What are the four central issues driving current federal health policy? Which do you believe is more important?

The healthcare expenses continue to grow and adressing the growth is a a major burden for policy makers. The number of unemployed/uninsured makes it difficult for insurance companies to keep prices down because the bigger the pool the more the costs can be spread out. Currently employers have been shifting the costs to employees through higher premiums and health savings accounts. Medicare enrollees have increased with the rise in baby boomers applying for insurance. The recession has created a demand for medicaid and other social programs putting the states and federal government in further debt. Cost drivers are technology and prescription drugs, rise in chronic diseases, and admin costs. The government contains costs by putting more regulation on the healthcare providers and on insurance companies.


Pharmacy costs have continued to increase due to greater drug use, higher drug prices, the launch of novel but expensive new drugs, and “trading” up from older generation drugs, possibly off patent, to newer, expensive brand drugs. Twenty years ago, pharmacy costs represented about 5% of total managed care health care costs, and today, that amount is closer to 20%. Certainly, we have significant new drugs for important medical conditions not previously available, and we all favor the increased appropriate use of cost-effective medications. Also, cost-effective drug use may offset or reduce the need for more expensive medical resource consumption. Regardless of the value, pharmacy program costs are increasing, and managed care responds by implementing various management strategies.

The four central issues driving current Federal health policy are as follows: 1) cost; 2) affordability; 3) accessability; and 4) quality of care. The federal government want to find more affordable health are so no one would be left out for health care. It is important to look for ways and means to lower the cost of health care. The recent transition of baby boomers coming to retirement has increased the Medicare and Medicaid expenses; therefore; affordability comes into focus. Also, if we lower the cost of health care might effect the quality of care if the government does not make sure the quality of care is included in the health care reform. I believe all of the above issues are important.


Four of the central issues that have become the focus of federal health policy are: Medicare and Social Security funding, future federal health programs, increase in the number of choices for consumers, and managed care competition in Medicare. In my opinion, the funding of Medicare and Social Security are of biggest concern. This is due to the fact that both of these federal trusts are about to be maxed out with needing to support an aging population of Baby Boomers. The funds were meant to have the current workforce support those who are retired and we are entering into a time where the current workforce is smaller than those who need to be supported by it.

Cost is important, as it must be balanced against tax revenue that the government collects. Affordability and accessibility are intertwined – high premiums decrease access to health care for most people – if they can’t afford the insurance (or if the insurance doesn’t provide enough reasonable coverage), people are less likely to seek healthcare services before they become emergent. Quality of care is huge – none of the other factors matter if the outcomes of care aren’t reasonably positive and based on efficient and effective use of medical resources. Our medical resources are limited. Therefore, according to the most basic economic principle – the law of supply and demand, the scarcer a resource is, the higher the price paid for that resource. However it isn’t that simple in healthcare. There are many factors driving up the costs – the least of which is the demand for those services. Time and time again we’ve read that the majority of healthcare spending is on a small proportion of the population that suffers from multiple, complex and chronic diseases. Yet a significant amount of our resources are consumed by other factors. Think about it. We’ve read about the healthcare reform and its requirements. But do we fully understand the costs of meeting those requirements? How much will administrative costs increase if we have to add people to the administrative side just to keep up with the regulations? What about the cost of investing (and reinvesting) in technology to keep up? How often will we need to update our computer systems and software? What will it cost to do so? How will those costs escalate (thanks to inflation) over the years? And what about wasted time and resources when billing and coding errors are made? How many claims are denied or returned to the provider because they weren’t “clean?” How complicated the claims process has become! With no standardization of claims processes, it is difficult just to know what to include on a specific claim for a specific payer.

Cost, medicare and social security are the central issues driving health care policy.   The question is do we have enough tax dollars to cover everyone health care in the USA?   Does our tax dollars cover the healthcare of our grandparents and now parents? I believe we absolutely do, but how do we free up tax dollars locked up on Military Defense ? The issue i believe is how to convince congress to unleash other spending to cover universal health care.

The price of healthcare skyrocketing and government programs such as Medicare and Medicaid are going to be hard pressed to keep pace. Something that I find very interesting is that most Americans that have insurance only really pay for a small percentage of the total cost for visits to see providers and have procedures done. Greg Scandlen from the National Center for Policy Analysis reports that 85% of healthcare visits are paid for third-parties. His article says the 15% that is for the most is alternative medicine, dental work, cosmetic surgery, and vision and he believes these costs have not drastically risen because people are more conscious about the expenses that they have to pay for directly. This involves increasing the number of consumer choices and letting the consumer know more details of the health expenses so they can make more informed decisions. The article lists some great ideas to controlling costs.


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