Health care provision in the United States is one of the world’s most advanced. It has witnessed significant transformation over time in terms what the private sector and the government provides (Baicker & Chandra, 2007). The provision of health insurance, in particular, has drawn a lot of interest from all sectors.
The essay discusses the role of employers in the payment of health insurance premiums and the use of available resources to provide healthcare. It also points out how specialization by physicians has contributed to inefficiency in the healthcare delivery system and the impact on consumers. Some challenges faced in the implementation of The Balance Budget Act of 1997 are discussed.
Financing of health care in the United States is currently very complex. Health care services receive payment from diversified sources and means (Sultz & Young, 2008). Paying for the health insurance premiums to the various insurance companies has been a major concern. Many employers have been responsible for the payment of the premiums owing to the workplace origins of illness and accidents.
However, a number of the insurance companies have raised the premium rates causing the employers to want to offload the financial burden to their employees (Sultz & Young, 2008). This transfer may be strongly supported by the employers due to the cost implications but, in my opinion, forcing the workers to pay for all the insurance premiums can be termed as exploitation. Instead, the burden should be shared between the two parties with a higher proportion going to the employer.
This is due to the fact most of the risks originate from the workplace. The other reason is that the government takes care of the many unemployed group and children and adding another group, the employed, would be an uphill task. Some of the various cost containment strategies employed by the employers have proved effective and hence there is no reason to overburden the workers with direct payment.
The provision of healthcare services requires the effective utilization of available resources. It is evident that the cost of providing healthcare in the US has been on the increase (Sultz & Young, 2008). The effective use of resources will go a long way in ensuring that appropriate health care services are provided.
In order to ensure this, policy makers should employ cost-effective analysis (CEA) methods to determine and recommend the best practices. The objective of good policies ought to be to achieve “the greatest good for the greatest number.” This will see many citizens benefit from the program compared to the individualist approach. The allocation of resources using the CEA will be informed by social, economic, ethical, and legal factors which are crucial determinants of various situations.
Specialization by physicians in the United States has helped in enhancing patient care outcomes. The cost of medical care system, however, has turned out to be very expensive (Baicker & Chandra, 2007). Researchers have found out that the quality of the services does not match the high cost of services offered. Physician specialization has been identified to inefficient due lack of consideration of other driving factors like demand and supply (Baicker & Chandra, 2007).
Failure to match the high per capita health expenditure with customer satisfaction has rendered physician specialization inefficient. Significant disparities in charges for similar health services by different physicians exist. Some states have short supply of specialized physicians leading to explosion in the cost of medical care. This implies that citizens in different states are charged differently for the same services.
The Balanced Budget Act of 1997 was put in place to transform the healthcare industry. It was designed in part to identify children who entitled to, but not receiving Medicaid benefits (Dick & Zwanziger, 2005). However, it has not been easy to find and enroll these children in Medicaid and then following up to ensure that they receive the required services.
The act did not guarantee universal provision of health insurance for all children and the challenge has been to identify the eligible child. Some children have missed Medicaid benefits for being classified as coming from ineligible families (Dick & Zwanziger, 2005). The challenge of ensuring that enrolled children receive the services has been hampered by the failure to include the stakeholders in the design of the programs, for instance the pediatricians.
The landmark options of health care offered by the act can be beneficial if well utilized. If the new options were to turn out ideally for consumers, the best criterion that would need to be met is the involvement of the consumers in the design of the programs to be offered. This will help them in getting a detailed understanding of all the service providers and hence in making informed choices.
The elderly Americans may benefit from universal healthcare services provided by the government. However, their low income as well as their higher risk of falling sick presents a great challenge to the low income and poor elderly. The government experiences financial drain as they provide care to them. Medicaid has provided a good alternative for the elderly since it pays for their Medicare premiums and other services (Sultz & Young, 2008).
The essay has elaborated on the role of employers in paying health insurance premiums for their workers and the effective allocation of resources in healthcare provision.
The impact of physician specialization has been discussed. The challenges experienced in the implementation of The Balanced Budget Act of 1997 have also been highlighted. America’s healthcare industry has undergone significant transformation over the past decades and a lot need to be done in order to ensure effective, quality and universal provision of healthcare services.
References
Baicker, K. & Chandra, A. (2007). The efficiency of physician specialization: evidence from the United States. McGraw-Hill Plc.
Dick, W. A. & Zwanziger, J. H. (2005). The provision of health insurance for the children: The Balanced Budget Act of 1997. New York Plc.
Sultz, H. A. & Young, K. M. (2008). Health care USA – understanding its organization and delivery (6th ed.). Jones & Bartlett Learning