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Those with financial constraints
Those who have not been uninsured, for a period exceeding three months
Have some sort of religious objection on insurance schemes and policies
Those who are undocumented immigrants
The financial torture doesnt end here. The amount which youll be obliged to pay
will increase each year. For example, if a fine is imposed on you in 2014, youll
pay whichever of 95$ or 1% of your total taxable income is greater. In the next
year, i.e. in the year 2015 youll have to pay whichever of 325$ or 2 % of your
total taxable income is greater. In 2016, youll have to pay whichever of 695$ or
2.5% of your taxable income, is greater. From that point onwards, government
will refigure the amount of fine based on your standard of living and cost of living
etc.
Now let us discuss some general aspects of USAs health care system. In USAs
health care system, health care facilities are mostly possessed and operated by
private sector businesses. This doesnt mean that state has nothing to do with the
health care. States and Federal government do possess certain health care facilities
as well.
Majority of the health care provisions and spending come from some big
programs like Medicare, Medicaid etc. Medicare primarily insures the people who
are older than 65 years. People, who are younger than 65 years, are either insured
by their employers or by the employer of some of their family member.
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A study which was carried out recently revealed that 30% of the total expenses
done on health care by Americans go wasted. The sum of wasted amount mounts
to approximately 570 billion $. To give you an illustration that how big this
amount is actually, let me tell you that the defense budget of USA for 2014,
which was prepared by Pentagon was nearly 527 billion $.
So this means that an amount bigger than our defense budget is being wasted
through our expenses on health care. There are many sinks through which these
dollars are seeping through. Some of these sinks are unnecessary services,
prevention failures, very high and excessive administrative costs, prevention
failures and frauds etc.
Apart from these reasons of wastage of health care spending, wastage can be seen
from another perspective and that is high expenditures on health care. It has been
reported by many sources that doctors and hospitals charge more for their services
and since the most of the health care facilities i.e. hospitals etc. are not owned by
government, it is quite difficult to put some sort of transparency check on them
and they make full use of this thing.
Let me add something to your worries and that is another fact. The fact is that
nearly one out of four beneficiaries of Medicare program, which is the largest
insurance program going inside USA, when get admitted at hospitals as a part of
their insurance policy, suffer some sort of harm during their stay at the hospitals.
Isnt that a shocking figure? Will you still prefer to get an insurance policy from
the afore-mentioned insurance company?
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What US healthcare system needs is some sort of transparency in private health
care facilities such as hospitals, clinics etc. Not only this, but there must be some
sort of policy statement of both government hospitals as well as private ones. It
should be ensured that the insured people dont get any harm during their stay at
hospitals.
If any citizen gets some sort of harm during his stay at hospital, he should be paid
the compensation and those responsible for the harm must be punished according
to the magnitude and nature of the harm. If a doctor commits some sort of
negligence, he must be taught a lesson as well. The least which can be done to
teach a lesson to a negligent doctor is to fine him or suspend his practice license
for a small period of time.
Us government should ensure that there are no expenses in the lieu of unnecessary
administrative costs. Audits of hospitals should be done quite minutely. The
insurance companies such as Medicare etc. need to make their conditions and
criteria better. If they succeed in doing so, the reduction in the expenses in lieu of
unnecessary services can be made and it will make a big difference.
Another thing which US govt. can do and which is likely to come under the attack
from critics is the provision of age based health care rationing at some level or
other. The purpose is to provide younger people with more opportunities and
facilities of health care at low/ discounted rates or even free, partially or
completely, than the people belonging to older age groups. These were few of the
flaws in US health care system along with a few solutions.
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References
Bentley, T. G., Effros, R. M., Palar, K., & Keeler, E. B. (2008). Waste in the US health care system: a
conceptual framework. Milbank Quarterly, 86(4), 629-659.
Time Magazine July 1, 2013.
Woolhandler, S., & Himmelstein, D. U. (1991). The deteriorating administrative efficiency of the US health care
system. New England Journal of Medicine,324(18), 1253-1258.
CNN Money April 10, 2013.