U.S. health care policy and the rising uninsured: an alternative solution.

Thomas Falen
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引用次数: 8

Abstract

The lack of adequate health insurance affects one's ability to access care, which directly affects one's health. In the 21st century, there are 44 million people in the United States without health care insurance. The majority of people without health care insurance are working people under age 65, because most people over age 65 are retired and have health insurance through the federal Medicare program. Maintaining a healthy population makes good business sense because healthy people are more able to work, buy goods, and pay taxes that contribute to a healthy economy and strong government. We must understand, through provider "cost shifting," the American public is already "footing the bill" for the uninsured. However, the actual amount is hidden and passed on to consumers in payments to insurance companies through raised premiums, deductibles, co-payments, exclusions from coverage, and direct out-of-pocket payments to providers (e.g., physicians, hospitals). Ironically, the very working poor who are uninsured and underinsured help fund the health insurance of select federally protected groups through taxation. A huge gap exists in the current United States system of health care wherein there is no cogent benefit, only a vicious cycle as the insured continue to pay more for their care to help compensate provider losses due to the uninsured. This in turn causes a growing rank of uninsured individuals that lack access to adequate health care. The purpose of this article is to assert an alternative to the current U.S. health care insurance system. It takes advantage of structures already in place to promote a "win-win" American health system premised on a workable tiered universal health care system in which there is a benefit to the major populace. As an emanation of a diverse society, the proposed system does not advocate a one-payer universal system that is not amenable to the U.S. health care, social, or political environment.

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美国医疗保健政策和不断增加的无保险人口:另一种解决方案。
缺乏适当的医疗保险会影响一个人获得医疗服务的能力,这直接影响到一个人的健康。在21世纪,美国有4400万人没有医疗保险。大多数没有医疗保险的人是65岁以下的工作人员,因为大多数65岁以上的人已经退休,并通过联邦医疗保险计划获得医疗保险。保持健康的人口在商业上很有意义,因为健康的人更有能力工作、购买商品和纳税,这有助于健康的经济和强大的政府。我们必须明白,通过医疗服务提供者的“成本转移”,美国公众已经在为没有参保的人“埋单”了。然而,实际金额是隐藏的,并通过提高保费、免赔额、共同支付、不包括在保险范围内以及直接向提供者(如医生、医院)支付的自付款项向消费者支付给保险公司。具有讽刺意味的是,正是那些没有保险或保险不足的工作贫困人口,通过税收为某些受联邦保护的群体的医疗保险提供了资金。美国现行的医疗保健制度存在着巨大的差距,其中没有令人信服的好处,只有一个恶性循环,因为被保险人继续为他们的护理支付更多的钱,以帮助弥补提供者因未投保而造成的损失。这反过来又导致越来越多的没有保险的人无法获得适当的医疗保健。本文的目的是提出一种替代现行美国医疗保险制度的方案。它利用现有的结构来促进一个“双赢”的美国医疗体系,前提是一个可行的分层全民医疗体系,这对大多数民众都有好处。作为一个多元化社会的产物,拟议的系统并不提倡不符合美国医疗保健、社会或政治环境的单一付款人普遍系统。
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