The Multi-Payer System

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.

Private insurance companies can inflate the price of their service if they desire. A universal healthcare system prevents that because it is run by the government.[2]

Socialized medical systems are designed to disregard the insurance industry and disregard income while providing health care for all. Healthcare in the United States is constantly changing and advancing, which requires the cost of health insurance to rise. The idea of socialized medicine is prominent, until the aspects of socialized medicine are brought to attention. Every aspect of a socialized health care industry is controlled and powered by the government; most doctors, nurses, medics and administrators are government employees, and the government decides when, where, and how services are provided. Even though socialized healthcare systems would save money, it is a prominent idea but not worth the problems because total government control over the way healthcare is distributed would result in complications of the citizens.

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 healthcare system in the United States is a system composed of many private insurance companies who act independently from one another. These companies make their money through premiums which are paid by the insured; therefore a major part of the healthcare system is privately funded. This type of market is considered to be an imperfect market because it does not meet the true requirements of a free market where there is unrestrained competition between providers. In our healthcare system there is an absence of a central agency to govern healthcare. There are multiple payers and third party insurers serving as intermediaries between financing and the delivery of healthcare. The United States has a multi-payer, heavily private system in which thousands of private insurance companies are responsible for paying some claims, while federal and state

The health care system is one of the largest industries in the nation. It employs nearly twelve and a half million people. Even though this many people are employed by health care systems, there is little to no competition between the many different systems. This results in the cost being whatever the system wants. People who are ill or

Another factor that has contributed to the over-utilization and increased treatment charges is the fact that providers set the prices for services. Patients were free to seek any type of healthcare services that they thought they required for their well-being, 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

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.

The Affordable Care Act (ACA) also known as Obamacare is a healthcare reform law that is intended to reform the health care system by providing Americans with affordable quality health insurance by controlling the growth in healthcare spending. Some critics of the Affordable Care Act say the ACA has not provided universal coverage, and one way to fix this is to adopt a “single-payer system.” I agree with these critics on the counts of the Single Payer System being a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Doctors and patients regaining healthcare freedom, the accessibility of full coverage, and with financial benefits, the Single Payer System should be adopted by America today.

An all-payer system, all payers (government, private, insurance, businesses, and individuals) pay the same regional rate for any given medical service and procedures. Even though the final amount each pay is still adjusted to the individual scenario in each unique case, they would be comparable across the board without extreme differences. An all-payer system would reduce extreme price variation within the same geographic area, eliminating the need for inflated/discounted rate for different groups (private payers rates are usually inflated to cover the discounted costs of other payers--Medicaid). On top of stabilized rates, an all-payer system will increase the transparency of the health care system. With generally comparable rates, patients will compare providers based on quality and performance, rather than price.

The United State healthcare delievery system is fragmented and expensive. While Canada uses a single payer system the United Stste uses a multi payer system. Both systems work, but one has more efficency and cost less. Meaning that in Canda the government is fully responsible for financing healthcare to all of canadian patiens.which is somewhat similar to universal health care. By using this approach Candian consider health care as a right every citizen should have reather than a privilage. Healthcare access should be granted to every person, healthcre should not be considerd as away to make profit only. The main goal shouls be providing healthcare access to all people. One of the iissues the Unted State has with healthcare is cost, It is because combanies want to make more profit out of hospitals and that drives up costs. While with a single payer system only government is responsible for costs, that tends to better deliver quality and reduce costs. There is no actual study that proves Cannada has a better HealthCare system but data has shown that Candian have a higher life expectensy and a lower infant mortality rate().

Health insurance in this country can trace its early origins back to 1847, when the plans were offered that provided disability compensation to participants, then, beginning in the 1930’s, insurance became more focused on financing the costs due to illness (U.S. National Library of Medicine, 2016). Unlike countries that have a single national program to fund medical services for their citizens, the United States currently relies on a multi-payer system to finance health care (Gusamano & Rodwin, n.d., p.55). Utilizing this multi-payer system certainly has implications within many areas of this nation’s health care delivery and its favorable impact over a single payer system for three of these; quality of care, timely access to treatment, and

Instead of using net income to increase salaries, it would be used for increasing health services (Relman 35). Development programs and modernization would be financed by independent grants going towards the needs of communities instead of profit (Gaffney 988). Performance costs would not be used for profits, advertisements, or business investments (Gaffney 988). In comparison, a single payer healthcare system would give complete health coverage leaving out deductibles and copayments to every American (Gaffney 987).

There is no debate that the costs of healthcare in the USA are the most important and often scrutinized component of a health system. Finding the perfect formula to increase the cost effectivity for everyone in our country has proved itself to be near impossible. There will always be a group of people who have a greater financial benefit compared to others in a “one-size fits all” type of system. This is why I believe a “consumer-driven” type of health system could better suit the needs of many socioeconomic levels of Americans. In this type of health system the patients have total control over their level of care, allowing them to choose which tier of health care best fits them and their needs. By allowing the consumers to do so, they will be in the market for budget-based healthcare giving them a mixed variety of options suitable for their lifestyle.

Another group often blocked is complementary or alternative health care practitioners. These restrictions and the insurance industry unwillingness to pay for these services, gives the physicians an almost monopolist control over health care. Providers must be able to enter the market for competition to work and there must be many providers vying for the patient. To get the most out of health insurance plans Consolidation of hospitals and multispecialty group practices increases the negotiating leverage of the group but in certain areas of the US a single large medical system has become the sole provider of major health service thereby restricting competition (Shi & Singh, 2008). This consolidation while giving the hospitals and group practice leverage when negotiating prices of supplies and services tends to increase the price of health care to the patient because there is no longer any competition (Shi & Singh, 2008). For these reason “competition will remain less effective in most health care markets, because the prerequisite for fully competitive markets are not fully met” (Federal Trade, 2004, p. 20).