A third approach in this area is the establishment of new co-pay programs which force patients to bear the costs of more procedures and treatments. This theory tends to shift part of the blame for over treatment back on the patient. Doctors claim that they order additional treatments because their patients insist on them. Forcing patients to share a greater portion of the costs of these additional treatments should arguably result in their being less demanding about receiving them.
Bureaucracy and overhead created in the delivery of health care and the administration of insurance benefits has also contributed to the substantial increase in health costs (Woodhandler 2003). The health insurance industry has campaigned to reduce health care costs but, in the process, has created a bureaucratic system that has effectively contributed to the problem. Additionally, compliance with governmental regulations has contributed to the bureaucratic difficulties as well. Practicing physicians and hospital administrator have been complaining for a long time that the costs related to legal compliance and insurance filings have been rising at an unbearable rate and that such costs are having a negative impact on their productivity. The same individuals complain that the lack of uniformity in forms and protocols make filing for insurance payments a costly experience. The solution to some of these overhead and administrative costs is the suggestion that the health care industry move to an accounting system where fee-for-services is abandoned and a system where services are provided pursuant to a set schedule. This would eliminate the need for each and every service having to be overseen and eliminate the need for the elaborate oversight system that currently exists.
The failure of the medical profession to adopt available technology has also caused an increased in medical costs. The profession has failed to adopt the use of email and still relies heavily upon traditional correspondence methods. One of the reasons offered is that fear of lawsuits causes doctors to ignore the use of email but concerns over the privacy rights of their patients. Access to emails creates a written record that doctors fear may hurt them legally in the event of litigation. Plus, insurance companies do not presently compensate doctors for preparing emails while they do for creating written medical records.
Another technology that doctors have been reluctant to embrace is the use of electronic medical records (EMR). EMRs have been demonstrated to promote better record keeping and to allow greater efficiency in the exchange of medical information between medical practitioners but physicians have been reluctant to alter their office policies in order to incorporate this technology into their practices. Doctors complain that the transition process is too time consuming and burdensome and that the benefits of its use do not outweigh the disadvantages. The new Affordable Care Act requires the profession to begin using the EMR system and pressure from the insurance industry is causing a move toward wider use as well.
The American health care system has been under strict scrutiny for several decades. Despite this scrutiny there has been seemingly little effort by the industry to address the problem. Pressures from outside the industry from consumer groups and government agencies have had some effect on the industry but the costs continue to spiral. Many had hoped that health care reform in the form of federal legislation would be helpful in curtailing the costs but the legislation which was finally passed was, because of political pressure, a watered down version of what was originally proposed by the Obama administration and has, so far, had little or no effect on any significant change. There may be some impact in the future when more provisions of the Affordable Care Act take effect but, for the present, there has been no change.
As was pointed out earlier, health care cost containment is universally viewed as a problem but there are no universally accepted solutions. The problems that have been listed herein and the corresponding solutions are just a few of the containment measures that have been suggested. A piecemeal approach is likely not the solution. What is required is a dedicated effort by the health care industry, the national government, and society in general to develop a new attitude toward finding a solution. Sacrifices need to be made by everyone. There is no easy solution.
Health care containment is a serious social problem and reaches across all aspects of American life and the solutions, if any, are complicated. Addressing the problems in cost containment and offering suggestions as to solutions is a task well beyond the restraints of this paper. A brief overview has been offered and has, hopefully, exposed the immense nature of this problem.
The reality is that the American health care system cannot go on much longer as it has. Already nearly fifty million citizens are without access to health insurance and far more are either underinsured or suffering under the burden of high insurance payments. Untold millions have foregone medical treatment because of its cost and unavailability. Hopefully reasonable solutions are in the near future.
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H.R. 3590-111th Congress. Patient Protection and Affordable Care Act (2009).
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