It is important as a healthcare consumer to understand the history of the healthcare delivery system, how it operates today, who participates in the system, what legal and ethical issues arise as a result of the system, and what problems continue to plague the healthcare system. We are all consumers of healthcare. Yet, in many instances, we are ignorant of what we are actually purchasing. If we were going to spend $1000 on an appliance or flat screen television, many of us would research the product to determine if what we are purchasing is the best product for us. The same state should be applied to purchasing healthcare services.
As the United States resumes debate over options for achieving universal health coverage, policymakers are once again examining insurance systems in other industrialized countries. More recent attention has focused on countries that combine universal coverage with private insurance and regulated market competition.
A Basic Screenshot of what US healthcare is Comprised of
Medicare: Medicare is a social insurance program for the elderly, some of the disabled under age 65, and those with end-stage renal disease. Administered by the federal government, the program is financed through a combination of payroll taxes, premiums, and federal general revenues.
Medicaid: Medicaid is a joint federal-state health insurance program covering certain groups of the poor. Medicaid is administered by the states, which operate within broad federal guidelines. States receive matching funds from the federal government, varying among states from 50 percent to 76 percent of their Medicaid expenditures.
Private insurance: More than 1,200 not-for-profit and for-profit health insurance companies provide private insurance. They are regulated by state insurance commissioners. Private health insurance can be purchased by individuals, or it can be funded by voluntary premium contributions shared by employers and employees on an employer-specific basis, sometimes varying by type of employee. Employer coverage is the predominant form of health insurance coverage. Some individuals are covered by both public and private insurance.
Out-of-pocket spending: Out-of-pocket payments, including both cost-sharing insurance arrangements and expenditure paid directly by private households, accounted for 12 percent of total national health expenditures in 2007, which amounted to US$890 per capita.
Based on the fragmented development of US health care, the system is based on individualism and self-determination and focusing on the individual rather than collectivistic needs of the population. For example, there are over 20 million citizens who have type 2 diabetes, a chronic and serious disease that impacts how your body breaks down food to obtain energy. This chronic disease has severe complications if not treated appropriately. Unless something is done to prevent this insidious disease, there will be 35 million heart attacks, 13 million strokes, 8 million instances of blindness, 2 million amputations, and 62 million deaths over the next 30 years.
Both private and public participants in the US health delivery system need to increase their collaboration to reduce these disease rates. Leaders need to continue to assess our healthcare system using the Iron Triangle to ensure there is a balance between access, cost, and quality.
Although the Health Care Reform intends to take away the flaws the current system is infested with, the journey is going to be long and tough. But it will definitely lead to a better outcome as compared to current situation.