HEALTH ECONOMICS

Health Economics

Health Economics

Health Insurance in America has become increasingly more complicated throughout history, for those people considered poverty stricken. Solutions to help educate and finance health insurance for the poor have been issues for many years. A solution that has been in place now for many years is Medicaid/Medical, which provides basic health care to those who qualify and are in need. However the un-discussed problem that has been around from the beginning but just not addressed is equality. American has provided the opportunity for a nation wide health care system but has omitted the equality of access in regards to appointment availability, specialty surgery (in most cases necessary surgery), prescription coverage and even denial to a primary care physician. These cost containment policies that are being implemented across the country are damaging our already frail health care system. It is time that the United States places the importance of health care equality up with that of education and state taxes.

A longstanding issue in low income health care has been the growing financial debt, especially in regards to prescription drug coverage. Dr. Peter J Cunningham, a senior health researcher at the centre for studying health system change, states in his article entitled, “Access to Prescription Drugs: The case of Medicaid”, that Medicaid program costs have become one of the largest items in the states budget, accounting for more than one-fifth of state budgets on average. Prescription drug costs have been one of the major cost drivers in the Medicaid program in recent years accounting for 33.7 billion dollars in 2003 and increasing by about 18% annually between 1999 and 2004 (Cunningham, 2006). Due to the increasing financial disparity, states have enacted some cost containment measures to alleviate such problems, but in turn have also made it more difficult for low income families to acquire necessary medications, containment measures such as: First, establishing “prior authorization, where a pharmacist is required to obtain approval from the state (or a subcontractor to the state) before dispensing certain drugs. Second, establishing dispensing limits, where the state limits the quantity of drugs that Medicaid will purchase (e.g. no more than a 30-day supply is a common restriction). Third, controlling the co-payments, which are usually less than 3 dollars per prescription? Fourth, substituting generic name drugs for the brand name medications. Fifth, initiating a step therapy, where the physician needs to demonstrate that a lower cost drug is ineffective before prescribing a more costly alternative” (Cunningham, 2006). These five cost containment measures were established to cut the states heavy financial spending on low income health care, but in doing so have slowly moved to cutting equality and access to health care commodities for low income families.

According to Cunningham virtually all states have enacted one or more of these cost containment policies and the number of states that enacted four or more has increased dramatically within recent years. “To understand the results, it is important to remember that Medicaid enrolees (especially adult enrolees) include some of the ...