Background of the Problem (Introduction)
Within the pluralistic structure of the U.S. health system, most Americans under the age of 65 are covered by either the employment, or by that of their spouses. About 65 percent of Americans are also covered by private insurance, both group and individual. The remainder of the people either receives health care through Medicaid or does not have health care at all (Gold, 1999, p. 5). One of the problems that has emerged is that increasing numbers of people are uninsured and have no access to health care. A large share of these people includes increasing numbers of children from impoverished families who are either unaware of the programs or are ineligible for some reasons (Gold, 1999, p. 5). Even for the people who are covered by insurance, the quality of health care needs to be greatly improved. Patients are furious at their lack of access to adequate health care. In the case of Medicare, even though senior citizens are satisfied with the level of care, the federal government is confronted with the spiraling costs of funding Medicare.
In the past, the establishment of the market system of the health insurance industry was considered to be adequate in providing health care for most Americans. However, as the years go by, it became obvious that increasing numbers of Americans have fallen through the cracks of the system. The primary reason is that most people afford insurance through their employment. With the change in employment structure, many Americans are no longer eligible for insurance by this path.
Even though health-care costs increased dramatically in the 1980s, HMOs have succeeded in providing cost-effective care for many people ("Echoes," 1999, p. 351). From the early nineties to the mid-nineties, health care costs began to stabilize. After the increase of private health insurance premium to 10.9 percent in 1992, the rates of increase of the premiums began to fall: 8 perc...