|2005 Healthcare Backgrounder|
By The People Backgrounder: National Healthcare Issues
What is the Nature of the Healthcare Challenge Facing the Nation?
Healthcare is also a major factor in our global competitiveness. The growing cost of providing healthcare poses challenges to our businesses, large and small. The cost of healthcare to employers climbed 12.4%- about five times the rate of inflation- between 2002 and 2003.
Healthcare Issues on the Table
Running through these debates are concerns about how to maintain quality healthcare, as well as how to share the financial burden. Another common thread in the discussion is the responsibility that government, businesses, and individuals should have.
Tackling the Rising Cost of Healthcare
Some say patients should shoulder more of the healthcare burden by taking on greater responsibility for health insurance costs through higher deductibles and co-pays. In this way, they suggest, patients will become more efficient healthcare consumers, getting only necessary treatments, buying lower-cost generic drugs, and thus lowering overall system costs. Critics warn that people, especially the poor, would delay or skip preventative and needed care, entering the system at its most expensive point—emergency care— and ultimately increasing costs.
Others say we should rely more on managed care, which lowers costs by limiting choices of doctors and drugs, promoting prevention, and reducing system inefficiencies through coordinated care. Critics worry that patients and doctors will lose decision-making ability and warn that the quality of care will suffer.
Still others say we should restrict government resources given to the system and force providers to become more efficient. Critics say the burden of these cuts may fall on the patients or lower the quality of care provided.
Finally there are those who suggest that the best way to reduce costs is through government involvement, either in the form of price controls or by introducing a national insurance system. Critics say that profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness than would be possible under a government-run system.
The Insurance Challenge: Responsibilities of Citizens, Business, and Government
Half of Americans say they worry a great deal about the number of uninsured people. Yet, we are still searching for solutions to the problem of providing Americans with coverage without sacrificing quality or overburdening our resources.
Some say government, not employers, should provide healthcare for all citizens. Supporters of this approach think we should move to a "single-payer" system, like the one in Canada.
Under this type of system, one government-run organization would collect all health care fees from individuals, and pay out all health care costs. Supporters say this would guarantee total coverage, relieve the burden on businesses to provide insurance, and save administrative costs. Critics warn this gives government too much control, and say that quality will suffer.
Others think there should be employer-mandated coverage so that all workplaces help cover their employees' health insurance costs. Critics note this would leave out the unemployed and self-employed. Large businesses say they are already overburdened by healthcare costs for their employees, and this approach would further negatively affect employment and their competitiveness in world markets. Small businesses say they would not be able to afford the new costs. (See text box below.)
Another option is individual-mandated coverage, which would require individuals to secure minimal coverage, perhaps funded with a tax credit. Critics warn that enforcement will be costly and the unemployed will require more government subsidies.
Another group believes that to continue covering the greatest number of Americans, our first priority should be to fix our troubled Medicare and Medicaid "safety net" systems. Medicare, the government system for covering the elderly and disabled, faces possible collapse. And Medicaid, the joint federal-state public system for the poor, is now the largest government health care program and is projected to cost $2.6 trillion over the next ten years. (See text box below.)
Finally, there are those who believe government, businesses and individuals should share responsibility for healthcare. While keeping the basic employer-as-insurer model, government could provide tax incentives for low-income families to make coverage affordable. Government could also be responsible for catastrophic care or other measures. And individuals not employed by large companies could be required to purchase minimal coverage.
Online NewsHour Transcripts:
May 3, 2005 -- Budget Proposes Medicaid Cuts The U.S. House and Senate passed new federal budget plans last week that will cut Medicaid spending by $10 billion over the next five years. A Senator and governor discuss the proposed cuts with Senior Correspondent Ray Suarez.
May 2, 2005 -- Tennessee Struggles with Medicaid Cuts Proposed cuts in funding to Tennessee's Medicaid program to help ease a state budget crisis stands to leave more than 323,000 people facing the possibility of losing health care coverage. Health Correspondent Susan Dentzer reports.
March 9, 2005 -- Disparities in Treatment Dr. Adewale Troutman, director of the Louisville Metro Health Department, discusses a new study he co-authored on racial and ethnic disparities in medical care with Ray Suarez.
© 2005 MacNeil/Lehrer Productions. All rights reserved.
Any publication or use of this material without the express permission
of MacNeil/Lehrer Productions is strictly prohibited.
|Copyright © 2007 MacNeil
/ Lehrer Productions.
All Rights Reserved. By The People is funded, in part, by: