What Kind of Healthcare System Do Americans Want: Government-Run or Market-Driven?

Introduction

The federal government has controlled the United States healthcare system for the past century through such tax subsidies as Medicaid and Medicare. Due to these national policies the health care costs have continued to escalate, making it too expensive for the most of Americans to afford a healthcare insurance (Department for Professional Employees, 2016). The United States of America increased its spending from approximately 25% to 50% in the last 40 years and these steps have resulted in higher health care costs (Schansberg, 2011). The market can reduce the inefficiency and ineffectiveness of the governmental programs in the health care system, since Americans would like to have a privilege of choosing the insurance plans they prefer in order to have control over the prices of the rendered services (Capretta & Dayaratna, 2013). Health care sector requires the government to perform the oversight role at the level of insurance prices as well as to provide physicians with license. Beyond these activities, the area of health should be allowed to be shaped by the competition of the market prices. This essay aims to discuss a health system the Americans would like to have. It discusses markets versus government control, consumer-directed health plans, the design of Medicare part D, the need for a real reform, and principles for an ethical health care system.

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Markets versus Government Control

The debate on the health care delivery starts with a usual definition of the problem that needs a solution, and then the political differences based on how the economy works are developed. The United States health care system is highly inefficient, and its orientation is broken that makes the cost too high and increasing. It leads to the fact that many Americans are unable to pay for the care or to buy insurance, so that the government has to struggle for the health care provision programs (Antos et.al., 2015). Many analysts and policymakers are dedicated to improve health quality and at the same time maintain a moderate cost. One side believes that the government is wasteful and unfocused, as there are many players, who do different things in various ways, yet none of their actions is in the interest of public, so as a result high costs appear. It argues that with fee-based services doctors are paid for what is done rather than for the quality of the delivered service, and it leads to the significant expenses, imposed on the federal government (,Reinhardt, 2011). It further leads to the high premium plans that hinder purchasing decision of the consumers, thus delaying the emergence of a real market in the healthcare. Market-driven health care will offer a competitive edge, in which services will be more patient-centered and service providers will be more efficient as well as innovative in the way they organize their work.

Consumer-Directed Health Plans

The United States health care system does not offer a competitive marketplace, at which the law would restrict individuals from purchasing insurance from their states. Moreover, the tax policy gives an advantage to the employer-based insurance plan but not an individually purchased plan (Capretta & Dayaratna, 2013). This fact compels Americans to take the employer-based insurance cover rather than to buy their own, and this is a clear evidence of how the government system has made the choices that were supposed to be made by the consumers. With the selection of the market-driven health care, the quality of health will be improved, as competitors will offer competitive services with modernized equipment in order to attract more clients. According to Capretta & Dayaratna (2013), the research has shown that consumers are very sensitive to the health insurance premiums and they would be more willing to switch to a more favorable plan. It is also noted that even the choice of a hospital is a part of consumer decision-making. Moreover, it is mentioned that those, who use free health care, tend to consume more than necessary that leads to high expenditures of the government. Therefore, market-driven health care will make consumers cost sensitive, and thus they will spend less on health, so that the state expense in the healthcare sector will be reduced.

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The Design of Medicare Part D

Medicare Part D, enacted in 2003, is a great evidence of the benefits of competition in the health care sphere within a system, controlled by the government. It offers voluntary drug prescription benefits to the elderly, but it is already in the insolvent sector, as it has added $14 trillion to its debt (Capretta & Dayaratna, 2013). The lawmakers later introduced the element of competition in the structure, and it is straightforward.  The private insurance bids on the premium it will charge for the covered drugs, and the government calculates what it will add, basing on the region. Since the government does not give a contribution, depending on the plan, chosen by the beneficiary, those who have relatively high premiums, pay an additional premium themselves. It has helped consumers to be cost-conscious and made the program perform much better than expected. It has been noted that the elderly have begun to shop for medicine more efficiently, comparing the use of prescribed drugs with the generic pills. A greater percentage of the elderly under the program say they are satisfied with the Medicare Part D, meaning that the market-driven healthcare is what would make Americans feel comfortable.

Need for Real Reform

Due to the fact that continued massive spending leads to permanent budget deficits, the government requires reforms that will solve the problem of the rising healthcare cost. Legislation has burdened the taxpayers as well as disadvantaged those with private insurance. The unfortunate connection of healthcare to the employment can be rectified through the realization of a free market (Schansberg, 2011). An employer-based health care insurance provides the coverage of a net price and increases the coverage amount, demanded by the employees, who do not pay taxes on health benefits. It means that the Treasury loses revenue when treating these benefits as tax preferences. It is also inequitable since it is not available for unemployed and self-employed people. Therefore, the best solution is to remove the subsidiary for all the employees and then to lower income tax by a similar amount.  For Americans, who are enabled to have control of their healthcare, employer-provided insurance as well as the Medicaid should be eliminated, so that the private delivery system can be established. According to Schansberg (2011), there has been from 25% to 40% increase in the private insurance and at the same time from 25% to 50% increase in the Medicaid and Medicare. Although private insurance is relatively expensive while the government programs are free, Americans would prefer to pay for health care that provides high-quality services.

Principles for an Ethical Health Care System

There has been a growing consensus on one principle, and it concerns the fact that patients ought to be of the highest significance in the decision making on the matters about the health care, but this is highly restricted by a single player system, represented by the government. The worst case scenario is when it decides to cut the budget from the top. It can affect everyone involved in the system, and that is why there is a great need to have a market-driven health care system. It would, for instance, mean that the governmental underfunding of the hospitals can lead to a lack of equipment such as the CT scan, and thus make the treatment of patients time-consuming and ineffective (Matthews, 2009). It is evident that getting on the waiting line does not actually mean accessing the health care service. Therefore, the government should not be so focused on giving universal and equitable health care, because it does not meet the needs of the Americans. It should allow establishing of the market-driven health care system that will offer quality and efficiency. It will make the service delivery competitive and the quality of the health care will significantly improve.

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Conclusion

In conclusion, it is evident that the Americans need a market-driven health care system. When comparing the government provided and the market-driven health care, one can see that the government wastes many resources on the provision of health care and imposes high taxation on citizens. Market-driven system, on the other hand, makes consumers cost conscious and thus reduces the high cost of health care. The policies present a barrier for workers, who choose to have a private insurance, since the government tends to favor the employer-based insurance plans. This issue deprives consumers of an opportunity to choose a convenient individual cover. The Medicare Part D created in the year 2003 is a clear indication that a market-driven health care is more preferable, since the elderly agreed to invest an additional amount of money in more expensive premiums, which the government fails to cover. Moreover, there is a need for reforms in the legislation, since Americans feel that those who are unemployed are discriminated when it comes to subsidiary by the government and thus it would be better to remove a branch as well as to lower the amount of tax in the same proportion. Finally, Americans agree that consumers should be given a voice in decision-making on the matters related to health care, so that the rendered services can become relevant.

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