Free Market Conditions In Healthcare

After years of schooling and hundreds of thousands of dollars in debt, doctors aren’t even able to work on their own terms. “Consumers allegedly have a “right” to what health care providers provide, a “right” to say what will be provided, when, and at what price” (Salsman 2012). Consumers shouldn’t have a “right” to what is provided to them or how much it costs. The government controls pricing and controls who can receive care and what kind. It’s not right that those who are actually working in the medical profession that they have lost control of their businesses.

Free markets which would allow patients more choices for health care coverage could also lower cost. Free market health care is a term used to define the choice a person has to buy insurance from anyone they please, regardless of state or employment . It is sold without government regulations, control, oversight or licensing. If you are paying for a service, shouldn’t you have the right to choose who you are purchasing that service from ? Why should government have a say in where and who you can buy your insurance from? In the State of North Carolina, we operate under a regulatory committee called the Certificate of Need (CON). According to the National Conference of State Legislature, the CON , is a program aimed at restraining health care facility cost and allowing coordinated planning of new services and construction. In North Carolina the state can’t dictate where you can build, what services you can offer and if they are valid. These services have already been researched by the organizations applying for the CON,

In the cold winter season, more people are going to come down with the flu or pneumonia causing an increase in demand for certain antibiotics and medical care (supply) necessary to treat these ailments. If physicians and/or hospitals do not increase their supply, this will cause a shortage in medical care available meaning the price for care will increase. This is, at its very basic, an example of supply and demand.

Expansion of the MCO model occurred with the enactment of the Health Maintenance Organization Act of 1973. This Act provided the foundation for managed health care and required employers with greater than 25 employees to provide and HMO offering. The Act served to counter Democratic efforts to nationalize U.S. health care and to stimulate competition within the health care market. HMO’s also began the concept of for profit health care operations. While most health care providers are not for profit (Phelps, 2011) and number operate under a for profit model. Non-profit dominates the healthcare sector based on their tax exempt status.

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

The Affordable Care Act was created to assure all Americans have access to affordable insurance, but as stated by Sir Isaac Newton for every action there’s an equal and opposite reaction. As more and more people become insured in this country, the for-profit insurance companies are reaping the benefits from the legislation of the Affordable Care Act.

The first thing to think about is the fact that health care accounts for approximately 8% of the U.S. economy. The Affordable Care Act, better known as Obamacare or other unsavory names is actually in my mind making the medical field and the availability of care for patients more difficult. Regardless of its benefits to some patients, Obamacare is making things much more difficult for doctors, nurses and anyone that is part of the medical profession. It has done nothing but increase paperwork, which is the major priority, and costs have continued to rise. From what I have witnessed has done nothing to increase the quality of care. Government bureaucrats and insurance companies, not doctors, are in charge of our health care. Obamacare is all about saving money, by not spending it on patient care and where the money is spent is being directed by special interest and profit-making organizations. They are dictating the way care is provided. Basically insurance companies are in control of who lives or who dies. The law contains spending cuts to Medicare that amount to $716 billion from 2013 to 2022. The end result of course is that seniors are the group that suffers the most since they are the group that seeks and needs medical care more than any other age group. Money is the priority and not patient care as government and insurance companies have a different agenda than health care providers. Should “for-profit” insurance companies exist, or should there be only “non-profit”

Many other glaring needs of health care reform were addressed through the ACA, but I want to focus on three main ripple effects that I believe need to be tackled in order to create a more well-balanced, consumer friendly health insurance market. 1) The amount of quality health insurance plans in America is dramatically decreasing: Health insurance used to be readily available in tiers; the highest tier, being the most comprehensive, had the highest monthly premium, but a low deductible (a patient’s out-of-pocket costs for surgeries, emergency visits, etc.). While the lower tier, which offered basic health care for routine visits, had a higher deductible. Today, insurance companies are being forced to offer “more affordable” plans,

Less than a hundred years ago, in the late 1920’s and 30’s, almost 90% of Americans did not have health insurance (Fall of HMO’s 4). They used a variety of home remedies and when medical assistance was truly needed, they paid for it out of pocket, even incurring vast amounts of debt. This had been the case throughout history, and it changed due to an important factor, medical equipment. The industrial revolution finally caught up with the medical industry and the country saw a vast change in the scientific instruments used by physicians. These instruments required a lot of money to make and care for which caused prices to rise. Due to this massive problem, a committee was formed of health care professionals and after a 5 year study, the Committee on the Cost of Medical Care suggested that health insurance co-operatives start. These corporate medical practices became known as Health Maintenance Organizations (HMO’s) and preferred provider organizations (PPO’s), and up until the 1970’s, were an experiment to regions across the U.S. Factors that hindered health care included bullying of “money politics” from both sides of the isle as well as Presidential views and tactics as well. President Nixon first

In addition, this multi-payer system allows health care prices be set though the private marketplace of the country driving high costs for everyone. This health care system is the only one in the world that gives the freedom of setting their fees and prices, as they see convenient, to the large number of independent providers of health care services and marketers of pharmaceutical and medical supplies that exists. By doing so, the system has become unaffordable for the uninsured because of its excessive costs, and health insurance companies have been forced to accept whatever prices they set since they need to have them included in their networks.

Some major reasons that a free, unregulated market in medical care might night be optimal are: Imperfect information, asymmetric information, barriers to entry, and third-party payers.

Many employees must designate a health plan through their employer. These days, as HMOs (health maintenance organizations) and managed care plans continue to proliferate, that means a choice between bad and worse. As employees line up in the lunch-room for a process called open enrollment, they may be surprised to learn that managed care rates have gone up — again. The mirage that managed care is cheaper care is finally fading. And, for the first time in years, employees may also have the promise of free choice in medicine in the form of a new method of financing health care. Consumers are already aware of horror stories involving HMOs, but cheap rates persuaded many that managed care is less expensive. Recent

I agree with the statement that you have made. A problem with how health insurance provider set up is the focus on payment weather to providers or the company itself. In my instances the changes to each process weren’t geared to providing better services to patients but more financial gain. “The five largest health insurance companies – WellPoint, United Health, Aetna, Humana, and Cigna - … earned over $3.3 billion in profits [between April and June 2011].” Shah goes on to contend that “Profit in the health insurance industry is the single greatest barrier to building an efficient, sustainable system of healthcare in this country” (Ubel,

A competitive market is one that allows easy entry and exit: a market in which companies are generally free to enter or to leave at will. This does not describe the health care market in the US. There are certain assumptions that the competitive market model operates under some assumptions, first is the consumer/patient has full information about the nature of the services required, the anticipated results of their decision and the benefits obtain from the service. This is not true in health care often time the patient is operating at a distinct information disadvantage when they require health care services such as insurance. If a patient purchases health insurance often they don’t know enough information to ascertain if they have

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients. In other words, competition ensures the provision of better products and services to satisfy the needs of customers (Glover & Rivers, 2009). In the health care industry, competition has an impact on many relational perspectives. There have been several studies examining the relationships between competition and quality of health care, competition and health care system costs, and competition and patient satisfaction. Some elements of competition in health care are price, quality, convenience, and superior products and