Health Care Solutions and Ideas Page
The United States of America is the wealthiest country in world, and yet millions of our citizens are denied access to sufficient medical care because of their personal economic restrictions. We have all heard this and we have all heard our politicians describe how they will fix the problem-usually around election time. What we don't hear, however is a plan that will actually work. Hillary Clinton even formed a task force to address the issue, and we all know what became of that. This paper will provide a brief discussion of health care programs, and then propose a few ideas for our future.
The problem, simply stated, is that many Americans do not have health insurance. This is most often the result of not being employed in a position where this benefit is offered or simply being unable to afford to pay for coverage. With health care costs as high as they are, lack of insurance or HMO coverage means a lack of complete access to medical resources.
Health insurance products vary significantly in price and coverage, A customer seeking coverage directly with an insurer can see a range from $60 per month to $380 per month just for an individual policy, family coverage adds to the price. The primary variable is deductible and patient contribution. For example, the $60 policy might have a $5000 deductible and require the insured to pay half of the costs. The high end policy might only have a $1000 deductible, and pay 80% of all costs up to, say $10,000, then 100% up to $l Million. Then there are the covered expense categories, like prescription drugs, home care, and maternity to name just a few. These major medical plans are technically a form of casualty insurance, where the customer pays an insurance company to take on the financial risk resulting from illness or injury.
The other category of health coverage is membership in a health maintain organization, or HMO. This type of plan is Similar to
an extended warranty or maintainance contract for an automobile.
Forgive the car analogy, but it works. Where health insurance covers
unforseen problems like auto insurance, the HMO is designed to keep
you healthy. The customer pays a fixed monthly fee and has access to
medical care. This access includes flu shots and regular check-ups,
charging the patient a co-pay ranging from $10 to $25 per visit. In
this type of relationship, the HMO has a vested financial interest in
keeping their members healthy, hence their emphasis on preventative
care. There ave those, however, that say that this financial interest
works against the patient because the HMO will try to avoid costly
tests and procedures in an effort to save money. The debate
continues.
Medicare and Medicaid are the two federally funded health programs, but the scope of this paper will not include a discussion of them.
Most Americans who enjoy coverage from private health insurance companies and HMOs do so through their employers. the company may even require coverage unless the employee care show other coverage in place and then opt out. Companies create benefit classes, and otter all those within a class exactly the same benefits. Lower paid workers can expect an adequate program where the company will sometimes only pay half, the half coming from the worker's paycheck. At the other end of the benefit spectrum are those offered to professional employees, and the highest benefit class reserved for senior management. It is very possible that a company will spend more on health coverage for the top-tier folks than the bottom-tier workers.
Health and medical benefits offered to employees are not considered taxable by the Federal Government as well as most if not all states. As a result employers are in the habit of offering high-level health insurance packages to many workers as part of their overall compensation packages in order to attract highly desirable talent. One side effect of this practice is to encourage insured persons to over consume health care service. This overconsumption is one of the many factors in the apparent soaring of health care costs.
Over the past ten years health care costs have grown significantly faster than the Consumer Price Index (CPI) for a variety of reasons. New technologies and rising malpractice insurance rates are the leading causes. As new medical technologies and diagnostic procedures are developed, many become medical must haves in hospitals and doctor's offices. Compared to ten or twenty years ago, a patient who goes to see his or her doctor for, let us say a cough and chest pain to rule out pneumonia, will be subjected to lab tests and other diagnostic aids, that probably didn't exist then. Just as a very small example, today's thermometer is a $50.00 electronic device that has supplanted a $1.50 mercury device. For a doctor not to use these latest and greatest tools might very well find themselves the subject of a malpractice claim it they failed to diagnose a problem.
As American law schools, a profit center for our universities, continue to produce growing numbers of lawyers we should be able to continue to see growing numbers of civil lawsuits filed in our country's courts. Whoever is to blame, civil litigation seems to be a growth industry in the United States of America. Medical malpractice claims have risen significantly in the past few decades. With these claims come large settlements paid by insurance companies who in turn must raise their premiums. With premiums in the tens of thousands of dollars per year, we can certainly see why doctor's fees have been increasing. In fact, there are many situations where a rural area is in need of a certain medical specialty, for example, OB/GYN, but the premiums are so high, no doctor can afford to establish themselves there.
Let us look now to a possible solution to the principle problem of Americans without access to necessary healthcare. In broad strokes, we need to propose a plan that will fill a gap in our current system, not the complete overhaul and restructuring that has been proposed by certain Democrats. The idea of a nationalized health care system is to dangerous to even think about discussing here-or anywhere for that matter.
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Written by: Owen R. Matthews