Sociology

Since the introduction of the first social security plan in German in the late 19th century, there have been substantial efforts made to develop one of the most critical instruments of social protection and welfare ever created by mankind. According to Mesa-Lago, the basic tenets for the establishment of social security programs are  (a) universal coverage (b) equal treatment (c) solidarity (d) comprehensiveness (e) unity, state responsibility, efficiency, and social participation in the administration and (f) financial sustainability (VI). The two most crucial social security programs with respect to expenditures and revenues in addition to number of insured and beneficiaries are disability, old age and survivor retirement fund and Healthcare (VI). Since the introduction of social security programs the world over, health care reforms have been more diverse and comprehensive. The focus of this paper is to evaluate the effects of social security programs on health care systems.

The linkage between health care costs and economy is quite obvious. The lack of an all-inclusive social security program implies that access to health care service is limited to the majority of the American population by virtue of high costs involved. The United States does not have a comprehensive health coverage plan for its population, with over 45 million people not insured and approximately 24 million living under an ineffective insurance policy (Baucus 6). In early 20th century, the United States formed a Committee on the Costs of Medical Care to carry out research and propose an economically viable health care system that would provide health insurance to Americans and stem rising health care costs. Although the Committee made several recommendations, none was adopted (Ross 129). The consequence is that to date, many American households and businesses are striving to stay afloat in the face of rising health care cost at the same time fighting to stay competitive both at home and overseas. An effective social security program is thus urgently needed to provide a high performing health care system that would avail all Americans with an affordable and a comprehensive coverage irrespective of their health conditions, age or medical history. The lack of an all inclusive social security program implies that health care costs for the uninsured are basically absorbed by those with an insurance cover. Insurance providers usually charge privately insured patients high premiums to pay for uncompensated care. A viable social security plan which guarantees all American a health insurance cover will bring to end the shifting of health care costs from the uninsured to those with coverage (Baucus 6).

A social security program that covers all the health care needs of Americans will serve as an effective tool in managing chronic diseases, improve health and absorb extra costs. This means that a vibrant health care system will enable health care providers, individuals and employers take active part in achieving the goal of providing health insurance cover to all Americans. Such a program would elevate the quality of health care and bring down costs so that employers are able to provide coverage to their employees at the same time compete effectively in the international market. This will in end put public health programs on a more sustainable course (Baucus 7).

Social security programs have played a significant role in the achievement of health care reforms such as broadening coverage and improving equity and quality of benefits. These programs have provided the insured an array of choices between competing health care insurance providers in quest of a more efficient and low cost health care system (Mesa-Lago VI). These reforms, combined with a decentralized health care system has ensured that majority of health care seekers are able to access a comprehensive health care services at lower costs. To make it more effective, legislations have been enacted with regard to social security program as discussed below.

For instance, in France, the parliament ratified an Act on Social Security Funding based on the recommendations from the National Health Conference and accounts commission. An example is the 2001 Social security Act which improved the remuneration provided by the health insurance scheme with regard to self employed people harmonizing them with those offered to salaried employees by the health insurance scheme (Sandier et al 20). The Act also established specific findings to be utilized for the modernization of health care facilities in addition to providing pharmaceutical information for doctors.

The Act also revamped the Ministry of Health and restructured it to include a directorate of health care and hospital with the mandate to manage the health care system resources, a directorate of social security whose role was to manage financial issues that include supervision of health insurance funds and a general directorate of health charged with formulation and implementation of health policy, among others (Sandier et al 20). The financial obligations for health care in France are also covered under the extensive system of social security. The statutory health insurance envelops the entire population despite the fact that it funds only about 75 per cent health spending. The 2000 Universal Health Coverage Act provides additional funding to cover to all eligible residents in the country. The Act provides that workers earning less than 6500 Euros in a year be excluded from making contributions (Sandier et al 35).

Under this act, eligibility in the statutory health insurance system is subject to income level and place of residence in France. There are three main health insurance schemes (a) the general scheme that encompasses workers in industry and commerce, (b) the agricultural scheme which envelops farmers and other workers in the sector and (c) the scheme for non agricultural self employed people that cover self employed and craftsmen among others. Health insurance schemes are supervised by the Social Security Directorate in the Ministry of Social Security and are expected to manage and meet set targets in the statutory health insurance system (Sandier et al 36). As a way of achieving its goals, the social security organization has put in place several measures to reduce expenditures arising from work related health risks.

The social security organizations in partnership with other pertinent stakeholders have initiated policies aimed at reducing health risks arising from work. For instance, the work place inspectorate is mandated to ensure that laws with regard to safety, hygiene and working conditions are adhered to. The Committees on Hygiene, Safety and Working Conditions examines risks associated with the work place and offers its views on the best working conditions to be adopted to reduce work related health risks. Doctors services and compensation are usually made available to victims of work related illness. For example, about 6400 doctors were made available in over 1320 workplace in 2000 (Sandier et al 59).

To achieve a more comprehensive health care system, the state has taken up an active role through the enactment of Social Security Funding Act and involvement of parliament. Major health care reforms have been put in place since 1990. For instance, the Constitutional Act (96-138 of 22 February 1996) established an annual legislation with regard to social security funding and putting a cap on the aggregate health care spending by the health insurance funds. The Social Security Funding Act (96-1160 of 27 December 1996) facilitated the transmission of income related health insurance contribution to the General Social Contribution setting national spending caps for health insurance with respect to available resources and putting in place public health priorities (Sandier et al 125). The 2003 Social Security Funding Act established the High Council to be used by health insurance to recommend solutions for the transformation of health insurance. It also facilitated the execution of payment per case for health care institutions, biased liberalization of prices for new drugs and simplified planning process and budgets for investment in the health care system (Sandier et al 125).

Conclusion
Improving health care system is one of the critical challenges that many countries face the world over. The effects of social security programs on health care system are quite obvious. For instance, in the United States, health reforms have been identified as a critical part in Americas overall economic performance both domestically and internationally. Social security programs are necessary to enhance health care reforms that can safeguard incomes of American businesses and working families. As observed above, over 45 million Americans have absolutely no form of health coverage and another 24 million people who claim to have one are underinsured. The government and parliament must enact appropriate legislations and provide financial support to meet this goal (Baucus 96). Some countries have been successful in enacting social security laws that have played significant role in establishing health reforms in the health care systems, particularly France. The United States health care system must address three key elements cost of health care, accessibility to care and quality care. Attempts to cover millions of uninsured using an ineffective health care system is bound to be costly and unsustainable. A stable and functioning social security program is the only way to achieve a health care system that is all-inclusive in scope (Baucus 96).