The American health market like the normal commodity market has changed its focus from providing quality services to maximizing the quantity of services provided to maximize profits, which they have succeeded in, but at the expense of the people’s welfare. There is a significant difference in the quality health care provided by salaried doctors and that provided by doctors who were paid per service, with the salaried doctors exhibiting better quality service delivery. These incentives have also caused many doctors to turn their backs on patients who cannot afford their services, which beats the purpose of being a doctor.
The quality of healthcare in the United States relative to that of other countries has been a major issue. A free market approach to healthcare much like the market for other commodities has been argued by one political advocacy to result in low quality healthcare as doctors compromise the quality of healthcare in favor of quantity and has been found to result in higher mortality rates (Hoffman, 2003).
The cost of healthcare in the United States relative to its economy is the highest in the world. There is need for a fiscal policy that will bring the costs of healthcare under control and ensure universal coverage of health care in America in the long run. The inconsistent coverage in health care has been a major concern. For example, a 2009 Harvard study found that there were more than 44800 deaths in the United States every year cause by lack of health insurance. It was also found that there were thousands of others who died annually due to lack of medical care.
The following essay covers the current health care condition in America and the stance of political parties in regards to the same and to reforms. Health reform has been discussed and debated by political parties in the United States for a long time with every party having a different opinion from the other and sometimes from the public. All Americans agree that there is need for health reform in America but few are willing to pay for it. There also seems to be a lack of consensus on the best approach with approximately 40 percent being democrats, 30 percent being republicans and 30 percent being independent (Birn, 2003). The main difference in the stance taken by the political parties is whether to improve the quality of health care by giving the public control over health care, an approach advocated for by the republicans or to provide universal coverage and allow for government intervention, the democratic approach.
While majority of Americans think that health care reforms should be addressed now, they cannot seem to decide on the timing. In light of other urgent matters such as the economic condition of the country the majority of the democrats think that the health care reform issue should be tackled immediately, while the majority of republicans think that at the moment health care reform is not affordable (Wainess, 1999).
When it comes to the question of raising money to cater for health care reform, the democrats favor government based funding. They support the ideology of increasing taxes for the wealthiest and also on unhealthy health practices such as smoking. The republicans on the other hand recommend that Americans be charged with the responsibility of funding this reform.
The Republican stance
Therepublicans unlike the Democrats believe in giving the power to make decisions to the people rather than to the government. When it comes to health reform therefore their focus is on the patient and his needs and wants rather than the government. Their main goal is the provision of better quality health care at lower costs. They disagree with the democrat’s goal of offering increased access without lowering costs. Republicans claim to have a bill that is workable and that will cover all Americans without costing the tax payer any money. This bill, the Empowering Patients First Act which they proposed as a replacement for the amendment of the Senate bill was rejected by the Senate Finance Committee. Their reasons were that this bill would not reduce the number of people without insurance cover and was feared to actually reduce health insurance coverage since it would do away with mandated coverage rules that are in operation in some States. The insurance companies would than benefit from more government funds by coming up with new insurance subsidies.
The republicans however, maintained their stand since they believe that charging the public with this responsibility is bound to increase doctors’ accountability and to increase competition therefore reducing costs. For a long time the republicans have been against government control in the health sector and advocate for private medicine practice as opposed to socialized medicine. The republicans objectives in advocating for less government involvement include encouraging the promotion of health and the prevention of diseases, protection of the citizens from restructuring effort that would result in rationing or complicated health care, create a cooperative environment among the health providers, the patients, the stakeholders and payers in the health care system and eliminating government interference between the health care providers and their patients (Williamson, 1994).
Their stance basically is one of increasing the patients’ control, their accessibility and affordability of health care. They also disagree with the democrat’s policy of increasing taxes for whichever class and government subsidies instead of lowering costs. They advocate for patients’ empowerment and reducing government intervention therefore curbing the bureaucracy that comes with the involvement of the government. Their argument against the involvement of the government is the lack of progress so far in light of their intervention. Their goal is to improve the quality and coverage of health insurance at lower costs. In their view, health care provider and American citizens, not the government is key to real health reform.
They believe that Americans have the right to an affordable health care plan which meets their needs. Therefore it is imperative that insurances be made more affordable by lowering premiums, and more secure. They also advocate for the employee’s choice to own coverage apart from the one offered by the employer or one linked to the job. The patients, not the insurance companies need to have the upper hand and the insurance companies need to strive to keep patients business as opposed to the patients striving to keep their insurance covers.
Republicans are concerned about the inequalities exhibited in the current tax system. In the current tax system the high income employees enjoy better health tax benefits compared to other Americans who cannot afford a health care plan. Part of their goal is to ensure all Americans receive equal tax benefits, whatever the means of their insurance. Tax reform is another strategy that would reduce health care costs significantly. Inefficiencies in healthcare have been partly perpetuated by a lack of clarity in regards to health insurance costs and the bearer of these costs in employment. Health insurance provided by providers is currently exempted from tax and it has been argued that taxing employer based health insurance would increase the tax revenue significantly. The Economist, in November 2009 estimated the increase in tax revenue in the event that employer based health insurance was taxed to be 215 billion dollars. Tax payers are more likely to change the system or their behavior that will impact on demand for health care services.
Besides ensuring individuals are in control of their health care, Republicans are committed to helping lower cost, improving quality of care as well as helping Americans adopt a healthier life and a culture of wellness. They also advocate for preventive measures such as vaccines and improved nutrition. An example is strategy suggested in aiding medical cost reduction is measures towards lowering obesity. Preventing overweight and obesity issues prevents a large number of diseases related to these conditions whose treatment is rather costly such as heart disease, cancer among others. Therefore lowering obesity is bound to significantly reduce healthcare costs. They also advocate for less smoking and consumption of alcohol (Willimson, 1994).
This is bound to lower the demand for health care services and therefore lower its prices. They also advocate for equal treatment of mental health care with physical health care. Access to health care should not only be limited to those seeking physical health care but also to those seeking mental healthcare.
One of the strategies that the republicans advocate for that is bound to lower costs is increasing competition. This can be achieved by providing the citizens with perfect information concerning health care so that they make informed decisions about health care and health providers. This should increase competition and consequently lower costs.
The republicans believe in the betterment of medical research especially by funding it. This would be accomplished by using comparative effective research among other tools. This would ensure that there is a body that is charged with the specific task of ensuring that the medical and healthcare field was at its best at all times. It would also be responsible for carrying out regulatory measures to ensure the healthcare system was based on quality service provision rather than quantity. Incentives presently being used by the health care system have been criticized as aiding in increasing health care costs. One of their major problems with current incentives is that doctors get paid for the number of services provided rather than receiving a constant salary. While this is aimed at encouraging them to provide more health services it could also cause them to compromise on quality services in bid to maximize the quantity of health care provided and in turn increase profits. Fully insured patients also contribute to the high health care costs since they have no incentive to consider minimal costs when choosing among alternative treatment methods. This has the effect of increased premiums by the insurance companies to all.
The republicans stress the importance of appreciating the health providers who do a good job and rewarding them. They should be paid for the quality of work they provide and not by the number or tests run or the cases they treat. The use of technology can be used to improve record keeping by making it digital therefore easy to store and to access. Technology is devoid of human error therefore making it more reliable. It encourages low costs, more efficient record keeping and more accurate treatment.
Recently a lot of funds have been directed towards improper payments that amount to medicare fraud. These crimes are highly lucrative for the perpetrators and are often difficult to trace. However, seeing as the amount of money that is lost to these fraudulent cases amounts to 60 billion dollars every year, there is need to address this issue and adapt measures to apprehend the perpetrators while preventing the likelihood of their successful perpetration. Thorough auditing needs to be done and more transparency and accountability measures implemented if these monies are to be saved (Cook, 2007).
These fraudulent practices besides costing the government a lot of money, may lead to lawsuits directed at the doctors often. Lawsuits often have the effect of increasing insurance rates and consequently increasing the costs of health care.
The Democrats’ stance
The democrats’ most consistent advocacy for years has been increasing health care coverage in the United States by advocating for access of health care to everyone. They have fought for the public to have some basic assurance and security in health care. A research study in Health Affairs found that 50 percent of personal bankruptcies were a result of medical bills, a finding that indicated the inconsistency in health care coverage in the United States. Over the years a couple of the presidents of the United States have taken measures towards the achievement of this goal, and most recently President Obama increased health care coverage to include four million children who do not have insurance cover. Therefore it advocates for public funded systems which have been found to result in high quality healthcare. This group has also criticized the quality of managed care and that of health maintenance organizations.
The shortage of doctors and nurses in the United States is another issue of concern for the democrats. A shortage of medical practitioners means healthcare services will become scarcer and therefore increase in cost. With an average of 2 to 3 doctors for every a thousand people, the doctors are swamped as it is. A deterioration of this statistic would mean less accessibility to quality medical care in addition to increased health care costs. They therefore advocate for the training of more doctors and nurses since the more they are the more likely the public’ security in health care since it means more doctors are available per a particular number of people (Cook, 2007).
Another measure that the democrats have advocated for is the bill passed concerning insurance coverage for persons with pre existing conditions. In the near future, uninsured adults who lack insurance on the basis of pre existing conditions will be able to acquire insurance coverage via a new program.