Coverage In The US Healthcare System

A part of the problem of cost was the establishment of “free” healthcare for those eligible for Medicare and Medicaid, between 1965 and 1971 where there was no limitation on benefits. The cost of healthcare increased from 39 billion in 1965 to 75 billion in 1971. Providers had no concern for the cost of their care seeing that SSA recipients had no limits

During the past few decades in the United States, health care cost has been skyrocketing, and many people have lost their insurance as result of the high cost. Approximately 45 million American s are uninsured or they don’t have a real health care plan that can cover all their needs. Some Americans have the perception that even with coverage, cost and other problems in the system, the quality of the Healthcare System in the US is better than other countries in the world, something that it is not true. As a matter of fact the United States is one of the richest, industrialized countries in the world where it spends a lot of money in its healthcare system. Spending more money in the Healthcare system does not mean it will be a better system, nor it does not mean it could not improve in some areas. In contrast, the Federal Republic of Germany where its healthcare system is completely different from the United States.

Universal Healthcare sounds appealing, but it actually lowers the quality and quantity of healthcare services that are rendered to patients, thus downgrading the healthcare system as a whole.  Not having to pay, with everyone having coverage leads to longer wait times for medical service and many people overusing health care services. Implementation of Universal Healthcare in the United States would lead to a detrimental crippling of the nation’s health system. For those countries that have implemented Universal Healthcare or a system similar to it, all or most aspects of the coverage such as cost and care is generally provided by and tightly controlled by the government, a public-sector committee, or employer-based programs, with most of the funding essentially coming from tax revenues or budget cuts in other areas of spending. This paper will conclude with comparing the US healthcare system to others and how the US has one of the most advanced systems in the world.

Health care spending in the United States of America as a percentage of the economy has reached astonishing heights, equating to 17.7 percent. This number is shocking when compared to other counties; in Australia health care is 8.9 percent, in United Kingdom 9.4 percent, in Canada 11.2 percent. If the American health care system were to hypothetically become its own economy, it would be the fifth-largest in the world. While these statistics sound troubling, they lead us to look for answers about the problems surrounding our system. The first health insurance company was created in the 1930s to give all American families an equal opportunity for hospital care and eventually led to a nationwide economic and social controversy that erupted in the 1990s and continued to be shaped by the government, insurance companies, doctors, and American citizens. In this paper, I will go in to detail about the various opinions regarding the controversy, the history behind health insurance companies, and the main dilemmas brought out by the health care crisis. Greedy insurance companies combined with high costs of doctor visits and pharmaceutical drugs or the inefficient hospitals all over America can only describe the beginning to this in depth crisis. Recently, the United States health care industry has become know for the outrageous costs of insurance models, developments of various social and health services programs, and the frequent changes in medicinal technology.

In March of 2010 the Patient Protection and Affordable Care Act was passed. “Without the ACA, the number of uninsured would be 56 million (Congressional Budget Office 2012)”, according to Shi &Singh (2015). The purpose of passing this particular act was to

Critics believe that the present functioning of managed-care is degenerative to health care. Managed-care firms control costs by requiring patients to use a “network” of approved doctors and hospitals, and by reviewing the actions of doctors. Patients have to pay more to visit a doctor who does not participate in the “network.” Managed-care firms second-guess doctors, considering only the costs. Patients are often prevented from visiting specialists to reduce costs. A managed-care company might insist that its doctors prescribe inexpensive generic drugs instead of commercial products. Many patients must, also, receive the insurer’s approval before undergoing treatments or operations. HMOs have been criticized for refusing to pay when a patient goes

Charles, the Affordable Care Act (ACA) was intended to correct the historical issues related to cost and access in the health care system in America (Pagel, Bates, Goldmann & Koller, 2017). The ACA was an attempt by the US government to ensure access to health insurance was available for more Americans. The historical role of the government in health care prior to the ACA had been that the government should only have a little involvement in the delivery and reimbursement of services with respect to having a role in policy making for the protection of the public’s health (Williams & Torrens, 2008). The role of government involvement has changed through the Medicare and Medicaid government programs. Today, these programs have the

The Affordable Care Act was constructed by President Obama to help transform the health care system. The Affordable Care Act is supposed to implement a system that would reduce the health care costs. This would also improve the efficiency of procedures by eliminating the denial of coverage due to pre-existing conditions. Unfortunately, over 44 Million Americans can’t afford the cost of medical insurance, but the law grants these Americans medical insurance benefits. Before this law was in place, insurance companies could deny patients the medical attention they needed, drop their medical coverage halfway through their treatment, and have a maximum payment they prepared to pay.

Health care reform and access to insurance have been staples of the American political agenda ever since the end of World War II. From President Truman’s call for universal coverage in the late 1940’s to the creation of Medicaid and Medicare to the Affordable Care Act, both parties have debated how to lower the rate of uninsured Americans. After nearly 70 years of debate in Washington and beyond, the number of Americans with health insurance has certainly grown (Miller, 2014). However, the number of people in the United States without coverage is still unacceptably high and a problem that should be addressed with a great deal of urgency and care.

The Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA), is far–reaching enactment that will change how a large number of Americans access health care. The intent of the ACA was to increase the number of insured, increase quality of care and making it affordable for everyone by reducing the costs and expanding coverage. Under the act medical providers such as hospitals and primary care physicians will have to change their practice financially, clinically and technologically in order to have better outcomes, lower costs and have better methods of providing care. The ACA also includes provisions that require all Americas to secure medical coverage or pay fines and it requires insurance companies to accept all applicants.

As we all know, the United States has been and continues to be on the edge of national health reforms due to uncontrolled healthcare costs. Since the U.S. health care system does not lead the world in health of its own citizens, 28 million Americans remain uninsured and 30 Million more are underinsured as of 2016 (Jama, 2016). The national health reform started in the early 1900s when the American people faced sickness that led to poverty. Working people had to miss work due to sickness which led to a loss of their wages and steady income, making it hard to pay for medical expenses. The decreased income, made it hard to seek medical attention, because it became a matter of just being able to cover necessities. President Theodore Roosevelt

6). We are able to see how these significant events impact us even now. As our health care system continued to evolve, the 1990s saw health care delivery and financing primarily controlled by indemnity insurers, nonprofit hospitals and private physicians (Gabel, 1997, p. 134). Health insurance premiums grew by 20% and enrollment grew from 36.5 million to 58.2 million (Gabel, 1997, p. 134). With the growth of managed care plans, hospitals began to merge and the development of large physicians group practices evolved (Kongstvedt, 2016, p. 14). These roots of managed care grew to give us the health care system we are familiar with now.

Healthcare in America is a very complex system. It is very different from what it used to be. It is moving from what was considered an indemnity type of care plan into a more managed care plan. There are a lot of factors that has influenced the fast growing system. Factors that are considered a contributing to this is the growth in the US population, people are living longer than before. An increase in technology, easier access to information. There is an alarming growth rate in the allied healthcare professionals. The cost and dependence on drugs and the pharmaceutical cost has increased. The rising cost of individual and family healthcare insurance. Because of the rising cost of malpractice insurance, case settlement and jury awards.

The implementation of the Affordable Care Act (ACA), popularly known as “Obamacare”, has drastically altered healthcare in America. The goal of this act was to give Americans access to affordable, high quality insurance while simultaneously decreasing overall healthcare spending. The ACA had intended to maximize health care coverage throughout the United States, but this lofty ambition resulted in staggeringly huge financial and human costs.

One explanation discussed in the chapter is that the shift toward managed care led to a one-time decrease in expenditures, but advances in medical technology continued, resulting in commitment growth in expenditures. This explanation implies that HMOs helped prevent rising health care costs during the 1990s, but have been unable to keep costs low due to rapid advances in technology. The structure of HMOs creates incentives for health care providers to skimp on the quality of care. HMOs used “gag rules” that prohibited physicians from discussing treatment options that were not covered by the plan, but government regulation has since banned these gag rules, allowing patients greater access to information. Medical technology creates new, and often more expensive, treatment options, which patients believe they should have. It has become increasingly difficult for HMOs to keep