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Rationale of Reimbursements

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Rationale of Reimbursements Systems Paper: Select one of the four health care payment systems (cost based, prospective payment, managed care based, or single payer. This system is what you will also discuss in Week 3 and Week 6.) Perform a literature search to find a professional journal article that discusses the rationale of your selected system. Summarizing the model. Conclude this overview with your critique of the system's effectiveness, strengths, and weaknesses. Paper, references and citations should be in APA format. The source should be from professional journals and/or government documents similar to those cited in the Selected Readings Page. Use at least three such references, one of which must be from the applicable era. (e.g. Medicare originated in the mid 1960's, managed care in the 1980s, etc.). This paper will be the initial portion (edited down) of your final assignment.

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The United States spends a greater percentage of its GDP on health care than any other country in the world. In addition, it also spends a greater percentage on per capita than any other country in the world. In addition, the USA is expected to spend an even larger percentage on health care in future. What is striking is that the USA is one country that does not have a universal health care system. Currently more than 80% of the Americans are covered under health insurance of some type. However, the US health card system has been plagued by inefficiencies. There are high transaction processing costs and the efficiency of consumer-to-provider payments is low. What is required is to reduce the transaction processing wastefulness.

The system being advocated by me is the single payer health care system. In this system those that provide health care like clinics, hospitals and doctors all get payments from a single source or fund. There are several developed countries that have used this system successfully. For example the Medicare system in Australia, the UK National Health Service and the Canadian health care system. In the single payer health care system there is one supply for paying health care providers. This supply of funds can be community-wide, state-wide or nation wide fund. The fund may be administered by a government or an insurance company.

In the USA the role of the fund provider can be played by a unit of the ...

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