Touching the Finish Line � the U.S Healthcare Dilemma

“U.S health policy is at the crossroads. Will it be able to continue down the path of reform or move backward,” asks Jonathan Oberlander PhD., in a study recently published in the England Journal for Medicine (NEJM). “The U.S medical care is often characterized as a “non-system,” says the report.

Major Findings

According to the study, “United States developed a patchwork of public and private coverage instead of a single insurance system organized by the government. Employer-sponsored private insurance emerged to cover working Americans and their families. Between 1987 and 2010, the uninsured population grew from 31 million (12.9% of the population) to 50 million (16.3%). Result – even today it continues to debate the topic of healthcare reform,” notes the study. It finds the U.S. insurance arrangements a complex one. “There are gaps in public insurance, says the report. Medicare beneficiaries face substantial cost sharing, and the program does not cover long-term nursing home stays. There is a shortage of doctors to attend Medicaid enrollees due to low reimbursement rates. As the costs of medical care increased, Americans’ access to health insurance is getting eroded.”

Critics allege that the U.S health system maximizes returns to providers, but not to the society. “Fee-for-service reimbursement allows providers to reconcile their ethical duties and economic self-interest. Regulators and private insurers would not be in a position to control costs,” they say.

“It is not smooth,” says Alexia Garcia, a political producer and correspondent for PJTV.com in her recent article in theFoxnews.com. Quoting Tevi Troy, former deputy secretary HHS under George W. Bush she says “costs of premiums are going to rise and ACA is not likely to make healthcare more affordable.”

HHS estimates that overall healthcare spending in 2010 increased at the second lowest rate in 51 years; the lowest being in 2009. There are reports that people are postponing or cancelling elective surgery, doctor visits and prescription refills. That shows millions of privately underinsured are forced to delay or forgo care. There are gaps and inequalities in the U.S healthcare insurance system despite the rise of employer-sponsored insurance and the arrival of Medicare and Medicaid. Linking insurance to employment provided insurers with a convenient risk pool and a reliable source of premium payments. The study observes that people employed in small firms are not able to access employer-based insurance coverage and purchase comprehensive policies due to prohibitive costs.

Touching the Finish Line

However, there is a silver lining. Any healthcare scheme that failed in the past helped the government to shape up its health policy in a better way. “Thousands of conscientious doctors today provide most Americans with good care. It is a story of progress, with substantial gains in health insurance coverage over the past century. The study actually praises the system for being highly innovative in producing new organizations and payment methods. The most crucial issue could be the fate of ACA after the 2012 presidential elections. Regardless of the outcome in elections, the system needs a fundamental overhaul to deliver more value for money. That requires setting aside “special interests and partisan politics by implementing long-term solutions.”