Introduction
Like many other systems in the world, the American healthcare system is in a mess. It exposes people to high level health risks with close to 46% of the population lacking health insurance while millions are underinsured (DeGrazia, 2008). This is according to DeGrazia in his 2008 article, The Hastings Center Report. This paper critically synthesizes DeGrazia’s article focusing on particular aspects like accuracy, contribution of the article to health care knowledge, currency and veracity.
Healthcare Status
As noted in the article, the current system is dangerous and fatal with several people losing their lives annually in the United States due to a vast majority of the population being unsecure in terms of medical insurance. Another disappointing scenario is lack of commitment among key players with some companies unwilling to submit their premiums while others have stringent rules to most people. Of importance is the position taken by Democrats in 2008 with most of the candidates opting to hold on to job-based insurance through individual mandates and employer mandates towards the development of public programs (DeGrazia, 2008). Another important idea is their harmony in the adoption of the single-payer insurance system that was to register everybody based on citizenship.
Healthcare Goals
Although not universally accepted, the following are identified as fundamental aims of having a working healthcare system: to achieve universal medical care, augment patient’s access to the services, to control health costs and maintain standard quality of the entire system (DeGrazia, 2008). While these sound tasking and demanding, many countries around the world have implemented them and significantly cut medical expenditure. Coupled with good delivery management, single-payer is cost effective and morally defensive in rescuing the healthcare sector.
Moreover, an understanding of the need for this system can be viewed in the context of medical care insurance. The link between employment and insurance emerged in 1929 for Dallas teachers before employers began offering insurance to attract workers (DeGrazia, 2008). With no taxation and incentives from the federal government, many other companies ventured into the insurance industry to make profit. Emergence of Medicare and Medicaid in 1965 improved the insurance services with costs being shared by federal and state governments respectively. However, increase in medical care costs threatened the system until early 1990s.
According to the article, Clinton’s proposal to maintain employment to allow more people to have access to medical insurance was politically shot down during his successful bid to Whitehouse. Nevertheless, managed medical care and free market have been unable to promote the American healthcare system. Based on the existing needs, major proposals were made which included: market reforms, tax credits, individual mandates, managed competition, employer mandates and expansion of existing healthcare programs (DeGrazia, 2008).
As discussed by the author, these proposals share a wide range of disadvantages which could be viewed as obstacles towards adoption and implementation. Firstly, there would be increase in administration costs especially within private insurance sector. In the same manner, many insurers would cautiously engage in adverse selection to avoid risky situations thus minimizing coverage space. Lastly, a lot of cash would be drained into the system to generate profits for private investors (DeGrazia, 2008).
Single-payer
The main point underlined under this segment is cost effectiveness of the proposed system. It would concentrate on providing services to patients without restrictions due to lack of competition. As a result, proper planning and budgeting would ensure savings and prioritized expenditure. Furthermore, it would guarantee quality insurance services without incurring economic incentives that compromise the ability to disburse services. Monophony would also be enhanced through negotiation of low prices to acquire pharmaceutical products. Lastly, single-payer could integrate information technology for storage and easy retrieval of patients’ data. Evidence for these emanates from Congressional Budget Office (CBO) surveys which indicate low cost for single payer. Medicare has also proved low cost with reduced administration expenditure. The same system has turned out to be successful in many countries, Canada is the best example (Gruca, 2001).
To the medical sector, this would be important since the single-payer system permits private delivery of services even though it is publicly funded. This would minimize restrictions imposed by private insurers. Doctors will also get motivated to work in a well administered system that guarantees quality service delivery enhanced via innovations and biomedical research. Through public-financing and managed-delivery, players would employ high level of management skills in channeling insurances to patients who need them.
Conclusion
The article is informative and takes a critical stance in analyzing the current medical system backed with substantial research evidence from Congressional Budget Office (CBO) among other sources. I agree with author’s position as depicted from the advantages of the single-player proposals above. What impresses most is the author’s emphasis on quality service delivery for needy people at reduced costs. To make it more realistic and argumentative, the article also addresses perceived challenges of single-payer together with evidence on why the assumptions are unfounded. The article also triggers the need to integrate information technology in medical care. This can be viewed as amplification of existing ideas automating medical industry. I generally agree with the article based on my understanding on the issues and consider it essential in redefining medical care in America through single-payer system of insurance.
References
DeGrazia, D. (2008). Single Payer Meets Managed Competition: The Case for Public Funding and Private Delivery. The Hastings Center Report, 38(1), p. 23-33.
Gruca, T. S. (2001). The Technical Efficiency of Hospitals under a Single-Payer System: The Case of Ontario Community Hospitals. Health Care Management Science, 4(1), p. 91–101.