Proposals to reform existing healthcare policies to reduce costs of healthcare services:
1. Increasing co-payments, co-insurance or deductibles
Summary
Increasing co-payment, co-insurance and co-deductibles means increasing the fixed medical fees paid by the individual in addition to what his insurance covers on a percentage basis. (Health Insurance Resource Center, 2012) Woolhandler, et. al. (2003) suggests that this reform is a crude method of matching health care services with health needs. They posit that sharing the expenses deter the patients from seeking medical care, such as effective medical treatment. Bartlett (2009) argued that designing a new health system must not only deter its costs through co-sharing without damaging the quality of health care available. This implies the negative effects of increasing co payments to quality healthcare.
Advantages and disadvantages of the proposed reform
Co-payment, co-insurance, deductibles reduce an individual’s out of pocket expenses. He/she only has to pay a small percentage of the whole medical bills. The rest is taken care of by the insurance company. An average co-insurance percentage is 80/20, thus, a small amount for patients. With this scheme, an individual also pays a lower amount of premium. The insurance companies adjust the premiums based on the anticipated payments the patient will need. (Woolhandler, et. al., 2003)
However, it also signals an uncertain bill for every medical check-up or treatment. If one is suffering from a serious condition, he may be required to pay a larger amount of money from his own pocket. Most patients do not want this certain uncertainty and they prefer to pay a fixed dollar amount such as insurance premiums. This reform can also be confusing for the policyholder. The percentage calculations are confusing. (Bartlett, 2012)
Comparison of discussion in the scholarly journal article and in mass media
The discussion the scholarly journal focuses on the three important actors in the healthcare system, the government or administrators, insurance companies, the patients who need quality care and the doctors who are the main instruments for health care. It emphasizes the reduction of costs which are compensated by reducing the professional fees of doctors and specialist and how this could impact in the quality of medical and health care the patients get. Meanwhile, the Forbes publication focuses on the national context of healthcare and how it fare up with the health care system and reforms in other developed economies.
Personal stand on the proposed reform and evaluation of the debate
I think that increasing the share of expenses for medical expenses is not an equitable way to share the total costs of medical care in the country. Most people will not be able to squeeze something out of their pockets when they need medical help.
There is no explicit debate in these two sources since they both point to the reduction of quality health care with the increase in sharing the medical expenses. The journal is just focused on the quality of health care while the Forbes publication is on the deterrence of a patient in seeking medical help, considering the out of pocket expenses.
2. Health savings accounts
Summary
Health savings account (HAS) is a tax-advantaged medical savings account that can be availed by American taxpayers when they enroll in a high-deductible health plan (HDHP). (Health Insurance Resource Center, 2012) According to McConnell (2005), in comparison with various specialties, the emergency department (ED) will be greatly affected by the HAS. Visits to the ED are urgent and as HAS holders become more conscious of their expenses, these visits may forego the appropriate care or treatment as holders may just opt for substitute care in less serious conditions. CNN Money considers the HAS as a positive thing for health care holders. (Gengler, 2010) It believes that it enables medical care for a lesser premium and it is advantageous for young people who do not always use their medical plans. (Ibid.)
Advantages and disadvantages of the proposed reform
The main attraction to HAS is its lower premium than the usual health insurance. Gengler (2010) advocates HAS because it also serves as a supplement to a personal investment fund. It says that even in retirement, a holder can tap the funds tax-free for medical needs. A holder can also withdraw it penalty free as he reaches 65 years old. HAS is also flexible.
Meanwhile, the low income population canot enjoy the benefits of HSA. Their income cannot match the benefit entitlements of the HSA. Also, the tax breaks offered under HSA are too modest in comparison with the actual cost of the health plans. (McConnell, 2005)
Comparison of discussion in the scholarly journal article and in mass media
The article on HAS in CNN Money hinges on the monetary advantages of securing an HAS. It shows how one can take advantage of the plan for medical and investment purposes. In monetary terms, HAS has many benefits. However, the quality of health care was not discussed. McConnell, on the other hand, discusses the medical implication of spending one’s own savings for medical care. He shows how the quality of health care is reduced when one anticipates the reduction in his HAS. For the author, this is a sad plight for policy holders.
Personal stand on the proposed reform and evaluation of the debate
I think that the features and benefits of the HAS far outweighs its disadvantages. I still think many middle class families and young generation groups can take advantage of this health care reform. However, when taken wholly as a national healthcare reform, this is not also advantageous for low income family. It will be disadvantageous for them since they cannot subscribe to the income bracket for tax reductions. The debate is incomparable because the CNN article features all the monetary incentives versus the McConnell journal which emphasizes the reduced quality of health care in relation to HSA.
3. Cost and or financing of healthcare
Summary
Gruber (2009) revealed that the foregone revenues linked with tax exclusions of employers' health insurance expenses amount to the second highest health insurance expenditure. The employers’ payments for their employees’ health benefits are not taxed and thus translate to tax breaks. However, the tax shelter does not benefit the employee more than the employers. Zhang (2009) reported that president Barack Obama will spend on various health reforms, constituting about $630 billion reserve fund over 10 years to finance the reforms in healthcare. The reserve would be funded through Medicare savings and tax increases. The Obama plan aims to spend $1.7 billion in 2014 to enforce penalties for Medicare fraud and abuses, inlcuding the anomalies in the federal insurance program for the elderly and Medicaid.
Advantages and disadvantages of the proposed reform
Health care financing is welcome news to the ailing healthcare industry. It is also very encouraging to note that the budget for health care has been extended to include health insurance for everyone and the closing of the health care deficit in the span of ten years. (Gruber, 2009)
However, it is met by criticisms for the public perceives the Federal government to be dictating the types of health care coverage they can avail. The new coverage may also negatively affect the business sector because employers may have various schemes for their health plans or packages. The financing scheme would also give extra burdens to the budget deficits which the U.S. government has.
Comparison of discussion in the scholarly journal article and in mass media
The two articles both lay down the positive news of the financing reforms in healthcare. It is noted that the journal article stipulates the downside of the tax breaks for the employees while the Wall Street Journal article stresses on the financial costs of overhauling the health care system. Gruber (2009) lays down some political considerations ofr these financial resources. For instance, Obama’s proposed budget for cost controls will not be netangled with the politicians or providers’ allocations. Also, the increase in sin taxes is difficult to relate directly with increase funds for health care.
Personal stand on the proposed reform and evaluation of the debate
I personally welcome the reforms which are initiated by the present government. Their intentions are good, no matter the outcomes may be. I just hope that the budget allocations really go to their intended beneficiaries and that the expected taxes from the alcohol and cigarettes really redound to more health care services, especially for the poor. I also think that employees should be given a break since they are already taxed in various ways.
References:
Bartlett, B. (July 3, 2009). Health Care: Costs And Reform. Forbes Magazine. Web. Retrieved on March 6, 2012 from, http://www.annemergmed.com/article/S0196-0644%2805%2900618-9/abstract.
Gruber, J. (July 2, 2009). A Win-Win Approach to Financing Health Care Reform. The New England Journal of Medicine, 361, p. 4-5.
Health Insurance Resource Center. (2012). “Co-Payment.” Web. Retrieved on March 6, 2012 from, http://www.healthinsurance.org/glossary/.
McConnell, K. J. (2005). What Do Health Savings Accounts Mean for the Emergency Department? Annals of Emergency Medicine, 46 (6), pp. 536-540.
Woolhandler, S., Campbell, T., & Himmelstein, D. U. (August 21, 2003). Costs of health care administration in the United States and Canada. New England Journal Medicine, 349 (8), pp. 768-75.
Zhang, J. (February 26, 2009). Health: Financing Health-Care Reform. The Wall Street Journal. Web. Retrieved on March 6, 2012 from, http://online.wsj.com/article/SB123566834450884603.html.
