Health care is one of the biggest privileges available to members of society. As with all privileges, high quality health care is not available to all members of society. Of course, there are exceptions to this rule just like there are exceptions to most of the rules set in place by society. A child or a handicapped person would not be expected to contribute to society, as a regular adult would be expected to. Likewise, if someone chose to pay for treatment above regular medical needs they have the right to do so.
As with all privileges in society, guidelines are set in place to regulate health care. The most widely used guideline is insurance. Most members of society who hold a full-time position in a company have access to medical insurance through that company. Members who only work part-time do not have access to medical insurance provided by the company where they are employed. “The uninsured are more likely to delay health care
There are members of society who receive health care without having to contribute, in a professional way, to society to receive it. These include the poor, the mentally and physically handicapped, the homeless, and illegal immigrants. Health care is provided to these members of society not because they have earned it but because society feels that it would be inhumane to deny them health care. This practice causes the overall price of health care to rise because these members of society are usually unable to pay for the services they consume.
Like other consumer goods, health care is available beyond that which is necessary to sustain life for members of society who choose to pay for it. One of the fastest growing medical professions is plastic surgery. Although some plastic surgery procedures are preformed to save lives, the majority of procedures are done solely for cosmetic reasons. This is due in large part to the value society places on appearance. Members of society who choose to undergo plastic surgery to alter their physical appearance do so with their own money. This is another guideline set in place by society. If plastic surgery is not needed to save a life, insurance will not cover it. This keeps the number of people who undergo plastic surgery for the sake of appearance to only those who can afford to do so out of pocket. This is also true for people who undergo psychological treatment. If a psychologist does not feel that a patient has a diagnosable mental disorder, insurance will not cover the treatment. Of course, the patient has the right to continue going if they choose to pay for the sessions.
With the cost of health care rising every year, it is only inevitable that it will have to be rationed at a large scale at some point. Some forms of health care rationing are already in place. Medicare is one example, it is only available to the poor and it only provides limited coverage to the elderly and to people with disabilities (Meckler; PNIS).
In order to ration health care, the reasons why health care needs to be rationed have to be identified for the new system to be affective. The biggest problem faced by the United States is the rising cost of health care. “Health care spending is rising much faster than wages, business receipts, or government revenues” (Rasell). One reason for this increase in cost is due to the development of medical technology. The more advanced the technology becomes the longer people in that society can expect to live. A longer life expectancy means that more medical resources are being consumed by the elderly (White; Cutler; Schwartz).
The pharmacological aspect of health care has also added to the rising cost and the need to ration. When a new drug is put on the market, it receives a twenty-year patent that allows it to have a monopoly on that drug. This allows the drug industry to make huge profits. Along with the cost of providing the drug industry a profit, consumers pick up the cost of educational seminars held by the drug industry to inform doctors of the new drug and the cost of marketing the new drug to the general public through television commercials (Pieper, video).
The fact that every other industrialized country spends less on health care than does the United States gives hope that containing the cost of health care is possible (Rasell). However, the strategies that have worked in other countries will not necessarily work in the United States. The United States needs to come up with a rationing system that fits the individual needs of this particular society. There are a few rationing strategies that the United States could enact to lower the cost of health care.
The first rationing strategy, although unfavorable to many, would be to limit high quality health care to members of society who contribute to the welfare of society as a whole. This system would only allow the members of society who do not contribute, such as the unemployed and the institutionalized, to receive the most basic of medical services. This would limit the number of costly procedures performed on patients who do not have the ability or the desire to pay for the procedure.
A second strategy of rationing would be to deny medical procedures to patients who were the cause of their own disease. An example of this would be to deny an alcoholic a liver transplant on the grounds that years of choosing to excessively drink damaged the liver and thus makes the patient unqualified to receive a new one. The difficult part of this rationing strategy would be setting the guidelines of who deserves certain procedures and who should be denied them. In addition, it would have to be decided if the procedures should be allowed if the patient chooses to pay for the procedure out of their own pocket without the help of insurance.
A third rationing strategy would be to limit the number of specialists who are allowed to practice. This would ration how many resources specialists would be allowed to use. A patient would be required to see a general practitioner and then be referred to a specialist before being allowed to see one. This would allow the general practitioners to diagnose illnesses and recommend treatments that do not require a specialist. The services performed by the specialists would only be used when one was actually necessary. This would limit the number of specialists practicing and would lower the cost to consumers by better utilizing the limited resources available to doctors.
To see short-term benefits of rationing, a combination of these three strategies could be used. If a system was devised that would make better use of the limited resources available, while at the same time keeping treatments available for those patients who would recognize long-term, life altering changes, the health care system would be better utilized. To see long-term affects, a complete over haul of the current health care system, including the infrastructure of hospitals and the number and specialties of physicians, would have to be conducted.
Supplying a universal insurance provider would make access to health care easier and the cost of medical insurance more affordable. “This approach eliminates private insurance, Medicare, and Medicaid and replaces them with a single, government-sponsored insurance plan.” Payroll taxes are used to finance the insurance while the services are provided by private hospitals and physicians. The physicians are then paid directly by the government. “The government uses the national and state global budget with fee schedules and institutional budgets to hold down costs” (Patel and Rushefsky; Daniels et al.; Woolhandler and Himmelstein). Benefits include the ability to choose a physician without any limitations and guaranteed coverage while on vacation or while moving. This system is also income friendly, it is based on the individual’s ability to pay. There would be less uninsured individuals because the amount paid is proportional to the yearly income of an individual or family. The extremely poor would pay significantly less than the extremely rich (Bernard;
Due to the elimination of private insurance companies, “billing would be straightforward, reimbursement would be quick, and paperwork would be kept to a minimum” (Woolhandler and Himmelstein; Lemco). With a reduction in paperwork, fewer resources would be used to produce the paperwork and less time would be spent filling out, mailing off, and filing paperwork. Physicians would have more time to spend with patients if the amount of paperwork they were required to complete was reduced. Patients would only be required to fill out forms the first time they visit a doctor and when personal information has changed. Files could all be kept electronically and could be easily transferred between physicians’ offices. It would also be easier to monitor the medications that patients have been prescribed by other physicians (Pieper). In addition, less drastic changes can be done to reform the current health care system of the United States.
First, if cosmetic surgery was limited only to people who required it to save their lives, valuable medical resources could be saved. Cosmetic surgery uses valuable medical resources, such as physicians, equipment, and basic medical supplies, that could be better utilized if they were used in procedures that saved lives, like open-heart surgery. Cosmetic surgery is an extremely expensive procedure that draws physicians to it with the prospect of high incomes. These physicians could better us their medical knowledge to save dying patients then to perform face-lifts or breast implants.
Secondly, if the money provided to organizations to perform disease prevention research were evenly distributed there would be more knowledge about a broader range of diseases. The best example of this would be cancer research, millions of dollars are spent each year researching breast cancer, melanoma, and cervical cancer and yet lung cancer, the number one leading cause of cancer related deaths in both men and women, is barely researched. If the funding was evenly distributed, we would know more about diseases that do not receive funding from private organizations, such as lung cancer. Not only would we be able to develop better treatments that relate to specific diseases but the chance of finding a treatment that could be universally used to treat numerous diseases would increase.
The facts of health care rationing and reform are issues that will have to be resolved eventually. Whether we decide to adopt a program that is already in place in another country or develop one that is uniquely our own, we have to remember that health care is a privilege and as such it should be run in the most efficient and economical way possible so it’s benefits can be enjoyed by as many people as possible.
Bernard, Elaine. 1992. “The politics of Canada’s health care system: Lessons for the U.S.” New Politics. Winter. From library readings, Chapter 5.
Culter, David M. 1996. “Cutting costs and improving health.” Pp. 250-65 in The problem that won’t go away, edited by Henry J. Aaron. Washington, D.C.: Brookings Institute. From library readings, Chapter 5.
Daniels, Norman, Donald W. Light, and Ronald L. Caplan. 1996. Benchmarks of fairness for health care reform. New York: Oxford University Press. From library readings, Chapter 5.
Eitzen, D. Stanley and Craig S. Leedham. Solutions to Social Problems Lessons from Other Societies. Boston: Pearson Education, Inc, 2004.
Meckler, Laura. 1998. “Lack of health insurance a problem.” Yahoo News. 19 October. From library readings, Chapter 5.
Patel, Kent, and Mark E. Rushefsky. 1995. Health care politics and policy in America. Armonk, N.Y.: M.E. Sharpe. From library readings, Chapter 5.
Pieper, Hanns. Class lecture. Sociology 230. Wallace B. Graves Hall, Evansville. 2006.
Pieper, Hanns. Class video. Sociology 230. Wallace B. Graves Hall, Evansville. 2006.
Policy News and Information Service (PNIS). 1998. “Issue of the week: Can managed care be managed?” (http://www.policy.com/issuewk/98/0608/index.html). From library readings, Chapter 5.
Rasell, Edie. 1994. “Overuse of medical services hurt the health care system.” Pp. 38-43 in Health care in America: Opposing viewpoints, edited by Carol Wekesser. San Diego, Calif.: Greenhaven Press. From library readings, Chapter 5.
Schwartz, William B. 1992. “Do advancing medical technologies drive up the cost of health care?” Priorities. Fall. From library readings, Chapter 5.
White, Joseph. 1995. Competing solutions: American health care proposals and international experience. Washington, D.C.: Brookings Institute. From library readings, Chapter 5.
Woolhandler, Steffie, and David U. Himmelstein. 1994a. “Resolving the cost-access conflict: The case for a national health program.” Pp. 85-98 in National health care: Lessons for the United States and Canada, edited by Jonathan Lemco. Ann Arbor, Mich.: University of Michigan Press. From library readings, Chapter 5.