Financial Pressures In Health Care


Financial Pressures In Health Care Essay, Research Paper

Financial Pressures Affecting Heath-Care

In the recent years Health-Care Services have been under tremendous financial pressures. This has brought about much inefficiency for both the private and the public sector. Raising many issues ranging from, shortage of highly skilled employee’s, outdated or unsafe therapy, and the lack of adequate insurance. Today the cost of hospital services and doctor fees are rising faster than ever before. There is a great need for reform in our Health care system. The government has been trying to come up with a new plan these past few years even though there has been strong opposition against a new Health Care system.

Impact on the Public and Private Sectors

Recently some insurers have been competing to insure the healthy and avoiding the sick by determining “insurability profiles” instead of competing on quality, value, and service. Paperwork has consumed much of the needed care provider’s time. In an average doctor’s office, 80 hours a month is spent doing paperwork. In hospitals nurses often h fill out several forms to account for one person’s hospital stay. Much of this time could be better spent caring for patients. Insurance company red tape has created a nightmare for providers, with mountains of forms and numerous levels of review that wastes money and does nothing to improve the quality of care. America has the best doctors who can provide the most advanced treatments in the world. Yet people often can’t get treated when they need care. The medical malpractice system does little to promote quality. Fear of litigation forces providers, and practitioners to practice defensive medicine, ordering inappropriate tests and procedures to protect against lawsuits.

There has been a declining amount of charity care being provided by the non-profit community medical centers, and for-profit providers, as well as an increasing abandonment of care to Medicaid patients. LOOKING TO MANAGED CARE EXECUTIVES the private sector-including both insurers and practitioners have so far looked to the government for solutions to this problem. Meanwhile, large employers believe that they have controlled the amount of cost shifting to them by negotiating lower premiums. As a result, their critical voice is not strong on this issue. It is possible to help meet this huge demand without sacrificing financial health. There are some operating models in existence being used by community clinics and other providers that might present alternatives for organizations to reincorporate care for these patients into their businesses. This is particularly true when states take innovative steps to further their role in this problem solving effort.

Difficulties faced by the uninsured

At a time of unparallel prosperity in the richest country in the world it is hard to believe that the U.S. is moving up in the ranks of the uninsured. To many Americans, the numbers are familiar – 44 million people without health insurance, or nearly 20 percent of the population under age 65. Eighty-five percent of them are working or in families were someone is working, mostly at low-wage jobs that offer no health coverage. Nearly one-third of the uninsured who work are offered coverage by their employer or through a family member’s employer but decline it for themselves or their dependents because the price is so high – and getting higher. More than half of the uninsured have been without coverage for longer than two years (Consumer Reports Issue 9).

More people are uninsured now than when President Clinton took office eight years ago promising health insurance for every American, and the long-term trend points north. Based on population growth alone, 47 million people will have no insurance five years from now (Consumer Reports Issue 9). This growth is at an alarming rate, especially when you take in to consideration that the uninsured usually receive what is considered second-class care and that is if they receive any at all. Many of the uninsured get treated depending on several factors, their age, their diagnosis, and how much money you have or can get together. Some families spend their entire savings to provide care for chronically ill, and disabled relatives.


For many of the uninsured, clinics have been a major corner stone. These government-founded clinics have helped many uninsured, but the care at these clinics is questionable. With most of the doctors on staff volunteering their much sort after time, and insufficient medication. This questions both the disbursements of government funds and the lack of proper planning.

The federal government funds some 3,000 clinics, and last year Congress channeled about $1 billion in federal money to them, including a $94 million increase to accommodate the huge demand for services. The number of uninsured people seeking care from these clinics is up 45 percent over the past decade, says Earl Fox, administrator of the Health Resources and Services Administration. Still, there is no money for 12 new clinics and 46 expansions that already have been approved. By contrast, Congress gave nearly $18 billion to the National Institutes of Health for research on treatments and cures for disease – therapies that may never reach the uninsured. Hundreds of other clinics receive no federal money and depend on donations as well as state, local, and private grants. (Consumer Reports Issue 9)

Suggestion for the Future

While the uninsured struggle day to day without any coverage, and not many options there are a few suggestions for the future. Congress has been looking into two different plans for the uninsured: tax credits and a medical savings account.

The tax credits are a specific amount that would be set aside for health insurance for the uninsured. It would be in essence like a refundable voucher. Which has some skeptics regarding refundable credits as a hidden welfare making some politicians unlikely to support them.

Medical savings account would be high-deductible insurance policies that would be combined with a tax-deferred savings account. A policyholder could either withdraw money towards medical expenses or simply let it accumulate. They would also be able to withdraw money for non-medical related expenses by paying a penalty if they are under age 65.

Programs including Medicaid, CHIP, and COBRA, which allows the unemployed to continue for a time on their former employer’s health plan, are more a patchwork of coverage than an insurance system. Indeed, some incremental reforms are better than others. Consumers Union has supported efforts to cover all children and expand Medicare to include adults ages 55 to 64, paired with regulations that prevent discrimination by insurers against the sick.

But those approaches keep the current system intact. And for taxpayers, that’s a very poor value. The public now pays to support the uninsured through federal payments to hospitals and community clinics and through state and local taxes. Yet the uninsured are getting second-class health care. And money is being wasted.

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