Health Policy in the United States

For more than two decades in the United States, state legislators have been involved in debating and enacting mandates on health coverage. These mandates are based on specific treatments, providers, categories of dependants and benefits that are health related. The Patient Protection and Affordable Care Act have established benefits that are related to health and acts as the new uniform requirement. This act covers individuals and health policies of small groups that are sold both in and out of health exchanges.  United States has issued expatriate plans that provide minimum coverage essential for these expatriate employees. Expatriate’s dependents are also covered regardless of their location in the world. This paper has an aim of applying a sociological perspective in analyzing the insurance mandates related to health and illness. The sociological perspective that will apply in this case is the functionalism perspective. 

Functionalism Theory 

The functionalism theory of sociology is also known to be structural functionalism perspective and it relates parts of the society and how they function. For the case of health insurance as a health issue, the sociological perspective of functionalism relates insurance with the society. Each aspect of insurance must be interdependent with and contributes to the society and its functioning as a whole. The government or state often provides health insurance cover for families and children and in turn the society keeps on paying taxes. This functionalism of the government and the society applies here perfectly and taxes paid to the state in this context helps the state in its running. The society and the government are interdependent and both do well with existence of the other. 

 

Functionalism Perspective in relation with Health Insurance in United States

Health insurance in the United States is any program that helps to pay for medical expenses in both private and public sectors. Purchased insurance, social welfare programs and social insurance are funded by the government and in a more technical sense they protect against medical services costs.  The public who are insured and have their medicals costs catered for are responsible to the government too according to the functionalism perspective. The society members serve the government either through employment, payment of taxes or serving the public. In the medical sector, health insurance has employees and those who run it and they serve both the public and the government through services. Mandates serving the insurance sector then bring gain both to the society and to the government and the relationship fits for functionalism perspective. 

Health insurance in the United States caters for the disabled who may term this to be disability cover or care. Disabled people in the United States are covered under long term nursing and needs for custodial care. For the functionalism perspective of sociology, disabled people gain from the government’s insurance on their health and treatment and they are also important to the government. Disabled individuals pay for the insurance benefits whether directly or indirectly and can do this through their family members. For those who do not work and may be reliant, there are charges for insurance that get paid on terms whether monthly, semi annually or annually. When the care takers get along well with the payment of insurance rates for the disabled then both the society and the government function to support each other. The different levels of financial protection by the government’s health insurance covers are paid back also depending with the level provided. Rich people in the society may take high paid covers and in return pay a lot of money. On the other hand, citizens who are less stable financially can pay for insurance health benefits that are for low rates. 

Share of Americans with their health insurance has been declining steadily with some insurance meant for the health coverage going unused. The problem could be because of unemployment and high insurance rising costs. This is true and is applicable in the functionalism perspective structure. According to functionalism perspective, the decline in American health insurance does not correspond to the societal structure. As mentioned before that unemployment and high costs of insurance must have led to decline in insurance share in United States. Functionalism perspective of sociology applies the relationships perfectly because each aspect of the society is often interdependent with the other.  An increase in rates of insurance and increased unemployment affects the society and the public. They may not be at a position to afford the expensive costs and because rise in insurance costs does not consider their pockets, the clients will also not consider insuring themselves. In the process of functionalism and interdependence, responses relate and any positive offer will in turn give a positive response. Negative actions also give negative responses. That is why the American health insurance declined because of high costs and unemployment instead of responding positively in a negative circumstance. 

Alternative to Health Insurance in United States

For health insurance in the United States, the main aim is to relieve people from huge bills during sicknesses and when they seek health services. Unlike the functionalism, perspective of sociology relates the services of health insurance with contributions from the society; the government should be most participating. An alternative that should exist within the American health insurance is not depending on the societal contribution but enrolling everyone for insurance. According to the United States Bureau of Census, 55% of Americans get to obtain insurance through their employers with a small amount of 10% purchasing it directly. The remaining percentage is not insured which is not healthy because insurance is needed by everybody for medical benefits.  In the US mandate based on health insurance, an alternative that would ensure that all people are insured should be insuring and enrolling everybody who is not insured. Bodies and organizations that can assist in funding insurance for those who are not able to pay adequately can be approached for help. These funding organizations are important because they will help balance the disparities in health insurance. Besides, availability of funds for health insurance will not make the state to depend on societal contributions entirely. Rise in costs of insurance will then not be experienced and in cases of unemployment, there will still be funds for catering for patients. 

The insurance mandate in America has less private insurance covers with public covers becoming more essential. The mandate that covers for the public mostly can have an alternative because after all even the private insurances are important. A report that was published by Kaiser Family Foundation found out that the public relied mostly on state Medicaid and SCHIP. The changes were because of economic downturns that are common and regulation should not increase insurance rates as it does. An alternative that the insurance regulators can do is increasing share by private insurance companies and decreasing their costs. As mentioned that insurance companies that are privately owned are expensive, the American state can act by reducing these costs. This should be in form of taxes and giving grants for medical purposes so that the private insurances are also occupied. However much public insurance is cheaper and safer, it becomes overpopulated and should balance with the private ones. A decrease in costs by the private insurance will automatically call for customers and other people will take the private insurance policies.  This alternative of reducing costs in the private sector of insurance can then enable an increase in essentiality of the private insurance.

Another alternative that will be best to promote medical health is by use of medical tourism. If the insurance rates make people not to acquire medical attention then the law should provide medical tourism. For medical tourism, patients can choose to travel outside the United States for their medical procedures. For clients who are underinsured or may be uninsured, medical tourism can be affordable and made available at the same rate that the United States could. Even if the traveling costs are considered, patients can still come out of their procedures with expenses that are manageable within the medical tourism idea. Insurance mandates besides lowering costs, taxes and giving donations can also then introduce medical tourism for better healthcare.

Conclusion

In concluding, health policies in the United States are best delivered if put into practice. Debaters and law enactors still involve themselves in making health policies that get implemented and are put to practice. The functionalism perspective of sociology further supports that the society should relate well with the government when it comes to issues of health insurance. A good relationship and balance between the features of the society would then balance operations and for insurance health services and costs will be balanced. In cases where Americans lose their jobs, health insurance benefits are also often lost and this exposes people to health risks. It is then advisable that medical policies balance in all aspects so that a better medical care can be provided for Americans. Besides, medical plans based on the insurance topic must be of help to citizens so that the costs of treatment are not felt directly.

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Oct 25, 2019 in Communications
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