The American Health Insurance System

The principle of market justice is a system where medical care and benefits are distributed on the basis of people willing and able to pay. Moreover, the principle of market justice assumes that the free-market forces for supply and demand can govern health care, individuals are responsible for their achievements, and the market works best with minimal inference with the government (Shi and Singh, 2013). On the contrary, the principle of social justice is when health care is equally distributed, and it is a societal responsibility. Social justice regards health care a social good that should be available to all citizens regardless whether they can pay or not. The social justice method assumes that the government can decide through rational planning how much health care to produce and how to distribute it among all citizens. The problem is that the United States does not follow free-market principles, which can be seen in market justice, and social justice has been ongoing and gradual in the United States. Social justice drives publically financed programs such as Medicare and Medicaid. However, market justice drives employer-based insurance (Shi and Singh, 2013). Nonetheless, there are many Americans who cannot afford insurance, or do not have a job and do not qualify for any public programs. The amount of Americans uninsured is because of health care costs. As health care costs go up, the middle class is diminishing. Health care can very well be a factor contributing to

The U.S. health care system faces challenges that indicate that the people urgently need to be reform. Attention has rightly focused on the approximately 46 million Americans who are uninsured, and on the many insured Americans who face rapid increases in premiums and out-of-pocket costs. As Congress and the Obama administration consider ways to invest new funds to reduce the number of Americans without insurance coverage, we must simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps even for those with access to insurance coverage.

The dysfunction of the American health care system implies that not everyone has access to the right medication and medical treatment. Middle-class families and chronically ill patients do not always have access to health care, and when they do they do not receive adequate treatment with regards to hospitalization and medical services or quality of service. The lack of payment reform results in

Health insurance in the United States is a highly politicized issue. In recent years, many strides have been made to extend health insurance coverage to all Americans with the passage of the Patient Protection and Affordable Care Act (PPACA). While the program has been vigorously debated in the public realm, arguments are often centered around political ideology rather than economic theory. This paper seeks to challenge the entire structure of the current health insurance model, since its inception in the 1950s. Through the overuse of a third-party payer model, a magnitude of problems have emerged that severely diminish the efficiency of health care allocation in the United States. This paper proposes a model that seeks to correct issues of cost, access, and market efficiency by adapting the Medicare Part D payment scheme for an all encompassing insurance model.

In this paper, I will describe the concepts of market justice and social justice, explain how the two principles complement each other and in what way they conflict in delivery of health care in the United States. Secondly, I will discuss how health care is rationed in the market justice and social justice systems. Finally, I will discuss the types of health insurance that is based on market justice and social justice principles.

The first characteristic of the US health care system is that there is no central governing agency which allows for little integration and coordination. While the government has a great influence on the health care system, the system is mostly controlled through private hands. The system is financed publically and privately creating a variety of payments and delivery unlike centrally controlled healthcare systems in other developed countries. The US system is more complex and less manageable than centrally controlled health care systems, which makes it more expensive. The second characteristic of the US health care system is that it is technology driven and focuses on acute care. With more usage of high technology,

Long time ago, there was no need for health insurance in America, as doctors had many clients because their services were not so expensive and in some cases in rural areas, people could pay by giving other items. Doctors were not as knowledgeable as they are nowadays to care for the sick, therefore this didn't have much effect then on the patients, as they were treated for the basic illnesses.

One of the great hypocrisies of American culture is found in its health care system. The United States claims in its Declaration of Independence that “all men are created equal” and that all of these men have the inalienable rights to “life, liberty, and the pursuit of happiness.” Yet this is the same country that allows over 120 people to die each day because they are uninsured. How can this nation claim that all are created equal and have a right to life when they deny healthcare to those who cannot afford it? This issue has come on the scene relatively soon, having only truly been discussed beginning in the early 20th century. Since that time, a fear of socialism stemming from tensions between the United States and the Soviet Union throughout the century has placed a stigma on the concept of universal health care because it is similar to the Soviet’s socialized medicine. In recent years, President Obama made great strides toward universal health care by passing the Affordable Care Act, but some would argue that while America is on the right track, more can be done to care for the nation’s poor. Others argue that the economic impact of such policies could cause problems for America. Though creating a universal health care system has complex logistical and economic consequences, health care is an internationally acknowledged human right and should not be denied to the American people.

In today’s society, there is still a great struggle with health care disparities and many lives are affected by the lack of this fundamental program in our society. There are millions of people who die each year because they are unable to afford quality healthcare. The debate still continues about healthcare inequalities, what causes this disparity and who are affected by it. Health care is more of a necessity rather than a luxury and even though skeptics may argue to the latter, it only underlines the importance of the need for the wellbeing and care of individuals. There are several factors that could contribute to the lack of health care in the United States which ranges from but not limited to race, gender, socio- economic status, and lack of insurance coverage. The truth is there is a great disproportion between who can really afford quality healthcare as appose to individuals who have it. One would imagine that an employed individual would easily afford quality healthcare but we could be no further from the truth, since one’s economic status is an essential determinant to its affordability.

Moreover, the lack of access to health care is morally wrong because it is a fundamental right for humans to maintain self-dignity, fairness in the dispensing of health care, and the inclusion of all in society. Kantian’s ethical theory would argue that it is a moral duty to distribute health care more evenly so that the disadvantaged members of society have a similar chance at access to care. The consequence of those health disparities among the disadvantaged affects everyone’s quality of care and affects communities’ adversely. As a result, the cost shift from annual emergency room visits by the uninsured cost the public over $100,000 billion annually and as a result, distributes approximately an additional $1000 to each family’s insurance premium (Lachman, 2012)). Another example of distribution injustice is the unfair allocation of health care among race and gender. Studies have shown that there is a racial and gender bias in end stage renal failure patients, there is a disproportionate number of white males referred to transplant specialists as opposed to blacks and women. Additionally, their wait on the transplant list is longer, if they ever make it onto the waiting list (Beauchamp, 2013).

The primary ethical issue related to cost containment in health care is distributive justice. The reality of limited resources necessitates their allocation to yield the greatest good for the greatest number of participants. Finding the balance between provision of value in health care and cost containment remains a fundamental ethical challenge for health care reform. Ultimately, there should be effective ways to contain the already high and steadily increasing costs of health care, it will become more and more difficult to provide care in the current or in a reformed health care system (American College of Emergency Physicians ,

From a social justice perspective, quality healthcare is perceived as an innate right of every individual. The problem with this perspective is it is not a universally held sentiment. For example, individuals would argue from an economic standpoint that social justice is a “value” and healthcare is a commodity which drives our nation’s economy, thus presenting

The Health Insurance Association of America describes Medicaid as a "government insurance program for people of all ages whose income and resources are insufficient to pay for health care." America’s Health Insurance Plans (HIPAA, pg. 232). Michigan Medicaid State Plan is an agreement between the state and federal government that identifies the general health care services, reimbursement, and eligibility policies in effect under Michigan Medicaid (Marilyn, T., (2013). The state of Michigan on December 30, 2013 obtained approval from the Center for Medicare and Medicaid Services to amend its 115 demonstration waiver “Healthy Michigan” to implement the Affordable Care Act’s Medicaid expansion. The waiver and association plan amendments went

Can our healthcare system be regarded results-based and rational? Dr. Otis Brawley does not think so. Neither do I. In his thought provoking book, How we Do Harm: A Doctor Breaks Ranks about Being Sick in America, Brawley paints a picture of a system that is riddled with both inequalities and inconsistencies. There are times I have wondered whether our health care is indeed the best in the world. I have had my doubts. After reading Brawley's book, I became convinced that there is an urgent need to ensure that our health care system is not only affordable but also rational.

Health care systems are organizations that are formed to meet the overall health needs of the population. Health care is regarded as one of the leading cause in promoting not only physical and mental health but the well-being of the population. Legislation is implemented requiring government to offer services to all members of its society. The role of health services and the organizations that provide aid is to focus on the health of an individual and to uphold their human rights. According to WHO (2013), a “well-functioning health care system requires a robust financing mechanism, a well-trained and adequately-paid workforce, reliable information on which to base decisions and policies, and well maintained facilities and logistics to deliver quality medicines and technologies (World Health Organization; 2013).