Laws are usually formulated to help in maintaining order in the society, the formulation of law should be a process and put into account the interest of the persons or the institution of the social groups that such laws will govern. When the contribution of such person is not given consideration, usually, there exist resentment and disproval of such laws. Of the critical institution in the society that have bore the wrath of such of laws, is the healthcare sectors and its practitioners. Many laws have formed centered majorly on the interest of the patients’ only rather than building bipartisan kind of law where every sector and party derives joy and pleasure in implementing. A number of legal issues have remained a subject of debate and dilemma to the healthcare providers, and the misunderstanding brought about by them has threatened to cripple this critical institution in the society. Of the contentious legal issue includes; Health Care Quality Improvement Act (HQIA), the Synopsis of General Staff Law Review and the Health Insurance Portability and Accountability Act of 1996 (HIPPA), all whose controversy has remained a topic debate and criticism from the practitioners.
Health Care Quality Improvement ACT (HQIA)
The Health Care Quality Improvement Act (HCQIA) of 1986 was informed the need to address the insistent cases of malpractice among the medical practitioners and the need to improve the general quality of the medical care across the entire United States. At the formulation of the law, series of medical malpractices and negligence had characteristic the health care sector and the public outcry was quite loud. There were extreme cases where such malpractices resulted to the death of the patients, T.A Brennan, et al (1991) asserted that “We estimated that 27 179 injuries, including 6895 deaths and 877 cases of permanent and total disability, resulted from negligent care in New York in 1984.” In as much as the legal framework was well intentioned and aimed at solving a critical issue in the sectors, it exercised a lot of restraint in the activities of the members of the profession. The law, however, does not put into cognizant the unique training and skills that the practitioner goes through in order to carry out their duties. The law limits the mobility of the practitioner who is deemed to have been involved in a case of malpractice, section 402. articulates that “there is a national need to restrict the ability of incompetent physicians to move from State to State without disclosure or discovery of the physician’s previous damaging or incompetent performance” (ssa.gov/OP), however, this law does not consider first the fact that not all cases of malpractice are deliberate.
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The HCQIA applies to the physician credentialing in certain ways, first, the act enables the review of the physician to be review by a competent board, and the physician must be given the opportunity and early notice of the review, similar, in the interest of justice, the physician has the liberty to request for credentialing, the act states that “ that the physician has the right to request a hearing on the proposed action, (ii) any time limit (of not less than 30 days) within which to request such a hearing, and (C) a summary of the rights in the hearing” (sec 412, b).The law, however, does not provide for adequate action to address the reasons behind many institutions may not be willing to carry out search reviews. To the physician, the acts seem intended to punish them for their frankness and actions that personally they may not have intended to undertake. Despite the benefits, “many hospitals and physicians have been reluctant to participate in peer evaluation because of the risk of potential liability and the fear of other personal and professional consequences that candid evaluation of a colleague may create” (Rodney H. Lawson et al, 2012). Therefore, this act excluded the contribution of the physician and thus its implementation will remain a great dilemma.
The HCQIA provides good legal anchorage for improvement of medical healthcare quality in the whole nation, however, the law excludes the practitioner a great deal, first, be stipulating has terms against their action, such as the review process, many of practitioner will practitioner will find it difficult to actions in the desire to help the patients as the consequences that can befall are worse. Similarly, the exclusion of the privileges of the practitioners such as their mobility will have great effect on the delivery of medical health care across their areas or regions of operation, Lawson et al (2012) notes that “hat a negative decision may expose the reviewers to a lawsuit by the physician who is denied privileges or disciplined.” Furthermore, the exclusion of privileges enjoyed by the physician may lead to internal conflict with the institution.
Synopsis of General Staff Law Review
There are extensive legal statues and acts that address the general issues of staff and labor relations. First, National Labor Relations Act (NLRA) provides for the employees of the private companies such as healthcare practitioners in the private practice to organize have the right to organize a union; to bargain collectively through a representative; and to engage in strikes, picketing, and other. The law provides for the protection from the employer against taking action against their actions. Secondly, the Family and Medical Leave Act (FMLA) of 1993 provide “certain employees with up to 12 weeks of unpaid, job-protected leave per year, it also requires that their group health benefits be maintained during the leave” (dol.gov). The act is designed to help the employee have time for personal growth. Another importance act that is a great relation to the general staff and labor relation is the Occupational Safety and Health Act (OSHA) of 1970. This was formulated to address issues of general staff well being, it was meant to support the “States in their efforts to assure safe and healthful working conditions; by providing for research, information, education, and training in the field of occupational safety and health; and for other purposes” (osha.gov, 2004). In order to promote the labor-management relations, the Congress enacted the Labor-Management Reporting and Disclosure Act of 1959 in which it is aimed at enhancing the reporting and disclosure of certain financial transactions and administrative practices of labor organizations and employers, to provide standards with respect to the election of officers of labor organizations, and for other purposes” (dol.gov).
General staff and labor relations act conflict with the healthcare administrator
Healthcare is a unique kind of profession, at the kind of work and circumstances that of work make it very troubling or generally difficult for the practitioner to obey or observe to the latter, the stipulate codes of conduct under the general staff and labor relations acts and regulations. While the Occupational Safety and Health Administration act was meant to provide the good working environment for the practitioners, the medical practitioners still find it difficult hard to cope as the working environment yet to be equipped with to support discharging of their mandate. In relation to this, Mathews Davies (2013) argues that “from my perspective as a policy researcher and the chief medical executive for the state of Michigan in the Department of Community Health, whether health care is a right or a privilege does not alter the fundamental challenge of allocating scarce resources in the U.S. health care system”. The law further lacks the strategy for marshaling and managing its healthcare resources to optimize population health.
Conflict from the perspective of a patient
The General staff and labor relations act also have the great impact on the general views of the patients, to a great extent, the law disadvantages the patients in that the law such as Family and Medical Leave Act (FMLA) of 1993which provides for a long period of up to 12 weeks off the job, such laws do not put into cognizant the fact that the profession is usually understaffed or the cost of employing more staff is considerably great and thus the facilities can just afford a few staff. Similarly, the legislation falls short of ensuring health care as a right, thus making it very difficult and costly to access, on the same not, Labor-Management Reporting and Disclosure Act of 1959 provision that provides standard with respect to the election of officers of labor organizations, and for other purposes, disadvantages the patients are they do have the opportunity to participate in the election of leaders in the facilities.
Health Insurance Portability and Accountability Act of 1996 (HIPPA)
The Health Insurance Portability and Accountability Act of 1996 provides for the Privacy Rule standards address the use and disclosure of individuals’ health information by organizations subject to the Privacy Rule — called “covered entities,” as well as standards for individuals' privacy rights to understand and control how their health information is used. The law came into force as result in the demand for a legal statue to publicize standards for the electronic exchange, privacy and security of health information. Depending who is giving their thought, the HIPPA remains a good and a bad legislation that stirred heavy political battles in the attempt to either disqualify it or prove importance. The uniqueness of this law is that it was “the first national health policy with such far-reaching implications since the enactment of Medicare and Medicaid in 1965” (healthaffairs.org) covering employees in all the states and three agencies in the federal government. The controversy of this law arose as result of it challenging the status quo; it establishes a controversial experiment with medical savings accounts (MSAs). The implementation of the act took too long because of the implication it could have created in the entire industry, factions that felt aggrieved rallied against its implementation, for instance, “some insurance companies and their allies in small business are lobbying state officials to designate their existing high-risk insurance pools as their alternative mechanism” (Brian K & Atchinson Daniel, 1997). Similarly, the implementation was further delayed by “division of responsibility between the federal government and the states in enforcing HIPAA and clarification about which state laws are superseded by the act” (Brian & Atchinson, 1997). Therefore, the delay in the implementation of the act was as influenced greatly by the politics in the country.
Impact of HIPPA
Implementation of HIPPA came with a great impact on the general healthcare industry, to the patients, HIPPA, to the patients, it was a great sense of relief as it allowed the freedom to choose one’s own insurance means, it “prohibited the states from regulating the health insurance of almost 60 percent of U.S. workers, those whose employers chose to self-insure” (Brian & Atchinson, 1997). On the other hands, the insurance stakeholders left decrying their inability to cover the diverse patients as the law was more stringent in their operation. In addition, the law allowed for the inclusion of every person, the health status of discrimination. For the healthcare providers, the effects were quite diverse, it limited the chances for research which would, however, influence the course of medical health care, HIPPA imposed barrier to the research process, barriers “included delays from institutional review board modifications, difficulty of getting de-identified data and subject paperwork and having to work with multi-site studies” (Lisa Dowards).
Implementing HIPPA in short time
Implementing HIPPA calls for a collective approach by which every stakeholder has the chance to articulate their thoughts in regard to the draft. The relationship between the federal government and the states could be sorted out as early as possible by allowing the working condition between them. This will be possible when the act clearly defining the role and responsibility of each government. From a practitioner’s point of view, the politics involved in the process could, however, be avoided and the time form implementation also reduced if consensuses on the issue of insurance are addressed amicably. The implementation of the act would best be required to establish the safeguards such as password protected authorization and encryption to access I which every person will feel that their data are free from access by unwarranted persons.
The relationship between the laws and healthcare sector are joined at the hip, it is important, therefore, that when formulating laws, the legislature put into consideration the contribution of the healthcare practitioner to all for smooth implementation of the law. Avoiding conflict between the various stakeholders to could also be necessitated by the inclusion of all the persons. While the laws have been very instrumental in shaping the course of the sector, over the years, it has been extremely possible to register such progress although very sluggishly because of the politics involved. To the practitioners, it is good that they stick to the standards and ethics of their profession in order to ensure that patients get the right medication and treatment. Similarly, the review board should also ensure that medical staffs brought on their board get justice and their own opinion and account are well considered before a ruling or recommendation is made.
References
Brennan, T. A., Leape, L. L., Laird, N. M., Hebert, L., Localio, A. R., Lawthers, A. G., . . . Hiatt, H. H. (1991). Incidence of Adverse Events and Negligence in Hospitalized Patients. New England Journal of Medicine, 324 (6), 370-376. doi:10.1056/nejm199102073240604
S. (2017, October 04). Social Security. Retrieved January 29, 2018, from https://www.ssa.gov/OP_Home/comp2/F099-660.html
Lawson, R., Lewis, N. B., Branchard, C., & Ryan, E. (n.d.). 1 Credentialing and Peer Review of Health Care Provid ers: The Process and Protections . 2012.
Department of Labor logoUNITED STATESDEPARTMENT OF LABOR. (n.d.). Retrieved January 29, 2018, from https://www.osha.gov/laws-regs/oshact/completeoshact
Right, Privilege-or Tragedy of the Commons? (2016, November 12). Retrieved January 29, 2018, from https://www.rwjf.org/en/culture-of-health/2013/08/right_privilege_or.html
Atchinson, B., & Fox, D. (1997). Health Insurance Portability and Accountability Act (HIPAA). Health Care Policy and Politics A to Z . doi:10.4135/9781452240121.n152
Dowards, L. (n.d.). The Positive and Negative Effects of HIPAA Employment Laws. Retrieved January 29, 2018, from http://smallbusiness.chron.com/positive-negative-effects-hipaa-employment-laws-18500.html
Secretary, H. O., & (OCR), O. F. (2013, July 26). Summary of the HIPAA Privacy Rule. Retrieved January 29, 2018, from https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html
Moss, W. G. (n.d.). Is Health Care a Human Right? Retrieved January 29, 2018, from http://historynewsnetwork.org/article/119553
