Private vs. Public Control
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Private healthcare insurance programs usually predict financial risks taken by employees in order to determine the cost of insurance. However, government healthcare programs such as Medicare and Medicaid do not measure the healthcare costs of individuals by the experience. It is quite difficult for government healthcare programs to use such methods to defray costs. These programs usually cater for a very large number of individuals hence making it difficult to measure insurance costs by experience. In most cases, individuals covered under these programs are unemployed and hence there is no need to look at risks they are likely to face. Furthermore, these healthcare programs usually cater for basic healthcare needs of individuals (Aizer, 2006). However, it is still important for these programs to defray costs using experience ratings. It can be achieved through introduction of strict requirements for eligibility of the programs. There can also be collection of crucial details on an individuals experience and use the information to allocate insurance funds.
The recipients of Medicare and Medicaid programs are low income individuals and mostly unemployed. The categorization can be achieved through setting requirements that individuals have to meet before they are considered to be part of the program (Aizer, 2006). The risk pools include children under the age of 21 years, low income adults who are institutionalized, disabled individuals, and individuals above 65 years. These programs do not provide medical assistance for everyone who is poor hence one has to meet these requirements before they become eligible. There are also people who are termed as being in the high risk pool who qualify for these programs. These are individuals who have pre-existing conditions like HIV/AIDS, cancer or diabetes and are turned down by insurance companies. These people can be categorized into the risks pools and get covered under government healthcare programs.
Currently, many old people are suffering from chronic illnesses that need healthcare services. Most of this people are not employed and hence can not afford to pay for healthcare. Most of the private insurance companies are reluctant to give old people insurance because of the many healthcare issues they have. It leaves the burden to the government and most of them depend of government health programs.
It is true to say that reason why Medicare will cease existing in its present form is there are still a high number of eligible recipients under the program compared to the decreasing number paying to the program. In order to run smoothly, the Medicaid program needs to be well funded. The decrease in funds into the program as compared to the increase in number of people benefiting from the program will lead to inefficiency of the program (Haugen, 2008).
It would be difficult for US to transit to the British style of national healthcare because the private sector largely controls healthcare in the US. The challenges the US would face in adopting a national healthcare system include funding. It would be difficult for the US to be able to fund the national healthcare systems. Another challenge is presence of private sector in healthcare industry. The US healthcare industry is largely dominated by private organizations hence making it difficult to establish a national healthcare system solely run by the government. Another challenge is the cost of healthcare. The rising cost of healthcare would make it difficult for US to adopt a national healthcare system (Haugen, 2008).
Employer-sponsored healthcare benefits should be maintained because they provide coverage for many people who are employed. It would be expensive for the government to provide healthcare benefits for all individuals in a country. The government can encourage these programs by offering incentives in form of subsidized healthcare in the country.
References
Aizer, A. (2006). Public health insurance, program take-up, and child health. Cambridge, Mass.: National Bureau of Economic Research.
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Haugen, D. (2008). Health care. Detroit: Greenhaven Press/Gale.
