Term Paper: Healthcare Policy

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[. . .] However, if their child is on Medicaid they will usually take their child to the doctor for proper screenings and checkups. Medicaid has been expanding, and the plan was for all children who were under 18 years of age and living in families that had incomes below the official U.S. government poverty line to be eligible for Medicaid. It is also worthy of note that underinsurance and uninsurance rates tend to be higher among younger adults.

There is some debate as to whether this is caused by lack of money to pay for insurance, or whether it is caused by unwillingness to purchase insurance when these people feel they are at a very healthy age. Over 22% of individuals in this country who are between the ages of 18 and 34 do not have health insurance. That number seems to drop as age goes up. It is also true that Caucasian individuals are more likely to be covered by employer-sponsored insurance then those of minority status. Unfortunately, many of the businesses around today that employ younger workers do not offer health insurance for these people, either because the workers are part-time, or because the firm is too small to be able to afford health insurance for their employees.

If they did offer health insurance, it would cost so much to each employee that it would not benefit them to purchase insurance. With some of the insurance rates available, it is often cheaper for individuals who must go to the doctor to simply pay for the doctor visits and prescriptions than it is to continue paying health insurance premiums. Especially in the younger generation, this attitude seems to be more prevalent. This is likely due to the fact that many younger individuals will work for quite some time and pay into insurance premiums that they will never use because they do not have chronic conditions or other problems that they may develop as they get older.

The health-care market is changing, and managed care organizations are becoming very prevalent in the insurance market. Many of them are replacing private insurance companies, and although the benefits are often not quite as good as private insurance benefits were, it is true that the premiums and deductibles are often much cheaper. There are some drawbacks to some of these organizations, however.

The main drawback is that there is a specific list of doctors that a person must choose from. They cannot simply go to any doctor or hospital that they wish. There is also the fact of needing a specific referral to go to a specialist. Private insurance does not always require this but HMOs, PPOs, and EPOs, which are all different types of health maintenance organizations often feel that they will not pay for a visit to a specialist unless it is authorized by the go family doctor and accepted by the health organization before the patient visits the specialist.

Medicaid is expanding as well. They are trying to make sure that everyone who needs health-care coverage in the United States gets it. The problem with this is that Medicaid often does not cover very much. It will cover the basics for children, and it will cover doctor visits and most prescriptions. It will not cover glasses or dental work, which many children need. Often, these children go without vision or dental work because the insurance that they have will not pay for it. Medicaid only covers the very basics, and while that is certainly better than nothing, it is not as good as having a good private insurance policy.

Originally, comprehensive health reform had been planned. That has been put on the back burner, but support for the smaller, incremental reforms at both the state and national level still remains. The desire is to significantly decreased or wipe out completely the number of uninsured and underinsured people in the United States. It is difficult to say whether or not these reform ideas will actually make much difference to many of the people that cannot afford insurance now.

Some of the reform ideas look good on the surface, but when digging a little bit deeper they don't look as good as they do at first. For example, one thing being look at was a guaranteed issue provision that would help with things like pre-existing conditions and other issues that stop some people from getting insurance. It would also help those who have small groups of workers and those who are moving away from group coverage and cannot afford individual coverage.

These provisions would allow these people to obtain insurance, where many of them now cannot. However, there would be no specific cap on what kind of premiums could be charged, and because they could charge whatever they want it is possible that the same people that this provision allegedly is attempting to protect would actually not gain anything because the insurance that they were now able to buy would not be affordable to them.

The biggest problem pointed out by this study is that having a job does not mean that health insurance is available. Of the uninsured individuals in the United States, around 80% are working. Three-quarters of these people are working full time. This means that those who go around talking about lazy people on welfare wanting the state to pay for their medical coverage need to stop and look again.

Many of the people who are getting state coverage or getting no coverage at all are working and trying to support their families in the best way that they can. Insurance premiums are so high that many of these people who make slightly too much to qualify for Medicaid cannot afford to purchase insurance of their own. Their choices come down to feeding their children or insuring their children. They choose to feed them in the hopes that will be enough for now, but it doesn't stop them from worrying.

The uninsured and the underinsured in the United States can be almost anyone. Most of them are working class, average individuals who are decent, honest, and just trying to get by. They are undoubtedly frustrated that they cannot afford health insurance for themselves and their families, and many of them are mad at the government because so much money is taken from them in taxes that they can hardly pay their rent, but yet they can't qualify for Medicaid because they make too much money.

Further government intervention is definitely necessary to help those in the most need of health-care. While many individuals feel that the government has done enough, there must be something else they can do to help these individuals out. It seems as though there should be a way to improve the Medicaid system so that those who are actively working, and can prove that they are actively working, can get proper medical coverage even though they make a little more money than what Medicaid allows them to make currently.

Some countries have government run health insurance, and although it has some drawbacks it has one large benefit: everyone in the country has insurance. This would stop individuals who have a great deal of money from having excellent insurance that covers everything while individuals who are working hard but not making a lot of money have only Medicaid, or sometimes nothing if they make too much money for Medicaid to grant them insurance.

At the very least, the gap between Medicaid and other insurance should be narrowed so that those who cannot qualify for Medicaid actually make enough money to be able to afford insurance through their employer or through private organizations. This would be relatively simple to do, although the government is concerned with the costs behind such a measure. However, hospitals cannot refuse treatment to those who really need it, and many of these people cannot pay.

If they had Medicaid the hospital would at least get some money from treating them, as opposed to getting nothing at all. It is a consideration for state and local governments to examine, as well as a consideration for the federal government in the form of a government-run national health-care plan similar to what a few other countries have.


Kaiser Family Foundation. 1997. Many working families struggle to get needed care and pay medical bills [online]. Kaiser Family Foundation; available at http://www.kff.org/archive/health_policy/uninsured/working/workingpr.html; Internet; accessed 31 March 2003.

Kaveny, M. Cathleen & Keenan, James F. 1995. Ethical issues in health-care restructuring. Theological Studies 56 (March): 136-150.

Kaiser, 1997.

Darnell, Julie, Rosenbaum, Sara, Scarpulla-Nolan, Lea, Zuvekas, Ann & Budetti, Peter. 1995. Access for low-income, inner-city, minority populations [online]. Center for Health Policy Research, The George Washington University; available at http://www.handsnet.org/Medicaid/gwu97.htm;Internet; accessed 31 March 2003.

Darnell, et. al, 1995.

Smith, Howard L. 1994. Healthcare reform perspectives of rural and urban hospital leaders: Issues and attitudes. Hospital Topics 72 (September): 20.

Darnell, et. al, 1995.

Rode, D. 1991. Considering charity care policy and procedure. Healthcare Financial Management… [END OF PREVIEW]

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