Brief Analysis on Health Insurance

Introduction

The issue of health care reforms has been an on-going debate for a long time in the United States. The two most contentious terms of the debate are the single-payer system and the universal health care coverage. While the two terms can sometimes be used interchangeably, universal health care coverage in most countries has been achieved without necessarily the use of single-payer systems.  Universal coverage is the health policy in which every citizen of a particular country has health insurance coverage. This system of health coverage was first adopted in Norway in 1912. In Canada, for example, there are virtually no citizens without a health care insurance as the government runs a universal healthcare coverage policy. In contrast, a single payer system is one organization or entity – usually the federal government – is responsible for all the health care financing and settling of claims while the care delivery is largely done by private care providers (Health Care for all – California, 2017).  All the necessary medical services e.g. physician care, medical supply costs, dental visits, etc. are usually provided for in the single payer coverage. The single payer usually dictates the terms of the coverage, i.e. the cost of care, contributions, and ranging benefits of the care. In the United States, the single care coverage is usually referred to as “Medicare for all.” The single-payer coverage may by extension be described as a socialized health care system, in which the government not only pays for the medical expenses but also runs the healthcare facilities. The debates on the health care coverage system to be adopted by the government has largely centered on the affordability and sustainability of the care, as well as the benefits received by the citizens. It is the role of the government to ensure that all the health needs of its citizens are met. However, the government also has other responsibilities besides health care providers and as such, it is imperative to critically evaluate the pros and cons of the health care coverage to determine the best policy to adopt both for the government and the citizens.

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Pros of Single Payer Coverage

  1. Every Citizen’s health needs are covered

A recent survey by Gallup indicated that slightly more than 11% of the United States population still lacks health coverage. While this figure might seem insignificant, people without health coverage are disadvantaged with access to health care services and benefits, including preventive and management services. A single-payer coverage helps to ensure that everyone in the population is covered, thereby promoting a healthier population. The Medicare for all programmes ensures that every citizen can get the medical service they require without having to worry about the costs of the services. According to a recent study by Bankrate, a lot of Americans have prioritized money in comparison to their health. This means that the cost of the health service sought is an important consideration for most people in choosing the service and the provider (Gaffney et al., 2016). Adoption of a single-payer coverage plan helps to mitigate this problem; the citizens will no longer seek health services on the basis of cost.

  1. Consolidation and Monitoring of the Quality of Care Provided

Single payer coverage system makes it possible for the government to develop a central, confidential database that will contain the necessary information about the patient and the provider. Most of the other insurance systems, especially the numerous private providers, are more intent on patient billing than tracking the quality of service the patients receive (Fuchs, 2018). Furthermore, a diversified insurance system means that each provider collects and keeps the information to themselves. Using a single-sourced funding system enables the consolidation of this information. The confidentiality of the information will be a key requirement of the database. However, consolidating the information makes it easy it conducts research on the quality indicators for the improvement of health care. Monitoring of the patient and provider behavior is also important in determining the quality of healthcare service. These include identifying the physicians or care providers that operate in violation of their professional code of conducts e.g. by ordering unnecessary tests to be conducted on the patient and conflicting with the patient on the cost of the service. Minimizing such incidents that often pit the provider against the patient ensures that the patient receives the desired optimal care.

Monitoring of the quality of service and the behavioral traits of the care providers using the consolidated information approach involves the utilization of a public accountability system. How the available resources are used form the guide that will be used to form the strategies for the optimization of health care.

Cons of Single Payer Coverage

  1. Eliminates Competition

There are several private health insurance providers across the United States. These providers greatly contribute to the economic development by creating employment to the people who work in those firms as well as income for the owners of the firms. Adoption of a single-payer coverage system does not necessarily mean that all the competition will be smothered, but the competition will be hurt all the same. A proper competition will ensure that the health plans and the quality of services are always in line with the consumers’ demands. However, lack of competition will increase the likelihood of stagnation of the benefits and coverage services provided. Some of the major breakthroughs and innovations in the history of medical insurance are attributed to private insurance providers. It is possible that with the decline in private providers the improvements and advancements in the insurance coverage will also reduce. While it is important to ensure that all the citizens are uniformly catered for by the government, it is also important to ensure that the insurance services that the government provides for its citizen are are beneficial to the citizens. The private insurance providers do a pretty good at keeping the government insurance coverage in check, and eliminating them will be detrimental to the progress of insurance.

  1. Significant Tax Hikes

Sustainability and affordability are important components in government-funded insurance systems. In a single-payer system, the government is the solely funds the insurance. Well, that money has to come from somewhere. In Bernie Sander’s Medicare for all proposal, the tax rates for all the income groups have to be increased so that the government can find the required additional funds to cover the entire population (Fuchs, 2018). In the single-payer coverage system, individuals will have to pay more for the coverage of others than for their personal coverage.

Conclusion

Healthcare coverage is an important component for a population and as such, the government has a responsibility to provide the coverage for its citizens. However, the choice of the insurance system is a contentious issue and the government as the government has to find a balance between the affordability of the care, its sustainability, and provision of the required benefits. The single-payer system is an apt platform to ensure that all the citizens’ health care needs are met. Despite creating uniformity, ensuring the quality of care and population coverage, the single-payer system also has its downsides. Of major concern is the increased tax burden for the citizens. The fear of lack of competitions is also another concern. Regardless, the single-payer system is suitable for uniformity in population health care coverage.