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Managed Health Care: Health Care in American Law

Situation. Imagine you are traveling in a country where socialized medicine is the legal norm, and your discussion with a citizen of that country turns to the topic of your countries’ (the US) respective health systems. When asked, how will you account for the fact that health care is far from being a fundamental right rooted in American Law?

Introduction

Publicly funded medical services can be termed as socialized medicine where the privately run healthcare faculties are non-existent and the health sector is run by the government. In the U.S in particular, conservatives believe this to be a downward spiral for their country as they associate it with socialism. The awareness of a right to health is in part attributed to the growing awareness paid to financial, societal, and cultural rights, as well as the right to health, by the worldwide human rights society. The Commission on Human Rights decided to assign a Special Rapporteur on the rights of everybody to the satisfaction of the optimal practical bodily and mental healthcare. This has seen over the past five years no less than four health-related General Comments have been approved by the UN treaty bodies. (Leary 1994).

American health care system

Notably, the American health sector is by far the most expensive in the world with patients constantly struggling to foot their medical demands with spending being approximated at about 16% of the GDP. While healthcare is acknowledged as a fundamental human right in most countries, in America there is much opposition to it as witnessed by the action taken by 14 U.S states in filing a lawsuit to challenge President Obama’s signing of a healthcare reform bill in March 2010. Consequently, the signing of this bill into law elicited a sharp reaction with further 36 states passing laws that are against the objective of the health care reform law. (Reinhardt et al 2004).

There is the Patient Protection and Affordable Care Act, which is supposed to subsidize insurance premiums, bar rejection of claims based on existing circumstances, set up support for research, and widen the eligibility criteria for Medicaid. This is to be funded by the government through an array of new tax regiments. Critics of healthcare being rooted in American law argue that the patient protection act’s requirement for individuals to procure health insurance or pay tax and tax penalties levied on them is a usurpation of power by the U.S government terming it as against and in contravention to the Tenth Amendment to the Constitution under Article 1 (Blendon et al 1993).

Healthcare in America is far from being rooted in American law as critics of this argue that healthcare is not a definite right even though the government through politics and its policies tries to justify this and provide for it. Despite the government’s actions in passing amendments that satisfy a minority of citizens, it does not actually put everyone into consideration especially those without health insurance.

A high level of competition among players in the health sector can be said to be both advantageous and disadvantageous to both patients and health care providers, with the private sector playing a key role in the provision of insurance and health services apart from government programs such as Medicaid and Medicare. This creates the standoff witnessed between health providers and patients due to soaring medical costs. (Cutler & McClellan 2001).

However, critics of a socialized medical system, which is commonly in use in most parts of Europe, argue that this will be a major downfall for the American health sector and instead of benefiting American citizens, it will further cripple them. Havighurst (2010) argues that “…The U.S. legal system has been a major factor, for better or for worse, in creating the conditions that determined how American health care would evolve in the past half-century. In several watershed events, important implications of the legal changes were not recognized by the observant public, industry insiders, or even decision-makers themselves. Yet each of these events set in motion powerful economic and political forces that dramatically altered the face of the industry.”

A point to note is that politicians and private players in the health sector are constantly against basing the American health care system on the law and as a fundamental right due to the fact that the provision of public healthcare by the government will hinder citizens with private healthcare from accessing it. They argue that this will result in tot an increase in tax and inflation rates will go up, private health insurers will either offer low-cost premiums or discontinue offering their services to Americans on the free medical plans.

Key players in the American health sector are convinced that American families should be left solely to make their own choices regarding their medical decisions and healthcare plans. (Melnick & Zwanziger 1995).

Allowing the government takes over management of the healthcare sector in America, may not seem a wise decision as this will have restrictions on some medicine and medical services. This may be deemed to be expensive as witnessed in Canada, where a certain cancer drug had been banned and patients had to seek medical care from the U.S where it was available. This brings to light the contrast between medical systems – ‘socialized medicine’ in other countries and the medical system in America. Although it may be expensive to obtain health care services in the U.S, it still is a major move ahead for American citizens away from the past systems.

Recommendations

  • Financial incentives to health provision facilities and physicians to deliver quality service is a key and important aspect that can and should be initiated so as to cut down on rising medical costs that are as a result of providers charging extra just to cover their expenses and be able to stay in business;
  • Government should put in places reforms that will revamp Medicaid and Medicare public programs to curb fraud and delays and denials by private insurers in settling claims;
  • Education and enlightenment of Americans on their medical right to better and quality healthcare; and
  • HMOs should undertake corporate responsibility of medical services so as to control health care costs.

Conclusion

For better services and affordable medical services rates to be achieved for Americans who cannot afford the high costs, all stake holders and key industry players from the pharmaceuticals, government, health insurers and health providers should be involved. The U.S needs to initiate programs and policies that seek to deal with the rising cost of health care. Consideration should be given to concerns on management, society, team advancement, and information technology at all levels.

In addition, a number of dependent aspects influence these efforts, which must each balance a number of tradeoffs between centralization and decentralization in labors to uphold the drive for excellent development over time. Also multilevel modification structure and related properties present an outline for reviewing development along the way.

Reference list

Blendon, R., Hyams, T. and Benson, J. (1993). Bridging the Gap between Expert and Public Views on Health Care Reform, Journal of the American Medical Association, 269(19), 2573–2578.

Cutler, D.M. and McClellan, M. (2001). Is Technological Change in Medicine Worth It. Health Affairs, 20 (5), 11–29.

Havighurst, C. C. (2000). American health care and the law–we need to talk. Health Affairs, 19(4), 84-106.

Melnick, G.A., and Zwanziger J. (1995). State Health Care Expenditures under Competition and Regulation, 1980-1991. Arnerican Journal of Public Health, 85, 1391.

Reinhardt, U. E., Anderson, F.G., and Hussey, P.S. (2004). U.S. Health Care Spending In an International Context: Why is U.S. spending so high, and can we afford it. Health Affairs, 23(3), 10-25.

Leary, A. V (1994). The Right to Health in International Human Rights Law. Health and Human Rights, 1(1), 24-56.