Public vs. Private Control

633 words | 3 page(s)

Healthcare reform is a topic that is become more critical in the United States due to changing demographics and concerns over the ability of programs such as Medicare and Medicaid to remain solvent. One of the most significant risk groups is the ageing baby boomer generation. As they age, they will place a disproportionate burden on the healthcare system, both in terms of overcrowding and in terms of their financial burden. This essay will explore several proposed methods for managing the healthcare crisis in the United States.

The use of risk pools in the private health insurance industry is one way to spread the risks in a manner that reflects the likelihood of incurring healthcare costs. Those that receive Medicare and Medicaid do not work and therefore, do not contribute to the system in the same manner as private healthcare insurance users. It has been suggested that a system of risk pools be developed for those who receive public assistance that is similar to risk pools used in private insurance. This not a viable method of cost control. First, the high risk recipient of the funds is not the one paying for it.

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One method that might work would be through shared costs with the publicly funded program for those in high-risk categories. However, this program would not work because those with the highest medical risk often are not employed and would not have the means to pay for the shared costs. In addition, those in the older age bracket have already paid into the system through many years of service. Even though they incur higher costs, they do not have the resources of the younger working population. A program similar to the risk pool system used in private insurance would not work in the private sector because the income profile of the users is different. Those that cannot afford health care in the first place would be penalized even further.

Unless a solution is found quickly, the publicly funded health care system will not be likely to survive into the future. Currently, there are 15 proposals being considered to help save publicly funded healthcare in the future (AARP, 2014). These proposals include raising the benefit age to increasing shared premiums for higher income beneficiaries. There are also plans to redesign copays and deductibles. These plans are designed to prop up a failing system, but as more users enter the system, these measures will have a lesser impact than in the past. Whether they will be enough to save an ailing system is doubtful.

The British system uses a Commonwealth fund to provide free healthcare for citizens and low cost health care for visitors (Sellers, 2014). The British healthcare system uses a simplified billing system compared to the United States. In the British system, physicians have an incentive to use lower cost treatments, rather than rushing to high cost alternatives, such as unnecessary surgery (Sellers, 2014). The first challenge in adopting the British system is that the billing system would have to be overhauled. The second major challenge would be an overhaul to many standard treatment practices in the United States. The third major challenge would be acceptance of these changes from the public.

The National Health System faces many of the same challenges as the US healthcare system in terms of shifting demographics and increased physical and financial demands of an ageing population (Grosios, 2010). They continue to face the same problems with overwhelming increases in costs due to obesity, diabetes, cancer, and other conditions that are preventable through lifestyle changes. National Healthcare is not the answer. The answer lies in motivating society to make changes that lead to a healthier lifestyle so that they do not burden an already overburdened system. Regardless of who pays for the care, the problems remain the same in both systems.

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