Commonwealth Fund, a New York-Based Essay

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The "bottom line" fiscal situation has become exacerbated by been the proliferation of HMOs, Health Maintenance Organizations, or managed care insurance plans. There is a huge debate regarding these services, their focus on costs and, some feel, not on care; the level of money spent on the bureaucracy of health care as opposed to patient advocacy, and yet, in most cases, HMOs are able to alleviate some of the burden, but also contribute to a more intense and expensive bureaucracy (Getting to the Real Issues in Health Care Reform, 2009).

Part 3 - Healthcare in the United States is provided by numerous entities, institutions, and programs. Healthcare facilitates are largely owned and operated by the private sector. Health insurance is also provided by the private sector, with large Health Maintenance Organizations (HMO's) having increasing presence within the last three decades. Exceptions to this are national programs such as Medicare, Medicaid, Children's Health Insurance Program and Veteran's Health Administration, all of which are part of the governmental bureaucracy (Americans at Risk, 2009). Healthcare reform in the United States is incredibly complex and divisive.

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Besides the costs of care, the American legislative system is set up so that non-medical personnel (e.g. Representatives and Senators) can debate the appropriateness of care in moral and ethical issues (e.g. abortion) and attach conditions to certain types of healthcare. However, in contemporary times, there has not been a single more debated issue since the Clinton years that matches the intensity of polarized opinion on governmental health insurance plans in the United States. It appears that even a minor threat or inkling of socialized medicine is enough to scare many pundits away from a universal, or one system provider.

REFERENCES

Americans at Risk. (2009, March). Retrieved August 2011, from Families USA: http://www.familiesusa.org/assets/pdfs/americans-at-risk.pdf

Getting to the Real Issues in Health Care Reform. (2009, November 12). Retrieved August 2011, from Center for Studying Health Systems: http://www.hschange.org/

Kaiser Family Foundation. (2007, January). Health Care Spending in the United States and OECD Countries. Retrieved August 2011, from Kaiser Family Foundation: http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

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