the ethics of non-employer and non-government-based healthcare insurance alternatives.
Employment Health Care Insurance and Alternatives
It is important to view the stabilization and declination practices that have been witnessed in the recent past specifically in the employment sector and health based insurance. Such facts emanate from various challenges that have been attributed to result due to the improper management system in the health insurance service and system of governance. It gets argued that the healthcare that exists today is not the real one that used to function in the previous years before the inception of world war two.
Various adverse impacts as Goldhill asserts have characterized the current healthcare insurance. Goldhill highlighted from experience and tragedies of death witnessed that the current employment and government health care is not geared towards servicing the citizens by providing quality services in the medical field. The author added that the current jobs and government health insurance are less concerned about the customer’s wellbeing, managing their cost of spending, transparency, and get seen to be wasteful in their dealings. The government of America has displayed a high level of poor administrative cost or spending, inability to provide for a considerable percentage of people, disparities in sharing the cost, enhancing labor-management conflict, and failure to inculcate the employers to work together towards the improvement of the healthcare and reduction of the cost effectiveness.
As the healthcare service continues to erode and becomes a liability in our country’s economy, there should be an application of comprehensive trajectories and complete system of administration that will help the future of the healthcare services (Goldhill, 2009). However, it should be acknowledged that no other system has emerged to replace the inexorable move towards the extinction of better services of the healthcare that got witnessed during its earlier inception. Health economists have gained insight on this, and numerous debates are nowadays initiated to ascertain the possible reduction in better performance index that has gotten witnessed in employment healthcare services.
This essay will conceptualize on the chronological history of the healthcare and employment-based health insurance services since its inception before the world war two up to date. Additionally, the paper focuses on possible and recommended alternatives that we should employ if we are focused towards serving the lives of many, as this will enable the country and its economy to get elevated immensely (Goldhill, 2009). As one focuses on our present trend in health insurance service, it is evident that the best alternative and models that we should embrace even without necessarily inciting the government through lobbying are those that Goldhill projected. The paper projects the critical issues at stake within the employment and government based health insurance (Bradley & Neumark, 2011). This aspect gets achieved by crystallizing the history of medical insurance and explaining how the country America got into this system. Present trends will vividly get examined and a conclusion arrived at by depicting the future healthcare insurance that the United States should employ to cater for almost all the Americas citizens.
In the past years just before world war two, many individuals especially the people of America paid their personal medical insurance directly or indirectly through their service providers. At the dawn of 1930, the inception of the blue cross that served as the non-profitable health insurance entities got initiated. It worked on the principles of offering citizens with health services at a fixed fee (Goldhill, 2009). By those days, health insurance was indeed a viable insurance entity that provided only the critical coverage of hospitalization bills that citizens could not easily afford to pay for themselves.
Almost all the other expenses got paid from an individual’s pocket directly to service providers. As time went by, the practice of employers paying for the healthcare insurance of their employees by the money that emanated from the employees taxable income arose. The Second World War made a great period of economic depression in many parts of the world and, therefore, wages got totally frozen due to the impacts of the war in the nations where it got experienced (Goldhill, 2009). The shortage of workers became paramount and to attract more workers, payment healthcare insurance was made prominent. This practice was greatly advantageous for the group insurance but not for individual employees and hence it gained a lot of concern among workers and the entire American population. The mid 1945 witnessed a dramatic increase in the number of the United States citizens who had gained access to the medical insurance.
The number rose dramatically to 77 percent by around 1963. This figure was equivalent to more than half of the employees population who had access to hospital insurance. By 1980, the employment health insurance reached its peak. Surprisingly enough, it has been declining since 1980. The Employee Benefit Research Institute (EBRI) asserted that hospitable coverage among the employees of ages 18-64 has declined to 2.8 percent between 1987 and 1999. Conversely, they also depicted that the number of workers that got covered by the hospital insurance was seen to have reduced by 3.5 percent since 1999 to 2004. The above data and statistics clearly indicate that the best days of the employment healthcare insurance got witnessed in the past and has continued to decline as years elapse (Goldhill, 2009). This factor is because it has displayed certain downfalls in the manner in which it renders the lives of individuals at stake and the extravagant nature that lowers the country’s economy.
The transformation that took place in the employment health insurance from being quasi-social insurance to a level of attaining actuarial principles is a factor that should get noted in the history of medical insurance (Evans, 2002). The latter level of transformation asserts that insurance should get geared towards protection of emergent and unpredictable risks that individuals or a group might encounter. It has precepts that premium will always get adjusted to the intensity of the risk. In social insurance, citizens or groups who are using the medical care do not have to pay for an additional premium since the outlying costs get shared equally and collectively (Goldhill, 2009). More so, those that are vulnerable to lower risks will subsidize individuals susceptible to higher risks.
The present: Employment healthcare based insurance has taken a different course over the recent past. The system has reshaped its form of administration since great competition has gotten witnessed because of the numerous firms that have come up (Goldhill, 2009). The present regime of the payment and government healthcare get attributed to many challenges that according to Goldhill is described as a system geared towards gobbling the nation’s resources rendering underdevelopment in our contemporary societies.
To date the system has been seen to demonstrate high administrative cost, inadequate coverage of the population, and inefficient allocation of costs. These factors depict the manner in which employers to some extent are the key players and beneficiaries since the inception of healthcare insurance services in employment. Just as Goldhill, (2009) projects, government based insurance has displayed the highest level of extravagance rendering it less competitive in the market with the inability to cater to their customers and misaligned incentives.
Administrative cost: Notably, the administrative spending encountered among the employment healthcare insurance is too high and employed a high level of extravagance. This aspect results from the overwhelming rise of many vulnerable systems and companies that sell and possess contracts with various employers since there is a high number of employees currently in the United States. This strategy increases the cost of administration comparatively (Goldhill, 2009). It has increased the cost of government insurance to approximately eleven percent with the exclusion of the cost the employers always incur in management, consultation, and brokers incentives. Therefore, government and the healthcare insurance agencies for employees have taken the forefront in increasing the cost of their services while maintaining inadequate services given to the workers.
According to Weeks (1979) many lives have gotten lost through the poor strategies employed by the insurance as well as the high costs of administration, which shrinks the pockets of everyday citizens. Due to low-quality services rendered to customers by the government, many individuals have resorted to private entities where better facilities exist on a lower and reduced price tag (Friend and Kohn, 2007). Some employees have devoted their time to join the community-based health insurance and prepayment health insurance where they get assured of sufficient services.
Allocation of costs: Over the past years, the cost of the employment-based healthcare has been passed off to workers in a manner that is not equitable. In the market full of stiff competition, lower wages emanate from the employers contributions. Irrespective of the increased productivity rate, wages have not advanced in the recent past. Such is because higher paid employees usually pay reduced tax as compared to those low paid employees. This strategy renders the low-class individuals within the society a great burden since they get exposed to heavy taxation beyond their capability.
Ineffective Labor Management: The Government and employment healthcare insurance has played a crucial role in inefficient labor management and the bankruptcies that have entrenched our societies. This aspect is because it interferes and disrupts mobility, what is commonly known as the job lock. As a result, this practice disrupts labor management and well-founded decisions by businesses/enterprises and individuals. In the process of employers attempt to impose the insurance cost to the workers or their subjects, they employ certain painful strategies that entails reducing the wages and increasing the taxable amount on each employee’s salary (Goldhill, 2009). The government or employment healthcare insurance, therefore, results in insecure and weak management and labor relationship.
The above factors vividly depict that even our present system of healthcare insurance services is not efficient. Goldhill, therefore, projects various alternatives that a business and government should employ to help raise the living standards of an individual as we foster higher economic developments (Evans, 2002). He argued that the healthcare crisis should be addressed critically to help save lives of many as this factor has led to the loss of lives including his father. He discourages the system the United States has employed over time that develops the healthcare insurance with incentives that unavoidably results to terrible results. Such incentives will emphasize on healthcare more than they should do to ensure the well-being of citizens. He advocated for an incentive that embraced prevention rather than treatment of the illness.
The author discourages the favor and complex practice that prevails in the healthcare sector and, therefore, advocated for transparency and equality in the services offered by the federal government in his area. Weeks (1979) believes that to attain the healthcare insurance services for security the federal government should start from the health system by initially addressing the problem of incentives. Healthcare insurance will have a top display because a key aspect that has worked to ensure the efficiency of the country’s economy. Therefore, the role of insurance should be reduced rather than expanding it. The government should exclusively focus on the problems they can address that get geared towards raising the level of our economy. These aspects may range from protecting us against hazardous events and catastrophes, protecting the citizens, foster safety standards as well as ensure adequate provider competition. The system of single payment has worked well in many developed countries. This system has helped reduce the extravagant nature of the government and its agencies.
The author also analyzes that subsidies should be substantially reduced to cater for every individual in the society. Lowering the subsidies will ensure that employees with low wages best suit the fixed price of the insurance fee (Goldhill, 2009). The federal government should also increase the salaries of the low earning employees for them to get ample time in paying the already increased price of the insurance. Employees should be advised to create mall wellness initiatives that will help in building a supportive workforce among the employees.
The author talks of the cost reduction that has been common among the healthcare insurance agencies in the United States. He proposes an alternative to better reforms that will help in controlling the balance and overspending that are witnessed in the medical insurance sector by the employers (Goldhill, 2009). The price should be fixed but not the cost. The government usually cuts costs as compared to reimbursement price. Therefore, they have been paying their services at a less cost as compared to private insurers. Performing a single server payment can help reduce the cost of administration and this aspect will enable the population have equality and reduction in daily spending.
Employment and government healthcare have displayed high levels in raising the performance levels among the common citizens as well as the state politicians. Since its inception, it has shown greater improvements even though the bigger gap remains that needs to are bridged to practice it in a more liberal manner that will ensure every individual in the society benefits from the strategy. Goldhill has been at the forefront in analyzing the future of healthcare insurance putting into an account the existing trends. He designed particular current policies that needs to be inculcated in healthcare if it is to be effective shortly. The old employment health insurance cannot gain any appraisal from anyone. No one can ever respect its system as it got termed as being an impediment to attaining success with regard to the country’s economy and the general well-being of citizens. Goldhill projects a scenario where his dad died due to inadequate hospital insurance and suggested that he sees the lives of many citizens in America endangered. Indeed, we should inculcate Goldhills alternatives in our current health employment health care insurances.
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Bradley, C., & Neumark, D. (2011). The effects of health shocks on employment and health insurance the role of employer-provided health insurance. Cambridge, Mass.: National Bureau of Economic Research.
Evans, R. G. (2002). Financing health care: taxation and the alternatives. Funding health care: options for Europe, 1, 31-58.
Friend, M. and Kohn, J. (2007). Fundamentals of occupational safety and health. Lanham, Md.: Government Institutes.
Goldhill, D. (2009). How American Health Care Killed My Father. [online] The Atlantic. Available at: http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/ [Accessed 9 Dec. 2015].
Weeks, L. (1979). Financing of health care. Ann Arbor, Mich.: Health Administration Press.