Social Medicine versus U.S. Health Care System - Essay Example

Social Medicine vs. U.S. Health Care System There are different health care systems functional in different countries. Health care system has a significant impact because of the essential nature of health care services. The common types of health care systems are socialized medicine and a mixture of private and public medicine as seen in the United States (Chen and Chung 3). Canada is the example of a nation that has a functional socialized medicine. The paper compares the components and effectiveness of socialized medicine to the health care system in the United States of America. Socialized medicine is defined as the provision of medical care for all using public funds (Ridic, Gleason and Ridic 112). The government pools contributions from all citizens, which is used to provide healthcare regardless of their financial status. It is an attractive because it can offer ‘free’ health care services. Canada is a fitting example of a country with a perfect socialized medicine system. In Canada, the purchase of private insurance has been made illegal to force everyone to use the public health care system. The United States health care system has traces of characteristics attributed to socialized medicine. However, it is different because it allows both private and public insurance to cover the cost of health care services. A mixture of both public and private funded programs characterizes the United States health care system (Raghavan). Health insurance can be purchased in the market without any controls. There are two kinds of health insurance providers, which are the commercial insurances and non-profit insurers. Medicaid and Medicaid are the health care insurance programs that are being supported by the government. The insurance programs provided by the government are meant for the disabled, young, poor and the elderly in the society. Majority of Americans depend on their employers to cover their healthcare costs. It is estimated that 61% of Americans depend on health coverage plan provided by employers (Ridic, Gleason and Ridic 113). It is imperative to note that a big part of the American population is uninsured because they are not employed, or their employers cannot provide health coverage benefits. The lack of a universal health coverage system makes United States special because it is the only industrialized nation without such a system. The unique feature in the U.S health care system is the fact that the system is dominated by the private sector. This section seeks to explore the details on Medicaid and Medicare. Medicare is the federal health program that is meant for people who are aged 65 and above. The program is administered by the government, which acts as the single payer. The program is supported by taxes earned from the payroll (Shi and Singh). The payroll tax is paid by both employees and employers. Individuals who have enrolled to pay premiums also help in financing the program. Parts B and D allow individuals who can pay premiums to enroll for the Medicare program. Part of A of Medicare supports hospital services while Part B covers the physician services (The National Bureau of Economic Research). Part D of the program supports prescription and benefits related to the issuance of drugs. The program is rife with many gaps, which explains why some people feel it is very inefficient. It does not support high-quality nursing care and preventive care. Medicaid has been formulated for the disabled and poor members of the society. It covers poor pregnant women, disabled people, and the elderly. The program is administered by the individual states and the District of Columbia. The funds for Medicaid come from the Federal tax and the State tax. Poor states are reimbursed the full amount they spend by the Federal government. The Federal government covers more than fifty percent Medicaid costs. The program offers comprehensive benefits. The main limitation is that it takes time to qualify for a Medicaid program. The socialized system in Canada and Europe is a single pay system while the system is multi-payer. The payers in the United States health care system are commercial insurance companies, state and federal governments (The National Bureau of Economic Research). They are responsible for reimbursing health care providers. The reimbursement process sin the United States is more detailed because of the many health care payers involved. The reimbursement process depends on the nature of the payer. The health care providers are reimbursed on a fee for service basis. The physicians under Medicare are also paid on the same basis, which also covers a section of Medicaid. However, the relevant government authority sets a fixed fee under Medicare and Medicaid (Wicks and Keevil 420). The most obvious difference between socialized and the U.S. healthcare system is the level of government intervention. The American system does not favor complete government intervention, which will see healthcare being treated as a public service. The American system limits government intervention based on the notion that market forces will facilitate cost effectiveness and efficiency in the provision of healthcare. On the hand, socialized medicine encourages government intervention because health care is viewed as an essential need. For example, in Canada and Europe healthcare is viewed as a public service, which is why the government is in full control of healthcare provision. Social medicine justifies government intervention because it helps in handling the problem of economic inequality and universal access to health care. In contrast to the social medicine system, the United States health care is focused on the ability to pay. The government acknowledges the existence of vulnerable groups, which explains the presence of Medicare and Medicaid. The assumption is that everyone is capable of paying for his or her health coverage. Anybody who does not fall under the vulnerable group should find a way to pay for health insurance. The American health care system gives the people a choice to select the extent of coverage based on preference and financial capability. Some might choose to be covered completely while others might prefer adequate cover (Raghavan). The system encourages competition among health care providers with the best providers getting many consumers. It explains why the wait time for patients in the United States is extremely lower than the patient wait time in Canada. It is very clear from the explanation that social medicine is a very simple system compared to the U.S. health care system, which is very complex. The issue of a financial barrier is also another significant difference between social medicine and the United States health care system. In a system of social medicine that is active in Canada, there is no financial barrier to health care services (Shi and Singh 65). For example, all Canadians are entitled to all the important health care services that are covered by the state government under the health care plan. The country has a law that prohibits people from paying for health care services. On the contrary, the United States health care system creates a financial barrier to health care services. The people with money can access quality health care service within a short time. Efficiency and quality are available for the haves in the society. However, the people without money are forced to go without medical care for long or receive a relatively poor health care service. The Affordable Care Act was introduced with the hope of reducing the number of people without health insurances in the United States. The high number of patients with no insurance cover explains the high level of uncompensated care reported by health care providers. The other difference in between the social medicine health care system and the United States health care system is the extent of benefits. Social medicine systems in Canada, Germany, France and Britain are comprehensive. For example, the Canadian health care system does not put a cap on the amount of money that should be spent on necessary medical care for all citizens. The insurance cover will pay as long as the health care service being sought is necessary. On the contrary, the extent of coverage in the United States health care system depends on the insurers. The insurers who provide public insurance offer limited coverage as directed by the government. Even the insurance cover from employers is limited. Many Americans who do not have insurance cover have family members with full-time jobs. In addition, small companies rarely offer health insurance to their employees (Shi and Singh 66). The limited nature of the health insurance coverage presents problems to families that do not have enough money to buy full coverage. The type of administration conducted in the United States health care system differs from the administration style seen in social medicine systems in Europe and Canada. The analysis of the Canadian social medicine system shows that health insurance plan is administered by a public agency found in each province. The agency is nonprofit. The provincial governments obtain equipment and assess the overall increase in the budget of hospitals. Doctors are salaried government workers. The majority of physicians found in private service are paid based on a fee for service system. On the hand, the administration of the health care plan in the United States private insurers, employers, local, state and federal governments. The different reimbursement systems make it possible to pay health care providers differently based on the insurance provider. In addition, the system is full of co-payments and deductibles. It is common for health care providers to bill patients the money that exceeds the value set by the insurance reimbursement system. It has no individual authority that is responsible for the whole system. Thus, the system is chaotic, and patients can be easily manipulated. Based on the state of the United States health care system and the countries using social medicine, the United States health care system is characterized by an advanced state of the art of technology. Advanced technology in the U.S. healthcare system explains the high-quality healthcare that one can get if he or she has the money. The advanced state of the art technology has helped in saving many lives especially when dealing with chronic illnesses. Research has shown that the elderly can live longer than their counterparts in other countries can because of the high level of efficiency in health care provision. The acquisition of latest technology can be attributed to the reliance on market forces, which pushes health care providers to provide efficient services. Efficient services attract people who can pay high premiums. The United States spends more than any other country in healthcare. The comparison of health care spending in social medicine and the US health care system is the level of spending and growth rate and the presence of a single payer. First, the Canadian government has been spending little on health care compared to United States. The cost of healthcare in the United States has been growing at an alarming rate compared to the cost of the Canadian system, which has been growing a relatively slower rate. Therefore, many studies have argued that the Canadian system is better because it provides healthcare to all people at a low cost. In effect, it is right to assume that the burden of healthcare costs is lower for people in a social medicine system than the people using the United States healthcare system. The presence of a single payer also explains the low healthcare spending that is characteristic of many social medicine systems. The presence of a single payer in a universal medicine system makes it possible to achieve efficiency in the administration of health insurance. The presence of many payers means many intermediaries and too much paperwork. All these factors serve to raise the overall cost of administering health care services in the country. Research has shown that some of the factors that drives health care spending up in the United States are the presence of many intermediaries, overcharging by health care providers and too many health insurance administrators. Currently, there have been discussions on how to reduce the cost of healthcare in the United States. The future of the healthcare system in the United States relies on the new legislature and the level of unemployment that continues to rise all over the world. There is increasing pressure for the United States to adopt a Universal healthcare system, because it will help reduce the overall spending on health care, and give everyone a chance to access quality healthcare (Pushman and Chung 100). Since studies have shown that the presence of multiple payers in the US healthcare system helps in increasing the cost of healthcare. A universal healthcare system will have only one payer, which will prevent health care providers from charging excess money for simple services. The future of social medicine is implementation in many countries. The rising inequality rates is pushing countries to adapt a social system to reduce costs and provide basic health care services. It should be noted that hard economic times in the future might compel social medicine systems to redefine the term ‘comprehensiveness’ in their systems. The U.S. health care system is starting to look more like the universal medicine system (Wicks and Keevil 421). The coming of the Affordable Care Act is an indication of the move towards universal coverage, which is characteristic of the social medicine systems. In conclusion, the U.S. health care system and social medicine are different in many ways. Social medicine has a single payer while the American system has multiple payers. Social medicines are relatively simple compared to the American system. The simplicity is attributed to the presence of single overall health insurance administrator, which is not the case for the U.S. health care system. Social medicine is cheaper to maintain than the American system, which is very expensive. Efficiency is higher in the American system compared to the social medicine systems. The high costs of the U.S health care systems have led to pressure on the United States government to emulate other industrialized nations and adopt a universal medicine system. Works Cited Chen, Kuan-Chou and Keh-Wen "Carin" Chung. "Using Systems Thinking To Analyze Health Care in the United States: Should We Move to a Government Sponsored Health Care System?" Academy of Healthcare Management Journal (2013): 3-12. Print. Evans, Jenna M., et al. "A Cognitive Perspective On Health Systems Integration: Results Of A Canadian Delphi Study." BMC Health Services Research 14.1 (2014): 57-82. 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