Lack of a proper health insurance policy has been a significant gap in the delivery of quality healthcare, especially for the chronically ill patients. The uninsured individuals face financial constraints that deny them a chance to access health services, emergency rooms, specialist treatment, and other hospital-based services ( Bodenheimer & Pham, 2010). When an insurance policy is not implemented that covers all individuals, the resulting problem is that the uninsured people will likely postpone health care or sometimes forgo it entirely. The population that is most affected by this gap include those undergoing long-term care such as the aged and young children with special needs.
The healthcare insurance policy problems trace back to 1938. With the acceptance of the germ theory of disease, the use of vaccines became common and regulatory bodies such as the American Medical Association (AMA) were formed. With many people wishing to see expensive doctors, creative ways to pay for services were formulated. Patients figure out a way of paying smaller amounts on a regular basis than waiting for an emergency. The early insurance policies, however, did not cover everything as they only focused on specific diseases. With time, the private insurance companies expanded and more wealthy Americans viewed it as the best way to approach health care payments. The government also began the program but with minimal success because most poor people have not been insured till date.
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Lack of healthcare insurance provides a socioeconomic problem to the patients especially given that long-term care is a costly program. Many people with chronic illnesses such as cancer and other forms of incapacitation such as spinal cord problems and mental disorder need lengthy stays at the hospital and nursing care facilities to improve their health. However, with the current healthcare insurance policy that does not comprehensively cover the needs of the poor. Such people face significant economic problems while paying for these services.
The uninsured people are most likely to suffer from adverse health problems that result from their inaccessibility to both inpatient and outpatient services as pointed out by Schoen et al. (2010). Children requiring special care will also suffer and may lead to other life time illnesses that result due to lack of vaccination. Patients requiring long-term care resort to staying at home due to the high cost of hospital charges.
Existing Initiatives
The Affordable Care Act is an effort that was put in place to reform the healthcare policy with regards to increasing the coverage of the insurance coverage to the poor. According to Rak et al . (2013), it was formulated to improve the existing insurance policies such as the Medicare that was enacted in 1965. The goals of the initiative included reducing healthcare costs, increasing coverage to the poor, improving the quality of healthcare, and also to enhance equity in healthcare delivery.
The initiative was started in 2014, and by this time, the population of the uninsured population was close to a half of the entire U.S. population. The initial policies did not take into account certain important aspects such as charging the same rate, accepting all applicants regardless of their conditions and sex. The funding of the act was through taxes and the cuts directed to the Medicare policy. There are certain shortcomings that the initiative has faced that it has now necessitated the need for improvement. The program has led to an increased in health care costs over a short term as it is hard to treat diseases that have been ignored for many years. It has also led to major taxing and loss of company-sponsored medical plans.
Regulation
The Affordable Care Act has certain regulations that it has developed to increase its coverage of people and services. One regulation is that it allows the employee's children below the age of 27 years to be covered in the health plan. It has also allowed for coverage of retirees. Also in the plan is that it does not cater for the costs incurred in the purchase of over-the-counter drugs unless a prescription is given. The initiative is being overseen by the Congress and the Senate given the nationwide impact it has on the people of the United States.
In conclusion, the initiative has played a major role of enabling access to affordable healthcare for all regardless of their economic status. It aligns with other prior initiatives such as Medicare but offers much better improvement in coverage. It is, therefore, an effective action whose advantages outweigh its disadvantages.
References
Bodenheimer, T., & Pham, H. H. (2010). Primary care: current problems and proposed solutions. Health Affairs , 29 (5), 799-805.
Rak, S., & Janis Coffin DO, F. A. A. F. P. (2013). Affordable care act. The Journal of medical practice management: MPM , 28 (5), 317.
Schoen, C., Osborn, R., Squires, D., Doty, M. M., Pierson, R., & Applebaum, S. (2010). How health insurance design affects access to care and costs, by income, in eleven countries. Health affairs , 10-1377.
