Why do so many people across the world struggle for their well-being? They would rather risk bleeding out in their car than to get an ambulance ride to the Emergency Room. This is because we don’t have a basic Universal HealthCare here in the United States. Universal Healthcare must be a norm among all Americans. Until 2010, the United States was the only major industrialized country without a universal health care system.
Critics of universal health care claim that such a system would remove all personal choice from the issues about an individual’s health care and medical decisions by essentially making any medical decision a political one in which the government would be entwined. According to a study by the Lancet, conducted by epidemiologists from Yale, 37 million people in the US cannot afford healthcare, and 41 million more don’t have even adequate healthcare. This being the case, we still haven’t made a “perfect” healthcare system. By the time a new president comes along, we must start from the beginning in making a new system.
So, where do we go from here? The government over the years to limit Medicare and Medicaid expenditure growth using various means. Uncle Sam tried before 1983 to pay hospital care providers on “a reasonable cost basis”. Since then it has used the prospective payment system (PPS), which entails classifying each patient as falling into a diagnosis-related group (DRG) and giving the hospital a fixed amount of money for treatment of that. The idea behind the DRG classification is to make the hospital financially responsible, at the margin, for healthcare outlays; that is, since the government’s payment per patient is, in theory, fixed, every extra dollar spent by the hospital on the patient means a dollar less in hospital revenue.
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Thus, making it easier on the patients when paying it out. Medicare Part B reimbursements were also originally set on a “reasonable charge” basis. But since 1992, most reimbursements were made based on a fee schedule. Medicare Part C pays a fixed amount per Medicare participant who enrolls in a health maintenance organization (HMO). And Medicare Part D pays a variable amount based on a preset formula for prescription medications. A large part of the expense’s government pays for is Medicare for us, but it does not cover everything, and some states don’t spend the full amount to cover these expenses making it fall on the less fortunate that can afford it. So, it does not mean it is all that universal for us.
The multiply sick Medicare participants are costing the system a lot of money. “Virtually all of the spending growth since 1987 can be traced to patients treated for five or more conditions.” (Thorpe and Howard) But why is this? Is the elderly developing more diseases and getting sicker? Are we seeking more screenings to prevent these diseases early on? One reason that we are experiencing is that our waistlines have only grown since our ancestors. With this added weight, comes complications. People are developing heart diseases, diabetes, arthritis, back problems, and cancer.
Another problem is that some doctors are more aggressively treating their patients, in some instances, over-treating them. Why is this? It is so the doctors can get more reimbursements through unnecessary treatments. I have fallen victim to this. Chronic migraines are a uncurable disease, so it is very difficult to find relieve from the harsh symptoms. From MRI’s to six different neurologist pouring medication down my throat that does not work, it seems pointless. Many people fall victim to this. It just makes our bills go up while they get richer.
Accordingly, our government is going broke paying for healthcare. The root of the Medicare spending-growth problem is the program’s fee-for-service structure. Healthcare providers can charge Medicare a fee when they give Medicare participants a service. There is every reason for Medicare costs to continue to explode and threaten our nation’s finances and our children’s economic futures. Fee for service remains the main payment mechanism for Medicare and is likely to let benefit growth in excess of per capita income growth as far as the eye can see. Even under recklessly optimistic assumptions in which the excess Medicare benefit growth rate in the future is only two-fifths of its historic value, the nation faces a Medicare bill it cannot afford.
All of this poses a big question today, when will this take effect? With the recent pandemic we are going through, many people are without health insurance and need help. With everything we have done in the past to the present day, we will slowly get there but it is possible.
