The issue of healthcare in the United States has elicited mixed reactions. Currently, the country is grappling with high levels of dissatisfaction in healthcare provision. However, despite such unprecedented levels of discontent, there is no clear way on how to reform the industry (Fiscella, 2011) . In the healthcare reform policy, the government aims at addressing several points. For example, improving access, this is to ensure that the poor in the country manage to afford healthcare. Secondly, the aim of the healthcare reform policy is primary care. Having robust primary care will go a long way in ensuring the country has a more equitable healthcare system. Restructuring of this program in certain areas is essential “payment reform, enhancing the training pipeline, transforming practice, and buttressing the primary care safety net” (Fiscella, 2011).
Thirdly is the uptake of IT in the healthcare sector. Benefits of the healthcare reforms are hinged on the use of IT. For example, people will have to rely on it to access patients’ records for better delivery of services. Such will ensure quality healthcare is provided. Finally, for healthcare reforms to be realized, there will be a need to utilize resources well. This means a restructuring of payment systems and the effective use of bundled payments. The main aim of this analysis is to determine the effectiveness of healthcare reform policy in providing quality healthcare.
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Healthcare Insurance
Usually, to cater for the high cost of healthcare, people tend to invest in health insurance coverage. That is, the healthcare reform policy is centered on lowering the insurance premiums to ensure most people can manage to buy them. Usually, insurance companies tend to have a higher premium for individuals as companied to group premiums. This means that the people who do not work for organizations tend to pay more in premiums. To encourage the uptake of premiums, the federal government usually subsidizes premiums offered by the employers.
Such a move means that people working outside of this system will have to contend with higher rates, which put millions of Americans at the risk of not affording healthcare services. Moreover, companies tend to deny coverage to people with pre-existing medical conditions. This usually forces people to seek alternatives, with most people associating with other groups such as COSTCO or the American Association of Retired Persons. This would often prove to be a good move as the federal government typically subsidizes healthcare for persons above the age of 65 via Medicare. Moreover, through Medicaid, the government subsidizes healthcare for families below a certain income threshold. Both the federal and state governments fund Medicaid.
Importance of Healthcare Reforms Policy
Several reasons have necessitated the need to introduce healthcare reforms in the United States. For example, the quality of healthcare services as well as the high costs. To start with, there is always room for improvement when it comes to healthcare services. This means there is still something that can be done differently to ensure the delivery of these services is more efficient. Thus, the healthcare reforms will enhance the delivery and quality of healthcare services. The policy will come up with a way through which to improve quality without necessarily raising the costs. Such reforms will mean the quality delivery of services to people who have pre-existing medical conditions (Nikolai, 2019). Also, it will ensure there is better integration between various healthcare providers. Healthcare reform policy will help curb the issue of the high costs involved in healthcare services in the United States. The cost has proved to be the major stumbling block when it comes to the provision of healthcare services. High prices mean that people cannot manage to pay for the services themselves. Introducing healthcare reforms would mean that people would lead to procuring the necessary services.
Secondly, healthcare reforms would mean easier access to healthcare services. In most cases, people who do not receive employer-based insurance could not manage to access healthcare services partially due to the costs involved as well as lack of knowledge. Given that insurance companies are out to make money, it means people can easily get scammed by dodgy companies and brokers (Nikolai, 2019). This means fewer people could manage to pay for quality healthcare services. Healthcare reforms would ensure that all people are in a position to buy health insurance at affordable rates. Also, the changes will ensure that the necessary mechanisms are put in place to ensure people who are not conversant with the idea of health insurance manages to learn about it and the providers.
Finally, healthcare reform policy would ensure the necessary healthcare practices are put in place. For example, for people living with pre-existing medical conditions, they usually don’t have access to an insurance policy or tend to pay more in premiums compared to other people. This means to deal with such problems, and the necessary reforms must be introduced. However, such issues were partially considered in the Affordable Care Act of 2010.
Recent Healthcare Reforms
The United States, in past years, has made the necessary improvements in ensuring the provision of healthcare services. Over the years, several policies have been introduced to right the challenges of healthcare provision. For example, in 1999, the Health Security Act was launched by the then-President Bill Clinton. Many people casually referred to the policy as Hillarycare as it was under her leadership. The Act offered universal healthcare coverage with controlled competition among the various insurance companies. The policy aimed at managing doctor bills and insurance premiums, a move that would have resulted in insurance companies providing insurance policy at affordable rates to both companies and individuals. The policy would be different from Medicare, as this sees the government directly agree with various healthcare providers. Medicare can be referred to as a single-payer system. Under that policy, the government aimed at making sure that all people had access to healthcare services. However, the bill failed a year later in 1994.
Another Act was introduced in 2010 under the leadership of former president Barack Obama. The Patient Protection and Affordable Care Act became law in 2010 and started phasing in new health benefits. For example, the Act introduced reforms that allowed people with pre-existing medical conditions to pay for the insurance policy. Also, children and people who were laid off were covered under this Act ( Obama, 2016) . To ensure the benefits were felt on a larger scale, the government offered subsidies to small businesses and senior citizens who usually face financial problems due to the high cost of drugs. Moreover, the Act ensures that there were enough healthcare practitioners by providing funds to ease any shortages of such personnel. To cater to these costs, the government used higher payroll taxes and fees to prescription drug companies. However, efforts have been made by the current administration to reverse these healthcare reforms.
Impact of Healthcare Reforms
The introduction of healthcare reforms is expected to have an effect on the economy. For example, the 2010 Healthcare Act saw more than 600,000 young people become insured. This happened as the ACA directed that children up to the age of 26 years were eligible to be covered by their parents’ insurance cover ( Kolstad, 2012) . This provision saw insurance companies record the highest profits in the first quarter of 2011. This is because more premiums were paid while fewer people required to be covered as most of them were young. Additionally, the percentage of small businesses offering insurance increased, resulting in fewer bankruptcies and better credit scores. This meant that spending power was high, leading to economic growth.
The healthcare reform policy is going to have an effect on hospitals. One of the implications of this policy is the increase in demand for inpatient hospital services. Also, an influx of inpatient will result in hospitals treating different underlying health conditions ( Kolstad, 2012) . This means these institutions might will need to invest more advanced machines. Moreover, hospitals will be required to invest in their personnel. For example, a hospital might require to hire more nurses and doctors to cope with the increase in demand.
Challenges facing Healthcare Reforms
One of the challenges facing healthcare reforms is poor accommodation of the patient’s needs. Life expectancy in America is high due to advances in medical science, technology, and delivery of healthcare services. However, higher life expectancy means with time, the country will have more citizens living with chronic conditions. The state expects to have around 70 million people aged over 65 years in 2030. Currently, over 120 million people have one or more chronic conditions. The American healthcare system is skewed, and it does not have the requirements to cater to patients suffering from chronic diseases. Few systems can cope with chronic diseases such as diabetes, heart-related diseases, and asthma, among others. According to research done, a system can only manage to effectively treat chronic conditions if the process is continuous across the set of providers ( McDonough, 2014) . This means that all healthcare workers need to work together with the patient to establish joint care plans with the necessary steps in place and agreed-upon goals and objectives. Such a move would ensure that the patient is well supported by the clinician as well as self-management programs. To ensure this effect is realized, workers working in such environments should be members of an interdisciplinary team, healthcare provision should be patient-centered, and proficiency in informatics application.
The other challenge facing healthcare reforms is the inability to assimilate the increasingly sophisticated science base. There has been an influx of funds aimed at facilitating biomedical studies. This has resulted in advances in clinical knowledge and technology. For example, the National Institute of Health received close to $23.4 billion in 2002, which dwarfed the $300 million the same institute received in 1887. Likewise, investments made by pharmaceutical companies have increased from $13.5 billion to $24 billion between 1993 and 1996 ( McDonough, 2014) . Such investments have resulted in double the number of drugs being approved for consumption since 1993, as well as a surge in a clinical trial from 500 trials in the 1970s to around 10,000 in 1998. This growth is not expected to reduce any time soon.
Previously, people thought that the education received by healthcare workers was enough to treat, evaluate, and develop the necessary clinical procedure. However, this assumption is void in that the current surge in method and knowledge would prove too much for human memory. Currently, it is a daunting task for clinicians to manage to keep up with the advance leave alone, gaining working experience on the usage of new techniques and concepts. This has been made even harder by the fact that few professionals are willing to expand their knowledge base to support the clinician in the application of such knowledge.
Slow adoption of technology has proved to be another challenge facing healthcare reforms. IT has become necessary in the provision of healthcare services with the internet proving to be a significant contributor. Adequate use of information has proved to be beneficial in the provision of services; however, the adoption of technology in enhancing healthcare access, quality, and service has been slow within the healthcare industry ( McDonough, 2014) . For example, in 1999, the healthcare industry used $543 per worker on matters related to technology. This was dwarfed by the $12,666 employed by the security brokers. As a result, the healthcare industry has not witnessed many revolutions compared to the other sectors of the economy.
Finally, failure to address growing consumerism among patients has proved to be a challenge. The issue has been made worse by easy access to information online. The internet has proved to be beneficial in that patients can access information and understand more about their health; however, patients want to make their medical decision based on information read online. This has set the patients and the practitioners on a collision course with patients registering frustration on not being allowed to contribute. According to the study, this issue has been made worse by the inability of the healthcare workers to communicate effectively with the patient or their relatives as well as failure to provide the necessary information that led to some decisions.
The healthcare reform policy is necessary if the government is to ensure quality healthcare services. Currently, a sizeable number of Americans cannot manage to afford healthcare services owing to the high costs involved in procuring such services. Health insurance is the primary source of funds for healthcare services. The policy will help regulate the insurance industry to make healthcare services affordable. To realize the benefits of such policies, the government must invest in the right infrastructure, such as hospitals and machinery. Healthcare policy has been facing numerous challenges; however, it is necessary if the country is to have a healthier population. The policy will also help the country to grow economically.
References
Fiscella, K. (2011). Health care reform and equity: promise, pitfalls, and prescriptions. The Annals of Family Medicine , 9 (1), 78-84.
Kolstad, J. T., & Kowalski, A. E. (2012). The impact of health care reform on hospital and preventive care: evidence from Massachusetts. Journal of Public Economics , 96 (11-12), 909-929.
McDonough, J. E. (2014). Health system reform in the United States. International journal of health policy and management , 2 (1), 5.
Nikolai. (n.d.). (2019) Healthcare Reform: What It Is and Why We Need It. Retrieved from https://www.nihp.org/healthcare-reform-what-it-is-and-why-we-need-it/
Obama, B. (2016). United States health care reform: progress to date and next steps. Jama , 316 (5), 525-532.
