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In reference to the health care system, a single-payer health care system where only one administrator or a payer usually a government run organization, is charged with the responsibility of collecting all healthcare fees and also paying out all the health care costs from one pool of resource. Under this system, all doctors, hospitals and any other health provider in the state bills each entity separately for the service provided (Preker, 2005). However, in the disintegrated profit health care system, there is the presence of numerous, tens of thousands of autonomous health care organizations (HMOs) and billing agencies. This system is characterized by enormous waste of administrative resources. This paper compares and contrasts the two health care systems in terms of access, economics, administration and perspective of the patients.
In terms of the access and benefits to the community, the single payer is different from the profit health care system in that health care is based on the need for the benefit and not on the ability to pay. Under the single payer, every citizen is entitled to and receives comprehensive health benefits under a medical cover that provides services for long term and home care, rehabilitation, prescription drugs, mental health care and both preventive and public health measures. On the issue of payment, hospital billing is non-existence, the hospitals ask for funding from the government pool to cover all their operating costs (Preker, 2005). The central authority is charged with budgeting for different issues such as hospital expansion, marketing and technological acquisition. Here in, the government acts as an employer and not an employer. In the profit health care system, each organization is charged with taking payment from the numerous insurance agencies in the states and its personal budgets for expansion.
There are overall high administrative costs in the provision of profit health care system. This is due to the fact that each organization personally has departments dealing with the billing and collection of funds from the insurance providers (Sherrow, 2009). Such costs are minimal in the single payer health care system because the organization just collects funds from one payer; the government. The general accounting office approximates an average saving of 10% due to elimination of those private insurance bills coupled with administrative costs. A single payer health care system is essential in cost containment. An economic study in the 2004 published in a medicine journal (The New England Journal of Medicine) approximated that the introduction of a single payer health care system would realize a reduction in the cost of health care provision by about US$ 400 billion. Consequently, the trickle-down-effect would ensure that individuals pay less to receive the same level of service due to elimination of deductibles and copayments.
The multi-payer profit oriented health care system presents the policy makers with complicated challenges in implementing a health care coordinated comprehensive policy. The single-payer on the contrary would be the simplest and also the most efficient health care system to be implemented and overseen by the legislators. Due to the ability to be effectively implemented, the system would also be successful. However, due to the centralized implementation, many business organizations in the facilitation of the health care system would go out of business. The insurance agencies, the organizations charged with the collection of funds among others would lose their businesses under the single-payer health care system.
Both these health care systems have not been successful in the handling of the basic issue in the health care system; making the health care system affordable to the average citizen. The profit oriented health care system is depicted by the people paying more for each higher level of health care provided. The more that the person pays; the better the health care service provided. The single payer does not effectively provide the solution for the poor citizens. By making the health care accessible to all, the government has to raise taxes to cover for the broad health care scheme. The cost is therefore transferred to the consumers of the health care in terms of taxes. The poor citizens continue being overburdened by the scheme in terms of taxes, just like the profit oriented scheme would in terms of insurance contribution.
Moreover, there is similarity between the two schemes in that they are both depicted by bureaucratic red tape especially in the collection of the funds by the health care providing organizations. Collection of payments from the numerous insurance agencies as well as the corresponding agency in the single payer health care system is a common challenge that both schemes have not been able to resolve.
Due to the capitalism and the free market enterprise that has thrived in the US economy since the founding of the nation, the profit oriented health care system has thrived at the expense of the single-payer health system and hence the universal health care system for all. The health care system debate has widely been confined to the politics of the nation with the proponents being branded “communists.” The debate should be based on the economics and the social effects of the scheme rather than the mere politics involved.
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