Reform Proposoal #2

Medicare is the federal health insurance program that covers most people age 65 or older and some young people who are disabled or have end-stage renal disease are also eligible. Medicaid is a federal government program designed to ensure that the poor and children and pregnant women living under poverty level receive quality health care.

Our second health care reform proposal is to strengthen these current government programs because we have good programs that just need to be built up, not completely torn down.

If policymakers want to improve access to needed health care services then significant changes to Medicare need to be made. As the ratio of retirees grows in relation to the working age population, it will be more difficult to fund medical care for seniors. Strengthening Medicare will require modifications in several areas. Some ideas to get the best value from our health care include placing a priority on preventative care and chronic care management and making health care delivery more efficient by developing clinical practice guidelines that promote service utilization. To improve health care decision making it will help to support funding for quality research that will improve health care value and design systems that provide applicable, timely and actionable information that will help physicians provide the best possible care. Patients should also have support and incentives. This can be accomplished by reforming beneficiary cost-sharing so that patients have a single premium and deductible for all Medicare services. Also, providing subsidies to help low income beneficiaries meet their cost sharing duties and looking into facilitating more efficient and meaningful approaches to cost-sharing will provide incentive to patients.

The Centers for Medicare and Medicaid Services (CMS) oversees the program at the federal level, while the states deal with the day to day business. CMS and Congress should enhance oversight of the Medicaid program. Congress should consider requiring increased attention to fiscal accountability by requiring Health and Human Services to improve the demonstration review process.

Some people believe that the financing issue in our health care system is not as important as others because they consider quality to be the most important of the three legs in the three legged stool of health care; cost, quality and access. They argue that the type of care people receive is the main thing that should be in concern. This would allow people to receive better service and treatments. Although this is an important point, we disagree because nobody can even go in for care if they can’t afford it. People are denied service because they do not have insurance and people are living without any health care because they do not have the means to pay. If more people could afford care, the U.S. could start the transition from acute care to preventative medicine.

Instead of bashing the current system we have now, we need to work on a plan that will fix it and make it more beneficial for more people. Strengthening the current government programs will help to make insurance and health care more affordable for Americans.

Bridget Morgan

1. Shi L, Singh D. Delivering Health Care in America: A Systems Approach. Sudbury, Massachusetts: Jones and Bartlett Publishers; 2008.
2. Dawn, Ralph. Medical Eligibility/Coverage. Topic Collection: Medicare and Medicaid. U.S. Government Accountability Office. December 15, 2009. http://www.gao.gov/docsearch/featured/medicaid_eligibility.html. Accessed March 10, 2010.
3. Gleckman, H. Long-Term Financing Reform: Lessons from the U.S. and Abroad. The Commonwealth Fund. February 17, 2010. http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Feb/Long-Term-Care-Financing-Reform-Lessons-from-the-US-and-Abroad.aspx. Accessed March 8, 2010.
4. Strategies to Improve Medicare. American Medical Association. April 2008. http://www.ama-assn.org/ama1/pub/upload/mm/399/nac_strategies.pdf. Accessed March 10, 2010.
5. Kanof, M. Medicaid Program. U.S. Government Accountability Office. September 9, 2009. http://www.gao.gov/highrisk/risks/insurance/medicaid_program.php#needs. Accessed March 10, 2009.

Reform Proposal #1

Financing is the key when it comes to health care reform. With approximately 41 million people uninsured, it puts financial strain on the hospital and the patients. With the uninsured not seeking primary care, they are receiving much more expensive care in the emergency room. In order to lower overall cost, the option to having affordable health insurance needs to be available to all.

We propose that the government should more closely regulate prices of procedures and hospital visits, making it less expensive for all. Insurance companies could then cut cost of premiums and insurance plans. Currently, the system has no set prices for standard procedures and the prices vary throughout the entire country. This will allow competition between insurance companies.

Insurance should be available to all, however we feel that the American people should have a choice whether they want to pay for insurance or not. Some people may feel that they still can not afford insurance but do not qualify for government programs; in this case, the government will provide tax breaks that are comparable to the cost of insurance one could get through an employer. That way, those who are not insured still receive some help for medical needs. The government should also provide a type of temporary insurance for those who are between jobs. It will allow those who are between jobs to not worry about health needs while they are switching jobs.

If there is more affordable coverage, this will allow more people to become insured. If there are more people insured, this will increase the number of people using primary care. When people use primary care, they are more likely to practice preventive care rather than waiting until a condition gets very serious and expensive to treat. Overall, quality of life would increase. With more people covered, hospitals can decrease the amount of cost shifting that is going on, making health care all around more affordable, even for those who could afford insurance in the first place.

Financing is the most important part of the health care system. If health care is too expensive, no one would be able to access health care. However, if health care had no money coming into the system, it is a good guess the care received would be less then satisfactory. There needs to be some balance between access, cost and quality. Financing is therefore the most crucial part of the health care system and must be closely monitored to make sure the system is working efficiently.

Mindy Opelt

1. Shi L, Singh D. Delivering Health Care in America: A Systems Approach. Sudbury, Massachusetts: Jones and Bartlett Publishers; 2008.
2. Health Care Crisis. PBS. Available at: http://www.pbs.org/healthcarecrisis/ uninsured.html. Accessed February 28, 2010.
3. Financing Health Care Reform. The New York Times. 2009. Available at: http://www.nytimes.com /2009/07/07/opinion/07tue1.html. Accessed February 28, 2010.
4. Antos, J.PH.D. Financing Health Care Reform. 2009. Available at: http://www.aei.org/docLib/Antos.pdf. Accessed: February 28, 2010.
5. Quick Facts on the Uninsured. Cover the Uninsured. 2009. Available at: http://covertheuninsured.org/content/quick-facts-uninsured. Accessed: February 28, 2010.