Issue Analysis In Healthcare

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.

Since the advent of health insurance in the 1950s, there have been many models of care that are come to the scene in an attempt to both control cost of care and improve quality of care. Insurance models came into being because the fee for service model used until then was proving to increase cost of healthcare without any measure of quality of services and care provided. Health insurance models have evolved from the basic hospital offered insurance to employer sponsored coverage plans. The US health system is broken both financially and quality wise with more than 20% of gross domestic product being spent on healthcare (Blackstone, 2016).

Supply and demand forms the most fundamental concept of economics. Whether you are a teacher, farmer, medical supply manufacturer, doctor or simply a consumer the fundamental foundation of supply and demand equilibrium is incorporated into the daily behaviors of our society. Consumers naturally look for the lowest price, while producer are influenced to expand outputs at greater cost. This is the same phenomenon in healthcare. With congress enacting the Affordable Care Act, many are seeking out the cheapest form of insurance, while at the same time wanting the greatest benefits.

When it comes to health care, cost is one of the biggest problems. Something needs to be done in order to make it possible for patients, families, and businesses to be able to afford health care. US does not always spend health care dollars in the most productive way. The cost of cancer treatments alone can cost up to hundreds of thousands of dollars, and the only way to pay for that is to raise the cost of the insurance to the patients. Cost is defined as the “price” of healthcare. The “price” or cost can come from various places such as, the physician’s bill, the cost of prescriptions, as well as what the employers pay to cover their employees. The cost of treatments, emergency room visits, medicines, the cost of newest technology and etc. is what is making our increase in cost rapidly. The rising costs leads to becoming a financial burden to families, even the ones that have health insurance, which can typically result in individuals not receiving the health services that they need.

There are different reforms being proposed to help fix America’s healthcare system that is dialing many Americans daily. Many Americans are finding themselves unable to pay the hefty sum, it takes to take care of themselves. There are two types of markets that could potentially solve America’s health insurance dilemma. These market reforms are called perfect competition or free market reform, and Affordable Care Act.

A major contributor to the rise of healthcare cost is that heath spending for individuals is primarily funded by third-parties. Because consumers of healthcare share little of the financial burden of the cost of the care they receive, patients and physicians are incentivized to utilize healthcare at a higher rate than they would if cost was a larger factor. The United States healthcare systems is based on a capitalist system but it operates in an imperfect marketplace that is no competitive. The current marketplace is not highly regulated as there is not a national health care program for all Americans which allow prices to be regulated and controlled effectively by a single regulating body. In this imperfect

It helped to provide coverage for low income Americans, and to assist them in managing the confusing healthcare industry to obtain the most efficient health care. Although the U.S. government should not interfere with market competition, more can be done to preserve the right of being healthy for every American. Within the Medicare and Medicaid programs, a greater option of choice and wider coverage could help improve the American healthcare industry and overall health of the average American

Health care reform has been a hot topic in recent years and more so with the expansion of the Patient Protection and Affordable Care Act of 2010. The debate that arises from the health care reform concerns which two perspectives, pro-government or pro-free enterprise, will best allocate resources to improve access, cost, and quality of care. I strongly believe the majority who favors each given group is influenced by their individual background. For those people who have grown up with health insurance, they most likely believe it is an individual responsibility, whereas people who struggle to be insured could benefit from a central role through the federal government and feel it is their right as an American citizen to receive such

There is a growing trend in the United States called pay-for-performance. Pay-for-performance is a system that is used where providers are compensated by payers for meeting certain pre-established measures for quality and efficiency (What is Pay-for-Performance, n.a.). We are going to be discussing what pay-for-performance is. There are different aspects of pay-for-performance which include; the effects of reimbursement by this approach, the impact cost reductions has on quality and efficiency of health care, the affects to the providers and patients, and the effects on the future of health care.

Another issue for fee-for-service system is that the providers set the prices for services. Patients were free to seek any type of healthcare services that they thought they required, while providers set the costs for each service that was billed to indemnity insurance companies (Shi & Singh, 2015). Insurance companies had little control on the types of services that the patient received and prices billed for each service. The fee-for-service model encourages excessive and unwarranted procedures and offers no incentives to utilize economical services (Smith, 2010). While the patients enjoy the freedom of being able to seek out their own services, over-utilization of expensive services on unnecessary and highly technical services increased healthcare costs.

Regulations that prevent insurance companies from participating in interstate commerce have caused competition to grow stagnant in the United States. This lack of competition has allowed the adoption of wasteful procedures by healthcare providers, which in turn passes the increased expenses back to the insurance companies. Therein, insurance costs increase, crippling consumer’s cash flow and quality of life. While healthcare costs continue to rise, people must scrutinize the current healthcare system.

As stated in the text, the United States provides a market based health system. Not until recently, the majority of the population could only access the insurance market through an employer based system. The ability to acquire insurance or gain access into the market outside of this medium was, in most cases, exorbitant for the average citizen. Nevertheless, government assistance programs like Medicare and Medicaid were made available to certain demographics of the population who qualified for these programs, such as citizens from the age

On March 32rd, 2013, President Obama presented to Congress a Healthcare Reform Stimulus Act, in which he ensured will help all the American people save plenty of money on health coverage and medical expenses; such as, hospitalization and treatments. The Affordable Health Care Act, bill was put into law to cover recipients who was paying high premiums reduce their premiums and to insure uninsured recipients who could not afford to purchase coverage get it at a cheater cost. Without a doubt, universal healthcare is still considered one of the most challenging social problems that we have to deal with today. Even though, this issue is unsolved there is still a lot to discuss that need to be clarified concerning affordable healthcare. During presidential election in 2012 both parties the Republicans and the Democrats presented different viewpoints on this ideologies matter. Obama care new health care policy was put into action this to provide more coverage to a larger percentage of low–income working American, it is less cost effective and more within citizens spending budget. “AHRQ-funded researchers compared data on health maintenance organization (HMO) premiums in various markets. Premiums were lower in more competitive markets, where a high percentage of the population was enrolled in HMOs and many HMOs competed for their business” (AHRQ, 2002, Para. 13).

One of the top major issues in this 2016 presidential election between the Democratic Nominee Hillary Clinton against, the Republican nominee Donald Trump is, how make The USA Healthcare system more effective and efficient while reducing cost. Both Presidential candidates have suggested distinctly different proposals to reform current US healthcare system known as The Patient Protection and Affordable Care Act which is, a comprehensive health care reform law enacted in March 2010 by President Obama. Mrs. Clinton agenda is to work within the existing ACA framework, furthermore she proposed additional policies intended to expand coverage, and reduce consumer out-of-pocket costs for individuals. Contrary to Hillary’s proposal, Mr. Trump’s agenda is to completely repeal Obamacare Act, and replace it with Market-Driven Health Care System also known free Market approach, as well as inclusion of patient-centered health care system principles. Numerous economist that analyzed Trump’s proposals come to conclusion, that healthcare market is fundamentally different from other industries, and cannot function efficiently and effetely in a traditional marketplace, because the differences factors which effects the demand and the supply side in economics of healthcare industry. This market have Unique Feature, such as, uncertainty and information asymmetries, furthermore adverse selection and moral hazard issue will get worse, also the spending for individuals as well as government in

There is a spacious room for lemon in insurance field. The price for health insurance is not fixed, it varies based on the level of the need an applicant may require for the insurance. As in the case of elderly people over the age 65, it is well known that it is very difficult for them to get health insurance because of its high price as they certainly will need it more than other applicants. On the other hand, employees working in companies are offered health insurance as a part of the companies’ policies and regulations. This actually create more room for lemon in the insurance field and less chance for old people who need it more. This ended up with adverse selection by the insurance companies. (A.Akerlof, Aug