Buy an essay on Funding for Health Care in the United States

Today, the funding of the health care system is one of the major issues of the domestic policy of the US because millions of Americans remain uninsured and, therefore, deprived of the access to health care services because they cannot afford paying for health care services they need. In such a situation, the necessity of the health care reform becomes obvious but, to implement the reform successfully, the US authorities have to study the experience of other countries and find the most effective approach to the funding of health care system. In this respect, Rice conducts an in-depth analysis of the current approaches to the funding of health care systems in different countries and extrapolates the experience of other countries on the US. In actuality, Rice distinguishes two major approaches to funding the health care system. On the one hand, there is a health care system funded by the state which uses state and public funds to finance health care institutions and health care system at large. Basically, this approach to funding of the health care system is widely-spread and many countries, like the UK and Canada, have already implemented this approach successfully. Today, the health care system of the UK and Canada are considered to be among the best in the world. On the other hand, there is the private funding of health care system through the health care insurance with minimal interference of state as is the case of the US and Switzerland, for instance. In fact, these countries have reached considerable success in provision of health care services too but the author raises the question of the availability of health care services to the uninsured population that naturally puts the US in a disadvantageous position compared to the UK or Canada where the state funding of the health care system makes health care available to all citizens. Nevertheless, the author argues that the qualitative assessment of different approaches to funding of the health care system and their effects on the health care system is unclear. At any rate, it is difficult to define clearly that the UK health care system is definitely better than the American one for instance because each health care system with its approach to funding has its advantages and drawbacks. Therefore, Price suggests to take into consideration experience of other countries, while developing the health care reform in the US.

To meet this goal, Price points out ten lessons for the US to learn. First, health services coverage should be universal. In actuality, this means that health care services should be available to all citizens that ensures the availability of health care services. On the other hand, the 100% enrollment to health care services, which are funded by the state, may affect the quality of health care services and the implementation of new, technologically advanced methods and equipment. Obviously, the rise of the population enrolled in the heath care programs funded by the state will decrease investments into the development and implementation of new, advanced technologies as well as the time on the delivery of essential health care services may increase because there will be no disparity among patients.

Second, coverage should be financed primarily from public sources or government-ensured social insurance using progressive revenue sources. The funding from public sources turns out to be the only way to provide the entire population with access to health care services and the use of progressive revenue sources can stimulate the effective use of funds and investment into the development of new technologies and methods of treatment. On the other hand, public or state funding may increase bureaucracy within the health care system, especially in regard to its funding. Hence, the rigidity of funding may decrease the effectiveness of the health care system.

Third, the delivery of health services can be carried out privately under the oversight of government, which acts as a purchaser of services. The involvement of private health care institutions into the provision of health care services contributes to the high quality of health care services because private institutions are interested financially in the provision of health services of the high quality. On the other hand, this approach increases the risk of corruption in state agencies and statesmen responsible for funding and selection and overseeing over private health care institutions.

Fourth, emphasis should be placed on containing costs through supply-side method. In such a way, Price attempts to maximize cost-efficiency of public or state funding of the health care system. However, the problem of control over the use of funds and assessment of costs persists.

Fifth, patient cost-sharing requirements should be kept reasonably low. Low cost-sharing requirements enlarge accessibility of health services to all patients but, on the other hand, it raises the risk of using health services by patients, who could have afford paying higher price than average patients do.

Sixth, to the extent possible, payments to providers should be coordinated among payers. Obviously, payers should coordinate their actions to maximize the effectiveness of the use of their money. On the other hand, providers can use patients’ privacy or other reasons to conceal financial information and misuse funds regardless of coordinated actions from the part of payers.
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Seventh, countries should proceed with caution in providing consumers a choice of insurer. The provision of consumers with a choice of insurer is essential to maintain the competition in health care market that means high quality of services, reasonable price and other benefits of a highly competitive market. On the other hand, the state or public funding aims at lowering costs that limits the choice of insurers.

Eighth, fee-for-service payment should be re-evaluated. Obviously, fee-for-service payment is not always effective and fair because patients may need a complex of services. However, the re-evaluation of fee-for-service payment may raise problems with adequate assessment of costs of health care services and the use of fair and equal approach to all patients.

Ninth, government should fund impartial research and analysis on health system performance. Such funding may increase the quality of health services and effectiveness of the use of state funds, but it also increases costs of health care funding for the state.

Tenth, government failure is not necessarily a greater problem than market failure in the health service sector. The government failure may be compensated by private capital through borrowings, attraction of investments, fiscal credits and other means the government can use to attract the private capital to the health care system. However, the government cannot tackle the problem of shortage of funds in case of a structural, systematic crisis in the health care market.

Thus, taking into account all above mentioned, it is possible to recommend increasing the government control and regulations of the health care system that implies the rise of the state funding of the health care system. This may be achieved through the elaboration of new health care programs like Medicaid and Medicare, to enroll a larger number of uninsured people. At the same time, the private health care services and health insurance should co-exist with state-funded health care services to maintain the competition and preserve the alternative to those who are not willing to rely on state-funded health care system.

References:

Davis, K., et al. (2006). “Mirror, Mirror on the Wall: An Update on the Quality of American Health Care through the Patient’s Lens.” The Commonwealth Fund.

Jaspen, B. (2002). Low-Quality Health Care Costs United States Nearly $400 Billion Annually. Knight Ridder Tribune Business News. Washington: Jun 11, 2002, p.1.

Lasser, K. E., Himmelstein, D.U. and Woodlander, S. (2006). “Access to Care, Health Status, and Health Disparities in the United States and Canada: Results of a Cross-National Population-Based Survey.” American Journal of Public Health, 96(7), p.1300.

Rice, T. (2003). The Economics of Health Reconsidered. New York: Random House.

Spiegel, M. et. al. (2003). “Quality of health care delivered to adults in the United States.” The New England Journal of Medicine, 349(19), p.1866.