Example

Health Care The greatest domestic issue facing both the politicians and the people of the United s of America is the inevitable reform of the health care system. In a capitalist society without a universal health care system for all, many seek health care through the corporations and small businesses which they are employed. “Most Americans – a total of 177 million – obtain health insurance through their employers” (Business Roundtable). However, millions of Americans either independently provide their own insurance, or they are left uninsured and financially vulnerable to illness or injury. Yet three major health providers have proposed plans to secure Americans’ health. The American Medical Association (AMA) has made the problem of how to cover the uninsured a top priority. They have proposed that “three pillars” are necessary in order to reach this goal. First, tax credits and vouchers can assist those who desperately need help, and in case the government hand-out becomes no longer necessary, they are fully refundable. Secondly, the AMA has proposed that individual choice of health insurance, with tax credits and regulatory reform, is an “effective means of reigning in runaway health care costs and premiums, without sacrificing highly prized benefits of health care” (American Medical Association). The third and final pillar concerns the regulation of markets in order to protect high-risk patients. “Regulations should protect high-risk individuals without unduly driving up health insurance premiums for the rest of the population” (American Medical Association). The AMA focuses their proposal primarily on government intervention in order to stabilize the health care system. The Business Roundtable (BRT) members are another leading health care provider in the United States, providing over 35 million employees and families with medical coverage (Business Roundtable). While the AMA focuses upon regulation in their proposal for the future of health care, the BRT supports a competitive marketplace in which health insurers can offer coverage across state lines and regions, allowing a greater number of people to participate in particular programs. Overall, the BRT focuses upon the standards necessary for the health care system to grow and continue to flourish, including the “adoption of uniform, interoperable health information technology standards; dissemination of consumer information on the cost and quality of health care and comparison of the effectiveness of health care services and supplies; promotion of changing payments by public and private payers, including Medicare, to reward value of services provided, not volume” (Business Roundtable). Most importantly, the BRT seeks to place an obligation on each and every American to have insurance coverage, either provided through an employer or independently. The National Business Group on Health (NBGH), in contrast to the AMA’s regulatory policy and the BRT’s expansion of the system, believe that health insurance is a “shared responsibility for all, and not just one or a few” (National Business Group on Health). They firmly believe that the individual is the bearer of responsibility when it comes to their own well-being. “People must play a significant role in maintaining their own health by making healthy choices and avoiding unhealthy behavior” (National Business Group on Health). But, the NBGH also considers the national economic situation and the competition inherent in the capitalist system which small businesses face on a daily basis. They believe that “employers need to have flexibility to create benefit plans that most appropriately take into account their economic position, scientific evidence and effectiveness, and the particular needs of the workforce” (National Business Group on Health). When it comes to the issue of the uninsured, the NBGH have concluded that necessary cost-sharing, while not preventing access to essential health care services, should be an essential part to every health plan, including those for the uninsured. President Barack Obama focused much of his domestic campaign for president on the issue of health care reform in America. His plan “provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans” (“The Obama-Biden Plan”). Also under Obama’s plan, the government will cut the costs of individual’s existing health insurance by $2500, and for those uninsured, they have the choice of new and affordable options from health care providers (with the deductions). He will accomplish this by “rolling back” the former George W. Bush tax cuts (for Americans earning over $250,000 per year) and retaining the current estate tax, creating over $50 - $65 billion dollars (“The Obama-Biden Plan”). Similar to President Obama’s plan, the AMA proposes that “risk-related subsidies should be financed through general tax revenues rather than through strict community rating or premium surcharges” (American Medical Association). With the new, affordable plan from the Obama Administration and the tax credits and vouchers proposals, the AMA believes that individuals and families who can afford coverage based upon their income should be required by law to have it. The most important similarity between the AMA proposal and President Obama’s plan is the regulations instituted to protect high-risk individuals from being penalized for their pre-existing health conditions and prevent insurers avoiding “the sick and cherry-pick(ing) the healthy” (American Medical Association). The issue of protecting those who would usually be taken advantage of due to preceding health concerns is prevalent in both plans. The BRT, along with President Obama, believe that government subsidies are necessary for those who choose not to obtain coverage through their employer or who cannot afford coverage on their own. The BRT proposal would “permit the individual or family to purchase private health insurance coverage with financial assistance through the private multi-state marketplace; or for low income Americans who have access to employer-sponsored health insurance, permit the individual or family to receive financial assistance for their portion of the premium” (Business Roundtable). However, the BRT proposal differs greatly with the policy of the Obama Administration in its primary focus. The BRT proposal centers on the individual’s choice for better care for themselves and/or their family, while the primary aspects of the Obama plan are concerned with the effect on small businesses and employers. Similar to President Obama’s plan, the NBGH proposal places its emphasis upon the struggling employers who attempt to provide the care necessary for their employees, but they also express the need for individuals to better comprehend their role within the health care system. “Employers can and should play a substantial role in helping their employees understand what they need to do, as well as supporting them with information, education and counseling support” (National Business Group on Health). However, dissimilar to the Obama plan, the NBGH seeks to promote the capitalist marketplace. “Government initiatives…should promote, not impair the functioning of the private market” (National Business Group on Health). The separation between government intervention and the profitable market is the essential division between the NBGH’s proposal and President Obama’s plan. A coherent “business” plan can possibly be assembled from each of these proposals. The AMA believes that government intervention is not necessary for the health care system to recover. “The government should allow the market to determine the details and success of purchasing associations based on economies of scale and other natural advantages” (American Medical Association). The BRT suggests that the expansion of current health care providers beyond the limits of intrastate activity would help to improve the overall health care industry. “A framework could be used to govern new, multi-state insurance market products, allowing insurers to offer health coverage across state lines within regions” (Business Roundtable). In the best interest of companies to provide proper care to individuals to create a stable customer base, the NBGH recommends quality over quantity in the health care industry. “While payment is related to quality or performance for most goods and services, in health care, people end up paying more for poor medical care and the additional health care needed to ‘correct’ poor quality” (National Business Group on Health). With each of the proposals, these health care providers can continue to strive through a struggling economy and maintain a profit. Reform with these proposed programs can make tremendous strides in addressing the nation’s need for reforming the health care system. Most notably, the affordability under Obama’s relocation of tax funds can enable those who could not previously afford health care to fit it within their budgets, and enable small businesses to provide a health care plan where it was previously impossible. Also, the tax credits and vouchers proposed by the AMA can alleviate some fiscal strain on individuals and families. However, these proposals fail to do enough to provide proper health coverage to all Americans. A requirement for all Americans to acquire and maintain health care coverage would be impossible for those living below the poverty line and cannot rely on Medicaid for treatment. Also, taxpayers who support the Medicaid and Medicare programs would also have to contribute to their own insurance plan. While each of these proposals, along with President Barack Obama’s health care plan, are simply a start to reform a failing system, but much more is needed to allow Americans to remain in good health. Works Cited American Medical Association. “Expanding Health Insurance Coverage and Choice: The AMA Proposal for Reform”. 2008. Business Roundtable. “Health Care Reform in America: A Business Roundtable Plan”. Washington, D.C., 2008. National Business Group on Health. “Principles for Health Care Reform”. Washington, D.C., 2008. “The Obama-Biden Plan”. 2008. 24 May 2009. Read More