Improving Access to Healthcare

Values As They Relate To The Delivery And Financing Of Health Care In The United States

Health Care Is A Human Right

Everyone should equally enjoy health care. It is one of the things in life that is essential. It may not be news when one is turned away from a concert or movie because they cannot afford a ticket. However, when sick people are turned away from medical practice, it can make headlines. Therefore, all people should have equal access to a reasonable level of the right health services, regardless of their capability to pay. The health care human right has been internationally recognized for long. In the Second Bill of Rights outlined by Franklin Delano Roosevelt (FDR), health care was included. Unfortunately, FDR’s demise hindered the Second Bill of Rights from implementation. However, Eleanor Roosevelt presented the draft to the United Nations, and it was extended and explained. The UN’s Universal Declaration of Human Rights (UDHR) board codified human rights, such as the basic right to health, in Article 25. The U.S, in union with the United Nations’ countries, adopted the global values.

Since the adoption of the UDHR, all developed nations across the globe have employed collective health care organizations. These systems ensure that all residents of a country enjoy their right to health care. In 2009, the United States was in a severe debate on whether health care should be a right. The center of the debate was on President Obama’s campaign to pass universal health insurance (Onarheim et al., 2018). After a year of public uproar, Congress passed the Affordable Care Act, which moved to ensure health care is a right. However, the controversy is still on. The ACA requires modification, even if it has achieved an immense deal, mainly increasing insurance enrollment. Still, much is yet to be achieved, such as how high quality, inexpensive health insurance for everyone can be guaranteed along with how to regulate the continuous rise in yearly health care expenses, which now exceeds $3trillion. In regards to ACA, determining results will be important.

Health Care Should Be Organized Around A Free Market

In an actual free-market system, consumers are allowed to buy health insurance straight from a competitive market. The patients would also meet health care expenses in cash for scheduled, standard health care they receive during the year and preserve utilization of insurance for unusual, costly incidences of health care that would meet the cost of these services as significantly as the demand of the market (McKalip, 2016). Although there could be inadequacy in the health care delivery via the market, that can be conquered using generous acts and provisional, premium safety nets of the government for health care. Moreover, a dynamic free-market act would help drive down health care costs and raise access for everyone, including people in low-income populations. An excellent case of a free-market system benefiting the common public is the payment of Lasik and plastic surgery (Herrick 2013).

It is evident that central economic planning values administer health care delivery and its economies instead of a free market’s natural action. In the central-economic planning model, the politicians and elite people develop rules for care delivery, fees, physician’s medical practice, and hospitals’ care. Central planning of the economy is a feature of socialist economics, and in history, it has failed both socially and economically. Centrally planned economies need fixing of prices by the states, resulting in shortages. In health care, doctors’ fees are mainly subject to the comparative cost resource-based organization, producing price regulations that perhaps results in scarcity of primary care physicians, mainly in particular geographical regions.

Care Should Be Equitable For All

Equity means justice and fairness. All persons should have equal opportunity to realize their full potential for health or access health care. On the other hand, equality entails an equal allocation of shares to get the same amount. The concept of equity exceeds equality. Some inequalities may be inevitable and cannot be deemed unjust (Fleurbaey et al., 2013). However, others, for example, those related to one’s ethnicity, residency, sex, socioeconomic status, age, or disability, may be evaded, and thus they are considered inequitable. They might be unjust or unfair and unequal, and since they are not exclusively determined by need, they may result in variation in outcomes. Access indicators include accessibility of resources, user charges, waiting times, among other barriers to health care. Therefore, equity of access is a supply-side occurrence, in that equal services are made more available to patients in equal nee.

The traditional insurance designs have provided the same benefit for all the enrollees. It has thus followed the principle of equality. At the service point, consumers’ cost-sharing is usually uniform, irrespective of the potential clinical gain or need (Fleurbaey et al., 2013). The idea appears to be great, but it can lead to highly unfair outcomes. Instead, insurance coverage should be designed in a manner that gives access to care for those who require it whenever they need it. That calls for a slight but critical move from equal to equitable access. Equitable access recognizes that medical need is a basic factor in determining where resources should be directed, and it does not regret treating individuals with diverse needs differently.

Competition Leads To Efficiency

Market completion in economic theory is believed to improve efficiency, stimulate innovation, enhance quality, and ultimately regulate cost. Encouraging Competition targeting an increase in efficiency and enhancing heath care quality has been the ‘tune’ of the past decades in industrialized nations (Scanlon et al., 2008). The supporters of Competition contend that its presence in healthcare, despite the imperfections of the health market, could have beneficial effects, whereas lack of it hinders managers from attaining efficiency in their organizations (Garattini & Padula, 2019). Given that decision-makers cannot depend on the market prices to match supply and demand, political demands are eventually prone to be the key inspiration of their policies. That is applied to justify efforts to instill a ‘quasi-market’ condition within the public division. With strict control, that would obtain the thought efficiency benefits of free markets without losing the benefits of equity of the conventional public systems.

Health care can be regarded as a classic illustration of “market breakdown” from the supply and demand sides (Scanlon et al., 2008). Patients cannot be regarded as typical consumers looking for the finest contract from the demand side, as they lack full information on illnesses and health services, making them vulnerable. Hence they are barely rational and usually ready for “financial blackmail. The ‘information imbalance’ opening of consumers in healthcare is taken by doctors, who create a ‘principle-agent’ association with them at the micro point and reply to insurance providers for the majority of healthcare recommended on the macro point, which makes patients responsible for the illnesses cost (Barros et al., 2016). The lack of unaccountability of the medication expenses produces a likely “ethical hazard’ for both the patients and patients.

How to reform the U.S healthcare system

To realize the implementation of health care as a human right, the United States’ healthcare system should always define value with patients and their families as the focus, completely empowered to be active participants in all aspects of care. Patient and family-focused care can improve outcomes, encourage safety, and reduce costs (Erickson et al., 2020). Planning effectively with patients and their families is important to the attainment of the “quadruple health care aim:” improving patient experience, lowering costs, enhancing health outcomes, and improving doctor satisfaction.

Every patient has an exclusive blend of lifestyle, socioeconomic, genetic, among other factors that impact the appropriateness of their care, effectiveness, and risk levels to treatment options. Apart from that, patients also have a variety of values and individual health goals that might eventually the best treatment option customized for them (Erickson et al., 2020). Consequently, discussing care options with patients and families can result in less forceful treatment that improves patients’ experiences and lowers costs. Besides, evidence shows that patients who are actively involved in their care tend to show low levels of anxiety, faster recovery, and high observance of treatment options.

To realize the value of a free-market economy would eliminate the present obstacles to the free-market and establish features of a free economy as fast as achievable. Changing to such an economy will come with its own expenses, and it has to go with generous acts from the health care providers’ population and a polite reaction from the patients’ population to accept their responsibilities and rights (McKalip, 2016). A free-market economy can be realized through the empowerment of patients. When a consumer is empowered, they are at the best place to supply for her or his needs. Using their shared economic action and power, many patients can improve quality, cost, and access health acre for all. The existing subsidy and tax arrangement severely weakens the patient’s ability to be economically empowered to provide their own health care. The code of tax selects those who are privileged and those who have to sacrifice, using imbalanced tax management for health financing out and in service and using a redistributive result of tax subsidies and tax payment according to income groups. A tax system that is equitable offers similar benefits to everyone, not only people selected by politicians, subjected to majority demands. Unequal treatment of an income of a person infringes their rights to benefit from the results of their work and destroys the unity with their families as they get a deterrent to “work honestly and effectively.” For example, to maintain a high level of health insurance subsidies, people have devised ways of not looking for work that pays extra, but would imply losing their subsidy. Many companies have also been shown to lay off an employee or reduce people from part-time and full-time jobs to evade penalties under the Patient Protection Affordable Care Act.

A free-market economy would also ensure that patients spend money for their regular, scheduled health checkup using their funds earned in a way free of tax. Ensuring deductibility of complete tax of healthcare funding would make it possible for people to put higher amounts of money into health savings. Thus, patients can finance their care using Health Savings Account (HAS), a method that involves them more in personal health care. Under the current economic model, patients are made to believe they can get a great deal for their normal annual premium fee. The insurance providers also strive to evade spending on patient’s medical care. With the enactment of the Patient Protection Affordable Care Act (PPACA), the insurance payment system was reinforced. A market-free economy system with health insurance as an insurance arrangement would ensure low premiums for everyone and facilitate a combination with HSAs. If the public insists on the government as an instrument for promoting healthcare financing, a more sensible and low-cost strategy would be to allow them to finance HSAs or High-deductible Health Plans tax-free. That should be tied to policy acts to encourage users’ education. Advocacy groups and medical associations can work to develop networks for physicians to work with patients in the programs.

Preferences of health care delivery may be determined by the quality of service, equity in health care quality, and focus on its improvement where come communities receive poor quality service is important. At the level of society, the observation that cultural, social and economic factors usually define perceptions and preferences of opportunities undermines the importance of addressing important structural inequalities and cultural norms.

Cutler (2002) asserted that the government’s consequences to achieve equity by increasing coverage were increases in health care costs, leading to top-down policies to regulate costs. That in turn led to worsening of quality and interest in market-forms modifications to remedy the problem. Tuohy (2012) has claimed that governments’ hunt for a system that realizes equity, regulates costs with high quality of care and leads to policy cycling as the government highlight policies that address most the critical failure of these three objectives and unreservedly ignores the others. Thus, after the world financial crisis, financial pressures imply that governments now center on cost regulation instead of quality and equity.

When striving to allow Competition in health care, the policy should consider that increasing or introducing healthcare provision is a demanding undertaking. The risk and success conditions should be carefully evaluated in each case. With the right policy design, introducing Competition can help meet certain health system objectives, but it is improbable to contribute concurrently and constructively to all. The introduction of Competition among providers calls for more policy actions. The market should be working properly and outcomes evaluated carefully and constantly. Ensuring transparency in the market through the accessibility of information on price, quality, and other applicable aspects enhances the performance of the health system (Erickson et al., 2020). Nonetheless, the difficulty of measuring and contrasting quality across health care services should not be underrated. The introduction of Competition among providers also needs the competition rules enforcement to prevent the building, reinforcement, and abuse of leading positions. Policy concerns on equity underscore the need for vigilant monitoring of provider competition that would impact diverse groups of persons. Whereas there lacks a general presumption on the effect of Competition on equity, Competition is not the finest tool for tackling equity issues. Effects on equity should be considered based on each case before predicting and monitoring outcomes.

References

Barros, P. P., Brouwer, W. B. F., Thomson, S., & Varkevisser, M. (2016). Competition among health care providers: helpful or harmful?. The European Journal of Health Economics, 17, 3, 229-233.

Cutler DM. Equality, efficiency, and market fundamentals: the dynamics of international medical-care reform. J Econ Lit 2002; 40:881–906. 10.1257/jel.40.3.881.

Erickson, S. M., Outland, B., Joy, S., Rockwern, B., Serchen, J., Mire, R. D., Goldman, J. M., Medical, P. Q. C. A. C. P. (2020). Envisioning a better U.S. health care system for all: Health care delivery and payment system reforms. Annals of Internal Medicine, 172.

Fleurbaey, M., Luchini, S., Muller, C., & Schokkaert, E. (2013). Equivalent Income And Fair Evaluation Of Health Care. Health Economics, 22, 6, 711-729.

Garattini, L., & Padula, A. (2019). Competition in health markets: is something rotten? Journal of the Royal Society of Medicine, 112, 1, 6-10.

Herrick D. 2013. Why can’t the market for medical care work like cosmetic surgery? NCPA Health Policy Blog, June 7. http://healthblog.ncpa.org/why-cant-the-market-for-medical-care-work-like-cosmetic-surgery/.

McKalip, D. (2016). Achieving moral, high quality, affordable medical care in America through a true free market. The Linacre Quarterly, 83, 4, 423-444.

Onarheim, K. H., Melberg, A., Meier, B. M., & Miljeteig, I. (2018). Towards universal health coverage: including undocumented migrants. Bmj Global Health, 3, 5.

Scanlon, D. P., Swaminathan, S., Lee, W., & Chernew, M. (2008). Does Competition Improve Health Care Quality?. Health Services Research Chicago-, 43, 6, 1931-1951.

Tuohy CH. Reform and the politics of hybridization in mature health care states. J Health Polit Policy Law 2012;37:611–32. 10.1215/03616878-1597448.