It seems more fitting for non-profits to handle health care than the private-sector as they make their decisions for the well-being of the people rather than for profit. Non-profit health care includes hospitals, nursing homes, blood and organ banks, disease charities such as the american cancer society, and even health insurers such as blue cross (O'Neill 99). According to non-profit nation, America's thirty thousand non-profit health organizations had $385 billion dollars in revenue (O'Neill 91). While the non-profit sector does alleviate some problems, the current structure favors the private sector; they have vast amounts of money that they are able to use to influence legislature for example. The picture above seems to show the number of components surrounding health care which has led to the mess we have today.
The article "Value of Nonprofit Health Care" laid the basic arguments for why non-profits are more suitable for handling health-care. It stated some alarming facts, such as two-thirds of Americans did not know whether their health insurance was public or private, and of that group 80-90% did not care. Unlike for-profit hospitals, non-profits use the earnings to reinvest in the organization such as by improving quality, service, and efficiency.The remaining profits are used for community benefits to help reach out to groups who could not otherwise afford services and serve in areas where little profit exists. Non-profits typically provide the services at a lower cost and are less likely to mislead consumers. More research and innovation comes from non-profit groups. Rather than researching drugs such as Viagra they would be more inclined to research cancer treatments providing a greater benefit to society. Further, they would focus on a cure, rather than long term drug use that would only alleviate symptoms (allowing them to sell more drugs). Overall, it has been proven that greater satisfaction comes from non-profits, and that they provide higher quality care. The stigma surrounding non-profits is largely false as they operate much similarly to the for-profit entities but with better intentions.
While I feel like non-profits are a better solution than the private sector the best option would be a government run system. The U.S. system is ineffective as a third-party payer system. The first and second parties are the medical providers and the patients. The third party is the insurance provider who pays the costs such as private insurance (employee or individually purchased) or public insurance (medicaid, medicare, SCHIP, and Vetrans (TRICARE, CHAMPVA). Only 13% of U.S. medical expenses are paid out of pocket (Leete). The insurance company would then collect money either as a deductible, co-payment (fixed amount), or coinsurance (percentage amount). It is interesting to think that the U.S. is the only democratic capitalist industrialized country without national health insurance and with largely privately funded health care (Leete). The U.S. could adopt a single payer system such as in Canada or a nationalized system like the U.K. A nationalized system seems possible as only 1/6 people are without health care in our country meaning that they are covered one way or another. It is more likely than not that the remaining could afford care or are eligible for Medicaid (for the low income) or medicare (for elderly and disabled). The link below explains how government programs and insurance work in-depth if you are interested in learning more.
http://www.census.gov/hhes/www/hlthins/methodology/definitions/cps.html
Further, the bureaucracy and administrative costs surrounding health-care are another problem; everyone needs health care and in the end people do whatever it takes to get it. Many choose to take certain jobs that they are overqualified for just to recieve coverage for their family. It is a complex game the insurance company plays approving some claims and denying others, limiting how many visits someone can have, and telling someone which treatments they are covered under. It creates a paperwork headache dealing with referrals and having to go through your primary care physician every time you need to see a specialist. Preventative care could actually save money and we already pay for emergency services. Opponents argue that providing universal health care would be too costly. This is largely false, currently the U.S. is spending a greater amount of its GDP than the countries within the E.U. having universal health care. It really makes me question where all the money has gone. The graph below helps compare the United States spending compared to that in the U.K. It shows a continuing divergence from the European countries and a steep rise in costs during recent years.
The health care system in the United States is an absolute failure. Government run health care could cut out the insurance company which makes a business out of denying claims. Personally, I feel like the government would be much more trusted in providing insurance; there would be less money lost to lobbying and political campaigns, investor profits, and executive bonuses. There would be a lot less denying of claims on technicalities. Health care is one area where the free-market should stay out. It is just such a complex sector that many become confused. Lets look at adoption services for example. If someone were making money by selling children it could lead to problems such as baby snatching. Simply, profits are getting in the way of someones well-being. It seems like an area such as this would need heavy regulation to make it work but the better solution would be to allow the public and non-profit sectors to take on this role. Where is the regulation surrounding health care? The complex structure surrounding the various components of this sector creates a mess, government health care is the solution, simply purifying this sector that amounts for 13% of our GDP. The below pie chart shows where the money goes, but it doesn't account for investor profits, and the money spent in areas such as lobbying, and exectutive bonuses.
The two questions that are asked in regard to health care reform. First, is the quality of care better? And what will it cost? Well, looking at other countries and how they provide care, Europeans love their health care, and they have a much greater amount of coverage than we do. The second question, in addressing costs, we already spend much more than they do and without the same results. We could copy their model of health care and introduce cost saving measures. We could have different tiers to our health care system, everyone receiving basic health care (such as medicade), and those contributing more could have a greater amount of coverage. We could stop costly treatments such as excessively spending money on prematurely born babies or keeping someone on life support. Simply, allocating this amount somewhere else could provide a greater amount of social well-being. It is crazy to think that 65% of someones lifetime health care expenses are spent during the last 30 days of their lives. Perhaps we should simply judge when and when not to treat someone since it draws from an insurance pool meant for everyone (death panels?). If someone wanted to spend their own money that is one thing but in the case of life support maybe pulling the plug would be the better option.
Here is a link to the the Affordable Health Care for America Act. As well, here is a video by the Henry J. Kaiser Foundation, this which explains many of the important aspects of this Act.
http://docs.house.gov/rules/health/111_ahcaa.pdf
Works Cited:
Leete, Laura. "Health Care Finance and Reform." Policy and Planning Analysis. University of Oregon. Eugene, OR. 01, 02, 2011. Lecture.
First off, based on your interest in the effectiveness of the European Model of health care, I thought you might find this interesting: http://cthealth.server101.com/why_doesn't.htm
ReplyDeleteIt provides an obviously pro-universal health care argument for why the US doesn't have universal health care, and why they should. There is also a website called Intelligence Squared US(if you google that, the website should show up) that deals with popular and controversial topics of debate. Where it differs from most information on issues is that it addresses both sides of an argument (I am guessing that is where the squared part comes from). Last time I was on the site it had a few interesting debates concerning Obama and health care reform.
In response to your post, I, too, think that there is much to be gained from government providing health care to all. It is impossible to deny the complete inefficiency and, as Professor Choquette said, the unsustainability of America's current health care system. Regardless of whether or not a hospital is nonprofit or for-profit, there are still millions of people who cannot afford the services provided by either hospital because they are either declared uninsurable or maybe cannot afford insurance.
One part of your blog I had trouble understanding was when you brought up the idea of having regulations surrounding universal health care. I guess I just see a problem with where to draw the line. For example, who decides what is considering too many kids? I was also confused as to what you meant by denying people of a low socio economic status benefits? I regard universal health care as a way to insure that such people can and will receive the same treatment as everyone else. Perhaps such questions are why the US has not warmed up to the idea of health care, for there is a lot of grey area and ambiguity as to the rules and conditions.
I agree that non-profit handling hospitals better because they serve the people and care about their wellbeing. For profit hospitals do have more power because they can influence government and I think they are favor more in terms of laws and regulations. I disagree with you on how for profit hospital spend their money, they also improve quality and reinvest that money. I also think government run system would be a good idea but not the best. It would open a new window of opportunity. There are some cities in America that has universal health care, such as San Francisco. The graph really does present a interesting comparison between the US and Europe healthcare spending cost. I don't know if people would trust government providing insurance because it could not be as effective and maybe some corruption.
ReplyDeleteI agree with you that non-profits are in a better situation to handle health-care than for-profits. I feel like non-profits are inherently more socially minded and care more for their patients, and can therefore provide better services.
ReplyDeleteIn terms of the nationalized health care debate, while I certainly agree with you that our system is not working there are many obstacles between it becoming a reality. There's a pretty crippling small business and insurance lobby, which you mentioned, that do not allow progress to happen in health care reform. This happened in the 90s and it's happening again now. It seems that healthcare reform brings fear into many people's lives and not rightfully so. The simple truth is that the insurance companies have the most to lose from reform and will fight to stop it.
http://www.prospect.org/cs/articles?article=the_obstacles_to_real_health_care_reform
As sickening as it is to say I agree that there is a tremendous amount of waste at the last month of a patients life, often times consultation between the hospital and the patients family can result in a responsible choice for the patient.
I found your solutions to the current governmental health care system problems interesting ways of addressing these situations. I do believe that do to the nature of our country, and the impact that capitalism and personal gain has had on the shaping of our nation’s general culture, that the complete denial of the American people’s respect for the treatment of their personal earned money to be futile. Notes of libertarianism and laissez-faire will always be connected in how we address national issues, whether the morality of the situation dictates otherwise, and trying to change an entire population of citizens would be ridiculous. That being said, clearly coverage needs to be extended to everyone of our American citizens as a basic right. That is why I found your solution of a blanket minimum coverage for all, with increasingly expensive coverage added along with personal (word) to sound quite effective. This would allow all citizens to take advantage of the kind of preventative check-ups that most uninsured citizens live without, and ultimately save the nation an extensive amount of emergency-room expenses.
ReplyDeleteCarson, I think you trust the government way more than many Americans do. In response, I leave you with a quote by French philosopher and political commentator Alexis de Tocqueville:
ReplyDelete“The morals and intelligence of a democratic people would be in as much danger as its commerce and industry if ever a government wholly usurped the place of private associations." (Page 45 in "Non Profit Nation").
Also, I think we certainly need to analyze European models of universal health care, but also realize how most of them are experiencing tremendous social and financial problems. Here is an interesting article by a UK publisher critiquing Britain's famed system (calling it worse than Estonia's!). http://www.independent.co.uk/life-style/health-and-families/health-news/uk-healthcare-worse-than-in-estonia-1017418.html
While our health care system NEEDS to be reconstructed, I disagree that adopting(typically failing) models such as that of Europe and our neighbor to the North will cure our financial and ethical ailments. Measures surrounding health care must be addressed as well (cost of treating illegal immigrants, selling insurance across state lines, tort reform, etc.). Steps to correct these issues will improve health care and allow nonprofits to hold onto their money, rather than have their money be withheld (or taxed in the future) by a government adding $2.3 trillion to the debt.