A_Broken_Healthcare

In a country that’s rated as the number one industrialized country in the world why are we rated last in healthcare and ranked thirty-seventh overall in the world' Now it is without question that our health care system has failed. The problem that we face today is how we fix it' First we need to look at the history of our health care system. Followed by looking at examples of other countries health care system such has Canada, Great Britain and the worlds top rated health care system of France. Then closely look at the proposed public option. And lastly come up with a plan that will fix this detrimental problem Americans face today. The early years of formalized health care in America (1880-1930) saw the establishment of the medical profession, both through the expanded duties and formal education of the physician and the growth of the hospital system. The start of the twentieth century also witnessed the beginnings of health insurance as a method of prepaying health care costs, and the American Medical Association's (AMA) growing control over the medical marketplace. By 1930, the United States had as many or more medical, nursing, and dental schools and hospital beds per unit of population as it has today. The Great Depression, however, slowed the expansion of health care facilities and personnel. Many Americans had trouble paying for the medical care they needed. Doctors tried to make allowances for patients in financial straits, but hospitals, with higher fixed costs, had much less flexibility. Between 1929 and 1930, average hospital receipts plummeted from more than $200 per patient to less than $60. Hospitals then began to turn to insurance plans as a way to guarantee a steady cash flow by spreading the financial risk. Later the Internal Revenue Service ruled that the purchase of health insurance for workers was a legitimate cost of doing business and could be deducted from taxable business income. The IRS also ruled that workers did not have to include the value of health insurance benefits in calculating their taxable income. These rulings amounted to a giant tax incentive for both employers and taxpayers and did much to institutionalize employer-provided health care into the system. In the 1950’s is when the great idea of health care really started to fail. Government encouraged the development and expansion of provider-oriented insurance plans that ultimately distorted the health care delivery system. Employer-provided plans offering first-dollar (front-end) and routine care coverage contributed significantly to the rise in health care costs. The preponderance of employer-provided insurance worsened the position of those without health plans because of the inflationary effect of third-party payment. The eruption in health care costs over the past few decades has been staggering. Personal health care expenditures per capita increased from $82 in 1950 to $2,511 in 1990 and it is expected to double every 10 years. (1) Now with insurance companies being the ones in charge of our health care system why would they let it get so bad' Unfortunately it’s a result of greed. Under our current system, money which could have gone to improve our health care by increasing access to it went instead to insurance company profits. That money could have improved the quality of health care received, worked to make the system financially sustainable, ensured that the system is responsive to patients and communities, and focused on health promotion and disease prevention. The role of insurance companies should not be to increase our premiums any time that they feel they need to put more money in their pockets. We have been there, done that, and it didn’t work out very well for us as taxpayers or consumers. So now that we know a little bit about the history of our health care and how it started to fail lets look at some other countries that are admired for being able to offer affordable health care for all their citizens. First, let’s look at the country most people refer to as having a great health care system, Canada. They offer free health care to all Canadian citizens. They have what is called a publicly funded health care system also known as “Single Payer”. Canadian system is a publicly funded insurance program where costs are controlled and both hospitals and doctors are private. Any Canadian can go to any doctor or hospital in the country. Each province has its own system and its own unique way of funding it. In spite of this decentralized approach, there are agreements among all provinces that provide for treatment of any Canadian citizen regardless of where the need occurs. The great success of their system causes almost all Canadian politicians, even conservatives, to defend it vociferously. It is called single payer because there is only one "payer"; there is no alternative program, such as private health insurance, to which Canadians can turn for basic health care. Since the wealthy as well as the middle income people have no alternative, they make sure it is funded adequately. This together with cost controls insures that everyone including the poor, who use the same system, receives the same high quality care. Canada has a much higher percentage of general practitioners and fewer specialists. Canadian doctors make about one third less that American doctors and yet their satisfaction level is high because they have more time to practice medicine because paper work is minimized. Since there is a "single payer", it is easier to set up and adhere to budgetary limits. Effective planning eliminates duplication of facilities and expensive technology. The economic advantages of the Canadian system are multi-faceted. Canadians are healthier and live longer than Americans. Preventive care to an entire population minimizes expensive care associated with undetected, untreated health problems. There is very little litigation because there is no need for awards to cover future health care costs; they are already covered. Further savings occur because there is no longer a need for a health insurance component of automobile or home insurance. There is less loss of productive labor due to absence and sickness and health care is much more practical and less expensive for companies to provide to employees. Estimates show that Canadians produce American cars for $700 less than Americans do because of the difference in the costs of providing health care to employees. The benefits to competitiveness are obvious. However there is still a flaw in there system. Due to low compensation and a lack of incentives, medical service providers, such as doctors and nurses, manipulated loopholes in the legislation to increase their salaries, some providers introduced extra-billing, which was the direct charging of extra fees to patients for insured services. User charges were another exploitation of the system. These were fees charged to the patients, which were not covered by insurance. Both the Congressional Budget Office and the General Accounting Office estimated that if we were to implement a health care system similar to the Canadian one, we could extend coverage to all Americans while saving billions of dollars annually. So if this “Single Payer” system is so great why haven’t we adopted this program a long time a go' Well again the answer is greed. The “Single Payer” ballot issue will appear in various states in the upcoming years. It is anticipated that, just as with the 1994 California single payer ballot issue, the health industry will spend enormous amounts to defeat them. It is also anticipated that the issue will receive very little press coverage just as happened in California. The health industry will not risk losing millions if not billions of dollars in profit just so we Americans can have better health insurance. Next we will look at England, who is rated eighteenth in the world. (1) England also has a publicly funded universal health care system as well as a private health care system. This means that everyone is entitled to the same state funded health care. The governing body is known as the National Health Service. The British National Health Service (NHS) advanced three core principles: that it meet the needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay.(3) Although the situation is improving, the National Health Service has been over-subscribed in recent years, creating a shortfall in the number of hospital beds available and long waiting lists can sometimes be a problem. Private healthcare providers are providing a quick solution, whereby patients pay for private healthcare either through insurance or each time they use their services. The private health care sector is much smaller than the NHS and does not have the same structures of accountability. It mirrors the NHS by providing private GPs (and many doctors in the NHS also have private practices), nursing homes, ambulances, hospitals and medical specialists, but it does not follow national treatment guidelines. Secondary care in the private sector: Secondary care, which refers to more specialized health treatment such as hospitals, mental health provision and care for the elderly, is well served by the private sector. While people may be registered with an NHS GP, the private sector is often used for secondary care such as: • Diagnostic tests for certain conditions • One-off specialist treatment, such as visiting a dermatologist • Specific operations in a private hospital • Non-essential treatment such as cosmetic surgery • Treatment for addiction or rehabilitation Again England’s health care system is not without its flaws. In higher populated areas, such as London, there aren’t enough health care facilities to handle all of its inhabitants. This results in long waits to receive care and waiting for an ambulance can take quite a long time due to lack of resources. This last country was rated as being the number one in the world for health care, France. (1) France, like the United States, relies on both private insurance and government insurance. Also, just like in America, people generally get their insurance through their employer. In France, everyone has health care. The program that controls peoples insurance is called the national insurance program and is funded mostly by payroll and income taxes. Those payments go to several quasi-public insurance funds that then negotiate with medical unions to set doctors' fees. (Doctors can choose to work outside this system, and growing minorities now charge what patients are willing to pay out of pocket.) The government regulates most hospital fees. This system works collectively to keep costs down. However it is expensive to provide this kind of health care and social support. France's health care system is one of the most expensive in the world. But it is not as expensive as the U.S. system, which is the worlds most costly. The United States spends about twice as much as France on health care. In 2005, U.S. spending came to $6,400 per person. In France, it was $3,300. To fund universal health care in France, workers are required to pay about 21 percent of their income into the national health care system. Employers pick up a little more than half of that. Americans don't pay as much in taxes. However, they end up paying more for health care when one adds in the costs of buying insurance and the higher out-of-pocket expenses for medicine, doctors and hospitals. Just like every other health care system there are problems. France, like all countries, faces rising costs for health care. In a country that's so generous, it's even harder to get those expenses under control. Last year, the national health system ran nearly $9 billion in debt. Although it is a smaller deficit than in previous years, it forced the government of President Nicolas Sarkozy to start charging patients more for some drugs, ambulance costs and other services. Debates over cost-cutting have become an expected part of the national dialogue on health care. Then there is the public option President Obama introduced. The central point of the president's plan is to create a government-sponsored health insurance program that would be an option for all Americans, similar to how Medicare is now an option for Americans over age 65. He has also said he'd "like to see" prohibitions against insurers discriminating against people with pre-existing conditions, and incentives for people to use preventive services and wellness plans. If you receive high-quality health insurance from your employer, Obama said, his plan won't change that, and you can still keep your insurance and your doctors. Millions of people who don't get insurance through their employer try to get insurance on their own and are turned down because they have a pre-existing condition. According to President Obama no insurance plan "would be able to deny coverage on the basis of pre-existing condition. Over half of Americans support the Presidents’ plan. However, there is a large group of people who are against health care reform stating “why change the best health care system in the world. Some also say that under the government proposed public health plan, “people will involuntarily lose their coverage and will be bled into the new plan,” said Heritage’s senior policy analyst for health care Nina Owcharenko. “They expect they would have their private insurance plans competing with the public plan but at the end of the day the public plan will be the last one standing,” she said. (5) The problem is that the price tag is continuing to increase because special interests are being bought out to support the legislation, resulting in spending cuts elsewhere. This leads us to question what the real impact of this legislation will be if it’s only covering 16 million of the uninsured, which is barely cutting into the true number of those without insurance coverage which some say is up to 50 million. Granted the Presidents plan is not the ultimate solution to the problem but it is a move in the right direction. And our healthcare system is by far not the best in the world and the top one percent in America will disagree but it’s true. America is ranked thirty-eighth in the world. However it is better then what Americans have now. If anything it will create more competition from the private sector to create quality health care. If they don’t adapt and cut down on their greed these insurance companies will lose all their profits. They will have to sacrifice profits to stay competitive. So what is the solution' I feel the answer is two parts. The first part is the Public Option but expanded to cover all American citizens. This will force the greedy corporate insurance companies to reevaluate their current business model, because to them it is a business and Americans are just numbers, and force them to compete, lower prices and improve on the quality of their health insurance. Now as far as a way to pay for the definite immediate costs to cover everyone this country needs to re legalize marijuana. The government could control, regulate and tax it like alcohol. The increase in tax revenue gained from this act would grow exponentially over the years providing enough money to cover all the expenses and provide this country with excellent health care for all.