Overall Goal of the Legislative Initiative
Dear Americans! First of all, allow me to thank you for your trust and support, which, I assure you, are not misplaced. However, I want you to know that there is much work to be done, so let me get straight to the point. In such a large and rich country as the United States, there should be no place for a travesty that we are calling the American healthcare system. The high prices and the questionable quality of services it provides only form the tip of the iceberg. We all have witnessed scandalous incidents in the hospitals for war veterans, in which the defenders of the fatherland have to wait for months for their turn to get the necessary procedures and tolerate rudeness and indifference on the part of medical personnel. I dare any of you to call this system the world’s best healthcare industry. Thanks to it, our homeland has the death rate that is higher than in countries with the universal health care system, while our medical expenses are two to three times higher than in any European country (Emanuel, 2014). In the case this problem is not addressed effectively and promptly, the entire nation is going to wither away. Therefore, reforming the health care system, to make it more efficient and affordable is the focus of my legislative initiative, which will be my first task as a President of the United States of America.
Centralization is the primary focus of the initiative. As you all remember, initially, the previous legislation was supposed to be based on the so-called single-payer system. In other words, only one entity was to provide reimbursement for healthcare services. However, very soon, it became clear that such an initiative would find the support of neither the Democratic nor Republican Party. As a result, the need for it, which had been asserted by American Presidents since Theodore Roosevelt, remained unrealized. It is obvious that there are those who would benefit from preserving the current insurance system that was created in the 1940s – hopelessly outdated, terribly complex, and absurdly expensive (Emanuel, 2014). However, the time has come to change the situation for the better. The new initiative will create necessary conditions for the consolidation of financial resources for the healthcare industry from the state and federal funds for the purpose of the subsequent single-channel financing of healthcare and pharmaceutical services that are provided to people.
The functioning of a single-payer system will allow defining a single funding health authority that will be given the right and power to manage public health insurance. It will operate on a territorial basis with branches in all states; inline, the basic public health insurance funds will be transferred to its regional offices (Emanuel, 2014). Moreover, this entity will control funds from both federal and local budgets and participate in the development of the budgetary strategy. It will also make payments on the financial support of the program of state and federal guarantees, as well as take part in its development program. Additionally, the entity will have the right to apply to the relevant authorities on issues concerning the budget financing of healthcare or partial financial support of the state guarantees program. In the case of an incomplete implementation of federal and local budgets for health insurance, it will be able to make proposals for the revision of the mentioned program. The organization will also monitor the use of basic public health insurance by providers. Finally, it will ensure the quality control of medical and other services that are offered by suppliers.
In such a manner, the entire system is going to become centralized; consequently, it will be able to deal with its primary task, which is guaranteeing the quality medical care to citizens in the case of an insured event, as well as the provision of healthcare services at the expense of the accumulated funds and funding preventive measures, more efficiently. In this case, the prevention refers to activities that are aimed at reducing the frequency of insurance cases or, in other words, an improvement of the overall health level of the nation. However, the limited financial capacity of our state due to the general slowdown in the production, as well as an increase in the budget deficit, has made it impossible to provide necessary healthcare costs only at the expense of the public financing (Brill, 2015). Therefore, a new insurance healthcare system is going to be a complex financial structure with own funds (both public and private), a well-organized system of financing in the form of payments (for example, employers will have to send the agreed percentage of payroll to health insurance funds on a monthly basis). It is also going to have a system of the command chain and the self-regulation ability.
Moreover, centralization also is going to become the core principle in terms of healthcare facilities management. Currently, public hospitals are run by local or state governments. However, chronic problems of the industry, especially long queues for the treatment and growing costs dictate the need for changes. As a result, the new initiative is going to allow for direct governmental control over these institutions. Of course, in addition to the public facilities, there is a significant number of private hospitals in our country. Therefore, the state is going to develop a unified budget that will limit the total amount of expenditure on healthcare and set the size of hospital expenses on fixed assets. For sure, many general practitioners and specialists that work at hospitals do not receive a fixed salary, while some of them are working under contract (Schulte, 2013). Still rendered compensation levels are going to be set by the federal government. Naturally, such a goal will not be easy to achieve, as the state governments and healthcare facilities may consider it an intrusion into their affairs. However, at these difficult times, the country must stand united, to overcome the presented challenges. In the end, we are the citizens of the United States of America and must act accordingly as unity is the primary source of our strength.
After everything that was said earlier, many of you present here may want to know about the core principle of the health plan distribution under the new system. It is decided that they are going to be distributed on a voluntary basis since the right for the choice of each citizen must not be abused. Ultimately, the decision regarding the feasibility of purchasing a healthcare plan must be made by people rather than authorities as everyone is the master of their own life. Inline, the task of the government will be to ensure the affordability of insurance rather than force it on everyone. The grave consequences of such a practice we all have already experienced in the past.
Changes to Traditional Programs
It is impossible to speak about healthcare reform without mentioning such programs as Medicare and Medicaid. First of all, it is necessary to note that none of them is going to be canceled; each and every American citizen will have free access to the healthcare services, even in case one cannot afford it. However, there is a need for change, especially in the terms of Medicaid as currently, this program is full of deficiencies and is rather ineffective. In particular, the federal government has to spend about $300 billion per year, which means that it often pushes many other important social programs and initiatives into the background (Schulte, 2013). Of course, there is no denying that our society must provide people with quality healthcare services. However, many of you will agree that it is better to give at least the basic care to every citizen rather than give preferences to certain individuals and, thus, drive a wedge between them and the rest of the population. After all, the United States has long been considered the country of equal opportunities, and it is our duty to preserve it as such.
Naturally, it is not surprising that recipients of Medicaid, many of which are present here, including the elderly people and immigrants, will not be mad keen on the words that were just said. Of course, they are not to be blamed as these words can be interpreted as the call for the expropriation of their share to distribute funds among all Americans in need of basic health services. The same can be said about governors of many states as they expect to face many problems, namely the need for redrawing the local Medicaid programs. However, this challenge must be addressed. Right now, Medicaid is developing a fertile ground for various sorts of shady business with crooks of all sizes seeking enrichment at the expense of this program. They range from people that sell the received medications to neighbors to doctors that prescribe completely unnecessary appointments to their patients (Brill, 2015). Again, the primary reason for such a situation is the lack of appropriate centralization and control. In such a manner, one can say that by facilitating the change, the government will be able not only to save money due to the reduction of the number of cases described above but also to prevent the bankruptcy of Medicaid as a whole. However, there are going to be no drastic measures that can result in tens of thousands left without access to healthcare. In particular, the Medicaid program is going to be made more flexible; it will present a different number of services to people with different incomes in different states. In addition, beneficiaries that have a sufficient income will have to pay extra for health services; thus, they will facilitate the burden of the program. Finally, Medicaid should pay less for drugs both to pharmacies and large pharmaceutical companies. Of course, many of you may oppose such a reform. However, it is the only way to prevent the bankruptcy of Medicaid, which would result in all of the beneficiaries, including those in the opposition, losing their privileges.
The goal described above requires the implementation of several measures that will help to strengthen and modernize the country’s healthcare system, as well as deal with the fraud and growth of Medicaid costs effectively. Among them, there is a list of drugs that are to be prescribed in the first place, the changes in the state health program, and many other issues that will make it possible to control prices and ease the burden of American taxpayers. As a result, it will be possible to save billions of dollars while maintaining high-end medical services that people of our country deserve. Moreover, there will be programs to combat fraud and abuse in the Medicaid system that are going to include audits, investigations, and verifications of requests that will allow saving billions of dollars on the annual basis. The initiative also provides for the creation of a special commission that is going to inspect healthcare facilities all over the country, namely examining the problem of the least efficient hospitals and finding a reasonable way to solve such problems. Therefore, the proposed initiative will lay the foundations for the effective and, most importantly, affordable healthcare. However, without continuous support from all of you, it will not be possible. In other words, only the joint efforts will allow creating a healthcare system that is truly worthy of people belonging to the key nation of the Western world. Let us join our effort and make headway!