Essay Sample on Health Care Funding in United States of America

In the United States, Health care is financed by different quotas. We can have the funding from the government; we also have private insurance especially for those who are employed and also we have out-of-pocket financing by individuals. A bigger percentage is through the government through its various programs like Medicare and Medicaid. Then we also have the private insurance plans for the employed population. These two are the major ones as the out-of-pocket is not popular because of the cost of health care in the US. These programs are different in terms of how they are administered as well as the beneficiaries. The Medicare is a health care program that is age-based. It is also a federal government health insurance that covers the aged individuals who are 65 and above as well as people who are below 65 with disabilities (Parker, 2018). It also covers people who have End-Stage Renal Disease. People who paid their Medicare taxes while they were working are automatically eligible for Medicare. It is not given in terms of income.

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Under Medicare, there are four parts with some of them having monthly premium that resembles private health insurance. One of the parts is Part which covers the cost of being in any medical facility (Parker, 2018). The second one is Part B which is a part that helps the consumer cover doctors, tests and other procedures. This part has monthly premium that is paid. Part C is called the Medicare Advantage which is a substitute to the Medicare plan. This includes Parts A, B, C, and D. This coverage is mostly done by private insurance companies. Part D covers prescription drug. It is also managed by private insurance corporations (Parker, 2018). Each individual in Medicare is required to have this cover unless someone has coverage from an outside source. This one requires payment of monthly premium.

Medicaid, on the other hand, is a community support program that is given on basis of economic necessity. This is usually paid by public funds that are collected through the taxes that are paid. This means that this program benefits the people who are financially constrained. The difference from Medicare is that this is both funded by federal government and state governments. It covers Americans with low-come, and each state gives it differently. It is given to the following groups; Women who are pregnant whether they are single or married (Parker, 2018). A parent of a minor or a teenager living alone. However, some states cover "children" up to 21 years old. It also covers the aged, blind or disabled who cannot afford healthcare coverage. Lastly, it covers those who are from low-income backgrounds. Medicaid covers inpatient and outpatient services, nursing-home and home-based health care, laboratory services, transport to a medical facility.

The private medical insurance plans are not covered by the government. These plans make sure that the beneficiaries are protected from high costs that they may incur when seeking health care services. Most of these private insurance plans are employment-based implying that the people who are formally employed are the ones that are eligible (Sommers, Gawande, & Baicker, 2017). There are so many types of private insurance plans that Americans can apply to be part of.

There are concerns in regard to these programs; Medicare, Medicaid and private insurance plans. For instance, Medicare isn't comprehensive and if you only have the traditional Medicare there a lot of gaps. Medicare doesn't cover long-term care and will only cover if one purchases Medicare Advantage or Medigap policy. This is a concern that should be addressed so that more people who require long-term care. Medicaid is also biased in terms of providing long-term care to its beneficiaries (Sommers, Gawande, & Baicker, 2017).

There has been a surge in terms of need for long-term care in US. The program is still facing problems especially in terms of expanding it. The private insurance plan have their concerns, for instance, they are provided through the employers, and that means they do not know the rise in terms of costs of the premiums. These are some of the challenges that need to be addressed in order to improve the health care services in the United States (Sommers, Gawande, & Baicker, 2017). The private insurance plans need to step up in their mandate to provide insurance to the people and employers should always look at the rising costs of premiums to make sure that the beneficiaries are not paying the extra on their own.

The single-payer national health insurance is a type of coverage that is available in countries like Canada. This type of insurance is also known as "Medicare for all." So how is it different from the model that is used in the United States? In this type medical insurance is provided by a single community or quasi-public organization. The agency manages the health insurance, but the provision will still remain under private hands mostly. Under this single-payer, all citizens are protected in all medical services comprising doctor, hospital, protective, long-term care, mental health, reproductive health, medical supply, dental care and other forms of health care services (Brown, 2006). This is as opposed to the US model that is the private insurance plans. This means that all the health care matters in Single-payer are all covered under one roof and not by different payers like the US system. This type of insurance covers a lot of the services including the long-term care something that the current system does not cover well. This is also good because it covers everybody and not categories of people who should be covered. It takes care of all medical needs of the people and organized by the public agencies.

The problems in the US health care systems can be reduced if we decide to adopt the single-payer insurance plan. For starters, this program is easy to fund as it is funded by taxes that citizens pay. Today, the system in the US is inefficient, profit-oriented and offered by many players. This creates discrepancies and inflates the cost of health care so much. Most of the programs that are currently being offered include payment of premiums, but when we adopt the single-payer, the premiums will no longer be there. This will mean that most of the people will save the money that they pay as premium. This single-payer will make sure that patients will no longer have to face financial constraints to get care. The patients will also have the freedom to choose which hospital and doctor they would prefer to visit. Something else is that the doctors will regain autonomy and have the freedom to treat their patients without any kind of interference. I think form my own perspective the country should try and adopt the single-payer model of insurance and do away with these many forms of plans which are sometimes expensive and irregular. This would see a great reduction in terms of medical costs in the country.

References

Brown, C. (2006). APA President Urges Support for Single-Payer Insurance System. Psychiatric News, 41(12), 1-38.

Parker, T. (2018). Medicaid vs. Medicare. Retrieved from https://www.investopedia.com/articles/personal-finance/081114/medicaid-vs-medicare.asp

Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health-what the recent evidence tells us.