Saturday, August 31, 2019
How much is a life worth spending? Essay
The value for life is truly indispensable. More than how we translate it to profound philosophical principles, moral grounds, and other abstract perspectives, it is seen even in our most concrete areas. For one, we have become so conscious of our health that we distinguish activities from those which can sustain life and those which do not. We have also explored on numerous options to take care of ourselves and avoid harm and pain. These and more may be due to how we naturally value our lives and life, in general. Even on a macro-level, it has manifested in the different areas of our society. From simple to complex social relationships and structures, the value for life has become a vital part. It has also become a determinant in every process of making decision in the society. We see this in the fast evolution health technologies and initiatives, fiscal and economics policies, and competition of businesses that provide health care in the corporate world. Truly, over the years, the value for life has been going beyond mere qualitative to quantitative manifestation. For this paper, we will focus on one concrete activity that is highly related and/or is directed by this value for life ââ¬â spending. People spend for health. And when we speak of spending, we donââ¬â¢t just refer to money that is being used to pay for services and/or products for health care. We also refer to other factors such as value system, social culture, and others. How much is a life worth spending? This paper will seek to answer the question by analyzing spending statistics of every individual and the government itself in the United States and by exploring on development of health technologies and how it satisfies individuals, and understanding issues regarding this. Health care in the United States is provided by many separate legal entities. Current estimations put US health spending at approximately 15% of GDP. In the United States, the majority of citizens that have health insurance either have employment related insurance or must purchase it directly. The federal government does not guarantee universal health care to all its citizens, but certain publicly-funded health care programs help to provide for the elderly, disabled, and the poor and federal law ensures public access to emergency services regardless of ability to pay. Those without health coverage are expected to pay privately for medical services. The generally high cost of treatment has led to the concept of doctors completing pro bono work, although in practice even serious conditions are left untreated. Health insurance is expensive and medical bills are overwhelmingly the most common reason for personal bankruptcy in the United States. A 2004 survey released by the National Center for Health Statistics estimated that approximately 70% of Americans were in ââ¬Å"excellentâ⬠or ââ¬Å"very goodâ⬠health. The overall performance of the United States health care system was ranked 15th by the World Health Organization (WHO) in 1997. American health care is provided by a diverse array of individuals and legal entities. Individuals offer inpatient and outpatient services for commercial, charitable, or governmental entities. For services, ââ¬Å"Ambulatory careâ⬠refers to health care outside the hospital; most health care in the United States occurs in the outpatient setting. ââ¬Å"Home health care servicesâ⬠are generally nursing enterprises, but are usually ordered by physicians. Private sector outpatient medical care is provided by personal primary care physicians (specialists in internal medicine, family medicine, and pediatric medicine), subspecialty physicians (gastroenterologists, cardiologists, or pediatric endocrinologists are examples) or non-physicians (including nurse practitioners and physician assistants). There are for-profit hospitals, which are usually operated by large private corporations and there are nonprofit hospitals, which may be operated by county governments, state governments, religious orders, or independent nonprofit organizations. Hospitals provide some outpatient care in their emergency rooms and specialty clinics, but primarily they exist to provide inpatient care. Hospital emergency departments and urgent care centers are sources of sporadic problem-focused care. ââ¬Å"surgicentersâ⬠are examples of specialty clinics. Hospice services for the terminally ill who are expected to live six months or less are most commonly subsidized by charities and government. Prenatal, family planning, and ââ¬Å"dysplasiaâ⬠clinics are government-funded obstetric and gynecologic specialty clinics respectively, and are usually staffed by nurse practitioners. Companies provide medical products such as pharmaceuticals and medical devices. The research and development for applications is primarily done in commercial R&D labs while the government and universities fund the majority of basic research. Much of this basic research is funded or performed by governmental research institutes such as the NIH and NIMH. On a general note then, the current health care system provides people with assistance or subsidy in hurdling over health welfare services. But this may or may not necessarily mean that people are truly being ââ¬Å"assistedâ⬠by these provisions. A closer look on individual spending will aid us in this conjecture. INDIVIDUAL SPENDING ON HEALTH SERVICES In the current review done from the data gathered from Centers for Medicare and Medicaid, $1 out of $5 dollar is spent by an individual for health-related expenditure such as hospital care, drugs, medical insurances, and other health care programs/supplements. This means that on the average, more or less 25% of an individualââ¬â¢s income goes to health spending. This already constitutes a huge part in an individualââ¬â¢s budget pie, along with other priorities such as food, housing, and the like. This is way higher than the 16% spending versus total income, in the last ten years. The increase of this rate has made several economists into considering other factors. For Mark Zandi of a famous economics resource online, this may mean that this spending tells more of the increase on the capacity of individuals to spend more for their welfare and health. This may be caused by increase in income, hence, increase in percentage of spending for this aspect. On the other hand, Paul Ginsburg of Center for Studying Health System Change thought that this may also be due to the increased information and awareness of the need to priorities health. Individuals must have considered health care really serious that they have given more priority for it compared to how they consider it before. Communication and other media have contributed much to this awareness. On another perspective on the level of health spending of individuals in United States, health expenditures have become one of the major reasons for personal bankruptcy according to David U. Himmelstein, et al. In 2001, 1. 458 million American families filed for bankruptcy. About half cited medical causes, which indicates that 1. 9ââ¬â2. 2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illnesses led to bankruptcy, out-of-pocket costs averaged $11,854 since the start of illness; 75. 7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick. This means that even in the presence of subsidized health services, medical spending of every individual still has not changed, it even went higher to the point that one experiences bankruptcy. Medical problems contribute to about half of all bankruptcies. Medical debtors, like other bankruptcy filers, were primarily middle class (by education and occupation). The chronically poor are less likely to build up debt, have fewer assets (such as a home) to protect, and have less access to the legal resources needed to navigate a complex financial rehabilitation. The medical debtors we surveyed were demographically typical Americans who got sick. They differed from others filing for bankruptcy in one important respect: They were more likely to have experienced a lapse in health coverage. Many had coverage at the onset of their illness but lost it. In other cases, even continuous coverage left families with ruinous medical bills. First, even brief lapses in insurance coverage may be ruinous and should not be viewed as benign. While forty-five million Americans are uninsured at any point in time, many more experience spells without coverage. We found little evidence that such gaps were voluntary. Only a handful of medical debtors with a gap in coverage had chosen to forgo insurance because they had not perceived a need for it; the overwhelming majority had found coverage unaffordable or effectively unavailable. The privations suffered by many debtorsââ¬âgoing without food, telephone service, electricity, and health careââ¬âlend credence to claims that coverage was unaffordable and belie the common perception that bankruptcy is an ââ¬Å"easy way out. â⬠Second, many health insurance policies prove to be too skimpy in the face of serious illness. We doubt that such underinsurance reflects familiesââ¬â¢ preference for risk; few Americans have more than one or two health insurance options. Many insured families are bankrupted by medical expenses well below the ââ¬Å"catastrophicâ⬠thresholds of high-deductible plans that are increasingly popular with employers. Indeed, even the most comprehensive plan available to us through Harvard University leaves faculty at risk for out-of-pocket expenses as large as those reported by our medical debtors. Third, even good employment-based coverage sometimes fails to protect families, because illness may lead to job loss and the consequent loss of coverage. Lost jobs, of course, also leave families without health coverage when they are at their financially most vulnerable. Finally, illness often leads to financial catastrophe through loss of income, as well as high medical bills. Hence, disability insurance and paid sick leave are also critical to financial survival of a serious illness. Given this analysis, we have two important things to look into. First is that, despite government efforts to assist people in medical services, we still see issues on personal spending which even result to bankruptcy. Such is factored by the current system running for medical spending that doesnââ¬â¢t seem to address concrete circumstance of people facing medical and health-related needs.
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