Health Care Systems Over the Last Several Essay

Excerpt from Essay :

Health Care Systems

Over the last several years, America's health care system has been undergoing a tremendous amount of changes. At the heart of these transformations is the role of the federal government in regulating the delivery of various services. For some this is troubling, as it will lead to a larger form of socialized medicine. This is when consumers will have less choice and the underlying quality will decrease. While others think that the government can protect consumers and negotiate lower prices for everyone. These contrasting views are highlighting how America's health care system is a combination of government and private entities working together. To fully understand what is taking place requires looking at: the definition of the health care system, the impact of beliefs / values, providing examples of models for health care delivery and explaining how these areas are used in the U.S. Together, these different elements will highlight the way these services are provided to stakeholders in America.

Definition of a health care system

A health care system is all of the different pieces that help to deliver the various products and services to customers. These include: the facilities, insurance companies, health care provider, doctors, nurses, suppliers, the government, nonprofit organizations, the general public and manufacturers. The combination of these factors is designed to effectively deliver specific health solutions to consumers (in a cost efficient manner). (Matcha, 2003, pp. 4 -- 5)

Implications of beliefs and values on a health care system

The different beliefs and values will have an impact on the health care system. In America, these ideas are based upon personal freedom and the size of the federal government. Like what was stated previously, these views will influence the intensity of the debate and the kind of programs that have been enacted. A good example of this can be seen with the Patient Protection and Affordable Care Act. When the law was going through congressional debate, many groups approached members of Congress in their districts. At the heart of their arguments, were the role that the federal government should play in health care and how this is tied to their values. In some cases, this occurred with proponents arguing that the law was necessary to deal with the rising number of uninsured and abuses that are occurring. This is based upon the belief that the federal government should protect consumers and effectively regulate these markets. ("A More Secure Future," 2012) ("Health Care Reform and the Supreme Court," 2012)

While many opponents felt that the law was a violation of their personal freedom. This is occurred by expanding the size of the federal government and forcing everyone to purchase health care. Moreover, they feel that when the federal government is involved in these programs it reduces efficiency, productivity and increases taxes. To prevent these kinds of policies they have a moral obligation to speak out against what is happening. ("A More Secure Future," 2012) ("Health Care Reform and the Supreme Court," 2012)

These different views set the stage for the conflicts that occurred at many Congressional town hall meetings. As both sides showed up to express their opinions, which are resulting in a toxic mix of anger and animosity. This is showing how the implications of beliefs and values will shape the kind of programs that are introduced. ("A More Secure Future," 2012) ("Health Care Reform and the Supreme Court," 2012)

In this case, the federal government could have followed a similar model to Canada. The fact that there was so much opposition to this kind of approach; meant that designers of the bill tried to limit the federal government's involvement. This was accomplished through expanding the states' Medicare and Medicaid programs. Then, they are providing the states, with a block grant in delivering these services to the general public. The implications of these beliefs are that any kind of programs will try to incorporate the views of both stakeholders. When this happens, the health care system will be combination of private and governmental elements. ("A More Secure Future," 2012) ("Health Care Reform and the Supreme Court," 2012)

After this occurs, is when the different sides will challenge the legality of the law. Depending upon the ruling, it will shape how the debate changes (with the acceptance of this programs) or if it will be renewed (if the law is declared unconstitutional). This is influencing the outcome by having both sides working to achieve conflicting objectives. As a result, this is fueling the overall arguments about the type of health care system America should have. ("A More Secure Future," 2012) ("Health Care Reform and the Supreme Court," 2012)

Examples of the various models of health care delivery used in America

Inside the U.S. health care system there are a number of delivery models that are available. The most notable include: managed care, governmental programs and private insurance. Managed care is offered to large employers, the basic idea is that everyone can be able to pool their resources together (in order to receive a lower rate). During this process, there will be an emphasis on controlling costs through primary care. In the event that someone needs specialized services is when they must receive approval from their primary care doctor. Moreover, customers must stay within a certain group of health providers that are working with the plan. As a result, the program is operated by private insurance companies. ("A Distinctive System of Health Care Delivery," 2010)

Governmental programs include: Medicare and Medicaid. This is offered to someone who reaches the age of 65 years old or has lower amounts of income. During this process, the federal government will negotiate a reduced rate for the services they are receiving. The patient will have to cover a certain amount of the costs (in the form of a deductible or copay). These areas are designed to provide the most vulnerable in society (i.e. The elderly and poor) with some kind of health care coverage. ("A Distinctive System of Health Care Delivery," 2010)

Private indemnification is when an individual will purchase health care protection from an insurance company. In general, this is used by those who are self-employed and other individuals that are not traditional employees (i.e. independent contractors). This is similar to other forms of coverage with the individual paying a copay and deductible every year (for a certain amount of services they are receiving). ("A Distinctive System of Health Care Delivery," 2010)

These different examples are showing how the health care delivery model in America is based upon a combination of programs working in conjunction with each other. As a result, one could argue that the system is hybrid of various programs. This is based upon their ability to deliver specific services that are vital to various stakeholders. ("A Distinctive System of Health Care Delivery," 2010)

Explanation of how the health care system applies to models of the health care delivery in the United States

These areas are designed to provide a total solution of health care services to the individual. The way that this is accomplished is they will have a combination of these programs to address specific needs. For example, someone who is working and receives health care coverage for his family may not be able to afford the high cost of prescription drugs. Under the programs offered by Medicare and Medicaid, they can be able to receive a discount (if they meet predetermined conditions). This is designed to address any kind of holes in the coverage that someone has through their existing policies. ("A Distinctive System of Health Care Delivery," 2010)

These areas are providing the public with a comprehensive health solution that is addressing their needs. This is achieved by not focusing on a single delivery model. Instead, there is an emphasis on having…

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