What are some of the main problems and issues pertaining to health care financing?
Statement: One of the biggest issues in health care financing is the amount of money spent. Health insurance premiums are continuously rising, the costs of prescription drugs are astronomical and employees are paying a much larger share of their health insurance than they have in the past. Many believe this rise in costs is due to the uninsured and underinsured. Another issue with health care financing or at least a factor that contributes to it is fraud, waste and abuse. Fraud, waste and abuse cost the health insurance industry billions each year. Fraud, waste and abuse can be committed by a beneficiary, physician, pharmacy/pharmacists or other provider.
Fraud, waste and abuse can consist of false claims or billing for services not received, billing for unnecessary services or for a free service or beneficiaries sharing their ID cards. There’s also double billing, forging prescriptions and not coordinating benefits correctly. Other things like the number of people aging (huge number of baby boomers) also puts a strain on health care costs and many people have chronic disease that requires frequent care or long-term care. All of these issues plus a host of others puts a huge strain on the health care financing system.
Reply: You raised an important point about the minority population! It is a known fact that illegal immigrants are less likely to have health care coverage than others. The reasons range from fear of deportation, farm worker cannot afford to miss a day of work, cannot afford it, and language barriers.
These are the facts according to Pew Hispanic Center (2006):
U.S. citizens less likely to have health insurance =14%,
Illegal immigrant less likely to have health insurance = 59%
Children of illegal immigrant less likely to have health insurance = 53%.
In 2006, state of Texas spent $1.6 billion in hospital costs on illegal immigrants. It is true the pressure of health care cost for illegal immigrant is real.
How to tackle health care for the illegal immigrants? The cost of doing nothing can be costly! What are your thoughts?
1. RESPONSE: YOUR THOUGHTS/COMMENTS (100 word minimum)
Statement: It is true that although the for-profit organizations have to pay taxes on their income, not for profit organizations do not intend to make a profit and hence in some instances, what they make does not attract any tax. Furthermore, not for profit organizations are formed with the goal of doing a social good or helping a certain cause for the good of the society. With that in mind, they do not have owners who require a profit at the end of the day. Thus their balance sheets do not have or recognize stockholders among their items in the liabilities section.
Reply: Along with what you just said, I would also like to add that even though for profit organizations have stockholders to be responsible to and not for profit organizations do not have stockholders to be responsible to, they both have stakeholders to be responsible to. Stakeholders can be managers, employees, even patients. Anyone that has or may have some effect financially or is affected financially is considered a stakeholder, and thus stills someone that the organization is responsible to. if the stakeholders, say, patients, that go to a for profit organization feel that they are not being treated right or are paying too much, the stockholders will be affected by this because they will not earn as much if the organization isn’t bringing in as many patients.
2. RESPONSE: YOUR THOUGHTS/COMMENTS (100 word minimum)
Statement: What is the best solution to provide health care for all? I think that is the major question rolling around in the minds of the government right now. How does the country afford to pay for it? Do you think that we would need to change our focus in medicine to a more preventative approach like most other countries to make national health care a more possible goal? I think that changing our focus to prevention could save thousands of dollars and many hospitals stays could be decreased or eliminated. Many Americans who are insured are also struggling from not having enough coverage. My husband is on 2 inhalers and adderal and we spend over $100 a month. That is small in comparison to many people. There has to be a better way…but what is it?
Reply: Much has been said about the astronomical cost of health care and the urgent need for reform but not much has been said about wellness. Some private or for profit organizations have shifts the gear to prevention or wellness. Healthy living and lifestyle is becoming popular. For example, Motorola opened wellness centers at 8 United States locations. The case study shows that:
ü Motorola Wellness Centers saved $3.93 for every $1.00 spent.
ü Participating workers cost the company $6.5 million dollars less in lifestyle-related medical expenses than non-participant.
ü The company wellness participants experienced annual Health Care cost rises of 2.5% compared to 18% for non-participants.
No doubt that wellness program does reduce cost while promoting positive image in the community. The idea of tax credits for dollars spent by organization for wellness program might be a great idea to reducing health care cost. What is your thought?
Reference: Motorola. (2009). Motorola: company wellness case study. Retrieved from http://wellnessprogramblog>
3. RESPONSE: YOUR THOUGHTS/COMMENTS (100 word minimum)
Statement: Through the Emergency Medical Treatment Act, the illegal immigrants can access emergency care. This is in most cases the hospital’s gesture of charity, can be paid by the patient’s insurance if any or by Emergency Medicaid. Through the extension of Medicaid coverage, the eligibility of illegal immigrants to emergency medical care would increase. This means that it would have more impact on the citizens through tax and payment of higher fees to access hospital facilities and care. Moreover, citizens are already paying medical care for illegal immigrants. This they do through Emergency Medicaid and other fees that are paid in hospitals. Therefore, it is a reality that the American people are paying for health care for illegal immigrants.
Reply: Though access to health care is essential to all human being, these people are forbidden by law to be in the country. Why should the American people pay for their medical care? The first thing should be to end all illegal immigration. As president Obama proposed that reforms would not apply to those in the U.S. illegally. It is an act of charity to help the poor but not the illegal immigrants. The American people will suffer financially if we continue to pay for health care for people in the country illegally. The best solution will be to enforce immigration laws and this will hence curb the act of people illegally migrating to the United States of America. However, we could have an exception for the children. This will save other legal American children since these children go to school and share playgrounds with those illegally born in the country.
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