HCAD 500The United States Healthcare System and Proposed Ref, Lecture notes of Accounting

Download HCAD 500The United States Healthcare System and Proposed Ref and more Lecture notes Accounting in PDF only on Docsity! HCAD 500 The United States Healthcare System and Proposed Reforms American Military University HCAD 500 The United States Healthcare System and Proposed Reforms Among advanced developed nations, the United States healthcare system is unparalleled. The United States lacks a uniform healthcare system, does not have universal healthcare coverage, and has recently passed legislation requiring nearly all healthcare coverage. The US health care system is best characterized as a hybrid system, as it does not operate a nationwide health service, a singular national healthcare insurance system, or even a multiple payer universal healthcare insurance fund. As the US’s healthcare system is widely inequitable and ignores preventive and primary care, the government should consider reforms to match other developed nation's healthcare systems, such as Germany. Therefore, we compare the United States' healthcare system to other advanced developed countries, emphasizing high healthcare rates and insurance coverage gaps in the United States. Also, we will then go over some popular approaches used in other countries to reduce healthcare costs, looking at the German healthcare services as a framework for non-centralized universal coverage, and compare the standard of healthcare in the United States. Health Care Spending In 2014, private funds accounted for 48 percent of healthcare spending in the United States, with individuals accounting for 28 percent and private companies accounting for 20 percent. The central government was accountable for 28% of expenditure, whereas state and local administrations were accountable for 17%. Even if the government subsidizes it, most health care is provided privately (Branning & Vater, 2016). In 2014, approximately 283.2 million persons in the US had health insurance, accounting for 89.6 percent of employees, with up to 66 percent of employees covered through a private insurance plan. In 2014, the US government provided coverage to 115.4 million individuals, or 36.5 percent of people, through Medicare amounting to 50.5 million, Medicaid amounting to 61.65 million, and military care or Veterans Administration mounting to14.14 million. However, an individual covered by several government plans. In the United States, almost 32.9 million people lacked health insurance in 2014. Health Care Cost Drivers in the US The main reason American citizens give for having difficulty getting health care is the exorbitantly high cost. American low earners are expected than their foreign counterparts to admit not consulting a doctor. At the same time, they are sick, not having a prescribed medical investigation, drugs, or continuation care, not filling a prescription, and not seeing a dentist. In the United States, 59 percent of doctors admit that their patients have financial difficulties. Branning and Vater (2016) state that, in 2013, 31 percent of uninsured adults said they did not get or delayed hospital services because of the cost, equated to 5 percent of adults who were privately insured and 27 percent of those with public insurance, such as Medicare and Medicaid. Although there is no apparent reason for increasing healthcare costs in the United States, analysts have described three contributing factors. First is the expense of emerging technology and prescription medications. The proliferation of more expensive, modern medical technology and medications drive health care expenditures for production costs. These create the need for more intensive, costly care services, even though they are not inherently cost-effective. Pharmaceuticals and several other non-durable medical services cost the United States $1,026 per capita in 2013, over double the OECD estimate of $515. The rise in chronic illnesses, such as obesity, is another reason for rising costs. Chronic disease-related healthcare costs account for a significant portion of overall healthcare costs, especially at verge-of-life healthcare. Sick individuals in their final years of life contribute for time employees without insurance fell to 17.7%, down from 24% in 2013. The uninsured rate for those who did not work for about one week fell from 22.2 % to 17.3% in 2014. Smaller businesses are also less likely to offer health insurance to full-time or part-time employees. In 2015, about 56 percent of small businesses, with 3-199 employees, provided health insurance, relative to 98% of large businesses. Since the ACA permitted more young adults (19-25) to stay on their parents' insurance plans, the number of covered young people increased statistically significantly from 68.3% in 2009 to 82.9% in 2014 (‘Department for Professional Employees, 2016). The number of young individuals aged between 26 to 34 years who had insurance rose from 70.9% to 81.8 percent during the same period. Children and minorities are disproportionately represented in the uninsured population. In 2014, 7.6% of non-Hispanic Whites were not insured, 11.8% of Black Americans were not insured, 9.3% among the Asian population were not insured, and 19.9% of Hispanics were uninsured. According to the Department for Professional Employees (2016), approximately 80% of the uninsured are residents of the United States. In 2014, 6% of children lacked health insurance. These kids are significantly more likely than insured kids to have unsatisfied medical needs, and they are five times more likely to go for over two years without consulting a physician. For the same coverage, females in a particular market also paid higher premiums compared to men. The ACA, which went into effect in 2014, prohibited this practice and limited coverage to those with pre-existing disorders. Within 2014, 19.3% of people living underneath the poverty threshold ($23,550 annually for a four-member family) lacked health insurance. As per the Department for Professional Employees (2016), 90% of uninsured people have family incomes less than 400% of the poverty threshold. This qualifies them for subsidized insurance via tax credits or extended Medicaid coverage through the ACA's state health exchanges. Healthcare System in Germany In terms of both cost and quality, Germany is among the best healthcare systems in the world. Its public insurance choice is made up of 240 different insurance companies. The non- profit "sickness funds" collectively support 90% of Germans, and the remaining 10% mostly being higher-income individuals, opting for private medical insurance (Busse et al., 2017). Healthcare expenses per person in this framework are below half of what they are in the United States. The system's specifics are instructive. The country does not depend on a consolidated, such as Medicare health insurance scheme, but instead on private, for-profit, or non-profit insurers tightly controlled to work towards desirable social ends. It is a choice that may have more momentum in the current political climate in the United States. The total insurance premiums to the country's sickness funds are about 15.5 percent of an employee's gross salary, with an income limit of $62,781. Both employers and workers contribute roughly fifty percent of the premiums (Woolf & Aron, 2013). In most cases, an individual employee contributes 8.2 percent of their salary, covering the other 7.3 percent. Premiums are also not affected by an individual's relationship status, family structure, or wellbeing and are not dependent on risk. No low co-pays and deductibles are common in Germany. Doctors are self-employed individuals whose insurance companies pay for each appointment and operation they conduct. They are, however, strictly governed. Each area has groups of workplace physicians who discuss annual budgets with insurers. Doctors must stick to their budgets because they would not be compensated if they exceed them. This helps to control healthcare costs by discouraging unnecessary procedures. In addition, the average German physician earns about $123,000 a year, which is around a third less than in the United States. Government general taxpayers fund cover children's premiums, based on the assumption that they are the next generation that will have the fiscal responsibility of the entire country, rather than just the parents. When prescription drug prices started to increase, Germany changed its prescription drug coverage in 2010. Before the amendments, pharmaceutical companies were free to set their prices on new products. They were not forced to demonstrate that the new medicine was superior to previously approved generic drugs (Kifmann, 2017). Manufacturers would dictate the price within the initial 12 months for a new drug market, owing to legislation that went into effect in 2011. A new method of benefits evaluation would start immediately after the medication becomes released into the market. Manufacturers must show that the new medication provides more effective treatment than the current standard treatment by comparative effectiveness testing. Drugs that do not have an additional value would be reimbursed based on a government price list. Patients can get new medications with no additional benefits, but they must take responsibility for the price difference. A premium would be agreed between the manufacturer and health insurers for medications with additional benefits. Recommendation for Healthcare System Reform The healthcare professionals in the US are among the finest in the world. Treatment in the United States, on the other hand, is inequitable and ignores preventive and primary care (Anderlini, 2018). In contrast to other advanced developed countries, the United States' healthcare approach has resulted in poorer health. The United States' healthcare system should consider reforming an all-payer system or multi-payer healthcare insurance system that provides universal health coverage through