September 8, 2013
AL420 Current Issues in Allied Health
Health Care Reform: Past, Present, and Future
Health care, and the lack thereof, in the United States have always been and will continue to be an issue. Currently, the United States does not have Universal Healthcare and those that do have health care coverage should feel privileged. The purpose of this paper is to discuss the: a) way healthcare is currently delivered, b) the history of health care reform, c) the current healthcare reform act, and d) what healthcare will be like in the future. Current Health Care Delivery System
The United States health care system is complex. It is not centrally controlled and has a variety of payment, insurance, and delivery mechanisms. The U.S. health system is mostly privately owned, either you have private health insurance, Medicare, Medicaid, or you are uninsured. In 2010, private financing, which is predominately through employers, accounted for approximately 34 percent of total health expenditures- 14 percent were out-of- pocket costs, 23 percent were paid by Medicare, 17 percent by Medicaid, and the remaining 12 percent by other insurance, payers, and programs (National Center for Health Statistics, 2012). An individual must have health insurance to receive primary health services or pay out-of-pocket. Health care in the U.S. is not inexpensive. According to the Centers for Medicare & Medicaid Service, U.S. health care spending reached $2.7 trillion in 2011, or $8,680 per person. This is 17.9 percent of the Gross Domestic Product. Health spending grew by 3.9 percent which was the same growth rate as in 2009 and 2010 (Center for Medicare and Medicaid Services [CMS], 2011). Because health care is so expensive it makes it difficult for those without health insurance to access primary care services. Health insurance is the primary means of accessing health care. The current health care delivery system is technology-driven with the newest medical technology being highly sought out. Patients assume that current technologies offer the best care and physician’s want to try the latest gadgets. Hospitals also compete on the basis of having the most modern equipment. This, in effect, drives up health care costs making it more difficult for individuals to obtain health insurance. Private Health Insurance
Private insurance is either obtained through an employer or purchased from a private insurance company. Millions of Americans have private health insurance coverage through a managed care system. Managed care is defined as a system of providing health care (as by an HMO or PPO) that is designed to control costs through managed programs in which the physician accepts constraints on the amount charged for medical care and the patient is limited in the choice of a physician (Merriam-Webster). Managed care is the most dominant health care delivery system in the United States and is available to most Americans that can pay for it. With managed care insured’s have a select group of providers to choose from and will pay a higher rate when care is provided by someone not on the list. Medicare and Medicaid
Medicare and Medicaid are both large health care sources in the United States. Medicare is available to those 65 years of age and older, those under the age of 65 designated as having certain disabilities, and persons of any age with End-Stage Renal Disease (Medicare.gov). There is a Part A, Part B, and a Part D (prescription drug plan). Part A is used for most hospital stays, nursing facilities, and hospice care. Part B is mainly for physicians’ services and outpatient care and there is a premium associated with Part B. There are millions of disabled and elderly on Medicare. Medicaid provides coverage for low-income families, children, elderly people, and those with disabilities. Families that make under a certain income can also receive Medicaid...
References: Affordable Care Act update: Implementing Medicare cost savings. CMS Office of the Actuary, 2010. www.cms.gov/apps/docs/AVA-Update-Implementing-Medicare -Cost-Savings.pdf
Centers for Medicare and Medicaid Services. National Health Expenditures, 2011. Retrieved from http://www.cms.gov/Research-Statisitics-Data-and -Systems/Statistics-Trends-and-Reports
Congressional Budget Office. Letter to the Honorable Nancy Pelosi. Washington: Congressional Budget Office: 2010. Retrieved at http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/113xx/doc11379/amendreconprop.pdf
Hoffman, Beatrice, (2003). Health Care Reform and Social Movements in the U.S. American Journal of Public Health, 93, 75-85. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447696/
Fact Sheet: The Affordable Care Act’s New Patient’s Bill of Rights. www.healthcare.gov/law/provisions/billofright/patient_bill_of_rights.html.
Medicare Eligibility. www.medicare.gov/MedicareEligibility/Home.asp
National Centers for Health Statistics. Health, United States, 2012. Hyattsville, MD. Dept of Health and Human Services. Retrieved from http://www.cdc.gov/nchs/data/hus/hus12.pdf
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