Health care systems, plans or schemes are arrangements premeditated to solve problems associated with the health care of targeted populations. Numerous structures of health care are found in existence worldwide. Different governments, charitable institutions, religious groups, trade unions worked intensively to develop a workable health plan in some countries, whereas in others, health systems just evolved (Steve, 2007).
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At the time when The Oregon Health Plan (OHP) was being established, Oregon was a leading national reformist particularly in the health care sector.An emergency-room physician, John Kitzhaber, who was also a sitting senator together with Dr. Ralph Crawshaw, originally drafted this health plan. The plan was initially designed targeting the working poor so as to make them have access to quality services in health care at fairly less costly prices. With this noble intention, it was then possible to make all citizens get access to a health insurance which was inexpensive. Initially, this plan had three components with the first component targeting the class of persons with incomes beneath the Federal Poverty Level (FPL) thus extending Medicaid to them. Secondly, a High Risk Insurance Pool component was established, a provision for those who refused and resisted any form of coverage due to the pre-existing conditions. The third constituent of this health plan was targeting small businesses together with their employees. It intended to provide them with a broader range of insurance options with the employees having an enhanced capacity to maintain and retain their health insurance just incase they switch to new jobs. Later on, progressive amendments were put into place so as to prioritize the services covered in Oregon Health Plan (OHP).
Statistics from a recent research carried out by United Health Foundation indicate that Massachusetts is ranked as one of the healthiest states in the US. This is because Massachusetts enjoys a well established health insurance strategy. Massachusetts health care modification which was enacted to law in 2006 makes it a mandatory requirement for most if not all of the current residents in that state to obtain a coverage in health insurance . Through the law, subsidized costs in the health sector is provided to all citizens earning amounts equal to 100% of the Federal Poverty Level, and it is partially subsidized to those earning amounts equal to 300% of the FPL depending on an income-based sliding scale. An autonomous public authority,” Health Connector” established by the law provides subsidized coverage and also assists individuals and small businesses to select and obtain private insurance. Tax penalties imposed on residents who decline to purchase these insurance arrangements is a positive way of ensuring that nearly all the citizens participate in the noble plan. These penalties are indeed a great funding source to this health care plan (LeBlank, 2007). It is evident that the Massachusetts health care is more precise and elaborate compared to the Oregon plan. Both policies developed in these two plans consider expanding Medicaid as apriority to working families with earnings that is below a critical FPL. Massachusetts plan unlike the Oregon has a legal restriction on a person’s right to the provided health insurance. It requires residents to purchase coverage failure to which they face a compulsory state fine. This has led to great criticism by the residents who think that it’s necessary to against rights of those less interested in obtaining this insurance coverage. In both plans however, taking good care of the uninsured cost is incredibly expensive. Massachusetts, alone recorded a stunning $1.3 billion uncompensated health costs in the recent past. Lower income individuals in both cases face harsh financial hardships by purchasing health plan in individual market with pre-taxed money. Due to the stannous effect these two health programs made on the economy, specific policies had to be put in place, an initiative essential to keep the objectives of the two intact (Clewer, 1998).
By empowering individuals purchase and own or make special arrangements to obtain health insurance, the Massachusetts plan for instance is likely to undergo a radical transformation especially if the residents are assured of retaining these policies regardless of the type of job or its status. As they make vital modifications major components of the health plan, state officials should avoid expanding the program and shun imposition of company or other employer mandates. On contrary to the Massachusetts health plan, the Oregon plan chose to promote the availability of these categories of health coverage for workers in small businesses by creating reforms at the small market insurance. These crucial structural changes not only provide enormous advantages to this class of persons but are also considered strategic and lucrative enough. This is also inclusive of the small employer reforms to the individual market. Despite all these, current market trends in Oregon show a reduction rather than it showing an expansion of insurance that is sponsored by the employer. This is a case experienced in smaller firms and firms with the dominance of low employees (Gruen, 2005).
The rising health costs and especially when the whole world faces the harsh economic agony, these health plans, particularly the Massachusetts have seen their officials take significant strides in trying to restructure their health insurance market. Experts have also suggested that those individuals should be allowed to buy and own health insurance and remain assured of the complementary tax treatment. This is only possible with the organization of a statewide exchange in health insurance that will also direct assistance to particular citizens with low income to enable them acquire private health coverage. With this type of economy, experts have warned that this could be a terrible omen for private investors and other businesses as well since the cost incurred in individual health insurances are bound to keep rising steadily. Oregon’s largest health plan,’Regence BlueCross Blueshield’ has in the recent past recorded five concurrent rate increases. The panic resulting from the economic crunch, several people are bound to forgo coverage or else take cover in the increasingly risky medical pool offered by the government. This is attributed to the very hefty increases in premium. Therefore, employees who have their employees in charge for their coverage are forced to make them spend more; this is for the sake of those programs under funded by the state and also to help subsidize health care of the uninsured. Proposals concerning modernization or intensive reforms of these two health programs will in the future need to undergo intense scrutiny to reduce or minimize after shocks received from a dwindling economy (Morris, 2007).
- LeBlank, S. (2007). Timing of health care law’s penalties could pose risks for Romney. New York: Associated Press.
- Wonderling, D., Gruen, R. & Black, N. (2005). Health economics. Maidenhead: Open University Press.
- Clewer, A. and Perkins, D. (1998). Economics for Health Care Management. London: Prentice Hall.
- Morris, S., D. Parkin and N. Devlin. (2007). Economic Analysis in Health Care. Chichester: Wiley and Sons.