Governments Role In Healthcare Market Economics Essay

Subtitle: Their benefits and weakness

HCA 586: Health Economics

Western Kentucky University


The discussion on the role of government has already been and continues to be a most favorite topic in American pastime. Use a framework to understand the role of the government to raise healthcare access issue in the United States, presented some examples of federal actions to reduce healthcare cost, improve patient access provide about 10 instructions: (1) the purchase of medical care, (2) the provision of medical care, and (3) to ensure access to quality care for vulnerable groups, and (4) to regulate the health care market, (5) to support the acquisition of new knowledge, (6) the improvement and evaluation of health technology and practice, (7) monitoring the quality of medical care, and (8) to inform the medical decision-makers, (9) the development of the health care workforce, and (10) convened interests from the entire health care system. (Reference: Tang, N., Eisenberg, J., & Meyer, G).

In this essay, I will discuss the government function of government provide the benefit on access for people and regulate the health care access market. Those basically compromise these questions: provide tax benefits, and regulate the market and insurance.


Healthcare will seize power, the headlines in the United States in the next few years. No any service, is expected to consume 40% of the gross national product of the world's largest economies in 2050, this phenomenon will be hard to ignore. Most consumers feel that the impact of health care costs has been clear influenced the business management. Some recent studies and recommendations clarify this problem and some possible solutions. Realistically view the U.S. healthcare, which need to spend approximately $ 2 trillion annually and it is used for administrative. On a per capita basis, it is about $ 280 billion more than the government in 21 other countries in life expectancy than in the United States, there are also some in the form of taxpayer-funded, single-payer system, this kind used to be called "free medical critics regime". (Reference: Heskett, J). To make matters worse, the current system that more than 40 million Americans have no health insurance. Because the employment or income is very low, the program provided by employers, which are incentives; And also tax breaks, both still do not help them. With so many spaces can be improved, the incentive should be sufficient to promote government take actions.

Given this level, failed to resolve these problems in the United States can have global economic impact, such as Depression. But are we solve them with the creativity they deserve? For example, to fight against tax increases, tax credits for later use (when savings kick in) issued to increase the amount of personal and corporate taxes? Provide universal coverage, the Government may have provide vouchers (together with the consumer-oriented education), all uninsured care for their discretion? In other words, may be consumer-driven solution is a combination of a single-payer system? What is the role of government in the United States health care? Government can help to ensure that access to the health insurance, which market cannot do that. By using public programs, such as Medicare and Medicaid, and influencing the private insurance by policy regulations. The federal government policies, including tax subsidies and regulations, subsidized health insurance more affordable to consumers and employers, and regulations to help ensure that insurance and the most benefits. The government plays a fundamental role in the regulation of health insurance companies and the sale of products. Different states have different functions, which may include authorized insurance companies and agents, to ensure the financial solvency standards and oversight, approval rate, assessing insurance companies fund projects to consumers.

Provide (tax policy or tax support):

Government subsidies for health insurance and health care appear to make some taxpayers more affordable. Moreover, subsidies may increase health care spending to decrease medical insurance and the cost of health care services. Federal laws, including the tax credit for health insurance and medical expenses. In addition to support access to care, these benefits have been the formation of a market for private health insurance. (Reference: Jenson, J., & Fernandez, B).

The government plays an important role in helping to ensure access to health care and health insurance. In 2013, the federal Medicare and Medicaid spending, the State Children's Health Insurance Program (SCHIP) is up to more than $ 634 billion in 2007, according to the Congressional Budget Office. These projects majority for elderly, low-income people, as well as people with disabilities, otherwise it will be difficult to find adequate and affordable insurance in the private market. For vulnerable people who lack insurance paid by the employer, the government benefits may be the only viable option.

In addition to provide health benefits for vulnerable groups, the federal government is using the tax and regulatory policies affect the private health insurance market. Tax policy to support access to health insurance and medical costs through subsidies and regulatory policies to support access by laying the ground rules affect the availability and appropriate insurance.

The benefits: The federal law, which including significant tax benefits for health insurance and health care costs. In addition to support access to care, these benefits have been the formation of a market for private health insurance, mainly because of the tax policy; in 2006 about 60% of Americans get health benefits through work. (Reference: Jenson, J., & Fernandez, B).

Subsidies for medical insurance: The world's largest health related benefits of a tax are excluded from their employers to pay insurance. People who accept employer pay benefits, the premium costs are not included in income; therefore it would not affect income and employment taxes. Health insurance tax credit, including self-employed taxpayers, deduction and tax credits are given to a limited set of individuals who have lost manufacturing jobs or to receive payment of the Pension Benefit Guaranty Corporation. These tax incentives, to preclude the employer to pay the insurance than less. (Reference: JCT).

Other subsidies: Tax incentives to help consumers pay for qualified medical expenses whom without insurance. People can also pay with some tax benefits account, which are eligible medical expenses.

The weakness: Despite all of these tax incentives to help people pay for health insurance and medical care, the government, like the market, does not serves everyone equally. People may or may not be able to get all the benefits; Even if they are qualified, support may or may not affect access.

Because tax benefits are closely related to the employment, thus, employee may get support, while the unemployed are not qualified. In addition, high-income workers compare to low-income workers have greater sense of awareness on savings tax, because the tax benefits are based on the marginal tax rate. The taxes support does not guarantee access and the lack of support does not affect it. Even with government support, low-income people are not certainly being able to afford the whole care or full coverage. In contrast, high-income people buy insurance, regardless of care they need, even without support.

In addition to not allocated support according to the need, tax incentives may increase health care spending. With subsidies, people can buy more insurance than other methods; and with insurance, people may use more unnecessary health care.


Government regulatory policy is another tool to influence the health insurance market. Regulations affect coverage and benefits by setting the basic rules for insurance companies and employers to provide health benefits. States have the primary responsibility to regulate the insurance, but the federal government seeks to resolve the medical insurance selected issues. Under normal circumstances, federal regulations do not solve the premiums.

The benefits: 1) Access to insurance: The federal government's policy does not ensure access to private health insurance, but it did help some consumers to obtain or retain coverage under certain conditions. Just like Obama said, Obamacare in 2014 will realize that the entire American citizen can get health insurance, which is mandatory and means eliminate all the uninsured. And also the HIPAA (Health Insurance Portability and Accountability Act), made in 1996, helps to ensure that the new insurance for individuals and their families when the applicant may change job. This program also helps to ensure continued coverage when beneficiaries get sick. The law also helps small businesses. Insurance companies to provide coverage in the small group market must accept every applicant does not consider the claims history of the group.

2) Adequacy ratio of benefits: In addition to help ensure access to insurance regulations, they also address the adequacy of coverage. Almost all such laws and regulations are from the states. Committee affordable health insurance, an industry organization, the welfare of the number of government regulations is currently ranked 1900. (Reference: Council, 2007). These requirements affect coverage for specific health benefits insurance companies, service providers and the patients. Examples include mandatory coverage for cancer screening, chiropractic pressure treatment, disabled and families. (Reference: Council, 2007). The federal law includes several interests and demands. These provisions cover the parity of mental health benefits, hospital following a normal delivery or cesarean section, coverage of prosthetic devices and mastectomy reconstructive surgery. (Reference: Jenson, J., & Fernandez, B).

The weakness: The regulations may promote access to insurance or specific interests, but they do not provide that everyone is equal. Even though, the government makes laws to help people get access to the health insurance, it cannot guarantee that everyone can achieve the same treatment. In addition, even if the regulations require insurance companies to sell or employer-provided coverage, qualified people may still find coverage is unaffordable. Task of interests is unfair to provide satisfactory service for every customer. Sometimes, the problem is uniform protection, sometimes the problem is the protection of the variable. On the one hand, some people think that the benefit tasks help to ensure adequate coverage, while the maintenance tasks increase the cost and limit the scope for consumers’ choice. On the other hand, because the most benefit authorization is from the states, consumers may or may not be protected, relying on the place where they live. In addition, the strategies sold by insurance companies must comply with the national task, exempt from the enterprise to protect themselves.


Government has a responsibility to protect and promote the interests of the society, including providing and regulating the quality health care services. Because the market itself does not guarantee that all Americans have access to quality health care, the government must protect the interests of its citizens, improve the market, and the disadvantages of the market regulation invalid or unfair. The ultimate goal is to achieve high-quality care requires a strong partnership between the federal, state, local governments and the private sector. Translate general principles into concrete action for the appropriate role of government in a rapidly changing, decentralized delivery system will require the joint efforts of the public and private sectors. (Reference: Tang, N., Eisenberg, J., & Meyer, G).

Moreover, the government has an important role in helping to ensure the availability, affordability and adequacy of private health insurance. In the market, the government use tax and regulatory policy objectives to improve access to coverage and benefits. Ideally, these policies will reflect prevailing social values, but it is very difficult to set the priority. Affordability should be priority, and if so, for whom? For consumers and employers buying insurance? For low income groups? Or for everyone.

The challenges faced by policy makers in improving access to health insurance, the effective use of the limited public resources, avoid unnecessary regulations which may hinder market innovation.