Reform proposals

Health policymaking in the US is a complex process involving the government and private sectors, institutions and political players. The issues in healthcare policymaking stems from diversity of interests and roles. Decisions affecting healthcare system and attempts to regulate the healthcare system are opposed by those wanting a market-oriented healthcare system. Achieving a comprehensive and consistent healthcare policy is not possible due to the short term approach of the policymakers. The policies are framed to produce solid results in a short time to facilitate reelection.

Thus the healthcare policy of the US is in an unsteady state, lacking consistency and unable to provide intended results. It is no wonder that the healthcare system in America is described as a waste and appalling. Several plans and strategies have been identified to reform the healthcare scenario in the US but which haven’t made much headway. Physicians have proposed a national health insurance on the basis of a single-payer system. The plan had been endorsed by over 8000 physicians when it was published in 2003.

The single payer financing system can help in saving about $350 billion a year which would be sufficient to cover everyone without any additional payment. Under this single payer system, all Americans and all medical services including dental, long term care and prescription drugs would be covered (PNHP, 2008). Physicians would be paid a negotiated fee for the service or receive a salary and regional health boards would be responsible for the purchase of infrastructure and expensive instruments. This Canadian style healthcare system would actually mean an expansion of Medicare to everyone.

An employer based healthcare coverage has also been proposed through a combination of employer based insurance and government subsidies to pay for the insurance costs of those people living below poverty line and assisting others in purchasing insurance. Employer based insurance plans include a ‘play or pay’ option to employers wherein they can offer government approved insurance plans to their employees by contributing about 80% of the costs or face a payroll tax. A committee led by the then first lady Hillary Rodham Clinton, proposed a major plan in 1992 to restructure the nation’s healthcare system.

The healthcare sector accounting for one-sixth of the nation’s economy, was intended to be reorganized through the plan. The plan had the total healthcare budget of the country to be set by the national health board. It also required firms and individuals to purchase healthcare insurance and use a variety of service providers including HMO’s, physician groups, nursing homes and hospitals. The plan provided exhaustive benefits like prescription drugs, dental coverage, mental health and guaranteed health insurance for all citizens. However the Clinton plan failed to get it through the Congress.

A plan with incremental or modest reforms was preferred by the people and the country was not willing to try a major comprehensive plan. The Open Access Plans of the Conservatives dismiss the calls for a federal take over of the nation’s healthcare system, arguing that most Americans are satisfied with their existing health insurance. They refuse to accept that the healthcare system is in crises and believe that incremental reforms can see it through even if there were any. Open access plans guarantee insurance to anyone who wants to purchase it although none would be forced to buy one.

The costs of basic insurance coverage for both employees and employers would be fully tax deductible. Employees having minimum wages and not covered by any insurance plan could get Medicaid coverage at reduced cost. Conclusion and recommendations The medical care offered by the US is the most advanced in the world. Researchers from all over the world are drawn to the US to spearhead man’s understanding and development in medical specialties. It is therefore an irony that the nation with the best medical care also has poor health statistics for its general public.

Therefore it is not wrong to conclude that the US healthcare problems has more to do with access to care, education and prevention of health problems than with the quality of care itself. With Medicare covering the aged and Medicaid covering the poor, many other Americans and their dependents don’t have any health insurance. Approximately 84% of the American population is covered either by private or governmental health insurance, leaving about 15% without any medical insurance. Most of these uninsured are those Americans who are not poor to qualify for Medicaid or old enough to get Medicare.

The elderly population is the fastest growing age group and thus there is an increasing need for long term nursing home care. Medicare only covers for the first 60 days of hospitalization and 100 days of nursing home care, when patient is sent from the hospital. People who cannot qualify for Medicaid or bear long term nursing care, could even risk losing their assets or their children’s inheritance. Senior citizens have also been demanding vigorously for long term nursing care under Medicare to be borne by taxpayers.

Irrespective of the plans and strategy, people can contribute to easing the load on the healthcare system, by demanding lesser services. They should be more health conscious and promote good health within their circle. The saying ‘prevention is better than cure’ has a direct bearing on healthy life. Exercising, food habits, avoiding risky behavior are all important in sustaining good health. Physical activity is very crucial for the well being of any individual. It has been proved by research that all can benefit from regular physical activities.

Such activities can include heavy exercises or just moderate exercises. Exercise can even benefit the old and frail, helping them to improve their mobility and body functioning. The US Department of Health and Human Services has recommended physical activity as a fundamental necessity to thwart the attack by diseases. Several thousand Americans suffer from chronic illness that could be either prevented or helped to recover through physical activity. Physical exercises can indeed bring a change in the US health scenario where 12. 6 million people have coronary heart disease, 1.

1 million people suffer heart attacks each year and 50 million people have high blood pressure. It is important to note that a 1993 study has attributed 14% of all deaths in the US to activity and diet patterns (US DHHS, 2002). According to the 1997-98 National Health Interview Survey, about one-third of people above 65 years of age lead a sedentary lifestyle. In persons above 75 years of age, about 54% of men and 66% of women reported no physical or leisure time activity. Among the young people in grades 9 to 12, more than one-third of them do not have regular physical activity.

Physical inactivity poses medical and financial risks for chronic diseases like heart disease, colon cancer, obesity, osteoporosis and diabetes. Physical inactivity in the population even reverses the progress made by the medical community in reducing the occurrence of chronic conditions like heart diseases. A study carried out by researchers from the Centers for Disease Control and Prevention found that people who were physically active had lower medical bills than those of inactive people. Physical activity and sports was seen to promote physical and mental health, and sociability in young people.

Such people are even less likely to be regular smokers or drug users. When physical and recreational activities are absent, they became susceptible to violence, gangs and drugs.


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