Understanding Stakeholders
When two people cannot come to an agreement on what to eat for dinner, expecting multiple stakeholders to agree on a national healthcare system is asking the impossible. Although the subject of healthcare reform is not new, it has proven irrefutably true the adage about never pleasing all of the people all of the time. The stakeholder’s agendas vary and overlap from financial, political, personal, national, and global viewpoints, with both major and minor players clamoring for a voice. For the sake of brevity, this paper covers the major stakeholders—the three branches of the federal government, employers, employees, and private insurers. Although the turmoil surrounding healthcare reform appears intractable and differing
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According to the Kaiser Family Foundation (2015), employers and their health insurers now cover 147 million non-elderly populations. This fact alone demonstrates the sheer volume of the juggernaut system and explains the system bureaucracy.
Administrative Complexity The administrative issues are compounded by the absurd multiplicity of insurance plans. A large percentage are insured through employer plans, which allow for customized policies. Taylor & Morrison (2011) stated employer plan documents would far exceed the 2,700 pages of the Affordable Care Act (ACA) if stacked on a table. Unfortunately, they found few people actually understand their own insurance plan.
Regulatory Complexity
The layers of complex mandates require scores of workers to oversee the new regulatory clauses contained in the ACA. While it is impossible to know the exact number, Barbash & Clark (2010) estimated the regulatory requirements created by the reform law created as many as 159 new offices, agencies and programs. This is a primary reason why the U.S. continues to have the most expensive, inequitable, and inefficient healthcare system in the
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Employees want affordable premiums and access to care, employers want to spend the least amount to insure their employees, and insurance companies want a low-risk pool and charge substantially more for outliers, which under the ACA, translates into higher premiums for everyone. The Commonwealth Fund (2013) conducted a survey that targeted these inequalities and found more than one-third of adults went without recommended or needed care or failed to fill a prescription because of costs. Additionally, one-quarter of the respondents reported having problems paying their premiums, had difficulties paying medical bills, or were unable to pay them at all. Certainly, the altruistic ideas of reform are still possible; however, the competing interests of the three demographics are not in harmony and will never be as long as the insurance companies continue to write the narrative and control the costs of healthcare premiums and obtaining
One of the most controversial topics in the United States in recent years has been the route which should be undertaken in overhauling the healthcare system for the millions of Americans who are currently uninsured. It is important to note that the goal of the Affordable Care Act is to make healthcare affordable; it provides low-cost, government-subsidized insurance options through the State Health Insurance Marketplace (Amadeo 1). Our current president, Barack Obama, made it one of his goals to bring healthcare to all Americans through the Patient Protection and Affordable Care Act of 2010. This plan, which has been termed “Obamacare”, has come under scrutiny from many Americans, but has also received a large amount of support in turn for a variety of reasons. Some of these reasons include a decrease in insurance discrimination on the basis of health or gender and affordable healthcare coverage for the millions of uninsured. The opposition to this act has cited increased costs and debt accumulation, a reduction in employer healthcare coverage options, as well as a penalization of those already using private healthcare insurance.
Access to healthcare provides financial stability by assuring people that they will not be financially destroyed by injury or illness. Additionally, when people can afford regular medical care they tend to avoid chronic problems and financial stress. In a study provided by the American Medical Students Association, researchers reviewed the costs and benefits of universal health care. They came to the conclusion, after reviewing other articles and statistics from multiple sources, that, “The annual cost of diminished health and shorter life spans of Americans without insurance is $65-$130 billion.” (Chua 5) This comes from people not having adequate health care and then losing their jobs because they...
During the study of various reforms that were proposed and denied, both the GOP and Democrats attempted to find a balance that would guarantee the success of their proposals. Years of research, growing ideologies, political views and disregard for the country's constitution sparked an array of alternatives to solve the country's healthcare spending. The expenditure of US healthcare dollars was mostly due to hospital reimbursements, which constitute to 30% (Longest & Darr, 2008). During the research for alternatives, the gr...
Healthcare in the U.S. has recently been affected by implementation of the Affordable Care Act (ACA) of 2010. The intent is to create a healthca...
Ghosh, C. (2013). Affordable Care Act: Strategies to Tame the Future. Physician Executive, 39(6), 68-70.
Agenda setting is the process that determines appropriate solutions to a certain problem of a given field (Kingdon, 3). The process itself consists of three streams: problems, policies, and politics (Kingdon, 16). These separate streams interact when windows of opportunity are open – solutions are fitted with problems, and the impetus for this relationship is amenable political forces (Kingdon, 20). Prominent agendas are determined by the problem or political streams, while solutions are crafted in in the policy stream (Kingdon, 20). In the field of health care, the agenda setting is based upon the high number of uninsured citizens, the rising cost of medical care, the development of Patient Protection and Affordable Care Act (PPACA) in response to this issue, and the key players that debate whether governmental involvement is the correct approach in the issue of universal healthcare.
Out of all the industrialized countries in the world, the United States is the only one that doesn’t have a universal health care plan (Yamin 1157). The current health care system in the United States relies on employer-sponsored insurance programs or purchase of individual insurance plans. Employer-sponsored coverage has dropped from roughly 80 percent in 1982 to a little over 60 percent in 2006 (Kinney 809). The government does provide...
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.).
Since the initiation of the Affordable Care Act in 2010, Americans have been put back in charge of their individual health care. Under this new law, a health insurance marketplace provides a haven for individuals without insurance to gain coverage. Just this year, citizens found out early whether they qualified for Medicare or the CHIP formally known as the Children’s Health Insurance Program. So much is to be learned about the Affordable Care act and this paper provides the roles of the different governmental branches, along with other important factors associated with this law.
In recent years, the number of Americans who are uninsured has reached over 45 million citizens, with millions more who only have the very basic of insurance, effectively under insured. With the growing budget cuts to medicaid and the decreasing amount of employers cutting back on their health insurance options, more and more americans are put into positions with poor health care or no access to it at all. At the heart of the issue stems two roots, one concerning the morality of universal health care and the other concerning the economic effects. Many believe that health care reform at a national level is impossible or impractical, and so for too long now our citizens have stood by as our flawed health-care system has transformed into an unfixable mess. The good that universal healthcare would bring to our nation far outweighs the bad, however, so, sooner rather than later, it is important for us to strive towards a society where all people have access to healthcare.
The Patient Protection and Affordable Care Act passed by President Barack Obama is a significant change of the American healthcare system since insurance plans programs like Medicare and Medicaid (“Introduction to”). As a result, “It is also one of the most hotly contested, publicly maligned, and politically divisive pieces of legislation the country has ever seen” (“Introduction to”). The Affordable Care Act should be changed because it grants the government too much control over the citizen’s healthcare or the lack of individual freedom to choose affordable health insurance.
One reason health care needs reform is people’s current plans being terminated. The ACA regulates and puts pressure on insurance agencies to offer more services to their customers, and
Health insurance, too many American citizens, is not an option. However, some citizens find it unnecessary. Working in the health care field, I witness the effects of uninsured patients on medical offices. Too often, I see a “self-pay” patient receive care from their doctor and then fail to pay for it. Altogether, their refusal to pay leaves the office at a loss of money and calls for patients to pay extra in covering for the cost of the care the uninsured patient received. One office visit does not seem like too big of an expense, but multiple patients failing to pay for the care they receive adds up. Imagine the hospital bills that patients fail to pay; health services in a hospital are double, sometimes triple, in price at a hospital. It is unfair that paying patients are responsible for covering these unpaid services. Luckily, the Affordable Care Act was passed on March 23, 2010, otherwise known as Obamacare. Obamacare is necessary in America because it calls for all citizens to be health insured, no worrying about pre-existing conditions, and free benefits for men and women’s health.
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Health insurance facilitates entry into the health care system. Uninsured people are less likely to receive medical care and more likely to have poor health. Many Americans are foregoing medical care because they cannot afford it, or are struggling to pay their medical bills. “Adults in the US are more likely to go without health care due to cost” (Schoen, Osborn, Squires, Doty, & Pierson, 2010) Many of the currently uninsured or underinsured are forced accept inferior plans with large out-of-pocket costs, or are not be able to afford coverage offered by private health insurers. This lack of adequate coverage makes it difficult for people to get the health care they need and can have a particularly serious impact on a person's health and stability.