Healthcare is one of the most critical aspects of human well-being, it refers to the various measures undertaken to maintain, and also improve their wellbeing. Healthcare services are classified into primary, secondary and tertiary care. The different healthcare services are a medical diagnosis, treatment, and prevention of physical and mental diseases in human beings. Healthcare practitioners or providers are the ones tasked with the responsibility of delivering the above healthcare services. The structure of health systems and access to healthcare facilities varies from one country to another due to various factors. Some of the main factors that influence healthcare across the globe are the prevailing socio-economic conditions and health care policies put in place by the different countries (Shaffer, 2013). Individual states have their health plans that are tailored to meet their healthcare goals and objectives of providing quality healthcare to its population. In most countries, the process of healthcare planning and provision is mostly administered by the government due to its significant impacts on the economy.
Moreover, the function of healthcare planning in some countries is done by various market participants. Either way, a proper healthcare system which is efficient and effective in its roles is one that is well financed, has a competent well-skilled workforce adequately remunerated, have appropriate policy guidelines and also modern health facilities equipped with relevant technologies that promote quality care delivery. Due to its diverse impacts on a country’s economy coupled with the changing patient needs and an increase in older population also known as the baby boomers generation which is more prone to chronic diseases, the present day health care has consistently been undergoing considerable reforms (Brown Jr et al., 2012). Healthcare reforms are largely defined as the changes of existing or creation of new healthcare policies which is mostly done by the government through the legislature with the aim of altering health care delivery processes. In most cases, proposed health care reforms attempt to improve the quality of care, enhance accessibility and reduce healthcare costs.
In the formulation of policies that facilitate health care reforms, concerning the United States, the focus of the debates often revolve around the issues to do with the right to access quality care, sustainability and the economic implications of government expenditure on healthcare (Shaffer, 2013). The United States healthcare system is made up of a mixed public-private system and is considered to be one of the most expensive systems compared to other developed countries of the world such as Germany, Russia and the United Kingdom. It means that the amount of money spent per person on healthcare in the United States is more than that of other countries. However, despite the United States government spending heavily on healthcare, its quality still ranks lower compared to other developed nations.
It is due to the disparities mentioned above in quality and expenditure on health care that the United States under the Obama’s administration undertook the initiative of reforming the United States healthcare system. The United States healthcare reform has a long history that dates back to 1965 when Medicare was introduced. Many changes had previously been proposed to address the many challenges that the United States health sector was facing. However, most were not accomplished due to political differences in the Congress. On March 23, 2010, the affordable care act (ACA) was signed into law; this is one of the most remarkable changes to the United State health care considered by many as a landmark reform (Shaffer, 2013). The act which is popularly known as the Obama Care seeks to improve the American healthcare system by ensuring that a quality and affordable care is made available to all Americans. While at the same time reduce wasteful spending on healthcare which has continued to grow to unsustainable levels, and consume most of the taxpayers’ money that could be used for the provision of other services such as quality education and poverty eradication.
The primary concern that the Obama Care Act seeks to address is the one to do with financial operations of the healthcare sector, with emphasis on health cover and insurances. The ACA aims to expand the services of Medicaid, which is the state’s sole health cover provider so that many people especially those with low income can qualify for health insurance coverage. Since Medicaid alone cannot cover all Americans, the Act provides incentives to employers so as to encourage them to provide health insurance to their employees. The act also seeks to bring sanity in the private health insurance by streamlining it purchase through the creation of the Health Insurance Exchange program; this helps in the provision of private health insurance to many Americans who due to some reasons such as moderate incomes do not qualify for the Medicaid cover (Sanger-Katz, 2014). Moreover, the act also puts measures in place that seek to enhance transparency and protect consumers of private health insurance from periodic unfair rate increases and exclusion due to pre-existing conditions. In general, the act provides for guidelines that seek to mandate each American to obtain a health insurance.
Since its signing into law in 2010, the ACA has brought about significant reforms in the United States healthcare. Some achievements of the act include reduction of the uninsured rates and increase of citizens who have gained access to coverage, improve consumer protection since many people, and also children with pre-existing conditions are not at risk any more of being denied health insurance due to their prevailing health conditions (Sanger-Katz, 2014). Furthermore, the act has reduced health care costs and improved the quality by eliminating lifetime and annual limits. The Act has also successfully reduced out-of-pocket costs for some medical needs which are preventive in nature such as immunizations, obesity, and cancer screening.
However, despite the high achievements of the affordable care act (ACA), there is still need for further reforms in the future health care system. The future changes should focus on financial operations with the aim of reducing insurance costs and improving their efficiency. Some of the changes that should be included in the reforms are allowing all insurance companies to provide cover to all citizens in any of the States provided it has complied with all the relevant States and federal regulations (Gardner, 2015). By doing this, the insurance companies will get equal market competition. Therefore, they will provide competitive premiums and citizens will have many options to choose. As a result, the cost of getting a health insurance will go down and become more affordable to Americans. Secondly, a policy should be formulated that will require all healthcare providers such as physicians, doctors and healthcare organizations such as hospitals and clinics to make public their prices for purposes of transparency. Putting such a policy in place will ensure that citizens can be able to compare and chose the preferable price for the medical service and procedures they need.
Conclusively, health care reforms should focus on providing incentives through reimbursements that encourage health care providers and organizations to provide quality care that is effective at a reduced cost rather than focusing on volume of work done and intensity of care provided.
References
Brown Jr, T. C., Werling, K. A., Walker, B. C., Burgdorfer, R. J., & Shields, J. J. (2012). Current trends in hospital mergers and acquisitions: Healthcare reform will result in more consolidation and integration among hospitals, reversing a recent trend in which hospitals tended to stay away from such transactions.Healthcare Financial Management, 66(3), 114-120.
Gardner, W. (2015). Policy Capacity in the Learning Healthcare System: Comment on" Health Reform Requires Policy Capacity". International journal of health policy and management, 4(12), 841.
Sanger-Katz, M. (2014). Is the Affordable Care Act Working? - The New York Times. Retrieved from http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html#/
Shaffer, E. R. (2013). The affordable care act: the value of systemic disruption.American journal of public health, 103(6), 969-972.
