A majority of concerned individuals have often perceived the United States to be at the verge of national health reform. Over the past few years, the cost of healthcare has been on the rise because over forty six million Americans are still uninsured. On the other hand, millions more experience under-insurance while other worry that they are not appropriately insured. The quality of healthcare in this country has been under scrutiny because the United States is viewed as one of the most developed countries in the world. Major problems surrounding the state of health came into the limelight in 2008 during the presidential campaigns. The costs of healthcare were among the major issues presented in many debates. It is undeniable to state that the United States has been on the brink of many national health reforms as early as the 19 th century. For instance, in 1912, the Bull Moose Party under the leadership of Theodore Roosevelt campaigned for the introduction of health insurance in industries. Furthermore, in 1915, a group of progressive reformers pushed for a system demanding for compulsory health insurance in eight states, but their efforts bore no fruits. Actually, over the years, there have been suggestions and different strategies of introducing a comprehensive health insurance system that did not have limits. However, these efforts have been thwarted when the reforms came with conditions that needed individuals to contribute more costs. On the other hand, many people have debated why the National health insurance (NHI) proposals have been unsuccessful. Even though the United States has experienced successful healthcare insurances such as Medicaid and Medicare, there is room for improvement and enhancement of the health sector such as launching a universal healthcare plan. Therefore, the paper will discuss a plan on the establishment of a single-tier system under the universal healthcare in the United States.
The past years have seen the cost of health in the United States drastically rise. Statistics indicate that the health insurance premiums have averagely increased by two to three times like the rates of inflation (Claxton, 2005). Even though the situation of lacking insurance majorly affected Americans coming from low-income families, middle-class citizens started to complain about the costs. According to Lu and Hsiao (2003), while looking at the rising healthcare costs, it has been found out that few employers are capable of providing the employees with a good insurance plan. Particular statistics indicated that the percentage of employers providing insurance dropped from sixty-nine percent in 2000 to sixty in 2005 (Claxton, 2005). Let us assume that all employers are capable of providing health insurance benefits. The increasing trends in deductible costs will influence the ultimate outcome because a majority of Americans will discover that they have low quality insurance or no access to healthcare.
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The increasing enrolment of Americans in the Medicaid program because of the rates has increased the ineffectiveness of the employer-based coverage. Several publications have talked about different health insecurities and the way millions of Americans are likely to lose their insurance due to their low income. Based on all these logistics, it is right to say that healthcare is not significant to achieve, but also imperative (Eisenberg & Power, 2000).
What the Universal Health Insurance Entails
The United States’ plan for having a universal healthcare system is set to be achieved through the multi-payer model of the universal health insurance (UHI) (WHO, 2000). It is important to understand the concept of the universal health system. First, it gives proactive and holistic care at the lowest level and ensures safety and proximity to home. For instance, when one uses the universal insurance, they are not limited to healthcare services within their state. They are free to receive treatment from any state without discrimination. Secondly, the universal insurance ensures equal access to care is provided based on the need for the services rather than the ability to pay. Thirdly, the insurance program ensures that the consumers have a variety of options on the organizations that insures them.
The rationale and the guiding principles
Every government that strives to establish a successful universal health insurance always has the goal of improving the healthcare system to attain their primary goals. These include maintaining the health of its citizens, offer the appropriate healthcare, deliver high-quality services, and achieve the best value from the health system resources. It substantial to remember that every health reform program that is set to be achieved must be assessed against these goals. Hence, the vision for planning the establishment of the universal health system is to create and efficient and effective single-tier health service, which enhances equitable access to high-quality care depending on the need. The United States federal and state governments must create a framework that meets needs of the people as well as the current healthcare systems. To promote effective planning, the country can learn from countries such as Canada that are under the single-tier health system (Deber, 2003).
The building blocks for the universal health care system
Before the country implements the universal health insurance, there are crucial building blocks that must be put under consideration. For instance, the system should reinforce the primary care services to assist in the delivery of primary care by removing costs as obstacles to access services. Secondly, different units such as the Special delivery units, which deal with the waiting times, should be available. Besides, a more transparent and effective funding system should be established. Licensing and registration should be made available for all the health care providers including the reforms of the private health insurance market.
Primary care in UHI
Strengthening the universal primary care (UPC) by eliminating cost as an obstacle for accessing healthcare should be among top priorities of the plan. It will involve the establishment of primary care work stream made up of two phases. The first phase of planning will offer an extension of the general medical services without charges to people with illnesses or disabilities under the respective legislation. The second phase will involve subsequent extension of these services based on the universal access. Most importantly, the work stream will be characterized with physical and ICT infrastructure to enhance primary care.
The Services That Will Be Covered By the Package
` In a more comprehensive way, essential health services covering of issues including HIV, tuberculosis, non-communicable diseases, mental health, sexual/reproductive health, and child health should be readily accessible to those who need them. The goal of introducing the universal health package is to offer increasing health services over time while at the same time trying to reduce the costs of services. Based on the Millennium Developmental Goals, the priority of the universal insurance should focus on key interventions (Wagstaff, 2004). Therefore, in the United States, the insurance plans to cover for services like HIV management, communicable and non-communicable diseases, sexual and reproductive health, and child healthcare. However, the system intends to introduce extra charges for mental illness and old age complications management since they involve staying in specialized facilities. Hence, these two situations will encompass the limits of the universal package. It is good news that other insurance plans such as Medicaid and Medicare are better suited to cover for people in this category.
Who should receive the services?
Everyone is entitled to get the universal health coverage insurance. According to World Health Organization constitution (1948), all individuals have the right to health care. However, when it comes to UHI, the government will consider the most vulnerable persons without imposing any restrictions. These are people living below the poverty levels and can barely afford treatment costs. Equity in the healthcare program will be paramount and the country will track the records of health care access based on different factors such as sex, income level, residence, immigration status, and age.
Funding of the Universal Insurance
After considering all the services that will be provided and covered by the health insurance, it is important to outline different ways on how the services will be funded (Dye, Reeder, & Terry, 2013). The preferred model that will be employed by the government includes creating a template for future financial arrangements. First, individual will pay their universal health insurance premiums directly to their preferred insurer. Secondly, the federal government as well as the state government will extend the private premiums by offering financial support payments directly to organizations that insures them on behalf of the eligible individuals. Furthermore, the federal and state governments will be involved in directly funding particular UHI services and costs such as ambulance services. Fourthly, the government will be involved in funding other health care and social services, which will be covered outside the stipulated UHI package. For instance, an individual who is on a long-term residential care will receive financial support from the United States government.
Since UHI will involve constant financial responsibilities by the state especially in supplementing the premiums, it will maintain the usual taxation as the primary source for raising funds. However, after the implementation of the program has picked up, the state will plan to introduce very crucial charges, which will delineate how the resources are allocated, grouped, and, managed. While doing this, the government will consider its efficient marketing rates and the numbers of people who are eligible for financial support, as well as the average amount of financial support payable as per the income levels or the financial criteria. On the other hand, the allocations of the UHI system will be pooled in the National Insurance Fund because it will be directly used to manage financial support payment to insuring organizations.
Impacts of introducing the universal health coverage in the United States
More often than not, there is a direct relationship between the population’s health and welfare. As stated by Travis et al., (2004) people are able to access medical services at low costs; they become more productive in their families as well as the communities. Moreover, the health plan is a good way to ensure that children are back to go to school without experiencing any unnecessary challenges. At the same time, the financial risk protection that the citizens will have prevent them from falling deeper into poverty because they will not be forced to spend money from their pockets, especially if they are not experiencing mental or age related problems (Yates, 2009).
Thus, the universal health coverage will be perceived as a primary factor in sustaining poverty reduction as well as reducing social inequities. Besides, when the United States finally implements this coverage, it will be a hallmark representing the government’s commitment towards improving health care in the country (Berwick, Nolan, &Whittington, 2008). A majority of publications have indicated that the increasing costs of health limit social and economic growth. Therefore, embracing a universal package will ensure that the low-income households are covered and their income can be channelled to other more productive areas.
Conclusion
In conclusion, the introduction of universal healthcare insurance will represent the most revolutionary and fundamental reform in the history of the United States. Therefore, it is important for the government create a solid framework and foundation during planning to strengthen and promote the system. According to Schoen, Davis, and Collins (2008), these frameworks manifest themselves in terms of building blocks. While planning for an effective and transparent UHI, the most important building blocks involve the structural building blocks such as the Healthcare Commissioning Agency, having independent hospital trusts, and community healthcare organizations. Secondly, there should be regulatory blocks covering the licensing of the healthcare providers and risk equalisation scheme. Moreover, financial building blocks are crucial in determining the future of the program and budgeting. On the other hand, it will be effective to include the information and holistic care building blocks. The information building blocks will ensure that new information systems such as unique identifiers and health information bills are effective and can maintain and sustain the UHI system. Lastly, integrated care will encompass new ideas that will be added to the delivery of patient-centered care.
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