Health Care System Reorganization
All of our citizens are entitled to universal health care coverage that guarantees access on a need basis rather than income.
It is a fundamental human right and an important measure of social justice. Governments should play a central role in regulating, financing, and providing health care. Everyone faces the possibility of ill health.
Risks should be shared widely to ensure fair treatment and fair rates, and everyone should share the responsibility for contributing to the system through progressive financing.
Health care costs are rising. Over the past few years, its expenditures have increased faster than reported increases in costs in other sectors of the economy. In fact, free markets don’t work for the healthcare system.
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There are two ways of financing health care:
The first is the private financing method, using worker and company money as premiums for the acquisition of private insurance, which provides medical care. The order set left far behind 47 million people without health insurance.
The second method, used by all developed countries in the world, is to tax workers for health care, which generates a pool of money, which is financed through the state budget. People in our country prefer private health insurance and private health care. Getting used to it, over time with the existing system, our people rejected all other proposals regardless of their abilities.
Analysis of the working system of private health insurance shows that it is essentially a social method of distributing collected premiums. Insurance companies collect premiums from all insured workers and spend them on the health care of patients in need. As we can see, the private sector is still only looking for profit. Social distribution is not carried out on a full country scale, but is only limited by each health insurance company.
Health insurance companies use unfair practices as the basis of their operations. They choose health insurance only those who are relatively young, healthy, working, who rarely get sick. They are constantly raising premium rates, excluding retirees who need much greater care.
Thus, health insurance companies established for themselves greenhouse conditions. They make billions of dollars in profits, which are basically just simple diversions from the means of healthy people who don’t need medical care. Therefore, the facility must be set aside in a special fund and used for treatment when the workers retire.
Under the existing system, health insurance companies have many reasons to limit our care and increase our co-payments and deductions. HMOs are notorious for refusing to cover necessary hospitalization costs, refusing people to cover for emergency room visits and refusing medically necessary procedures and therapies.
The main reason why our system is so expensive is that it has to support profit-hungry HMOs. In the US, thirty percent of every premium dollar goes towards paying administrative fees and profits.
HMOs stand as useless barriers between doctors and their patients. A question occurred. Need to have an HMO in the system? The answer is clear. No need for HMOs. This is an unnecessary link and should be removed. It is necessary to establish a system that allows providers to concentrate on care, not on profit margins.
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The health care system needs fundamental changes and improvements. Rather it consists of what it takes to decide on the mature task of improving medical care, simultaneously lowering expenses and providing all our citizens with good care. This major issue caused no further delays. It is generally recognized that healthcare in our country is the same as that of small businesses, and all participants are interested, like every business, to receive the highest possible profit.
Splitting medical care into small medical offices does not support development in this area and the fundamental medical task of lowering medical care costs for the following reasons:
state-of-the-art medical technology cannot be used in these offices; conditions do not exist for a high level of organized healthcare; doctors prefer to minimize time for patient medical examinations; cost for services is not the best idea in this area.
The aforementioned drawbacks in turn lead to:
growth in medical staff services and administrative costs; decreased efficacy of outpatient treatment, increased patient visits and unnecessary referrals to hospitals; increase in aggregate spending on medical care.
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Under the circumstances of the irrational organization of medical care in our country, it is necessary to find a new structure to meet the requirements of contemporary reality.
Inevitably comes to mind the conclusion about the feasibility of reorganizing the entire structure of medical care. Instead of a large number of small unproductive medical offices, it is better to organize large-scale multi-profile medical clinics, each of which is connected to a nearby hospital and works in two shifts.
These outpatient clinics should be equipped with modern medical and information – computer technology, as well as contemporary laboratories, and carry out in them all the necessary medical examinations, tests, procedures, etc., significantly improving the quality of medical care and productivity of everyone’s workforce. medical staff.
Another important step – a fundamental change of the existing payment system for the care of medical doctors. We offer the introduction of an hourly pay remuneration system in the form of salary levels. Salaries for doctors should be set depending on qualifications, confirmed every five years, exemplary 150-200-250 thousand dollars per year.
In addition, the distribution of bonuses for successful operations and excellent medical care of patients should be established. This will certainly divert doctors’ attention to quality health services for patients. In essence, only such radical changes can be called medical care reform.
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It is possible to set up a non-profit public organization for the medical care of the entire nation’s population, with branches in all states. Nonprofit leadership must be carried out by the best experts in the fields of medicine, science, economics, finance, and public relations. They must take full responsibility for the medical care of the entire population and the use of means to finance it.
This should include effective mechanisms to control the costs of medical care. All controversial questions must be decided between the medical specialists of this organization and the treating physician. It will be a managed health care system. Managed care reflects the country’s distinctive approach to universal human challenges. Medical treatment costs must be contained.
The rationale for the boundary setting policy should be explicit and publicly available. The rationale should show how the policy promotes good care for individuals and optimal use of available resources for large populations.
It is possible to relieve doctors of the need for insurance against cases of medical error, lifting them from the heavy burden of unnecessary expenses. Medical doctors, no doubt have to bear the responsibility for criminal negligence in the performance of their duties, which causes irreparable harm to the health of treating patients.
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Come questions. How is the implementation of health care financing in the new era?
The main and only source of financing is the use of special taxes for this purpose. There should be a scientifically justified tax percentage on workers’ income and corporate and business profits, generating funds, which should finance expenditures on health care.
For these funds must be directed to Medicare and Medicaid facilities. Thus, any means to finance medical care must be directed from the budget to public nonprofit organizations. This organization, in an appropriate manner, must draw up detailed estimates of its budgetary expenditures. Within reasonable limits of this budget will be maintained a full system of medical care.
Scientific institutions with appropriate profiles should draw up such a budget. If one could put it that way, we can no doubt assume that the cost of maintaining medical care under the new favorable conditions would be much lower than it is now. It seems to us, that the proposed improved system establishes a shield for uncontrolled medical care spending, which under the system of presenting unlimited bills to Insurance, Medicare and Medicaid companies is growing, relentlessly downhill on the brink of disaster.
New types of medical care and financing systems must decide the topical issues of contemporary health care.
Only a complete reorganization of the health care system will lower medical costs. Otherwise, the cost will go up constantly.
