The subject of health care reform is a battle that has been raging since the 1990s. This issue erupted when the cost of health care began to rise.

Coincidentally, the increase in costs rose around the time Healthcare Maintenance Organizations (HMOs) made their appearance.

The actual format of HMOs -- which were first established in 1929 with Ross-Loos Medical Group in Los Angeles, California -- did not take shape until 1977 when HMO health care plans were established by the Fallon Clinic and Blue Cross Insurance of Massachusetts. These became the originating HMO "plans" most individuals rely on today for their health care coverage.

Types of Health Care Services Available

Various ideas within health care reform have been floating around since 1985. The reason health care reform is so difficult to resolve, in a single word, is "cost."

In many countries of the world, health care is free or offered as a single-payer plan.

In the US, health care is mainly the domain of HMO or HSA (Health Savings Account) plans. Americans receive their health care through insurance providers through their employers or individually purchased.

In order to offer world class health care services, cost plays an important role in quality health care services delivered. Physicians, diagnosticians, surgeons, and others linked to medical care cannot work without being paid for their services.

Plans like Medicare and Medicaid are partially funded through payroll tax deductions, spread out over the lifetime of employment.

In single-payer plans, payments for health care services are managed by a single, central entity. In Germany, Canada, and England, for example, single-payer health care is provided by either the central or provincial governments.

Why Free Health Care Wouldn't Work in the U.S.

In Canada, England, and Germany, these governments set regulations on the cost of health care services provided by those in the medical industry. In the US, medical costs are dependent upon health care insurance providers.

One of the primary reasons why free health care wouldn't work in the US is its sheer population size.

For example, the population of California is larger than that of Canada. In terms of GDP, California ranks fifth in largest economies, leaving states with smaller populations and economies to manage health care costs via state-licensed insurers.

Conclusion

The reason why free health care wouldn't work in the U.S. relates directly to cost of providing state-of-the-art health care services. Free health care services won't work without a comprehensive plan to pay for medical services and medical providers.

With free health care, costs would be paid through higher taxes on the employed who would pay for their own personal health care needs and that of the indigent.

So until we find a viable solution to our health care woes, patients will have to continue resorting to pawn shops and viaticals to pay their medical bills.

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