Discussion Health care reform 2
Discussion Health care reform 2
One feature of the US health care system is that it is the most expensive healthcare in the world with results that would not agree with the cost. It is interesting to see that the US healthcare system has tried to evolve over the years and in that evolving has actually increased the cost of healthcare (Bodenheimer & Grumbach, 2020). Competition has fueled the improvement of healthcare, but at the cost of raising healthcare costs for the individual. There are other countries that have better health care systems in place, for a fraction of the cost. It would be interesting to investigate the actual cost of care and how much insurance companies gain compared to their actual payout. There is much that could be improved in the US health care system. It could be possible that the monetary issues prevent there from being major reform to the system because companies make such a large sum of money that they do not want things to change. As the US health care system has tried to change and become seemingly more affordable through the use of policy changes there has been an increase in the amount of money that they government pays, which is actually paid by US citizens through taxes (Bodenheimer & Grumbach, 2020). It seems that whenever the US health care system is taking one step forward it is also taking two steps back.
Challenges
The Affordable Care Act (ACA) did provide more individuals with health care coverage. This has improved the health of many individuals. One condition of the ACA is that it protects individuals with preexisting conditions from insurance companies denying care based on their condition (Healthcare.gov, n.d.). This is a great benefit for many individuals, but it comes at a cost for the insurance companies. This mandatory coverage causes insurance companies to then have to try to balance out coverage for those individuals that are ill versus those individuals who are healthy which can end up costing those individuals that are healthy to pay for others in their groups (Bodenheimer & Grumbach, 2020). This causes insurances to have to base their premiums on an experience rating versus a community rating which potentially provides unfair coverage to individuals (Bodenhemier & Grumbach, 2020). This seemingly minor change from the ACA has a ripple effect in the way that insurance companies need to charge for care and how they will determine premiums for individuals. The ACA in general is an example of how the policy making process is in the United States. Making or changing policy in the United States is a very slow, very incremental process which makes it hard to change or add policies (Walden University, LLC, 2011). The ACA was a worked on for a long time and because of the changes that were made many companies had to adjust accordingly. Health reform in the United States is difficult because there are so many entities that want to make sure that they are not being left out or hurt in decisions or policies that are being made and so they will stall or stonewall different policies if they feel that it does not benefit them. When there are policy changes then there are adjustments that need to be made and sometimes that effects so many different things that the changes end up being a negative instead of a positive, such as individuals who have to pay too much for the ACA healthcare and therefore opt out and are fined for that decision (Bodenheim & Grumbach, 2020).
References
Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.
HealthCare.gov. (n.d.) Understanding the Affordable Care Act. Retrieved from https://www.hhs.gov/healthcare/about-the-aca/index.html
Walden University, LLC. (Executive Producer). (2011). Healthcare policy and advocacy: The policy process. Baltimore: Author.
The evolution aims at making healthcare services more suitable due to the emerging healthcare conditions. Unfortunately, the evolution has made the cost of healthcare shoot (Wosik et al., 2020). Surprisingly, most uninsured Americans are now struggling to afford hiked medication bills. The advanced healthcare services that focused on making healthcare quality and patient satisfaction have turned into a nightmare for most Americans who cannot afford it. The introduction of the ACA and Medicaid programs are intervention mechanisms from the federal and the national governments. Most American politicians understand the ramifications of the changes in the US healthcare system and the entire sector (Tran et al., 2019). Therefore, to avoid the increased inability of Americans to access quality healthcare services have forced the authority to intervene through insurance programs. Also, the policy change in the healthcare sector is targeting the most vulnerable Americans. People living with disability and the elderly population is among the targeted population. Similarly, the government programs consider both the underemployed and unemployed Americans.
References
Tran, B. X., Vu, G. T., Ha, G. H., Vuong, Q. H., Ho, M. T., Vuong, T. T., … & Ho, R. (2019). Global evolution of research in artificial intelligence in health and medicine: a bibliometric study. Journal of clinical medicine, 8(3), 360. https://doi.org/10.3390/jcm8030360
Wosik, J., Fudim, M., Cameron, B., Gellad, Z. F., Cho, A., Phinney, D., … & Tcheng, J. (2020). Telehealth transformation: COVID-19 and the rise of virtual care. Journal of the American Medical Informatics Association, 27(6), 957-962. https://doi.org/10.1093/jamia/ocaa067
