A Patient Advocate's View

What’s Wrong with the American Health System?

What’s wrong with the American Health System? Misinformation-Disinformation and Lies. The American People, including most of our lawmakers do not understand how the health system works.

There are two parts to the American health system ,the delivery of care and the financing of care. In other countries there is only one answer to “how do we deliver care and how do we finance it?” In the US there are many thousands of answers.

In the US, the delivery of care is regulated by the Department of Health  and the Department of Education in each State. Health Care providers are licensed to provide a defined service under a set of rules which include obtaining a level of education and experience and maintaining the proper facility and equipment. It is this part of the system that we point to when we say the American Health System is the best in the world.

However, the Financing of Care is regulated in many different ways. The Federal Government funds and creates the rules for Medicare. Each State receives some funding from the Federal Government for Medicaid coverage of the poor, while the State and Local Governments create the rules under which they will pay for that care.

Most people in the US get their coverage through private insurers, either through their employer or through an individual policy. Insurers can define the delivery system they will pay for, as long as they abide by the rules of their State for licensing of health providers and minimum regulations for reserves, showing that they can pay for the services they offered in their policy.

The Affordable Care Act (ACA) seeks to refine the guidelines underwhich States receive Federal Funding for Medicare and Medicaid and to mandate minimum standards for private insurers. It also intends to raise revenue to fund the changes through a new tax.

There is no question that it is a complicated system for which those who are healthy and have coverage are perfectly satisfied. It only becomes a problem when you are sick and need to find funding for your care. The opposition’s suggestion as to an alternative to the ACA is to allow the purchase of insurance across State lines, which would nullify the protections established by the State who represents the needs of their constituents.

Their other suggestions is to reform the laws under which a patient could receive damages in the case of malpractice. Their claim is that providers could lower their costs, which may be true to some extent, but is defensive medicine the only driving factor in rising health care costs?

As a small business owner, I am disappointed that the reform path chosen by our Government did not provide for a Public Option or even better for the Single Payer system that works so well for other countries.  I am angry about the new tax.  I would agree to pay for getting a comprehensive coverage package and to pay for my share of protecting the poor, however I do not see the ACA accomplishing this.

I am happy that there is a discussion about what our health care system needs because I don’t see either side laying down their misinformatiom-disinformation and lies long enough to find a solution to our funding problems.

Written by Caryn Isaacs, Patient Advocate and Health Policy Expert. Reprinted from LinkedIn group; Adult Children Caring for Aging Parents, discussion started by Ray Ashton 2nd, Founder, STAR Preventive Wellness – CEO, AFFECTS LLC Houston, Texas Area

July 23, 2012 - Posted by | Uncategorized | , , , ,

No comments yet.

Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: