Dominant Issues In Healthcare

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1.) Cost containment

The concern for cost containment in health care is growing as exponentially as the cost of health care in the United States. According to the World Health Organization, The United States spends about 16% of its GDP on healthcare alone [http://www.who.int/whosis/whostat/EN_WHS09_Full.pdf]. Based on the pattern of growth of healthcare expenditure since the 1970, economists and statisticians predict that the US will spend almost 20% of its GDP on healthcare by 2017 if we do not implement a method to contain costs [Howard L. Smith, Myron D. Fottler and Borje O. Saxberg. Cost Containment in Healthcare. The Academy of Management Review Vol. 6, No. 3 (Jul., 1981), pp. 397-407]. Further, without intervention, the rapid rise of healthcare costs have the potential to bankrupt the country.

While soaring healthcare costs are an issue in and of itself, there are certain political and economic mechanisms (and, of course, with the addition of time) that can alleviate the issue. For example, any economy seated in the uncertainty of a capitalist society is subject to market fluctuation and therefore inflation and deflation of costs. Thus, as the economy ascends from recession, the cost of healthcare will decrease. Also, unrest among the uninsured and underinsured have and will continue to force change in health care policy, which will be geared towards lowering the cost of healthcare. Cost saving legislation would be in the best interest of citizens as well as the government; government subsidized programs (Medicaid and Medicare) absorb an enormous amount of the cost of emergency services to the uninsured and underinsured. With the wheels of government and economic fluctuation in place and, slowly but surely, turning, there still remains a dominant problem. While tiny incremental changes take place, employers are rapidly losing incentive to provide quality managed care plans to employees. Rising healthcare costs increase the desirability of insurance plans. Rather than negotiate contracts in favor of the employees, it is becoming easier and more cost effective for employers to obtain cut rate managed care packages. Insurance providers know that the market for their product is high, and they can get away with managed care packages that favor profitability rather than quality for the beneficiary.

Ideally, employers would become a vector for health and wellness. Businesses could allocate funds and resources toward individual health management and target efforts to encourage lifestyle changes. Some examples of employer encouraged health and wellness initiatives are:

? Disease management (for at-risk employees or employees undergoing initial treatment)
? Financial incentives for behavior/lifestyle modification
? Employee education on healthcare matters
? Greater cost awareness by making provider costs more "visible" to participants (e.g., providing incentives to employees who discover inaccurate billing)
[http://www.gfoa.org/downloads/corbaHealthCareCostContainment.pdf]

This plan, unfortunately, would create a dichotomy of well and unwell corporations. For e.g., Google might have the funding to provide their employees with a phenomenal health and wellness program, while a small bakery might not. What is needed and what would be more realistic is a solution implemented at the federal level in order to ensure equity. Such a solution would consist of healthcare cost sharing between individuals and the federal government. Though it seems like this might increase government spending, it will not. With the burden of cost on the individual, s/he recognizes the risk of poor health. This will give citizens the incentive to take advantage of preventative care measures and it will cause them to value health care services rather than absent mindedly overuse them.

2.) Increased Access

A brief glance at the history of health in America reveals a steady increase in life expectancy, a ...