I. Introduction The health care industry has recently witnessed some of its roughest years in recent history with regards to financing, including long term debt financing and working capital financing. Then, just as the capital markets began to mend, the most comprehensive health care bill was passed since the creation of Medicare was enacted in 1965. On March 23, 2010, President Obama singed the most comprehensive health care system reform law since the creation of the Medicare program. This new health care reform known as The Patient Protection and Affordable Care Act (ACA), and subsequent related legislation, expands Medicare and Medicaid coverage, and attempts to control health care costs and improve health care delivery systems. Nonetheless, it also inflicts significant requirements on health care delivery systems that will increase costs, such as; decreasing some traditional sources of funds available to health care delivery systems; and increasing the pool of government funded patients. These changes create financial strains and uncertainties that could unfavorably impact the financing available to the health care industry at a period it cannot afford. II. Health Care Reform A. Reasons for Health care Reform Health care reform is needed for the following reasons: • Firstly, health care charges are skyrocketing. In 2011, the average cost for a family of four increased 7.3%, to $19,393. That's almost twice the cost just nine years ago. By 2030, payroll levies will only cover 38% of Medicare costs. The rest will assist to the government allowance deficit. • Secondly, health care reform is required to improve the value of our health care, which is currently the lowest in the evolved world. Chronic diseases cause 70% of all U.... ... middle of paper ... ...or behavioral healthcare organizations that are understanding enough to embrace clinical decisions to support technologies such as those mentioned above. In the approaching era of affordable healthcare, those who can clearly demonstrate factual worth in their product will be rare and in high demand. Given what we understand about the occurrence of behavioral health conditions and their influence on overall healthcare spending, healthcare providers have the exact expertise needed to illustrate significant value in a system that rewards performance. Regrettably, such improvements in value (i.e., outcomes divided by cost) are not incentivized in the common fee for service payment models, which encourage quantity, not value. Altering this is one of the core concepts of healthcare reform and affordable care – to move from incentivizing volume to paying for performance.
For decades, one of the many externalities that the government is trying to solve is the rising costs of healthcare. "Rising healthcare costs have hurt American competitiveness, forced too many families into bankruptcy to get their families the care they need, and driven up our nation's long-term deficit" ("Deficit-Reducing Healthcare Reform," 2014). The United States national government plays a major role in organizing, overseeing, financing, and more so than ever delivering health care (Jaffe, 2009). Though the government does not provide healthcare directly, it serves as a financing agent for publicly funded healthcare programs through the taxation of citizens. The total share of the national publicly funded health spending by various governments amounts to 4 percent of the nation's gross domestic product, GDP (Jaffe, 2009). By 2019, government spending on Medicare and Medicaid is expected to rise to 6 percent and 12 percent by 2050 (Jaffe, 2009). The percentages, documented from the Health Policy Brief (2009) by Jaffe, are from Medicare and Medicaid alone. The rapid rates are not due to increase of enrollment but growth in per capita costs for providing healthcare, especially via Medicare.
Miller, H. D. (2009). From volume to value: better ways to pay for health care. Health Affairs
The U.S. spending on health care is an outlier compared to other industrialized countries. On an individual basis heath care in the U.S is approximately double what other industrialized countries spend. On a total spend basis, the $3 trillion currently consumed in this sector represents the world’s fifth-largest economy. This high spending on healthcare is unsustainable in the long term. Businesses, individual consumers, and the government are consequently not insulated from the shrinking economic growth due to the ramifications of the high healthcare costs. In a global competitive market the U.S. business will lag behind other industrialized countries unless these high healthcare costs are curtailed. In addition, individuals, even those with insurance face the grim prospect of bankruptcy due to the high cost of care.
Healthcare has been a topic of discussion with the majority of the country. Issues with insurance coverage, rising costs, limited options to gain coverage, and the quality of healthcare have become concerns for law makers, healthcare providers and the general public. Some of those concerns were alleviated with the passing of the Affordable Care Act, but new concerns have developed with problems that have occurred in the implementation of the new law. The main concerns of the country are if the Affordable Care Act will be able to overcome the issues that plagued the old healthcare system, the cost of the program, and how will the new law affect the quality of the health delivery system.
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
The fourth key point is payment models. In order to make sure quality health care is given across the board you have to follow the money. In this section it talks about an idea of restructuring the payment scheme. Using bundled payments “offer the potential for promoting equity by redirecting resources to health care values...
The Affordable Care Act (ACA) is a federal that was signed into law by President Barack Obama on March 23, 2010 to systematically improve, reform, and structure the healthcare system. The ACA’s ultimate goal is to promote the health outcomes of an individual by reducing costs. Previously known as the Patient Protection and Affordable Care Act, the ACA was established in order to increase the superiority, accessibility, and affordability of health insurance. President Obama has indicated the ACA is fully paid for and by staying under the original $900 billion dollar budget; it will be able to provide around 94% of Americans with coverage. In addition, the ACA has implemented that implemented that insurance companies can no longer deny c...
American people look at their insurance bills, co-pays and drug costs, and can't understand why they continue to increase. The insured should consider all of these reasons before getting upset. In 2004, employee health care premiums increased over 11 percent, four times more than the rate of inflation. In 2003, premiums rose 10.1 percent and in 2002 they rose 15 percent. Employee spending for coverage increased 126 percent between 2000 and 2004. Those increases were lower than expected. (National Coalition on Health Care, 2005, Facts on health care costs). Premiums have risen five times faster than workers wages, on average. If medical spending continues to rise by just two percent more than personal income, by 2040 Medicare and Medicaid would hit 18.5 percent of the gross domestic product, leading the federal deficit to be 20.7 of the gross domestic product. (Melcer, R., 2004, St Louis Post-Dispatch, Rising Costs of healthcare pose huge challenges).
There has been a lot of talk and debate lately over Health Care Reform, as people are trying to answer the question – Should a universally accessible health care system be implemented in the United States (US)? This ongoing highly debatable issue remains a hot topic among US citizens from all walks of life, from the very poor to the very wealthy. Health Care Reform affects everyone. The vast majority of the US population is very dissatisfied with the current state of health care. According to the ABC News and Washington Post cooperative poll, 57 percent of Americans aren’t satisfied with the overall system of health care (Langer, 2009). Consequently, the issue of the Health Care Reform was born, but before analyzing the actual aspects of this reform it will be wise to brush up on those major attitudes and concerns which occupy ordinary people and how they respond to the unfolding changes in the area of health care and social security.
Throughout the years, there have been many individuals and families who have not been able to afford healthcare. Some programs have helped to provide for those in need, but they have not provided to all needy citizens. In an effort to provide more people with the healthcare and insurance they truly need, the United States government has developed the Affordable Care Act. The act’s purpose is to expand Medicare, which was originally developed to provide for the elderly and the disabled, to those who are not disabled but are in times of financial hardship. The Affordable Care Act was originally developed to ensure healthcare to all individuals who could not afford it on their own. It would seem that the increase in the number of patients would benefit hospitals, but this act does the opposite of its intended outcome. There are more patients visiting the hospitals, but the act lowers the costs of their medical bills, which in turn decreases the hospitals’ incomes. This decreased source of income causes both the patients and the employees to find new solutions to the increased amount of issues that they now endure.
2. The twin problems of the health care industry as viewed by society are cost and access. First of all, the cost of getting health care is very high and it is getting higher each day. This has been mostly caused by the combination of high cost and an increase in quantity of services provided to the communities. The other problem involves access to health care. American enjoy limited or no access to health care. Many efforts have been done to reform this, but still but still many people are left without access to the care. These two problems are related due to the fact that if the health care industry gets to high off course people no longer will be able to have any access to it. The higher prices are, the lower access people have to it.
In order to make ones’ health care coverage more affordable, the nation needs to address the continually increasing medical care costs. Approximately more than one-sixth of the United States economy is devoted to health care spending, such as: soaring prices for medical services, costly prescription drugs, newly advanced medical technology, and even unhealthy lifestyles. Our system is spending approximately $2.7 trillion annually on health care. According to experts, it is estimated that approximately 20%-30% of that spending (approx. $800 billion a year) appears to go towards wasteful, redundant, or even inefficient care.
Being a healthy human is one of the most important aspects of life. The preservation of human health significantly affects the length, quality, and before anything else happiness of a person in their lifetime. Being healthy enables people to enjoy the fruits of their labor like raising children, growing old with a significant other, or attaining their dreams. Americans seem to understand this concept and indeed value health, some so much as to view health care as an inalienable right. The health care system should provide people with confidence in services provided, cutting edge reliable treatment, and should not cause bankruptcy and corruption. Year after year politicians debate issues and offer solutions but the system never changes. Powerful corrupt lobbyists from insurance companies, pharmaceutical companies, and the American Medical Association make sure the existing conditions are maintained. The American health care system is absolutely damaged and will result in more uninsured, unhealthy, and financially broken American people unless it is changed.
Health care must be fully accountable for quality and the patient experience is simply the patient's perception of quality. Society should question and debate on how healthcare organizations should show improvement for consumers. This can help organizations create reliable health coverage cost and evaluate medical performances for families and individuals in the future. Physicians and organizations are now evaluating patients with collection of electronic data to improve a patient’s...
The cost of US health care has been steadily increasing for many years causing many Americans to face difficult choices between health care and other priorities in their lives. Health economists are bringing to light the tradeoffs which must be considered in every healthcare decision (Getzen, 2013, p. 427). Therefore, efforts must be made to incite change which constrains the cost of health care without creating adverse health consequences. As the medical field becomes more business oriented, there will be more of a shift in focus toward the costs and benefits, which will make medicine more like the rest of the economy (Getzen, 2013, p. 439).