The Health Costs in the U.S.
The health costs in the U.S. are growing rapidly. Rising costs can be attributed to the new expenses of acquiring contemporary medical technologies for the use in the treatment of the aging baby boomers together with the inefficient and expensive system of health care funding (Kemble).
Approximately 60% of health costs are taken care of by the federal programs through taxes including government employees; health care plans, Medicaid and Medicare, among others (Kemble).
Private insurance accounts for about 20% whereas the rest is paid out-of-pocket (Kemble).
Both employers and the government are not willing to carry the burden of the rising health care costs, and hence the burden is being pushed to the individual payers (Kemble).
The U.S. health care financing is inefficient. It is the role of this paper to offer three proposals for dealing with the problems of costs and coverage in the US healthcare system.
The Balanced Choice
The balanced choice is among the attractive alternatives to deal with problems of costs and coverage in the healthcare system. Balanced choice helps to improve the single-payer model and offer administrative simplicity with cost-effectiveness and flexibility of market factors for both the patient and the physician (Kemble).
The alternative proposes a single-payer standard option whereby funding means are pooled, and good health coverage is for everyone. Prices and the covered care would be determined by a balanced choice governing board analogous to the Federal Reserve Board in the financial markets (Kemble).
The single-player will have a co-payment that can be waived in events of financial hardships. Billing and administration under the proposal will also be greatly simplified.
The Standard and Independent Option
The balanced choice would cover a standard option fee for a service. Doctors will have an independent option allowing them to charge extra fees for extended services. If a client demands prime appointments or enhanced access to a doctor, the doctor will charge based on the costs of such services. In the new proposal, doctors will offer services under both standard and independent options, and it will be upon the patient to choose the one that suits them (Kemble).
Patients using the independent option will be cost-conscious and negotiate with the physician concerning treatment choices available. The market forces would play their role in eliminating the role of insurance or the government. Doctors will have to focus on the quality of service to justify the fees paid. Together with being innovative, it is most likely that such benefits will spill over to patients choosing a standard option. The balanced choice governing board will balance both options to avoid inadequate funding from the standard option. The board will also have the power to control both options. Hospitals could be reimbursed using global budgets hence saving billing and administration costs (Kemble). The proposal limits government control and the rich are encouraged to pay higher as well as the application of point of service forces of the market to keep fees at a reasonable rate. Furthermore, the proposal eliminates the competition between private insurance and public system health resources by introducing an independent body further eliminating administrative costs of private healthcare plans.
Reducing Healthcare Costs
Healthcare costs can further be reduced by addressing the sources of wastage such as overtreatment. Such a model will require identifying particular medical procedures, medicines or tests that do not benefit patients and implementing policies and other levers in payment, management, and training to reduce the use of such procedures in inappropriate cases (Berwick, Donald & Hackbarth 1514). Other healthcare stakeholders should also embrace the efforts to cut costs in practice accordingly. The Affordable Care Act provisions for cutting payments are expected to achieve millions of savings on Medicare and Medicaid. The savings are realized via direct savings and do not account for medical practitioners’ behavioral change. It is expected that the savings will be over $600 billion from 2011 up to 2019 (Berwick, Donald & Hackbarth 1515). If the waste reduction goal is implemented, the total savings will exceed the figure. Some of the reforms in ACA being witnessed aim at curbing wastage. Accountable healthcare institutions and bundled payment can lead to more seamless care. Aggressive enforcement of government insurance also reduces fraud.
A Tax-Financed Healthcare System
Lastly, a fully tax-financed healthcare system whereby people, employers, and private firms are responsible for care coverage through the taxes to the government can be effective. Such a system would mean healthcare givers are private, but the government would have the responsibility to offer payment for services received like the Canadian healthcare model. A tax-financed model will enable everyone to be covered, be more efficient because administration costs would be reduced substantially (cover the uninsured). There is also a potential to control more costs if the government effectively negotiate prices with hospitals and pharmaceuticals.
Conclusion
In conclusion, the paper offered three proposals for dealing with the problems of costs and coverage in the US healthcare system. The current healthcare system is ineffective. The total administration costs are too high compared to other models. The costs are not evenly distributed across the citizens. The coverage is more on low-income earners and the senior who cannot pay for their care costs. A large uninsured population poses high health risks. Healthcare proposals to solve the current menace must also include how the costs can be distributed as in the balanced choice model.
Works Cited
Berwick, Donald M., and Andrew D. Hackbarth. "Eliminating waste in US health care." Jama 307.14 (2012): 1513-1516.
Cover The Uninsured, (n.d). "Health Care Coverage in America: Understanding the Issues and Proposed Solutions." Healthpolicy.org (n.d.).
Kemble, Stephen B. "A Better Idea for United States Health Care-The Balanced Choice Proposal." Hawaii medical journal 69.12 (2010): 294.
