Essay
Summary and reflection: Remedy and reaction
In his book, Paul Starr develops a chronological account of the evolution of the healthcare policy in America which is arguably the main topic that has dominated the public arena and the political landscape for years (Starr, 2013). It is also arguably one of the policy areas that has elicited ideological differences and created political alignments all in the name of seeking the best formula in which the American population can access quality care across the lifespan. Universal coverage ideologies began way back in the Progressive era with the idea of social insurance that would enable the protection of home life and subsequently the management of the hazards of illness within populations (Starr, 2013). Starr argues that in the need to find this formula that would create a viable and sustainable social insurance, the USA has gradually developed policies that over time have created a trap that has satisfied a majority of the public while at the same time enriching the healthcare system so that today it is very difficult to formulate a complete overhaul or change of the system; in essence, the system has been enriched and protected so that it has remained highly bureaucratic but at the same time achieving a great deal of its core objectives (Starr, 2013).
In the content, Starr has his focus on the different regimes that have overseen the healthcare system and how each has contributed to the system we have today. The author acknowledges that the system that Americans enjoys today, while most of it has been implemented in the Obama era, the Clinton era played a key role in its development with credence to Hillary who was the driving force and the idea behind the system in place today. Starr points out a concern that the universal healthcare system as it is today is highly accountable to the top 10% of the people who indeed account for by up to 70%of the total costs of the system creating a high risk situation (Starr, 2013). With this idea then there has been a persistent need for a formula that would help assure of the viability of the plan into the future and that includes forcing some groups, people or employers to take part in payment of the health insurance which is a plan to distribute the risk.
This is within the knowledge that even as the health population continue to shun healthcare insurance, then it becomes gradually expensive to sustain and leading to a situation referred to as the adverse selection. The policy makers according to Starr have continually sought to promote the formation of alliances or groups that would otherwise help spared the risk and ultimately lower the costs of the premiums in the long run (Starr, 2013). This then brings in the context that the federal authorities have to continually seek to enroll as many people as possible in the healthcare insurance system to assure of its sustainability even as it becomes larger, complex and costly so that at least the risk of failure is spread by having a wide capital base (Starr, 2013).
Health Care Access, Portability, and Renewability (HIPPA) stands out as one of the Acts that has been formulated to help ion the regulation of the open market within which the health insurance operates. In the belief that the insurers out there are in business there was a need for a law that will regulate the breadth and availability of healthcare plans for individuals and groups. This is within the context that these insurers may take advantage and exploit individuals and groups especially where creditable coverage durations are set out by the insurers thus eliminating the user from accessing some vital services through their plan (HHS.gov., 2015).
On the other hand, the CHIP (Children's Health Insurance Program) is essentially a federal run programs that provides matching funds to uninsured children hailing from families with moderate incomes that cannot sustain the available Medicaid plans due to extremely high costs outside their capability. The purpose of this program is to afford children form such backgrounds the quality care so that their family economic status does not necessarily limit their right to live healthy and access the necessary care services (The Kaiser Commission on Medicaid and the Uninsured, 2007). However, the guidelines and policies of the implementation of the program vary from state to state since each state is given the mandate to determine the legibility to this program within the confines of its demographics (The Kaiser Commission on Medicaid and the Uninsured, 2007). Medicare part D is concerned a plan available within the Medicare Plan and thus eligible for all enrollees of the Medicare. It is however optional and it is a private plan that is concerned with a coverage for all prescription drugs. This plan is afforded to individuals through their parent insurance company which is approved by Medicare (Kaiser Family Foundation, 2014).
The fact that the Medicare Part D is set out as a private plan for which an individual has to enroll even after taking any of the other plans places further costs on the individual especially those within the low income groups. In the absence of automatic coverage for prescription drugs, the low income groups may not be in a position to achieve the completion of the care plan as set out due to the struggle of raising funds for purchasing the drugs and this then beats the logic of the universal coverage as it avoids a critical element of the care process; usage of prescribed drugs. The Part D of Medicare needs to be amended such that it is incorporated as part an additional and automatic element of the other plans especially those that target the low income groups.
References
HHS.gov. (2015). Your Rights Under HIPAA | HHS.gov. Retrieved from http://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
Kaiser Family Foundation. (2014). The Medicare Part D Prescription Drug Benefit. Retrieved from http://files.kff.org/attachment/medicare-prescription-drug-benefit-fact-sheet
Starr, P. (2013). Remedy and reaction: The peculiar American struggle over health care reform. Yale University Press.
The Kaiser Commission on Medicaid and the Uninsured. (2007). STATE CHILDREN’S HEALTH INSURANCE PROGRAM (SCHIP) AT A GLANCE. Retrieved from https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7610.pdf
