Healthcare Reform Ways the Healthcare Thesis

Excerpt from Thesis :

Transparency empowers consumers to become better shoppers. Economists assert that transparency stimulates productivity, for example, in exchange for money, one individual obtaining fair value. In every aspect, except healthcare, Davis points out, transparency, is supported. The contemporary dearth of transparency in healthcare has led to many Americans not being able to effectively shop for the best quality of service at acute care hospitals. Davis argues that transparency permits consumers, particularly those uninsured individual, to know actual charges, as well as the quality of services they will received.

The critical issue in Health Care Reform, according to some, Davis (2008) notes, is power. When consumers know less about the facts, those who do know possess the greater power. These with more power generally consist of "the hospitals, the insurers, and the healthcare policy makers" (Ibid., ¶ 14). Consumer-driven healthcare aims to switch the power to the consumer and the partnering provider (¶ 14).

Three significant factors relate to healthcare, cost, access, and quality.

Cost relates to the ability to adequately finance healthcare, whether through insurance or self-pay. It also links to the ability to pay copayments and deductibles.

Access does not only denote availability of services in a particular area (facilities, equipment, and personnel), it also includes transportation to services. This may be the individual lacking a vehicle, money to purchase gas or to pay someone to supply transportation.

Quality, the Institute of Medicine explains, encompasses the extent to which health services augment the probability of desired health outcomes, comparable to standard practice.

And When either cost, access or quality is missing, that missing component interrupts healthcare. "In the traditional healthcare model, cost, access, and quality can serve as and barriers the healthcare, forcing consumers to be passive recipients, whereas in the consumer-driven healthcare model, the consumer is an active participant in the process," Davis (2008, ¶ 16) asserts.

And Health Care Problems

Currently, due to their being uninsured, according to the article, "Doctors, patients, and the need for health care reform," (2009) published by The New England Journal of Medicine, more than 46 million people regularly risk their health and financial stability. Approximately 25 million more Americans do not have enough insurance to satisfactorily cover their medical needs. This situation contributes to bankruptcies, caused by high medical costs, to increase. Due to rising costs and new press abusive practices by the health insurance industry, the sickest and most vulnerable Americans are put at risk.

Regardless of their station in life, all Americans should be able to access the care they need, not just the care they can afford, The New England Journal of Medicine stresses. As the growth of health care costs continues to be unsustainable, the healthcare crisis appears grim, partially due to the following reasons that plague the U.S. Healthcare system:

Impending workforce shortages, excessive volume-based purchasing, rising costs, and unpredictable Medicare payments.

Due to the numerous gaps in the way each component (consumers, employers, providers, and health plans) operates, Davis (2008) asserts, the current traditional healthcare system is broken. Recently released findings from the Association of American Medical Colleges indicate that 15 years from now, there will be 159,000 fewer doctors than the U.S. needs, practicing in the country. During 2009, primary care physicians are reported to be particularly in short supply.

The article, "Insuring America's health: Principles and recommendations (2004) published by the Institute of Medicine of the National Academies, asserts that not having insurance contributes to approximately 18,000 unnecessary deaths every year in the U.S.

America reportedly leads the world in spending on health care. The U.S., however is one of the wealthy, industrialized nations that does not ensure all its citizens have health coverage. "To help policy-makers, elected officials, and others judge and compare proposals to extend coverage to the nation's 43 million uninsured, the Institute of Medicine of the National Academies offers a set of guiding principles and a checklist in…[the] report, Insuring America's Health: Principles and Recommendations" (Insuring America's...
...The report culminates a series offering a thorough, comprehensive examination of the affect that the lack of health insurance has on individuals, as well as their families, communities and society as a whole.

The following set of guiding principles is based on evidence reviewed in the Committee's previous five reports, along with new analyses of past and present federal, state, and local efforts to reduce the number of individuals who are not insured. Prominent principles for guiding the Healthcare Reform Bill debate and evaluating various strategies include:

1. Health care coverage should be universal.

2. Health care coverage should be continuous.

3. Health care coverage should be affordable to individuals and families.

4. The health insurance strategy should be affordable and sustainable for society.

5. Health insurance should enhance health and well-being by promoting access to high-quality care that is effective, efficient, safe, timely, patient-centered, and equitable. (Insuring America's health…, 2004, ¶ 4)

Average American Healthcare Insurance

Stephen Heffler, Sheila Smith, Sean Keehan, M. Kent Clemens, Mark

Zezza, and Christopher Truffer and Warren Moon (2004), all with the Office of the Actuary, Centers for Medicare and Medicaid Services, in Baltimore, assert in the journal publication, "Health spending projections through 2013," the health share of gross domestic product (GDP) is projected to increase from where it measure 14.9% in 2002 to 18.49% in 2013.

Reform plans reportedly need to include more, according to Ken Alltucker (2010), feature writer for the Arizona Republic. Alltucker reports in the article, "Ex-Mayo CEO: Health plan lacking," that the former head of the Mayo Clinicasserts that the health-reform bills promoted through Congress met challenges due to the sponsors focusing too heavily on insurance reform, while neglecting to emphasize quality health care. One location, nevertheless, Rochester, Minnesota earned President Barack Obama's recommendation to serve as a national model of health care as its reported high quality and efficient delivery of care reflects goals of the reform bill.

Denis Cortese, Mayo's former chief executive officer, currently an Arizona State University faculty member, argues that the current House and Senate reform proposals fail to tackle the health the issues of incompetent care and escalating costs. "While the health-reform bills seek to extend health insurance to more Americans, & #8230; even the rosiest projections for the competing bills would leave about 26 million Americans without health insurance" (Cortese, as cited in Alltucker, 2010, ¶ 4). Cortese further argues that even though reforms would basically position new requirements on private health insurers, they do not address how businesses and consumers secure quality care amidst ongoing costs. Cortese contends that patients often receive a bill based on ambiguous contracts among doctors, health insurers and hospitals, along with other health providers; no matter the outcome. Cortese argues that the current health care system is not rational.

Max Baucus (2009), writer for Healthcare Financial Management, reports that the broken healthcare system in the U.S. cost the country's economy more than $200 billion during 2007. In the article, "Healthcare reform a moral imperative, an economic necessity: Healthcarereform is not just a moral imperative; it's an economic necessity, and the numbers speak for themselves," Baucus points out the following concerns:,

1. Annual healthcare spending in the U.S. reportedly outpaces economic growth by approximately 2.4% each year.

2. Businesses may witness their healthcare costs double; from $429.8 billion to $885 - within 10 years.

3. The cost of the average family employer-sponsored health insurance plan will reportedly reach $24,000 by 2016. This indicates that a minimum of 50% of American households would need to invest more than 45% of their income to purchase health insurance.

Baucus (2009) concurs that the U.S. healthcare system crisis constitutes more than a crisis for the uninsured and related health concerns as it ultimately affects the U.S. economy and the average American.

For healthcare reform to be effective, merely having access will not be enough, Baucus (2009) stresses. To help ensure healthcare reform proves effective, Baucus contends, particular goals need to be met. One primary goal is that the insured also needs the guarantee that he will receive quality healthcare. When this occurs, Baucus states, "coverage will make the insurance markets function properly, and costs will go down for all policyholders" (Baucus, 2009, ¶ 5). As the various components in health care interrelate,, however, one cannot address it bit by bit.

Baucus (2009) contends that reform:

Must create incentives for healthcare providers to focus on delivering the best care and closely coordinating with a patient's other doctors and providers.

Should invest in the resources healthcare providers need to deliver care, such as cutting-edge technology and up-to-the-minute research and information.

Work to reduce fraud, waste, and abuse in the Medicare program (¶ 7).

Must create a competitive insurance market where health plans compete on price and quality rather than on the ability to segment risk and discriminate against individuals with…

Sources Used in Documents:


Aday, L.A. & Cornelius, L.J. (2006). Designing and conducting health surveys: A

comprehensive guide. San Francisco, CA: John Wiley and Sons.

Alltucker, K. (2010). Ex-Mayo CEO: Health plan lacking. The Arizona Republic. Retrieved January 18, 2010 from

Baucus, M. (2009). Healthcare reform a moral imperative, an economic necessity: Healthcare

Cite This Thesis:

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