Government healthcare financing

Executive Summary- Outline
This paper examines the health care funding system in the United States from for-profits organization, not-for-profits organizations,government, private insurances, and physician practices/PCMH . Our group will look at the various health care financing methods available from private to the public, which includes the government’s health care fund. Healthcare draws attention to the fact that all Americans vary in terms of class and, therefore, not all can afford private insurance policies. Thus, the government health care financing ensures equity among American citizens and ensures that all citizens have access to medical care without having to dig too deep into their pockets or worry about being bankrupt. We will also look at the merits of government funding healthcare programs and its disadvantage that the private sector is offering health insurance to lose a competitive advantage against these government-funded programs, While also analyzing several key categories and explaining how their financing and reimbursement work in the United States.
Health Care Financing
Funding medical care has advanced through the years, from individual installment to medical insurance. Each state requires the government to fund medical care, for instance, the US, where legislative subsidies rise to fifty percent of all current expenditures. Funding medical care not only involves the methods of raising medical care funds but also includes the processes of allocation of these funds. Naturally, competition for funds in a system exists, and the way sectors allocate these finances affect how divisions provide services and sets priorities. Consequences relating to the economy and decisions made in resource allocation are significant determinants of the healthcare economy. Therefore this research paper will expound on the health care financing system in the USA and why the government health care funding is essential.
Ultimately, funding medical care in the United States has an impact on the quality of medical services provided (Niles, 2019). There are different choices for financing medical care running along a continuum from private to public. These are the separate installment, which incorporates partial individual refunds, voluntary personal insurance, for example, mutual and supplementary insurance, statutory insurance regulated by the state, social protection, hypothecated funding, medical tax assessment, and general taxation. Numerous nations possess minimum levels of average spending and distribute their scarce assets inappropriately. Consequently, the US private medical coverage plans operate with authoritative overheads of about thirty percent as compared to Canada’s provincial coverage, which works with managerial expenses of less than five percent.
In the United States, the most extensive insurance programs funded by the government include Medicare, which is responsible for funding medical expenses for the elderly and people who receive more prolonged-term treatment with dialysis. Medicaid in the US, on the other hand, refers to the funds that are allocated for people who live below the poverty level and those who have disabilities (Berchick & Barnett, 2018). Medicaid and Medicare insurance programs are administered by the Health Care Financing Administration(HCFA), which is a federal agency within the united states department of health and human services. The HCFA is responsible for educating the beneficiaries of the program to make sound medical care choices and improve the outcomes of medical care (Comwell et al., 2016).
Ideally, medical health care in the United States ranges from private insurance to public insurance; however, to provide equity among American citizens, government healthcare was introduced. Government healthcare has several advantages, which include the free choice of citizens to choose their doctors and hospitals they want to receive medical aid. Government health care ensures that none of the citizens die or go bankrupt due to a lack of health insurance as everyone acquires insurance from the day of birth. However, government funding in the United States poses a rather great competitive advantage to the existing private insurers.
As much as the USA is the highest spender in medical care finance, it still ranks below other countries in terms of medical indicators. A report done by the US institute of medicine inferred that the lack of medical insurance causes 20,000 excess deaths in the USA. In a report by the World Health Organization (WHO), a global strategy issued stressed the significance of being productive in the utilization of assets as a crucial element in health development (Kuruvilla et al., 2016). WHO recommended legislatures to preferably allocate to primary and transitional medical care services, specifically to the rural areas. The report concluded that misallocating resources between regions in the pharmaceutical sector are more likely to lead to an unproductive medical system; for example, primary care lacking funds while the tertiary framework has ample funds.
There are many health care funding alternatives available to the American system. Still, since not all Americans are of the same financial status, the American legislature came up with the government fund, which ensures equity among citizens and effective medical care to all citizens. However, the government has to ensure the effective allocation of funds to the healthcare system to ensure its stability and effectiveness.
Physician Practices/PCMH
Primary care providers are adopting Patient Centered Medical Home (PCMH) processes to improve the quality of care. According to Society of General Internal Medicine (2019), “over the past several years, the PCMH model has been adopted by Medicare and private payers, which offer financial resources and technical assistance to practices that agree to participate” (Gimm, et al.). CMS released an innovation project to reform healthcare costs by creating PCMHs. PCMH models enforce CMS’ triple aim, which is better quality patient care, improved health, and an optimization of costs (Tyrrell, 2019).
The Multi-Payer Advanced Primary Care Practice (MAPCP) model, Medicare and Medicaid services (CMS), and private payers have provided supplemental payments to 849 primary care practices that are part of PCMHs. These benefits were only offered in eight states, where on average Medicare payments were capped at ten dollars per month.
 
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