HMO
The American Health Care system has prided itself on providing high quality services to the
citizens who normally cannot afford them. This system has been in place for years and until now
it did a fairly decent job. The problem today is money; the cost of hospital services and doctor
fees are rising faster than ever before. The government has been trying to come up with a new
plan these past few years even though there has been strong opposition against a new Health
Care system. There are many reasons why it should be changed and there are many reasons
why it shouldn’t be changed. The main thing that both sides heads towards is money. Both sides
want to save money just in different ways.
The movement for changing the Health Care system believes that there is a need for change
because of the problems that the system faces today cannot be handled. Every month, 2 million
Americans lose their insurance. One out of four, 63 million Americans, will lose their health
insurance coverage for some period during the next two years . 37 million Americans have no
insurance and another 22 million have inadequate coverage . Losing or changing a job often
means losing insurance. Becoming ill or living with a chronic medical condition can mean losing
insurance coverage or not being able to obtain it. Long-term care coverage is inadequate. Many
elderly and disabled Americans enter nursing homes and other institutions when they would
prefer to remain at home. Families exhaust their savings trying to provide for disabled relatives.
Many Americans in inner cities and rural areas do not have access to quality care, due to poor
distribution of doctors, nurses, hospitals, clinics and support services. Public health services are
not well integrated and coordinated with the personal care delivery system. Many serious health
problems -- such as lead poisoning and drug-resistant tuberculosis -- are handled inefficiently or
not at all, and thus potentially threaten the health of the entire population. Rising health costs
mean lower wages, higher prices for goods and services, and higher taxes. The average worker
today would be earning at least $1,000 more a year if health insurance costs had not risen faster
than wages over the previous 15 years . If the cost of health care continues at the current pace,
wages will be held down by an additional $650 by the year 2000. More and more Americans
have had to give up insurance altogether because the premiums have become prohibitively
expensive. Many small firms either cannot afford insurance at all in the current system, or have
had to cut benefits or profits in order to provide insurance to their employees. Those problems
are just with the system, the main part of the problem comes from the insurance agencies.
Quality care means promoting good health. Yet, the agencies waits until people are sick before
they starts to work. The agencies are biased towards specialty care and gives inadequate
attentions to cost-effective primary and preventive care. Consumers cannot compare doctors and
hospitals because reliable quality information is not available to them. Health care providers
often don't have enough information on which treatments work best and are most cost-effective.
Health care treatment patterns vary widely without detectable effects on health status. Some
insurers now compete to insure the healthy and avoid the sick by determining "insurability
profiles" while they should compete on quality, value, and service. The average doctor's office
spends 80 hours a month pushing paper. Nurses often have to fill out as many as 19 forms to
account for one person's hospital stay. This is time that could be better spent caring for patients.
Insurance company red tape has created a nightmare for providers, with mountains of forms and
numerous levels of review that wastes money and does nothing to improve the quality of care.
America has the best doctors who can provide the most advanced treatments in the world. Yet
people often can't get treated when they need care. The medical malpractice system does little
to promote quality. Fear of litigation forces providers to practice defensive medicine, ordering
inappropriate tests and procedures to protect against lawsuits. Truly negligent providers often
are not disciplined, and many victims of real malpractice are not compensated for their injuries.
Purchasing insurance can be overwhelming for consumers. With different levels of benefits,
co-payments, deductibles and a variety of limitations, trying to compare policies is confusing and
objective information on quality and service is hard for consumers to find. As a result, consumers
are vulnerable to unfair and abusive practices.