Health care finance has changed drastically over the last five decades. Initially, Medicare and Medicaid were established to help the elderly, lower income families, and the disabled, afford decent medical care. It has now grown into a multi-billion dollar industry and over the years it has changed to benefit not only the elderly and poor, but everyone. As medical technology grows, so do the costs of health care for everyone. In his health care reform, President Obama says our health care system is one of the biggest causes of our economic troubles, going so far as to name it a, “ticking time-bomb.” (Johnson, Linda A., 2010).
Historical Trends in Healthcare
According to National Health Statistics Reports, an estimated 44 million people in the United States lacked medical insurance for the year 2008. The National Health Institutes Survey or the NHIS, found that from the year 1959 through 1968, the percentage of people who had health insurance was steady at 79% but took a significant nose dive to 67% by 2007. The NHIS was started in 1957 and since that time there have been many changes in the way health care is financed. (Cohen, Robin A., Makuc, Diane M., Bernstein, Amy B., Bilheimer, Linda T., Powell-Griner, Eve.,2009).
Medicare and Medicaid were brought into being by the Social Security Act of 1965. These two programs were brought about to help provide financing for the medical needs of low income families, the elderly, and disabled people. Only 8 years after they were formed, the Health Maintenance Organization Act of 1973 was passed by Congress.
The HMO Act provided grants and loans to start or expand HMO’s and for some HMO’s, it removed certain state restrictions. This act also required companies of a certain size to offer their employees the choice of an HMO or the more traditional health insurance. (Woolley, John T. & Peters, Gerhard, 1973).
In 1985, the Consolidated Omnibus Budget Reconciliation Act (COBRA), was passed, allowing employees who have been terminated or quit their jobs to continue coverage at their own expense for up to eighteen months. In addition to offering this option to former employees, COBRA also entitles children and spouses of employees who have passed away to continue their insurance coverage for up to 3 years. Almost ten years after this was enacted, the Health Insurance Portability and Accountability Act of 1986 was passed. The U.S. Department of Labor explains HIPPA as providing, “rights and protections for participants and beneficiaries in group health plans.” (U.S. Department of Labor (UDL), no date given). HIPPA also limits exclusions for preexisting conditions and does not allow for discrimination based on an employee and his or her dependents based on their health. (UDL, no date given).
These important acts, along with many other acts, laws, and events help us to see where health care finance has been and where it is heading. Our health care history and the costs of health care impact our access to care and the costs on the delivery of these services.
Impact of Health Care Costs on Access
Many people are facing gaps in their health insurance coverage because of rising health care cost in the American. According to Commonwealth Fund Biennial Health Insurance survey, between 2001 and 2003 the cost of health increased from 29% to 37%. Even with health insurance, almost 29% of the insured were not able to afford the care they needed. Higher health costs prevent people from seeking medical attention when needed as well as preventing them from filling prescription, skipping medical tests and foregoing treatments they need. (Collins, 2004).
According to The Agency for Healthcare Research and Quality, 16 % of those who are carry public insurance, 6 % with private insurance coverage, and 11% of those who have Medicare and a supplemental policy, have trouble getting in to see a specialist when one is needed. Another 5 percent with Medicare reported difficulty to seeing a specialist. (Carper, Kelly, Mashlin, Med & Steve, MS. (2009). There are many other groups with limited access to quality health care due to the cost factor, two being, those with chronic illnesses and children.
Impact of Health Care Cost on Service Delivery
According to World Health organization (2010), “health services are the most visible part of any health system, both to users and the general public.” Health services rely on recourses, treatment, staff, drugs, and finance. Health services have influenced prevented treatment in home health care and community services. One way of improved quality of health services is providing organizational managed services to its providers. High rising cost of health care always affect the economics of financial security of patients. The rapid health care cost has increased due to the rise of diabetes, heart disease, and asthma.
A key issue that threatens health services is the lack of management and consumers trust. Another key factor for increasing health cost is payment policies reimbursement rates of Medicare and Medicaid. These services can be reduced by improving efficiency of delivery of service, finance, and reduce the rate of spending growth. With data met decision makers establish goals to assure policies pricing are cost effective and overall improvement for low income patients. The continuous rise of health care cost is continuing to increase insurance premiums, consumers out of pocket cost, and employers. With this notion the rising cost of health care cost has burden consumers and employers.
Government Attempts to Control Costs
Recommendations for Improvement
Providers work hard to provide care and save lives. Therefore, the successes that care provider provide is different across the country. The providers are paid by today’s payment center because of the quantity of care of work than working together for the outstanding care. The system “reformed” will give payments toward activities that the provider provides in a fashionable manner, this shapes the growth in spending. The United State spends more than 17% in health care. When 2017comes the health care will use up 20% of the gross domestic product. The spending is increasing and the nation ranks low-in places. The report shows no progress toward the quality of care containing the cost of patients and the provider. Because the spending is so high is invariable to the patients, business, state, and federal governments. In 2008 the wrong payment for Medicare was 3.6%. The National Health Care Anti-Fraud Association calculated $60 billion per year. This protects the programs and cut abuse, fraud, and waste that compete in health care. Public schools and private schools are affected by the health care. Federal health programs for instance Medicare induce the wide changes in the system. Medicare flourishes higher quality, and more cost effective care throughout the health system.
In conclusion, currently the quality of our health care programs and the rising costs are at their worst in decades. The government and our current generation needs to strive towards making the needed changes to improve our health care programs with a positive and secure future for the next generation.
Agency for Healthcare Research and Quality. (2010). One in 13 U.S. Who Needed to See a Specialist Reported Access to Be a “Big Problem”. Retrieved from: http://www.ahrq.gov/news/nn/nn012010.htm
Carper,Kelly, Mashlin, Med & Steven MS. (2009). Agency for Healthcare Research and Quality. Variations in Perceived Need and Access to Specialist Care among Adults in the U.S. Civilian Noninstitutionalized Population, 2007.
Cohen, Robin A., Makuc, Diane M., Bernstein, Amy B., Bilheimer, Linda T., Powell-Griner, Eve. (2009). Health insurance coverage trends, 1959–2007: Estimates from the National Health Interview Survey. National health statistics reports; no
17. Hyattsville, MD: National Center for Health Statistics. Retrieved February 15, 2010 from http://www.cdc.gov/nchs/data/nhsr/nhsr017.pdf.
Collins, Sarah R. (2004). The Commonwealth Fund. Health Care Costs and Instability of Insurance: Impact on Patients’ Experiences with Care and Medical Bills. Retrieved from: http://www.commonwealthfund.org/Content/Publications/Testimonies/2004/Jun/Health-Care-Costs-and-Instability-of-Insurance–Impact-on-Patients-Experiences-with-Care-and-Medical.aspx
Johnson, Linda A. (2010). Q&A: Why health care’s economic impact matters. USA Today. Retrieved February 15, 2010 from www.usatoday.com/news/health/2009-06-19-health-economy_N.html.
Tate, Angel. (2010). What Can Be Learned from the Historical Trends in Rising Health Care Costs? A Look at a Century of the Costs of Health Care. Retrieved February 15, 2010 from http://www.associatedcontent.com/article/2695537/health_care_reform.html?singlepage=true.
U.S. Department of Labor. (no date given). Continuation of Coverage- COBRA. Retrieved February 15, 2010 from http://www.dol.gov/dol/topic/health-plans/cobra.htm.
U.S. Department of Labor. (no date given). Portability of Health Coverage- HIPPA. Retrieved February 15, 2010 from http://www.dol.gov/dol/topic/health-plans/cobra.htm
World Health Organization. (2010). Health Service Delivery. Retrieved from http://www.who.int/healthsystems/topics/delivery/en/index.html
Woolley, John T. & Peters, Gerhard. (1973). The American Presidency Project. Santa Barbara, CA. Retrieved February 15, 2010 from http://www.presidency.ucsb.edu/ws/?pid=4092.