The American Health Insurance System

The primary ethical issue related to cost containment in health care is distributive justice. The reality of limited resources necessitates their allocation to yield the greatest good for the greatest number of participants. Finding the balance between provision of value in health care and cost containment remains a fundamental ethical challenge for health care reform. Ultimately, there should be effective ways to contain the already high and steadily increasing costs of health care, it will become more and more difficult to provide care in the current or in a reformed health care system (American College of Emergency Physicians ,

There are two main distribution principle regarding health care in the United States. The first being social justice, and the second being market justice. The delivery system has continued to undergo periodic changes, mainly in response to concerns with cost, access, and

Can our healthcare system be regarded results-based and rational? Dr. Otis Brawley does not think so. Neither do I. In his thought provoking book, How we Do Harm: A Doctor Breaks Ranks about Being Sick in America, Brawley paints a picture of a system that is riddled with both inequalities and inconsistencies. There are times I have wondered whether our health care is indeed the best in the world. I have had my doubts. After reading Brawley's book, I became convinced that there is an urgent need to ensure that our health care system is not only affordable but also rational.

The Health Insurance Association of America describes Medicaid as a "government insurance program for people of all ages whose income and resources are insufficient to pay for health care." America’s Health Insurance Plans (HIPAA, pg. 232). Michigan Medicaid State Plan is an agreement between the state and federal government that identifies the general health care services, reimbursement, and eligibility policies in effect under Michigan Medicaid (Marilyn, T., (2013). The state of Michigan on December 30, 2013 obtained approval from the Center for Medicare and Medicaid Services to amend its 115 demonstration waiver “Healthy Michigan” to implement the Affordable Care Act’s Medicaid expansion. The waiver and association plan amendments went

From a social justice perspective, quality healthcare is perceived as an innate right of every individual. The problem with this perspective is it is not a universally held sentiment. For example, individuals would argue from an economic standpoint that social justice is a “value” and healthcare is a commodity which drives our nation’s economy, thus presenting

The dysfunction of the American health care system implies that not everyone has access to the right medication and medical treatment. Middle-class families and chronically ill patients do not always have access to health care, and when they do they do not receive adequate treatment with regards to hospitalization and medical services or quality of service. The lack of payment reform results in

The U.S. health care system faces challenges that indicate that the people urgently need to be reform. Attention has rightly focused on the approximately 46 million Americans who are uninsured, and on the many insured Americans who face rapid increases in premiums and out-of-pocket costs. As Congress and the Obama administration consider ways to invest new funds to reduce the number of Americans without insurance coverage, we must simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps even for those with access to insurance coverage.

Long time ago, there was no need for health insurance in America, as doctors had many clients because their services were not so expensive and in some cases in rural areas, people could pay by giving other items. Doctors were not as knowledgeable as they are nowadays to care for the sick, therefore this didn't have much effect then on the patients, as they were treated for the basic illnesses.

Moreover, the lack of access to health care is morally wrong because it is a fundamental right for humans to maintain self-dignity, fairness in the dispensing of health care, and the inclusion of all in society. Kantian’s ethical theory would argue that it is a moral duty to distribute health care more evenly so that the disadvantaged members of society have a similar chance at access to care. The consequence of those health disparities among the disadvantaged affects everyone’s quality of care and affects communities’ adversely. As a result, the cost shift from annual emergency room visits by the uninsured cost the public over $100,000 billion annually and as a result, distributes approximately an additional $1000 to each family’s insurance premium (Lachman, 2012)). Another example of distribution injustice is the unfair allocation of health care among race and gender. Studies have shown that there is a racial and gender bias in end stage renal failure patients, there is a disproportionate number of white males referred to transplant specialists as opposed to blacks and women. Additionally, their wait on the transplant list is longer, if they ever make it onto the waiting list (Beauchamp, 2013).

Health care systems are organizations that are formed to meet the overall health needs of the population. Health care is regarded as one of the leading cause in promoting not only physical and mental health but the well-being of the population. Legislation is implemented requiring government to offer services to all members of its society. The role of health services and the organizations that provide aid is to focus on the health of an individual and to uphold their human rights. According to WHO (2013), a “well-functioning health care system requires a robust financing mechanism, a well-trained and adequately-paid workforce, reliable information on which to base decisions and policies, and well maintained facilities and logistics to deliver quality medicines and technologies (World Health Organization; 2013).

Bernard Williams declares that the proper grounds for distribution of healthcare is ill health and that this statement is a necessary truth. In this paper, I will argue that Williams is correct in believing that the distribution of medical care should be based on the ill health, but is incorrect in his assumption that this claim is in fact a necessary truth. I will begin by explaining the relevance of inequality to the question of distribution of health care, with the focus being on the distinction between inequality of merit and the inequality of need. I will then move on to illustrating why Williams believes that medical care should be distributed on the basis of ill health. Finally, I will explain why I believe that Williams is

The first characteristic of the US health care system is that there is no central governing agency which allows for little integration and coordination. While the government has a great influence on the health care system, the system is mostly controlled through private hands. The system is financed publically and privately creating a variety of payments and delivery unlike centrally controlled healthcare systems in other developed countries. The US system is more complex and less manageable than centrally controlled health care systems, which makes it more expensive. The second characteristic of the US health care system is that it is technology driven and focuses on acute care. With more usage of high technology,

Our group accomplished the objectives of this project through the lenses of health disparities in America and pending execution of The Patient Protection and Affordable Care Act(PPACA)’s pay-for-performance (P4P) payment system. This group argued that such a shift to PAP may cause health care providers to avoid treating high-risk and disadvantage patients. Thus, decreasing the provider’s performance score, increase readmission, and in turn, widen the health disparities gap. Also, our group investigated societal influences on health policy from a utilitarian society, which argues that social justice is achieved even if the needs and wants of a few individuals are sacrificed for the benefit of the majority population. Hence, in a society governed by traditional utilitarianism principles, health disparities between the upper-class Americans and disadvantaged minorities would

The principle of market justice refers to the distribution of health care in a free market economy. Furthermore, the production of health care under the free market economy is dependent on an individual’s inclination and ability to purchase services at the current market value. In fact, the free market stresses the economic and moral injustice of granting an individual access to services that they have not earned. On the other hand, the principle of social justice system is one in which the government controls the production and distribution of health care to ensure that the distribution is equitable. As a matter of fact, under the social justice system health care is regarded as a social good that is collectively financed and available to

Health insurance in the United States is a highly politicized issue. In recent years, many strides have been made to extend health insurance coverage to all Americans with the passage of the Patient Protection and Affordable Care Act (PPACA). While the program has been vigorously debated in the public realm, arguments are often centered around political ideology rather than economic theory. This paper seeks to challenge the entire structure of the current health insurance model, since its inception in the 1950s. Through the overuse of a third-party payer model, a magnitude of problems have emerged that severely diminish the efficiency of health care allocation in the United States. This paper proposes a model that seeks to correct issues of cost, access, and market efficiency by adapting the Medicare Part D payment scheme for an all encompassing insurance model.