The United States of America has elected its new president for the next four years. This leads to controversy that surrounds healthcare and health insurance. This is an especially important and significant issue. This article will explain the new changes and problems that have occurred in healthcare and insurance. This affects many of people throughout the world. Including varying opinions on the best ways to deliver healthcare, the role the government plays in insurance. It also includes ethical decisions of access to healthcare. In this we will explore the history, key issues and solutions for this. 

HISTORY SUBHEAD

The healthcare system has evolved significantly over the last century. In the early years of healthcare most things were private. That means everyone that wanted the services had to pay out of pocket for said service. 

The rise in health insurance began in the 1930s. Hospitals needed to earn money for the services they were providing. This is when the blue cross and blue shield was founded by Justin Ford Kimball in 1929.(History of Health Care – Blue Cross Blue and Shield History | BCBS.com | Blue Cross Blue Shield) This establishment led to what we have today, which is health insurance from employers. 

In the post-World War II era, employer-sponsored health insurance became the norm in the United States, leading to a significant transformation in how healthcare was accessed and financed. The introduction of Medicare and Medicaid in the 1960s marked a pivotal moment in public health policy, providing health insurance to the elderly and low-income individuals, respectively. However, these developments also sparked debates about the sustainability and equity of healthcare access.

ACCESS

 Access to care is one of the most critical issues with millions of people not having access to health insurance. This number is around 26.1 million people or 8.8% of the total population. (Approximately 8% of the population — 26.1 million — lacked health insurance in 2019) With this amount of people lacking insurance, they often delay treatment or get no treatment at all. 

According to Marva Lous a Eskenazi Health pharmacy technician “I have watched many people come in her with no coverage at all. It sucks knowing that they can’t get anything from us because they have no way of paying for it at all.”

CARE

The next key issue is the cost of care. The rising cost of healthcare is a major concern for people. This has led to major debates about the efficiency of pharmaceutical companies and hospitals. Everything used to be cheaper for healthcare, but prices have been driven up by new drugs coming out. There is around a 7% increase in health insurance cost.  We have drugs like Biktarvy that are used to treat HIV but this drug to be made and distributed will cost the patient $3,981 a month. There are also others such as Ozempic and other drugs for diabetes that are extremely expensive for the patients. 

GOVERNMENT ASSISTANCE

In the world we have today there are two major groups of health insurance from the government: Medicaid and Medicare.   Medicare is primarily aimed at individuals who are either 65 or older. It does come with some exceptions though such as younger people with disabilities like End Stage Renal Disease. One of the defining characteristics of Medicare is that it is not income-based; eligibility is determined by age or disability status rather than financial need. This means that anyone who meets the criteria can enroll in Medicare, regardless of their income level.

 In contrast Medicaid is designed to assist individuals and families with limited resources. This program serves a broader demographic, it is just about everyone as long as they can see a struggle and need for it. Unlike Medicare, Medicaid eligibility is primarily determined by income and varies significantly from state to state. Each state has the authority to establish its own rules regarding eligibility, benefits, and the administration of the program. Each state’s insurance also only works in that state. Once you leave and try it elsewhere it will not work for another state.  

ACA

Major Players in the Debate are the government who play the biggest role in regulating healthcare and insurances. They play the biggest role because the government decides the laws that lead to cost, quality of care and what must be provided to everyone who has insurance. The Affordable Care Act (ACA) is one notable example of government intervention aimed at expanding coverage and improving care. Health insurance companies are key players in the system. They decide the types of coverage offered, the premiums charged, and the payment structures for providers. Their profit motives can sometimes conflict with patient needs, leading to debates about their role in healthcare.

Ethical considerations play a significant role in the healthcare debate. Questions arise about the moral obligations of society to provide healthcare to all individuals, regardless of their ability to pay. We can see this from places like Eskenazi health who provide a service for Marion County residents. They provide a financial assistant program for those that qualify. They see them as a company that makes a lot of money and want to give back to the local residents with these programs. With this they eat the cost of the visits and medical supplies to prove the patient with what they can afford. Many other hospitals will also eat the cost of individuals who don’t pay. They do this for certain things but not everything. Other times we can see that bills will be sent to collections if kept unpaid. These can mess up individuals' credit scores and keep them in debt. 

UNIVERSAL HEALTHCARE

While the controversy surrounding healthcare and health insurance seem insurmountable, various solutions have been proposed. Universal Health Coverage advocates argue for a single-payer system that guarantees health coverage for all citizens. This model could potentially lower administrative costs and allow for more fair access to care. A public insurance option could have competitive pricing to private entities and drive those prices down. There could be regulatory reforms that strengthen regulations on insurance companies. This would help address access to insurance and the cost of it. 

CONCLUSION

The controversy surrounding healthcare and health insurance is complex an issue. It has problems with access, cost, quality, and ethics. As we move forward, it is crucial to still be engaged in these discussions and advocate for solutions that prioritize patient care and improve health outcomes. We can see in the future how some of these problems might arise. There has been a newly elected president in Donald Trump who has already brought up healthcare. There is a republican dominated senate, house and supreme court as well. Will this help improve healthcare, or will we continue to bring more problems to people?