In the year 2012, when former U.S president Barack Obama signed the Affordable Care Act, It saw millions of people getting insurance coverage. The Affordable Care Act saw a significant change in healthcare coverage, with over 70% of people claiming insurance coverage within a short period ( Watts et al., 2015). The Affordable Care Act is an example of how public laws and policies can have a significant impact on healthcare consumption in the country. Currently, different Republican politicians led by president Trump are championing a move to repeal the Affordable care act. However, many people still propose different policies to reduce the cost of care in the country. Such are reasons that make it essential to study the impact of public policies on healthcare in a country. The government has a critical role in the healthcare sector ( Blue et al., 2016). Through enacting various healthcare reforms and policies, the government does regulate the healthcare market, insurance, and healthcare consumption. The public policies that have an impact on healthcare do not necessarily relate to health. However, public policies that influence the factors that reshape healthcare or the drivers to health have impacts either directly or indirectly on health. In this research, the aim is to understand some of the public reforms and legislations that directly influence health care. It also aims to look at how the government has a significant influence in the healthcare sector by coming up with public reforms and policies that directly affect the decisions in the sector. Further, the research will also major on the upcoming election and assesses different candidates concerning their ideas on health and how their proposed reforms targeting the healthcare sector might revolutionize the industry. The last part will be a comparison of healthcare policies and structure between Canada and European countries. The government has made numerous landmark public policies that have had huge impacts on the healthcare sector. The government gets involved in the healthcare sector directly as a means to influence the market. Currently, government spending in the USA health sector is $ 2.5 billion. Also, the government has spent over 400 million dollars on Medicaid, and this have changed the healthcare sector in the country ( Tarasuk et al., 2015). It is the mandate of every government in a state to ensure that the healthcare cost for the citizens is low. The government place numerous regulation in different public sectors that drives health to reduce the cost and reduce the train in the economy that numerally takes place when there is a high rate of healthcare spending. By definition, public policies are regulations that target specific issues that affect the public, to rectify them and make them better. The government uses such public policies when it wants to rectify a situation in the economy ( Watts et al., 2015). The U.S government provides healthcare through a third-party system where the party reimburses doctors for the bulk of the cost of healthcare services they provide to the patients. It is because of search reasons that the government has tried to come up with numerous policies such as Medicaid and Medicare as a way to influence the healthcare sector. In the history of the United States, different presidents have had numerous public policies that have a hard critical impact on the healthcare sector. The social security Amendment, for instance, had a crucial effect on healthcare consumption in the country. It was the bill that was aiming to improve health by establishing Medicaid and Medicare. Furthermore, the Consolidated Omnibus Budget Reconciliation Act of 1985 was another land-breaking public policies that also had critical impacts on health ( Tarasuk et al., 2015). Currently, the fight to increase the minimum wage rate in the country, for instance, are some of the current debatable public policies that are likely to shift the demand in healthcare as the government is trying to find a balance to improve healthcare accessibility in the country. Furthermore, the recent court battle to repeal the Affordable Care act is some of the ways that the government uses to increase the accessibility of healthcare and increase healthcare consumption. Such is expected to continue as numerous candidates that are eyeing the 2020 election are laying their plans on the health sector. The country is likely to see some changes in the healthcare sector when such leaders will have the chance to lead America ( Hall &Lynskey, 2016). Their care has been many groundbreaking policies that have had an impact on healthcare in the United States. Social security Amendment of the year 1965 was a public policy that was signed by President Lyndon Johnson. It established the Medicare that focused on cost reduction healthcare by ensuring that everyone was receiving social security benefits that covered hospitalization. It was also covering physicians and outpatient services in the country. According to Watts et al. (2015), this was a move that increased the primary healthcare consumption rate in the country by 25%. In the year 1972, President Richard Nixon also later expounded on the social security Amendment that also ensured that the disabled individuals were also part of Medicare. The policy had benefits for multiple individuals in the United States. Since its establishment until the year 2015, there were about 60 million people who had benefited from this policy ( Tarasuk et al., 2015). The Social security Administration published the graph below that shows different categories of people who have benefited from this policy. From the graph, it is evident that the policy has increased healthcare consumption and demand in the country, thereby having a directed influence in the healthcare sector in country. Source: https://www.ssa.gov/oact/STATS/OASDIbenies.html
In the year 1973, the Health Maintenance Organization Act of 1973 was also another groundbreaking public health policy that was critical to the healthcare sector in the country. It was a healthcare policy that later renamed to Health Maintenance Organization (HMOs) as an alternative to fee-for-fee plans. Furthermore, there was a Consolidated Omnibus Budget Reconciliation Act of 1985 was also another policy that was critical in the healthcare sector. It was a public policy that was allowing the employees to continue accessing healthcare even after they lose their jobs. Csete et al. (2016) show the effect of this public policy on healthcare. The statistics reveal that due to the policy, there was an increase in healthcare consumption by 5%, mostly for those who had been in medical leaves and those who had lost their job in the U.S. Healthcare Insurance Portability and Accountability Act of the year 1966 was a policy that was targeting the insurance sector and how they operate in the healthcare market. The aim of the government in enacting this policy was to regulate the insurance companies by placing sanctions on the nature of people the insurance companies should exclude from their plans. By regulating the insurance sector, which is a business sector, the government uses such policies to ensure that it encourages healthy practices and also encourages healthcare consumption to create a healthy population in the country ( Csete et al., 2016). Obama care also known as the Affordable care Act, is late on the list as a public policy that, despite seeing a lot of controversies and court cases, has achieved milestones by encouraging many people to get healthcare cover. The policy call all people in the country to acquire healthcare insurance. Through different programs, the uninsured percentage in the U.S population has hit 9%, thanks to the Affordable care act. As a result of such public policies that target the healthcare sector in the country, there have been numerous improvements in the manner in which U.S healthcare consumption. In the United States presently, the total percentage of people who have insurance cover is 90%. About half of these individuals have covers from private businesses and jobs. However, 17% of these individuals have healthcare covers under Medicare ( Blue et al., 2016). Note that Medicare has been a joint policy program for both the states and the federal government that ensure that there is healthcare accessibility for the seniors and those with disability. Furthermore, there is about 17% of these population that have insurance covers under Medicaid. Medicaid is also a public policy program that ensures that those who have low income in the country can access healthcare at an affordable cost ( Blue et al., 2016). A round 5% buy coverage on the individual market, either through the marketplaces established by the ACA or directly from an insurance company. About 9% of Americans, almost 30 million people, have no insurance. The statistic is critical as it showcases the impact of public policies in healthcare. From the statistics, it is evident that the cost of care in the country has become much more affordable not only for the rich people but also for the average citizens because the government has made it so through the use of different public policies. The Pie chart below is a representation of how Americans get health insurance in the healthcare sector. Source: Fiedler, C. (2019).
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Note that these are numbers that are subject to change in the future. People can change their minds on the nature of the insurance cover they need, and this may change the percentages on the pie chart. Further, there can also be other public policies that can shift the demand for specific insurance cover, and all these changes how people consume health in the country. The government involves directly in the healthcare sector. First, it is the government that regulates healthcare. The government relies on other bodies that are a concern with health in the country to regulate the healthcare practitioners. In this manner, the government ensures that there is only those who have a specific qualification in the field of healthcare are involved in providing healthcare services to the people. The government also comes up with different policies and programs to ensure that the healthcare providers in the country are standard and cost-effective for the population( Csete et al., 2016). Healthcare policies such as the Affordable Care Act are an example of policies that the government comes up with to ensure that the citizens access healthcare at a favorable cost. The government also funds the healthcare institutions by coming up with different programs that aim to boost the institution, mostly the public healthcare programs in public hospitals in the country. It is also the government in the country that pushes for insurance organizations to create fair premium rates for the patients and the hospitals. Note that the healthcare system in the country relies mostly on the third for reimbursement. In that case, the government ensures that there are no discrimination regarding insurance premiums. It is also the government that comes up with most economic policies that are drivers to healthcare issues in the country ( Tarasuk et al., 2015). By influencing the economy, the government is therefore involved directly in defining the path for the healthcare sector in the country. There are tools that the government further uses to control how the healthcare sector operates in the country. The first tool is taxation. The government tax all the private and public healthcare institutions, and in this manner, it gets involved directly in the affairs of the public health sector. The government also has research departments that deal with matters of health in the country. In this manner, the government gathers data, conducts an analysis of data from different hospitals, and provides reliable information to different healthcare agencies. Such pieces of information are critical as they are used to understand the health status of the population as well as different emerging conditions that should remain on the radar in this sector. Another tool is purchasing. An excellent example, in this case, is the Federal waivers, Medicaid managed care are some ways through the government uses its purchase as a tool to control the healthcare sector. The government, therefore, has a role in contributing to the success of the healthcare sector in the country. Through tools such as taxation and numerous policies on the health sector, the government has a direct role in influencing the healthcare sector and ensuring that the public gets affordable care. The 2020 election is about policies argument with candidates championing for the policies they believe are right for the citizens of the country. A critical analysis of these policies could be an excellent way to predict the direction the healthcare sector may take in some years to come. President Donald Trump is one of the candidates that people are looking forward to as he prepares his bid for a second term on the seat. One of his proposals is to reduce federal funding for programs that subsidize coverage for low and middle-income people and eliminate specific regulations that apply to private insurers ( Csete et al., 2016). The proposal has three parts. The first is to repeal the Affordable Care Act coverage programs. The main parts targeted by Trump are parts that provide financial assistance to people who buy individual market coverage, as well as the ACA’s funding for states that expand Medicaid. If the candidate gets the votes and wins the election, the country may see an increase in the number of people without healthcare insurance coverage ( Blue et al., 2016). The second part of this proposal is to eliminate the regulation of the Affordable Care Act. Note that the Affordable Care Act mandates every person to get insurance without which such a person is liable for a fine. With Trump's leadership appealing this specific regulation, there is a possibility that there will be more people who are likely to withdraw from these programs, and this may still increase the number of people without health insurance coverage. The last part of this proposal is to limit funds for Medicaid. “Currently, the federal government contributes a fraction n (62%, on average, in 2017) of each dollar a state spends on its Medicaid program. President Trump would change this arrangement so that the federal government would contribute a fixed amount that would be smaller than under current law.” It is a change that is likely to cause different states to make changes to their Medicaid programs. Some of the most anticipated changes in case such a proposal becomes a law include reducing the amounts they pay to medical providers. The states are also likely to reduce the nature services they cover, as well as the number of people who receives healthcare insurance. On the other side, the Democratic party is proposing the idea of a single-payer system for the healthcare sector. These candidates, instead of introducing policies that would see the industry reducing the spending, the proposals from this side is to expand government programs and spending to cover for most of these uncovered individuals. It is a proposal that would include everyone through a single, unified program, rather than the patchwork of coverage sources we have today. Senator Bernie Sanders’s Medicare for All is a reflection of this policy as it aims to achieve affordable cater for all people in the country. It will cover all medical services and will not need any deductible from the clients. Under Senator Sanders’ proposal, the government would administer benefits and payment providers, as in traditional Medicare. The likely impact of this policy is an increase in the number of people getting insurance cover. Another likely change is that there will be increased spending in the healthcare sector as the government will be striving to achieve the limits set by the proposal. It is thus apparent that the public health proposal by both the democratic and the republican government diverse on the rate of spending. One side encourages spending on health while another side limit spending. Canada has one of the best Healthcare systems and is rated highly due to government policies and involvement to create a better system that encourages healthcare affordability to the population. In this country, the government finances health insurance, and the private sector delivers a lot of care. For Canadians, it is a policy that the government at the provincial level runs the insurance. Most Canadian have supplemental private insurance through their jobs to help pay for prescription drugs, dentists, and optometry. Thus, the government has the task of ensuring that it pays for 70% of healthcare spending in the country. Such a system is slightly different from European countries. Take, for instance, Britain; the state operates under what is describable as socialized medicine. The government not only finances care but also provides it through the National Health Service. Like Canada also, most of the services are free to the citizens as the government caters to most of these services. Unlike Canada which rely more on private and public insurance, the government in this country do not rely more on insurance ( Csete et al., 2016). Canada and Britain are pretty similar in terms of spending. Both spend just over 10 percent of G.D.P. on health care. Canada also differs from other countries such as France which relies on small non-profit firms that sell health insurance for different healthcare consumers. Like Canada, too, public insurance covers most of the insurance services, and this means that the government spending on the healthcare system is about to 86%. Switzerland and Germany are other countries with admirable healthcare policies. Their policies are based on universal care systems like that of Canada ( Carey &Crammond, 2015).
Conclusion
The government, through public policies, has a powerful role in ensuring that the country's healthcare system is stable. Through public policies that influence the drivers to healthcare factors, the government ensures that the healthcare providers in the country are affordable and have standard quality for the citizens. In the United States, there is a likeliness that healthcare will change drastically based on numerous proposals that are likely to take a toll in the next election. In such a case, such changes will still exhibit the power the government has on define the direction the healthcare sector takes in the country.
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