The health care debate in the United States excites great passion. Issues such as how to make care available, to structure insurance, and to rein in spending by the government, corporations, and individuals frequently take center stage. So, the big question is who controls healthcare today? Well, it would appear that the hospitals, providers, insurance companies, managed care companies, the government, third party payers, just to name a few control the health care in the United States.
“According to Boxer (2009), “There is no national consensus on what healthcare should be or what the U.S. healthcare system should look like. Americans want the best healthcare, when they want it, at a price everyone can afford. This is certainly an unrealistic expectation, unachievable in the foreseeable future. So then, someone, some agency must define healthcare and decide what the U.S. healthcare system will look like. By default, this responsibility has fallen on the third-party payers ….. As third-party payers gained greater control of the U.S. healthcare system, providers and consumers correspondingly lost control, and the competitive market forces seen in a true business model were affected.
In the 1990s, many patients rebelled, objecting to bureaucratic decision-making and long delays for “optional” services. To this day, managed care is criticized in many circles. It is still with us however, and its role is certain to grow. The fundamental appeal is financial. All managed care plans have a built-in incentive to limit costs, because more treatments do not automatically mean more revenue for health providers. Today, many cost-control methods, such as integrated and electronic medical records, are already common in H.M.O.’s. During managed care’s heyday in the early 1990s, inflation in health care costs was much lower than it is now.
The US government is heavily involved in the provision of health care with 33.5% of the total money spent for health care coming from US government. Considerably more in financing than the delivery of health care. The US government’s involvement in health care delivery is more from laws and regulations that can affect our health care status, such as what drugs are approved through the FDA, accessibility of health care records, prevention and control of infectious diseases, and increasing involvement into regulating health financing. With regard to the size of the federal government’s involvement in the delivery aspect of health care, I do think that regulations are important but they can also get in the way of improving the system of health care in the US.
Regarding financing, the US government involvement is huge and ever increasing. As we age, health care issues become more frequent and potentially more chronic and now, the largest portion of our population, the baby boomers will soon be eligible for Medicare. In addition, there is Medicaid for the poor. Everyone wants the best possible health care without having to spend much for it. Working for a company that offers a good health insurance program, it’s easy to say that government should not be involved in the financing aspect. But, when one becomes unemployed and is not able to afford health insurance, then the view of government involvement in financing changes. So, for that reason, I am in favor of the US government’s involvement and it should be as big as it needs to be. Healthy people are more productive.
These market forces are thought necessary to achieve quality and access through cost containment. With this price and quality disconnect between consumer and provider, costs have escalated, quality and access have decreased. I have come to realize that even though insurance companies might not decide on treatments, they do however have the power to veto what the doctor and patient decide. Simply because they control the purse strings, and that gives them the final say.I do think access to medical care is a right and everyone should have the right to health care as healthy people are more productive and can contribute more to the welfare of our country.
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