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Policy Sector: Healthcare
Introduction
As the societal and corporate environments become more complex, individuals are being expected to perform optimally in order to enhance growth and development. In particular, societal expectations have equally become complex and in order to survive and thrive, populations are increasingly being required to exhibit executive functioning at all times. It can not be disputed that the health of the populations is at the center stage of effective functioning. Essentially, individuals that are robust health wise tend to be more productive than their counterparts. Regardless of this recognition, most of the governments have failed dismally to provide for the health needs of their populations. Global reports indicate that poor health conditions are one of the major courses of the stagnation that is currently being experienced in the economic sector. Just like other countries across the globe, America has failed to provide for the holistic health needs of its populations.
Recent researches indicate that the health sector problems have adverse impacts on the holistic wellbeing of America. To a great extent, these also contribute to developmental delays that have been experience din the recent past. The complexity of the health care issues has increased over time. In this regard, it can not be disputed that health care problems have persisted for a significant period of time now. The inherent persistence implies that either the relevant parties are not taking vital steps to address it or the steps being taken are not sustainable. It is for the preceding reasons that this study deemed it necessary to review the policy issues in the health care. Arguably, relative findings would be instrumental in resolving the intrinsic inconsistencies in an effective and timely manner. This would improve the performance of the populations and enable the country to attain its national goals and objectives in different other sectors.
Major Policy Issues
The major policy issues are wide and varied. To begin with, Mahar (2006) indicates that the issue of lack of insurance for a significant percentage of the American population is critical. Although a significant percentage of the poor population is currently covered by Medicaid, statistical evidence ascertains that others are not. The affected segment of the population in this regard constitutes the low income population that works for employers that do not provide medical insurance. This group is further increasing in number as more job opportunities shift from the manufacturing to the service industry.
Another problem pertains to the issue of the country spending too much money on health care. Economic reports ascertain that health care assumes a significant 16% of the national economy. The implications of this rise are felt by American employers and family that are responsible for shouldering the cost. Relative insurance costs according to Mahar (2006) have doubled in the past decade and are further escalating at a very fast rate. From a global point of view, the country spends the highest amount of financial resources of health care. Regardless of this, the increasing costs have not improved the health of the Americans in any way.
Another health policy issue entails a significant percentage of the employees receiving restricted insurance coverage. In this regard, it is agued that most of he insurance plans tend to be negotiated between insurance providers and employers. In most instances, they are limited to one insurance carrier or HMO. For this reason, most of the employees end up having limited options with respect to health care provider alternatives.
What the Government is doing with Regard to Each
The American government is responsible for ensuring that the preceding issues are addressed and the health of the American population is secured. Currently, it is taking certain distinct measures to address the concerns accordingly. However, these have not yielded significant results to date. With respect to catering for the needs of the uninsured, the government has directed all employers to provide insurance for the employers. Further, Mechanic (2003) indicates that it has taken distinct steps to expand the children’s State-Children Health Insurance Program (S-CHIP) to the adults. Basically, this insures children whose parents’ salary is too high to get Medicaid ye to low that they can not afford private insurance using other state programs, or Medicaid expansions. A significant percentage of the democrats’ advocate that parents should also be allowed to participate in this system is order to cater for the uninsured.
With regard to health financing, several proposals have been put forth by the government in the past. To begin with, a proposal has been suggested to advocate for employers providing for the entire insurance costs and paying for 80% of the premium costs. Through time, the government has also made significant effort to guarantee the unemployed as well as those who have lost their employment continue insurance cover. Proposals have also been put forth to regulate the insurance policy. In this regard, individual states were expected to cite either one or multiple regional alliances to purchase insurance on behalf of the insurance industry.
The government has also taken measures o enforce medical saving account. The MSAs in this regard were expected to be a personal property and individuals as well as employers were expected to make deposits in these accordingly. The relative deposits were supposed to be tax free and individuals would be penalized for withdrawing money for other expenses apart from health insurance premiums and medical expenses. The money that they would not spend would slowly earn interest and they would be allowed to use for medical expenses especially after retirement.
With respect to providing restricted health options for the employees, many states have taken practical steps to enact the ‘patients’ bill of rights’. This addresses part of the alleged abuses that have been detailed under this concern. The legislation has been instrumental in guaranteeing specialized medical coverage, emergency treatment and it has also detailed an appeal strategy for individuals that have been denied relevant services.
What Explains Government Action or Inaction
In most instances, the government enforcement of the above mentioned measures has been compounded by increased opposition from major stakeholders in the industry. Concerning the issue of restricting the health options to employees, reports indicate that the government has taken efforts to expand the initiative to the national scale. The policy issue regarding whether the employees should be accorded the right to the health maintenance organization for their malpractice has stalled the process. In the case of medical savings account, the opponents of this have argued that this proposal is ideal for the young generation. However, withdrawing the relative individuals from the insurance pool would have for reaching implications including an increase in the insurance rates.
Other oppositions have been experienced from the insurers as well as provider organizations. In essence, the inherent opposition can be attributed to the complex nature of the health reforms. In this regard, Mahar (2006) indicates that the health sector has various stakeholders who have differing views regarding their position on the emergent complex issues. Making them to have a unified approach to most of the concerns can prove unyielding especially in instances where the affected stakeholders have a great influence or comprise a majority of the opponents.
Major Contemporary Challenges
There are different emergent challenges that are compounding the relative efforts that have been previously undertaken by the government to improve the healthcare societal facet. The relative challenges need to be addressed from a modern perspective in order to yield beneficial results. Seemingly, most of the problems stem form the process of policy making. In most instances the democrats and republicans have been unable to come to an agreement concerning sensitive policy issue. This has further been compounded by the multiple parties or stakeholders in the sector. Consulting with all of these during the process of policy formulation has in most instances yielded minimal results. This is because each party and administration has its own individual approach to policy formulation. The characteristic competing and overlapping jurisdictions have culminated in the fragmentation of administration as well as overly specific programming. All the preceding multiple factors have greatly compounded the process of formulation of ideal policies in the sector.
Another contemporary challenge that is being experienced by the sector pertains to inadequate financing. In this respect, it can not be disputed that the cost of healthcare has increased significantly in the recent past. Global trends indicate that this problem is being experienced across the globe. Health services and products have increasingly become very expensive and there affordability is becoming a major challenge. This can be attributed to the diversification of medical problems and the relative complex medical procedures that are required to address the inherent concerns.
Another contemporary problem compounding the health sector and relative improvement efforts pertains to the lack of awareness of the public regarding their health rights. In this respect, Fox and Fronstin (2000) indicate that the public is not informed about its rights and privileges with regards to healthcare. It neither understands nor appreciates its stake in the health sector. This has increased its vulnerability to exploitation by the health providers as well as the employers. The inherent profit oriented approaches that are assumed by the health providers make it difficult for them to cater for the needs of the patients in a sustainable manner. The government on the other hand has failed dismally to provide the relevant regulation. As aforementioned, this is attributable to various factors that range from the complex process of policy formulation, implementation and enforcement to increased opposition from the major stakeholders in the health sector.
Proposed Solutions
There are various solutions that have been proposed to address the current state of affairs. To begin with, the federal government has been advised to review its priorities with respect to providing healthcare. In this regard, it has been advised to place great emphasis on the respective leading indicators of health. For instance, although continued insurance of the uninsured facet of the society is of paramount importance, it is argued that the Medicare and Medicaid funds can be effectively employed to improve the health of individuals that currently benefit from the respective programs. In this regard, the government needs to work closely with all the stakeholders to simplify the relations between them and ensure that the public is aware of the available services as well as how it can benefit from the respective services.
Prioritization of health concerns according to the health critics would enable the government to reduce the amount of resources that are currently being employed to finance relative initiatives. In addition, the improvement of relations would ease the formulation as well as implementation of important health care policies.
Another solution that has been proposed pertains to implementation of important regulations to govern the operations and decisions of health care providers. In most cases, the American public has suffered in the hands of health care providers. In addition to charging high rates, the respective providers have been implicated for offering very few health care options to the public. The government in this regard has been urged to step in to curb the inefficiencies accordingly. The inherent regulation would go a long way in ensuring that the public has unlimited access to quality healthcare at affordable cost.
The Most Feasible Solutions
At this point, it can not be disputed that the health sector has various inconsistencies that are compounding the general health of the American population. Although the government has taken certain measures to counter the scenario, these have yielded minimal results because of various factors. Besides being opposed by a significant percentage of the stakeholders, the government has not been keen on effective enforcement of the relative measures. The following proposals can go a long way in improving the current state of affairs and ensuring that the American public has access to quality health care.
With regard to providing insurance services to the uninsured, the government should enforce the regulations requiring the employers to provide insurance packages to all employees. These need to be consistent with the mount of income of the employee but should be able to cater for basic healthcare. To enhance optimal output, the insurance providers on the other hand need to regulate their rates and ensure that they are in line with the economic and social dynamics as well as expectations. This can be useful in ensuring that the public is not denied its right to health care. A more non compromising government stance in this respect can go a long way in ensuring that relative concerns are implemented and enforced. At this point, it should be noted that relative efforts have been compounded by increased opposition from various parties (Hwang & Grossman, 2009).
With respect to financing, the government should review its priorities in this regard and ensure that the current provisions provide optimal benefits for the beneficiaries. Arguably, the current system can provide for the entire health need of the American population if important reforms are made. In particular, improving the interrelationships and increasing collaboration as well as coordination between major stakeholders can go a long way in eliminating current inconsistencies. Finally, the employers and health management organizations need to be compelled to provide sufficient health options for their employees. Employees in this regard should be accorded the right to sue them accordingly. If the insurance rates are regulated, this should bear optimal results in the long run.
Models of Typologies that Best Capture the Sector
One of the models that best captures the US health care pertains to the Bismarck model. This was named after the Germany founder Otto Von Bismarck. It essentially employs the insurance system that is in most cases financed by the employees and employers using the payroll deduction system. The American health care is also reflective of the business model. In this the drugs move form the manufacturer to the distributor then to the healthcare providers, patients and employers. The employer and employee play an important role in financing the relative services. The health providers are profit oriented and look forth to maximizing relative profits at the expense of the normal citizens.
How the Sector is Similar to and Different from Three Others
This sector is similar to and different form other sectors in different ways. Compared to the education sector, both have inequalities as a certain segment of the public does not access quality education and healthcare. The differences are that the health sector offers other options for the disadvantaged. Compared to the housing policy, the former has major improvements than the health policy. Statistical evidence indicates that the government provides quality housing for a significant percentage of the population. Likewise, the transport sector is better than the healthcare sector in different ways. In this regard, the government provides affordable and adequate transport system for its population. In addition, the respective transport systems are diverse and maintained accordingly.
References
Fox, D. & Fronstin, P. (2000). Public spending for healthcare approaches 60 percent. Health Affairs, 19 (2), 270-75.
Hwang, C. & Grossman, M. (2009). The innovator’s prescription. USA: McGraw Hill.
Mahar, M. (2006). Money driven medicine: The real reason health care costs so much. New York: HarperCollins.
Mechanic, D. (2003), Policy challenges in improving mental health services: Some lessons form the past. Psychiatric Services, 54 (1): 1227-1232.
