US Health Care System

United States Health Care System

The objective of this work in writing is to answer as to what is working with the U.S. health care system and what is not working with the U.S. health care system. This work will address the needed reforms and the current role of government in health care. Finally, this work will answer as to what the role of government should be in health care.

This is not your father's U.S. health care system. No statement is ring more true as previous U.S. generations saw little governance of the health care system as it was a private industry in the American structure. Government today is however, greatly involved in the health care system and to many, such as the writer of this work, the government has overstepped its boundaries in a democratic governance structure.

What is Working and What is Not Working in the U.S. Health Care System

It is unfortunate that there is very little working about the U.S. health care system in contemporary times. Cited as reasons for this failure are such as deviation from treatment "based on the best scientific evidence" resulting in unnecessary costs and this can be in part blamed on lack of accountability in the present U.S. health care system structure. In fact, the major problems with today's health care system are structural and systemic in nature.

The current health care system is not user friendly for small businesses and their employees and this is because the U.S. health care system imposes a heavy 'tax' on small businesses and their employees or in other words high broker fees, fixed administrative costs and adverse selection result in small businesses paying approximately 18% more per employee than large firms for the identical health insurance policy resulting in lowers wages and eating into small business profits. The outcome is a disadvantage for small businesses in the market both in terms of employing the best workers and the market for the small business product. (, paraphrased)

These constraints oftentimes mean that small businesses do not insure their employees and it is reported that the higher health care costs result in "small businesses [being] far less likely to provide insurance for their workers than larger businesses" (The White House, 2011) In fact, firms with three to nine workers only insure their employees at a rate of 49% while those with 10 to 24 workers insure their employees at a rate of 78%. (The White House, 2011, paraphrased)

III. Needed Reforms

Reforms in health care that are needed include the ability of small businesses that meet specific criteria being able to make health insurance purchases through "an insurance exchange -- allowing them to choose among a multitude of plans that would provide better coverage at lower costs than they could find in the current small group market. In addition, a small business tax credit should be available to small businesses providing health insurance for their employees, which would serve to "alleviate their disproportionately higher costs and encourage coverage." (The White House, 2011) Current reform options are reported to include "financial incentives for medium- and large-sized firms to provide health insurance coverage through so-called "pay-or-play" provisions. Firms with payrolls or employment levels below a certain threshold, which would include the vast majority of small businesses, would be exempt from the pay-or-play provisions." (The White House, 2011) Also important is the creation of an insurance exchange, which would serve to make provision of more options at lower costs. Sliding scale subsidies should be made available to low-income families to allow them to purchase health insurance and health insurers should be disallowed in screening potential enrollees for conditions that are pre-existing. Finally, reforms should serve to drive entrepreneurial activity "by increasing the incentives for talented Americans to launch their own companies" thereby reducing the phenomenon known as 'job lock in which workers are reluctant to leave a job with employer-sponsored health insurance" based on a fear that they would not secure another job with the same level of insurance coverage.(The White House, 2011)

III. Government's Role in U.S. Health Care