Healthcare is one of the most fundamental prioritizations by different governments in the world today. Although significant advancement has been realized in this sector over the last few years, there are still critical disparities when healthcare dynamics in the US and the rest of the world are compared. To ascertain the differences, a comparison of dimensions of care between different countries is plausible. Patient Protection and Affordable Care Act (PPACA) is one of those legislations that can hint at the extent of progress of the healthcare system in the US. This paper aims at analyzing the US healthcare system, compare it with others in the world based on its rank, explore the dimensions of health that characterize such systems, and analyze how the Patient Protection and Affordable Care Act influence healthcare delivery in the US.
Dimensions of Health Care
Dimensions of care signify the performance of a given healthcare system. The first dimension is the care process, an element that encompasses four domains of care provision, particularly safety of care, the level of coordination, preventive care, patients’ engagement, and their preferences. The above component intricately interacts to ensure patient-centered healthcare provision. Another dimension is access to care, which entails the extent to which care is affordable and provided on time. Affordability considers the cost of bills and the extent to which patients can pay for healthcare out of pocket. On the other hand, timeliness regards ease of access to information, booking appointments, or access to primary care. The administrative efficiency dimension mainly dwells on the evaluation of barriers to healthcare experienced by patients. To a large extent, efficiency is measured in terms of the effort expended by clinicians or other healthcare personnel in dealing with paperwork or resolving disputes related to paperwork. Equity is another dimension that is closely associated with the access dimension. It looks at the health performance of both low and high-income populations within a country. Survey measures from the access and care process are used to determine whether there is a gap in care access among different income groups. The last dimension is the healthcare outcomes. It entails a measure of a population’s health that signifies how well it fairs on. The measures include population health outcomes, mortality related to healthcare, and disease-specific healthcare outcomes.
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Rank Comparison of Health Care Systems
Access to healthcare is the most critical dimension that is used to measure healthcare performance. This is so because it is a prerequisite to the other dimensions. If a population cannot afford care or access it on time, there would not be a population to be assessed for healthcare equity, care process, or administrative efficiency. Therefore, care access is an indispensable element that, when achieved, the rest can be strategized around.
From the different countries analyzed, the Netherlands is the country with the most accessible healthcare system (Schneider et al., 2017). One of the reasons for superior performance is universal health coverage in the country. All adults are required to have a form of healthcare insurance while children have free access to healthcare. Additionally, the collaboration between the government and the private sector in care provision is high because competition and monopoly by all players are moderated (Van de Ven et al., 2008). Besides, while the healthcare system is significantly developed, patients also have the freedom to choose where to get care, how to, and when. This makes care coordination and access ease possible because there is increased collaboration and understanding between patients and physicians, resulting in evidence-based care. The country with the least performance is the United States system (Schneider et al., 2017). Poverty and lack of healthcare insurance by a significant portion of the population are barriers to care access. Another barrier is poor healthcare information flow between care providers and social workers (Kullgren et al., 2012). Limited healthcare supply and poor healthcare infrastructure, especially in geographic areas inhabited by the minority, is another major problem. The Navajo Nation, for example, has few poorly equipped healthcare facilities.
Patient Protection and Affordable Care Act (PPACA)
One central element of the Patient Protection and Affordable Care Act (PPACA) is patients are protected against discrimination based on pre-existing conditions. The act provides that insurers cannot deny coverage to a patient based on their health conditions before initiation of the insurance process. Additionally, benefits related to such conditions cannot be limited ( Kimberly & Eric, 2020). However, an exception to this rule is the grandfathered individual health insurance plans, which are plans bought before March 23rd, 2010. Since brokers or insurance companies might have sold plans that fall under this category off the marketplace, some might not include rights and protections stipulated by the affordable care act. Concerning this stipulation, the law has not changed over time. However, the law did not take effect in 2010 when the Affordable Care Act was enacted. It began being effective on January 1st, 2014. Before that, the federal government put in place the Pre-Existing Condition Insurance Plan (PCIP) Coverage program. It was to ensure the coverage of those with pre-existing conditions but did not have any form of insurance for at least six months or those denied insurance because of their healthcare conditions. The program was meant to ensure the smooth transitioning of such populations to protection by the ACA. Under the stipulation, some of the pre-existing conditions that insurers cover include cancer, diabetes, Alzheimer’s, drug addiction, and HIV. According to the American Cancer Society, in 2020, 1.8 million Americans were diagnosed with cancer. Additionally, according to the substance abuse mental health services administration, 20.4 million Americans had substance addiction-related issues. These, among other Americans with conditions that fall under this category, are now covered.
Another component of the PPACA is that young adults can benefit from their parent’s insurance until they are 26 years old. The law holds regardless of whether the young adults live with the parents, have children, are tax dependent on them, or have left school ( Kimberly & Eric, 2020). There are, however, state laws that slightly differ. In Delaware for, example, for the young adult to be covered, they have to be 25 years or younger, unmarried, and share the same address as the insurance provider. In Illinois, veterans can keep their young adults dependent on them on the insurance plan up until their 30 years old. The rule has not changed over time. Due to this inclusion, approximately 2.3 young adults in America have access to care.
In conclusion, the PPACA has significantly increased healthcare coverage in the US. I, however, think there is still much to be done by the federal, local government, and private players to increase access to care. Although the PPACA has positively impacted me in that I have easily acquired healthcare insurance, I believe universal health coverage is still a dream far from being achieved in the US. The minority are the most affected, hence, the need for resilient healthcare systems among such populations. Thus, while I believe that there have been positive healthcare reforms in the near past, it is unclear what the future holds.
References
Kimberly, S., & Eric, E. (2020, October 30). Obamacare Explained Simple Enough to Explain to Your Kids. The Balance . https://www.thebalance.com/obamacare-explained-33060
Kullgren, J. T., McLaughlin, C. G., Mitra, N., & Armstrong, K. (2012). Nonfinancial barriers and access to care for US adults. Health services research , 47 (1pt2), 462-485.
Schneider, E. C., Sarnak, D. O., Squires, D., Shah, A., & Doty, M. M. (2017). Mirror Mirror 2017 . New York: Commonwealth Fund.
Van de Ven, W. P., & Schut, F. T. (2008). Universal mandatory health insurance in the Netherlands: a model for the United States?. Health affairs , 27 (3), 771-781.
