Analysis of Health Care Reforms

Introduction

Public policy plays significant role in current political area. Political decisions deal with interests of representatives of various social levels. Healthcare system and current reforms in this field are one of the burning subjects to debate among ordinary Americans, experts, and policymakers nowadays. Despite great achievements, contradictory political strategies have led to inevitable disappointment among the population.

Healthcare system has always been subject to donate. In fact, during the last decades, American health care involved dramatic investments, remaining one of the major causes of budget deficit in the United States. To illustrate, the U.S. directed about $2.2 tn on healthcare system. This spending is equal to 16.2% of the country’s GDP. In particular, in 2008, “46.3 million people in America, out of population of 300 million, were uninsured” (Blodget, 2013). The intervention of the American state authorities turned to be a necessary measure to boost the current health care situation in the United States.

Background

The health care field has always been problematic. Children, elderly people, and individuals who lost or changed their place of work remain to be the most unprotected categories of Americans. The U.S. authorities attempted to improve the state of affairs in the health care system after the World War II. To illustrate, Medicare and Medicaid programs were adopted in 1965. The government introduced COBRA in 1985. In 1996, HIPAA was enforced. Later, SCHIP was introduced.

In the 1960s, the U.S. government introduced popular health insurance programs, Medicare and Medicaid, to boost the level of life in the most unprotected categories, such as elderly and moneyless people. Medicare coverage included four parts. Module A provided payments for hospitalization. Module B dealt with outpatient services, such as doctor’s consultation and medical treatment. Module C regarded advantage plans. Module D was connected with medical support. Complimenting Medicare, the U.S. authorities introduced the Medicaid program in 1965. Originally, this coverage dealt with children from poor families and their caregivers. These programs were dramatic success. Nowadays, approximately 62 million of Americans possess Medicare and Medicaid coverage (Healey & Evans, 2014, pp. 131-155).

The U.S. government adopted the consolidated Omnibus Budget Reconciliation Act (COBRA) in 1985. This legislation contributed to further boosting the level of life among the Americans in need. Dealing with numerous issues, COBRA regarded private pension coverage and disability insurance.

In 1986, the American government introduced the State Children’s Health Insurance Program (SCHIP). It protected children from poor families, suggesting medical coverage to them. In 2010, the adoption of the Affordable Care Act (ACA) contributed to the urgent necessity of further reforming healthcare delivery. According to the document, all the U.S. citizens must possess their own health insurance program. Since 2014, individuals who employ more than 50 workers lacking health insurance coverage have to pay the penalty of $2,000 per individual every year. This fact will lead to enhancing the number of purchasing insurance programs up to additional 27 million issues (Healey & Evans, 2014, pp. 131-155).

On March 23, 2010, health care reform, or Obamacare, was launched, causing brisk disputes among policymakers, experts, and ordinary citizens of the United States. The transformations refer to the Patient Protection and Affordable Act. Many experts support the reforms in the health care field. However, the transformation has resulted in disappointment among certain part of Americans who consider that the above-mentioned political decision does not benefit society and just plays politics (Blodget, 2013).

Current Status of the Health Care System in the United States

The health of the nation is one of the major values of the state. However, cost, quality of the U.S. caring, and access of the ordinary American citizens to modern health care system are the subjects of concern. Therefore, the health care reforms can be defined as a challenge.

In 2010, the President Obama declared eight key principles of the health reform. First, American citizens are to have free access to high-quality health coverage. Second, obstacles to the coverage, comprised in the former conditions, are to be eliminated. Third, the coverage is preserved under the circumstances of a person’s loses and job changes. Fourth, this legislation defends average families against bankruptcy connected with health spending. Fifth, any patient enjoys the right to choose a doctor and the most preferable coverage plan. Sixth, enterprises and the government have the privilege to decrease long-term cost growth in medical treatment. Seventh, levels of quality in health care are to be boosted, focusing on patients’ welfare. Finally, special attention should be paid to preventive care and wellness (Edmonds, 2010).

Reforms caused numerous benefits. According to the statistics, the field of insurance market is dramatic, including “over 47 million non-elderly uninsured people in the USA (aged 0 – 64), approximately 17 million of them will be insured in 2015, 90% of individual market enrollees will receive federal subsides” (Anderson, n.d.). In particular, approximately 40% of the supposed enrollees are to come from California, Texas, New York, and Illinois.

According to calculations, hospice market will experience reductions by 0.3% during the interval from 2013 to 2019. Accordingly, health market will suffer from about 1% decrease. The reform introduces “12 clinical process measures for Acute Myocardial Infarction, Heart failure, Pneumonia care, surgery infection prevention, infection rates and 8 HCAHPS patient experiences” (Edmonds, 2010).

The reform defends the interests of the Americans in need. The accent is made on the category of elderly people in particular. In fact, senior citizens are one of the most unprotected categories of Americans. To illustrate, the United States takes the leading place worldwide, directing the amount from $5,000 to $43,000 to its retiree. To compare, the UK spends on the goals approximately from $2,000 to $10,000. Germany directs from $5,000 to $12,000 to its pensioners. Finally, Sweden lavished about $4,000 – $7,000, while Spain directs approximately from $3,000 to $6,000 to these needs (Edmonds, 2010).

Significance of the Reforms in the Health Care System

In the U.S., health care coverage plays significant role in both national and households’ economy. To illustrate, approximately 160 million Americans have employer-sponsored insurance coverage. About 17 million U.S. citizens bought the insurance package, participating in the private insurance market. Approximately 100 million Americans enjoy government-sponsored insurance plans. In particular, 49% of the population possesses individual insurance programs, 16% have Medicaid, and 13% enjoys Medicare. However, 16 % of Americans in the eligible categories are uninsured (Keckley & Copeland, 2013, p. 121). Currently, certain transformations take place in the American health insurance industry. First, the role of employers in the domestic insurance market is changed. For example, a significant number of American citizens possess insurance coverage purchased by their employers. Therefore, employers share business responsibility. Second, the range of insurance providers in the health care area is decreasing. This phenomenon is a result of the employers’ free ability to choose the most preferable provider. Finally, preventive health care programs are extremely popular. In fact, the ratio of preventive programs is about 75% of the coverage costs (Keckley & Copeland, 2013, pp. 122 -123). This fact contributes to the improving of the state of affairs in the health care on the national level.

The key stakeholders of Obamacare are the patients who benefit from the transformations. Socially unprotected individuals can receive high-quality medical treatment. As stakeholders, physicians, hospitals and employers are involved into reforms as well. Nevertheless, they are not satisfied with the reforms because they receive additional duties. To illustrate, about 2,400 private nursing personnel considers that the new health legislation does not express their interests. In fact, approximately 26% of nursing respondents are inclined to continue their private practice. The rest of physicians intend to retire or to work part-time. Employers complain of the unclear issues in the legislation comprising 2,400 pages. As for insurers, they have excellent opportunities to enhance their markets. Constant negative statements made by journalists and policymakers destroy their reputation. One cannot reject the possibility of turning some insurers into private actors lobbying their interests through policymakers. Public officials do not have similar opinion about the reform. In fact, the U.S. President Barack Obama made an unprecedented step to boost the healthcare. Nevertheless, the Republicans do not support this reform. In fact, they declared war against Obamacare, Bob Bennett and Chuck Grassley being among them. The policymakers emphasize that the reform is detrimental for the American economy (Cafasso, 2011).

Transformations in the delivery system are the relevant step in the American health care. To illustrate, active introduction of EHRs contributed to the improving of the health service. Patients can receive proper medical treatment in suitable time and the way most convenient for them. Since 2013, the cost of the Medicare coverage has reflected on hospital payments. Obamacare eliminated overpayments to Medicare Advantage programs (Kirk, 2010).

Despite positive effects, modern American health care system faces numerous challenges. First, value-based purchasing coverage is extremely important to hospitals and health care clinics. Nevertheless, nursing personnel complains of the penalties of CMS’s reporting. To illustrate, CMS discovered above 257,000 professional providers who do not intend to use electronic health records innovate

Implementing electronic medical records has been subject to brisk debates during the recent decade. An electronic medical record can be referred to as a digital variant of the traditional paper-based medical histories for patients. Electronic medical records are used for patients’ diagnosis and treatment. Electronic medical records contain data about a certain individual, such as patient’s contact information, data about patient’s height, weight, and body mass index. Moreover, electronic medical records include information about previous and predicted medical treatment, medical orders, and prescriptions. Furthermore, electronic medical records comprise details about patient’s medical improvement and surgical facts. Finally, electronic medical records involve billing details such as insurance, discharge summaries, and treatment plans.

Nevertheless, experts draw public attention to several drawbacks of EMRs, such as privacy protection, medical records synchronization, considerable expenses and legal inconsistency, shortage of similar terminology, system design, and indexing. Initiating electronic medical records is expensive. Physicians and hospitals do not have financial return from investing their money into the electronic healthcare system. Moreover, installing, maintaining, and updating the above-mentioned system pose many difficulties. Finally, privacy, confidentiality, and security of patients’ health data cannot be guaranteed. In fact, providers keep digital Protected Health Information in various electronic systems. Nevertheless, the common threat for all the current data systems is their vulnerability to cyber-attacks (Auerbach, 2012, pp. 606-610).

Conclusion

Public policy takes unusual place in the current political area. Nowadays, modern policymakers adopt numerous legislative acts to protect the interests of individuals representing different social levels. The current healthcare reform, or Obamacare, is one of them. The key stakeholders of the reform are the most unprotected categories of the U.S. citizens, such as children, elderly people, individuals who lost or changed their place of work. The U.S. government made steps to improve the state of affairs. Policymakers adopted Medicare and Medicaid programs, COBRA , HIPAA , and SCHIP. The introduction of Affordable Care Act (ACA) contributed to the urgent necessity of further reforming of healthcare delivery. Finally, the current health care reform, or Obamacare, was launched, causing brisk disputes among policymakers, experts, and ordinary citizens of the United States.

Despite numerous benefits, such as effective protecting interests of the moneyless Americans, modern American health care system meets numerous challenges. Value-based purchasing coverage and its consequences, as well as implementing electronic medical records have recently been subject to brisk debates. Many physicians and even insurers are not satisfied with the reform. The Republicans argue that Obamacare will damage the U.S. economy. Nevertheless, the transformations in the healthcare field are urgent. The solution is to find the wise decision for escaping inevitable pitfalls of every political transformation.

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