Health Care Reform Debate
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Healthcare reform is a general rubric used for discussing major health policy creation or changes—for the most part, governmental policy that affects healthcare delivery in a given place. Healthcare reform typically attempts to:
- Broaden the population that receives health care coverage through either public sector insurance programs or private sector insurance companies
- Expand the array of health care providers consumers may choose among
- Improve the access to health care specialists
- Improve the quality of health care
- Decrease the cost of health care
- 1 Netherlands
- 2 Russia
- 3 Taiwan
- 4 United Kingdom
- 5 United States
- 6 Elsewhere
- 7 See also
- 8 References
- 9 External links
The debate over healthcare reform in the United States centers around questions of a right to health care, access, fairness, sustainability, and quality purchased by the high sums spent. The mixed public-private health care system in the United States is the most expensive in the world, with health care costing more per person than in any other nation, and a greater portion of gross domestic product (GDP) is spent on it than in any other United Nations member state except for East Timor (Timor-Leste).
A study of international health care spending levels in the year 2000, published in the health policy journal Health Affairs, found that while the U.S. spends more on health care than other countries in the Organisation for Economic Co-operation and Development (OECD), the use of health care services in the U.S. is below the OECD median by most measures. The authors of the study concluded that the prices paid for health care services are much higher in the U.S.
The U.S. is the only wealthy, industrialized nation that does not have a universal health care system, according to the Institute of Medicine of the National Academy of Sciences and others. The number of people in America without health insurance coverage at some time during 2006 totaled about 16% of the population, or 47 million people. In addition, many or most of those with insurance are not sufficiently insured, with high-deductible policies, policies that do have limits on what they will pay for or policies that cost a significant percentage of their income.
In spite of the amount spent on health care in the US, according to a 2008 report, the United States ranks last in the quality of health care among developed countries. The World Health Organization (WHO), in 2000, ranked the US health care system 37th in overall performance and 72nd by overall level of health (among 191 member nations included in the study).
International comparisons that could lead to conclusions about the quality of the health care received by Americans are subject to debate. The US pays twice as much yet lags other wealthy nations in such measures as infant mortality and life expectancy, which are among the most widely collected, hence useful, international comparative statistics.
Brian Gratzer of the Manhattan Institute is at the forefront of individuals who argue that these differences have little to do with the lack of universal health insurance.
Whether a universally accessible health care system should be implemented in the U.S. remains a hotly debated political topic. Reform proposals include the removal of the private health insurance market, the establishment of a “public option,” premium subsidies to help individuals purchase health insurance, increased use of health information technology, research and incentives to improve medical decision making, reduced tobacco use and obesity, reforming the payment of providers to encourage efficiency, limiting the tax federal exemption for health insurance premiums, and reforming several market changes such as resetting the benchmark rates for Medicare Advantage plans and allowing the Department of Health and Human Services to negotiate drug prices.
A fundamental problem in evaluating reform proposals is the difficulty of estimating their cost and potential impact. In an effort to cut drug costs and potential drug-related toxicities, medical doctors have been instructed by the FDA only to prescribe those medications which are “absolutely indicated” in the management of patient’s illnesses. The empirical data and theory underlying cost estimates in this area are limited and subject to debate, increasing the variation between estimates and limiting their accuracy.
Another impediment to implementing any reform that does not benefit insurance companies or the private health care industry is the power of insurance company and health care industry lobbyists in the United States. Possibly as a consequence of the power of lobbyists, key politicians such as Senator Max Baucus have taken the option of single payer health care off the table entirely.
Public opinion on health care reform, sometimes called health system reform, suggests a high percentage desire reforms; however, do not want to see their taxes raised. According to The Patient Poll, a study of Pennsylvania adults age 21 and older conducted in July 2008 by The Institute for Good Medicine at the Pennsylvania Medical Society, 63.4 percent believed that the United States should enact some form of universal health care.
But, when asked how this care should be funded, only 26.8 percent were willing to have their taxes increased. On a national polling level, similar results were found in a USA TODAY/Gallup Poll that suggested high interest in overhauling the health care system, but less enthusiasm on the funding mechanisms. Another survey of Pennsylvanians conducted in July 2009 through The Patient Poll from The Institute for Good Medicine at the Pennsylvania Medical Society suggests that the majority of Pennsylvania adults (68.2 percent) believe that health care is neither a right nor a privilege, and that both government and individuals bear some degree of responsibility.
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