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Healthcare, Guaranteed& by Ezekiel Emanuel
Brief Overview of the Authors Main Idea
The book under analysis is called Healthcare, Guaranteed: A Simple, Secure Solution for America reveals a comprehensive plan for restricting the quality of health care delivery in the United States. Ezekiel Emanuel suggests that eliminating employer-healthcare and introducing an independent program for assessing healthcare plans can provide the government with wider perspectives and options. In particular, the author also insists that healthcare delivery should be put into a broader context of social environment to fit the basic American values. Creating new vision of healthcare can also affect other fields of life in the United States.
Examining the Authors Viewpoint
To attract the readers attention, the author starts with the criticism of the current state of healthcare in America. He provides the deplorable examples of rates of birth and death, as well as focuses on the insurance scheme preventing from guaranteeing equal medicine to all citizens of the United States. In order to emphasize the inconsistence of healthcare reforms, the author introduces percentages of budget spending on health care that are much greater than in other developed economies. Nevertheless, about 50 million Americans remain uninsured.
The proposed guaranteed healthcare plan could replace the whole modern structure of health care budgeting in the United States by providing each American household with a guarantor for covering all health care services through an insurance company. However, the actual transition from the established systems to a completely new healthcare insurance plan is a sophisticated process, but it is an obligatory measure to be taken to improve the current situation. In particular, the author argues, through comprehensive reform, we can improve efficiency by decreasing excessive administrative expenses, eliminating waste and reducing fraud (Emanuel, 2008, p. 25). Judging from the book chapters, re-evaluating financial resources and budgeting schemes constitute the fist step to improving the situation and rebalancing costs. In this respect, specific attention is given to the analysis of technological advances that can hardly compete with cheaper alternatives for providing appropriate health care services. Further, the author refers to the scope of medical procedures as another obstacle to improving the situation and eliminating the problems. The challenge does not only lie in the techniques and tools by means of which all medical procedures are carried. Rather, the problem specifically concerns the communication models and collaborative plans employed in a nursing setting. In particular, the author highlights that consistent coordination and integration of care, along with exceptional communication, should promote significantly the existing health care plans. While articulating the above-presented ideas, the author relies on persuasive anecdotes from real-life situations.
The main problem of the current health insurance system in the United States consists in re-arranging the system in a way that can insure all the citizens with no exception. It should also reduce expenses on controlling insurance and eliminate the discriminative tactics of insurance companies toward their clients. Moreover, the proposed plan takes advantage of the Obama proposal because the Emanuel program is less complex and expensive. Despite the advantages, Emanuels new plan can enhance competition among health reforms, demand for value, as well as new campaigns introducing alternative technologies in producing drugs and improving health care service. Such a perspective does not explain how old system affects the global budget allocation and, as a result, severe misunderstanding arises concerning the schemes of global budget working. With regard to these constrains imposed on healthcare insurance, the Obama campaign proposal also includes similar approaches and provisions under which the entire population should be properly ensured.
Overall, the debates over the healthcare situation in the country are badly articulated because many of the arguments are unbalanced, exaggerated and unjustified. However, there are useful evaluations as well, which should be taken into consideration by health policy analysts. Moreover, the highlighted misconceptions make it possible to reconsider the reading in a broader context. Further, a discussion of the benefits of Emanuel and Obamas methods can be helpful and, therefore, a synthesis of both could produce much better results. Notwithstanding the benefits, Emanuels contribution to the analysis of the drawbacks of healthcare insurance system deserves serious skepticism because there are too many ambiguous arguments to rely on.
As the description of the current situation in healthcare is too emphatic, the assessment of financial issues is poorly balanced as well. In particular, the author ignores the political challenges of value-added taxes, which are withdrawn by the conservatives. Due to the fact that a VAT is a sort of sales taxes, the state legislators and governors resist to introducing proposals because of the fear of federal government encroaching stage revenue sources. There is a big contradiction between the discussion of tax payment system and the tables presenting numerical data. This is of particular concern to a 10 % VAT can be used to pay for health insurance and cover the new health insurance plan (Emanuel, 2008). With regard to the above presented evidence, the authors analysis of cost control seems to be exaggerated and inaccurate. In particular, Emanuel makes use of outdated data to prove that Medicare in the United States is subject to fraud and poaching.
The constrains are also represented through the prism of a single-payer mechanism. In particular, the author offers subjective interpretation of the plan that based more on personal statements rather than on serious, evidence-based analysis. Hence, Emanuel (2008) critically refers to the cost controlling issues stating that budget allocation is irrationally carried out (p. 56). Despite the above-highlighted misconceptions, the book at issue successfully manages to introduce goals of reform to ensure coverage at a moderate cost. Thus, appropriate treatment techniques introduced by the appropriate people with the right instruments stand at the core of health care insurance reconsideration.
In order to highlight the potential threats of the current health care insurance system, the author argues, the combination of continued payments for unproven tests and treatments, fraud and uncorrected payment problems&threatens to bankrupt our country (Emanuel, 2008, p. 56). However, although the cases of inefficiency and fraud are serious, the situation is not critical as compared to that in the private sector. In this respect, the author emphasizes, We need an infrastructure that facilitates the integration of services and collaboration among numerous healthcare providers (Emanuel, 2008, p. 70). Certainly, introducing a new incentive system can promote efficient insurance schemes, but specific focus on cooperation and collaboration does not allow to assess demographics of people who are not covered by insurance yet.
While representing a comprehensive cure plan to be addressed, Emanuel fails to provide a unique approach to improving the issue. At the end of the book, there is a set of diagrams and charts analyzing four schemes of Emanuel lay outs. The main mistake of a single-payer lies in leaving the private health care systems unchanged. In order words, introducing improvements to the insurance system does not guarantee the solution to all problems in the field of health care. However, paying attention to health care system through cost controls is also essential because it fits a single-payer scenario. Variations on Emanuels Health Care Boards are much more effective even in a multiple-payer scheme because it does not imply regulating private insurance companies. Therefore, the political and economic environments play a vital role in transformations of Medicare in the United States. Therefore, the idea of single-payer scheme promoting a qualitative transformation is not consistent enough. The major problem here lies in the political forces directing the improvements. The political influence on the competing schemes is justified, though the problem is not associated with a single-payer perspective. Rather, the failure of health insurance network lies in incomplete mechanisms enhancing the role of private insurance companies.
The book under analysis introduces an alternative path to improving health insurance in a country. Despite a number of numbers and statistic proving the deplorable situation, the health-care network undergoes difficulties because of inappropriate policies introduced. Therefore, although Emanuels comprehensive cure plan contains a number of misconceptions and mistakes, it can still be used as a basis for further development of new insurance schemes that can contribute to the effective work of Medicare. The plan is also coherent with the U.S. unique combination of equality and individualism. In addition, the book provides several important themes for consideration, including goals of reform, history, and single-payer initiative that in combination create arguments for action. The contradictions of the plan are also connected with liberal directions proposed by the author.
Reference
Emanuel, E. (2008). Healthcare, Guaranteed. A Simple, Secure Solution for America. US: PublicAffairs.
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