Thursday, March 17, 2011

Health Care Reform - Position Paper

Health Care Reform in United State

There are many Americans that do not have health care in the United States. To be exact forty-five million Americans are uninsured. Health care should not only be offered, but affordable for all.  Some of the biggest problems with our health care system right now are the unbearable cost of insurance premiums, denial of services due to costs or loss of coverage because of lay off or changing of jobs. Thousands of families, who live at low-income jobs, can’t afford health care and also thousands of students in college who fear sickness or injury because health care is unaffordable for them at this time. Families exhaust their savings trying to provide medical expenses for disabled relatives. Ultimately, if current trends continue, the question is not should everyone have health care, but will anyone have health care. There is no easy way to solve the growing health care problem in this country.

Health care economic system presents many challenges for consumer.  This paper addresses and discusses the reasons why United State should have a universal healthcare system, and reveal the issue behind Americans faces without a universal plan.  My argument is based on these major issues: the people involved and their experiences, a variety of groups' opinions, the political background, issues of cost, and comparisons. After taking into account these arguments, the readers should have a full understanding of why we should or should not adopt the universal healthcare system.  Currently, Managed care is the most common form of health insurance in the United States, and provides more a cost efficient coverage than paying a fee-for-service charge but also a very complicated system.  The advantages of managed care to the consumer are 75 to 80 percent medical expenses covered and 20 to 25 percent deductible. The consumers under managed care coverage would only need to make their monthly premium payment and co- payments. Managed care makes health care more affordable to the consumers. The disadvantages of it would be the consumers only able to see caregivers affiliated with the managed care organization, having to pay co-pay every visit, rising premiums, under treatment, and too much red tape to get necessary treatments.

     There are so many problems with our society’s health care. Everyone wants to find a solution, but no one has been able to come up with one yet. Many different things have been tried, but none have put a cease to the exorbitant costs, which most believe to be the main problem.

There are five issues when it comes to the health care cost rising. The first is prescription drugs, second is the increase of technology advances, third is the aging population, fourth is cost of hospital services and doctor fees, and fifth the increase of fear in medical litigations against doctors malpractice.  In order to prove the above issues of increases, the story starts with Vui Nguyen, my family’s friend who was sick with a terminal illness, Lung cancer.  The cost of different type of scans and other tests, CT scan (computed tomography), PET scan (positron emission tomography), MRI (magnetic resonance imaging), and Bronchoscopy to diagnose and confirm her cancer was 20000 dollars. The cost of chemotherapeutic drugs to treat her cancer was 3000 dollars per day.  According to the Controversies in Lung Cancer guide book an estimate of the cost of common chemotherapeutic drugs in Lung cancer was 2889 dollars per dose [1]. Tim Bonfield, the author of Hospital Costs Stays Vary Widely article, said that the Average hospital charges for stay can range from $4,600 to more than $11,000 per day [2].  Vui’s health insurance would compensate 80 percent and she paid 20 percent of her medical cost; “I feel lucky to have a good health insurance plan” she said.   Sometime hospital and doctor fees are not easy for consumer to understand and swallow, and rising faster than ever before.  This issue has been discovered by Michael Finney, the author of Financial Nightmare Of Hidden Hospital Fees article, “Don was thrown from his bike and knocked unconscious. He eventually ended up inside an ambulance where he received care and made phone calls canceling that night's dinner plans. After a few tests, some cuts and bruises were attended too, and he was on his way. The real hurt came when he received the hospital bill.  “For the two hours and forty-five minutes I was there, the bill was $24,000 some odd dollars. And I just couldn't understand it.” There were charges for supplies, EKG and the like, all expensive, but understandable. Then there is this, "trauma activation" - that's being ready for Don's arrival. A cost of $12,420. The hospital says "the activation fee is not a time or resource-based fee." Don has insurance. So the bill is discounted, then his company pays its share. Still Don has a bill of $6,000. The hospital, however, is offering a generous repayment plan.” [3] Citizens with insurance are affected because they must pay overpriced hospital fees.

What happen to people who are uninsured or underinsured? They will require pay up-front 80 percent of all the service frees. This story was public on The Shocking Truth About Upfront Hospital Fees article by Sid Kirchheimer, “After Dave Williams learned in April that the mass in his neck was malignant, his doctor referred him to a local cancer center. At his appointment, he was stunned at what he heard. “They said, ‘We’re looking at $30,000 worth of treatment, and we need $20,000 upfront,’ ” says Williams, 62, of Beeville, Texas. “I said, ‘I don’t have that kind of money.’ ” For the retired landscape designer, the hospital’s demand was an especially heavy blow, since he had recently paid off $273,000 in out-of-pocket costs for his ex-wife’s care for ovarian cancer (his employer-sponsored health plan refused to cover her because she had cancer when he enrolled). “I became poor trying to save her, but she died,” says Williams, who now lives in a trailer on a friend’s property. In his case, he applied for “charity care” at other hospitals but was rejected because he has saved about $10,000 in a 401(k). “They all asked for a lot of money, upfront, before they would do anything to help me,” says Williams, who is still exploring his options.”  [4] These showed the differences in prices between the costs in hospital admissions for people with fee-for-service plans and those without insurance.

 It is hard to imagine life without health insurance; especially, if you have any type of medical problem that requires treatment.  Doctors, physicians and surgeons are only willing to put out a big effort if you have insurance and money to go under extensive medical treatment.  Example: what happens if you or members of your family have a terminal illness and requires an operation or surgery, but does not have health insurance to cover the procedure? What happens if a lack of medical insurance prevents you or your family from seeing a doctor, which could result in health problems that had not been identified but could have been treated before they became life threatening? These situations may seem far-fetched, but they could happen to people who lack health coverage every day.

Ten years ago, as a college student I had to pinch pennies to make it through school; therefore, every last penny counts when my financial situation was tied. I did not have enough left to pay for health insurance. My health insurance would cost 250 dollars per month. Unlike most college students I was over the age of 23 and could not be covered by my parents insurance.  During the last semester of my senior year I noticed that my stomach hurt after each meal but I hid from my family and avoided to see doctor because I did not have enough money to pay for any service.  My health condition continued to get worst until few weeks after my graduation and luckily by that time I found a part time job in the research center at Colorado State University; during the lab experiment I almost collapsed and decided to see the doctor to check out my health problem.  At the doctor office, a nurse collected my blood, ran some tests and reports my test result back to the doctor who reviewed and called the hospital; set up an appointment for my colon or colorectal surgery for the next morning.  How scared and panicked I was while the doctor was unhappy with my diagnostic results and said “your health situation could be prevented early, and why didn’t you come in for check up when you first noticed of the problem.” Quickly a thought and question went through my mind, how bad was it and how could I pay for this surgery?  I was not paid any attention to the doctor’s criticized complaint about my reason for not seeing him earlier to prevent this situation.   Finally I calmed down and told the doctor that I did not have health insurance because I only worked part time.  He said, “You can have out-patient hospital surgery, hospital have a loan program and you could sign up and pay back the loan later.”  I did not have any other choice, followed the doctor’s advice by borrowing 27 thousand dollars and having my colon surgery with out-patient hospital surgery option.  While researching health care information to support my thesis of why should we have universal healthcare system in America, I realized that all my pains throughout 4 months of college could be avoided if I had health insurance to explore the problem earlier. I believe a single payer health care system or national health care system would provide a number of benefits. It would cut the overall costs of health care and decrease the amount of major diseases.

The current status of health care in United State is inefficient and change is needed but there are conflicting opinions on how drastic the change should be. From a political standpoint, democrats believes that health care is a basic right and should be guaranteed to every American; while republicans feels that it is difficult enough to pay their current health care plan premiums and to try create a plan to compensate for everyone.  Individuals’ views to this are a hot topic and an issue that will be heavily discussed on the next few years.  There are many reasons why health care system should or should not be changed.  The main concern that everyone heads toward is money, and wants to save money just in different ways.

Last week, President Obama signed health care reform into law. The goals of health care reform are to cut medical costs, make the delivery of health care more efficiently, and to promote preventive medicine, and expand primary care for everybody.  The new bill requires all Americans be covered by health insurance, and also is the first major change in the United States insurance system in decades. Insurers will be no longer allowed to deny coverage to individuals with pre-existing conditions; and young adults will be able to stay on their parents’ plans until the age of 26. These changes must be managed to insure that high quality care remains at the forefront of medical care.   While these changes are positive in many ways, but also create concerns among both the health care consumer and provider. One problem with implementing the Universal Health Care system is the issue of fairness of payment from each individual. For instance, there is a man who works out regularly, eats healthy, doesn’t drink or smoke and a man who smokes, drinks and is obese; are they expected to pay or be taxed the same for the same care? What about the difference in gender? Is a man more susceptible to injury or disease than woman? How do Americans pay for health care?

Everyone has an opinion on health care. One thing is clear of how we want to have a better health care system which is cost effective to the nation.   In my opinion, I think health insurance is one of the nation top problems, the premiums are rising and many small businesses just cannot afford it. Many Americans end up not having health insurance. We need to find some way to make sure that every citizen of the United States is able to have affordable healthcare for themselves, and their families.  I believe our country could benefit greatly from a universal health care program, if given the proper time to develop a comprehensive plan. However, if a weak plan is implemented too early, a new problem could develop that is far more a problem than the one we face now.   I also think the cost of health care would be reduced if we apply home care program where patients don’t have to stay in hospital, prevent insurers from overcharging doctors for their malpractice insurance, compare hospitals and doctors prices before arrive at their office but this would require the detailed publication of cost from both hospitals and doctors, and travel oversea for any diagnosis or surgery.  According to the Healthcare Fees article, “A hip replacement in the US can cost upwards of $43,000. Overseas it can cost as little as $7,100.” [5]


Work Cited
2.       Hospital costs, stays vary widely. Copy of text: http://www.enquirer.com/editions/1999/03/28/loc_hospital_costs_stays.html
3.       Financial Nightmare Of Hidden Hospital Fees.  http://abclocal.go.com/kgo/story?section=news/7_on_your_side&id=3527613
4.       The Shocking Truth About Upfront Hospital Fees, Copy of text (http://bulletin.aarp.org/yourhealth/caregiving/articles/cash_before_care_0.html)
5.       Healthcare Fees: http://www.healthcarefees.com/

References:
http://pc.patientadvocate.org/briefs.php
http://www.aetna.com/about/aoti/aetna_perspective/uninsured_college_students.html
http://abcnews.go.com/GMA/OnCall/story?id=6986420&page=1

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