America's health care system is in trouble. More money is spent on health care in the U.S. than any other country in the world. Our terminally privatized and competitive health system is the most expensive, yielding some of the poorest results. Health care spending is spiraling out of control, and our attempts to forestall this waking giant have proved ineffective. According to the most recent figures of the Congressional Budget Office, almost seven percent of our gross domestic product was spent on Medicare and Medicaid in the year 2004. American [health care] is characterized by both feast and famine: it leads the world in delivering high-tech medical miracles but leaves 45 million people uninsured. David Broder, of the Washington Post ascertains that costs for health care are rising at a rate four times faster than wages in America. Rising private-health insurance costs are being differed to employers, which are then shifting the cost onto the employees via higher premiums or lower wages. Increases in insurance premiums are decreasing the availability of employment-linked insurance plans.
[...] According to a Kaiser/Health Research and Educational Trust-sponsored survey conducted in of total enrollment in health plans was to the less-rigid PPO form of managed care. The fact that Americans seem to prefer more choices when it comes to their health care plans suggests that a consumer-driven system with unlimited choice would fit well with established values. The history of managed care is a story wrought with good intentions. A system that began almost by accident was promulgated by unions that wanted affordable health care for their workers, lawmakers that wanted to curb health-related spending and physicians that were concerned with aligning their economic goals with their duty to serve their patient. Managed care began during World War II with the industrialist Henry J. [...]
[...] Now that we know the potential successes of a consumer-driven plan and the pitfalls of managed care plans, it would be helpful to look at the Claremont Colleges health insurance offerings to see how they illustrate the clash between managed care and HSAs. Faculty and staff of the Claremont Colleges are offered a choice of two HMOs, one PPO and one high-deductible health plan (HDHP), which is in essence an HSA. The Blue Cross HMO and Kaiser HMO both offer 100% coverage on most services and a low maximum out- of-pocket expense for a very low monthly premium. [...]
[...] Kaiser the Future of American Health New York Times Oct Nov < http://webct.claremont.edu:8900/SCRIPT/CM_GOVT105_01_FA06/scripts/serve_hom e>. Broder, David. Broken Health Care System.” Washington Post July Sep < http://webct.claremont.edu:8900/SCRIPT/CM_GOVT105_01_FA06/scripts/serve_hom e>. Krugman, Paul. “America's Failing Health.” New York Times Aug Sep < http://webct.claremont.edu:8900/SCRIPT/CM_GOVT105_01_FA06/scripts/serve_hom e>. Robinson, James et al. End of Managed Care.” Journal of the American Medical Association 285 (2001): 2622 Oct < http://webct.claremont.edu:8900/SCRIPT/CM_GOVT105_01_FA06/scripts/serve_hom e>. Enthoven, Alain C. “Where Are Health Care's ‘Hondas'?” Wall Street Journal Oct Nov < http://webct.claremont.edu:8900/SCRIPT/CM_GOVT105_01_FA06/scripts/serve_hom e>. Bodenheimer, Thomas and Kevin Grumbach. Understanding Health Policy. [...]
[...] On par with doctor dissatisfaction, a system hated so much by the American public has no hope of surviving, especially when this “backlash is merely the tip of an iceberg of hostility toward any entity that would substitute its own priorities for those of the individual citizen.” Now that we have addressed the trials and tribulations of managed care, it is wise to introduce the alternative, which will hopefully gain support as it is found to reverse or slow the advance of health care spending. [...]
[...] A order” in a managed care system means that a provider may not inform a patient about alternative methods of care or services provided by other doctors that are not in the health plan network. As shown in the PBS Frontline episode Dr. Solomon's Dilemma, the order” in place prevented a PCP from referring his patient to an out-of-network group of physicians that had the most experience treating her particular kind of cancer. The result: the woman dropped Dr. Solomon as her PCP and left the health plan to get treatment from the more experienced doctors. [...]
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