American Health Care Reform and Its Future - Term Paper Example

? American Health Care Reform and its Future Toni Rogers MED130 Final Paper Introduction The issue of healthcare reforms is perhaps one of the few subjects that can be considered to be a cross cutting and fully universal outreach; bearing in mind that anyone can fall sick were their status and class has no merit. While the wealthy classes can afford to the high cost medical care in the best and most expensive hospitals due to the universal care policies in place, every taxpaying American has a stake in the provision of health care services for their fellow citizens. Various discriminatory processes of the health care system of America has injected the need for reform. The paper will be discussing the future of the American health care reforms and will be analyzing its future prospects. ‘Obama Care’ and politics When Obama became president in 2008, he promised to justify his election by bringing positive change in America’s services, such as education, health care and the economy in general. While there is little doubt he can bring change, its positivity, especially during the campaign period, has become relative based on political opinion and ideology. Democrats claim he improved the health sector considerably citing the reforms in healthcare popularly dubbed “Obama care”. The opposition is attempting to use the flaws in the health reforms to try to bring him down. Even with the issue of health care in itself as a whole; one can easily deduce it’s a stormy debate. Many people expect Obama care to have a decisive influence on the results of 2012 November election, although it might continue long after. Adverse effects of insurance companies and significance of health reforms Medical reforms have been taking place on different levels in America for the last several decades. Two of the most pertinent aspects of medical reform are embodied in the federal statutes enacted in 2010 patient protection and affordable care acts. One of the most contentious issues pertaining to this was the concept that all Americans should have healthcare payment coverage, and this brought about controversy, as it had to be resolved in the Supreme Court (Torrey, 2010). Prior to the Affordable Care Act, patients with chronic conditions or debilitating injuries were not able to buy insurance unless they were covered with their employers (Amadeo,n.d.). As a result, those who could not afford private treatment would have limited options and most would be forced to wait for death with no recourse. The insurance companies hardly perform the function as insurers. Majority of the non elderly Americans or it can be said that around 60% of the Americans are bestowed health insurances by the employers of the companies where they work. The risks are borne by the companies where the Americans work. The insurance companies processed the billing claims. The insurance company backed by their data and market power identifies people who are healthy and bring them under their varying risk coverage and will readily exclude the unhealthy people from the purview. The insurance companies also imposes barriers like that of the need of prior authorization for tests and treatments and then the denial of the medical services for which they are insured and then attempts are taken for avoiding paying for the services. This also injects a negative feeling within the patients regarding the receipt of required medical care as well as imposes administrative pressures on the doctors as well as the patients. However, new policies have changed this, and it is approximated that, by 2014, insurance companies refusing coverage to individual is based on such criterion will be in breach of the law. The insurance companies will be substituted by the accountable care organizations composed of group of doctors, hospitals as well as providers of health care who will be coming togerher in the provision of full range of medical care for the patients (Emanuel & Liebman, 2012).Health reforms, will also benefit senior citizens who will save money on prescription drugs, eliminating the doughnut hole that makes expensive drugs inaccessible to them, though need them most(Amadeo, n.d.). Children, and by extension parents, will be safe from the Machiavellian antics of insurance companies such as raising premiums or be denying care for any reason. Furthermore, the advantages accruing to adults with pre-existing conditions will also apply to them. Moreover, young adults who previously lost coverage from their parents after graduating high school (if they did not attend college),otherwise, they would remain covered as long as they are under 26; with the exemptions of those who will have secured employment and covered by their employers (Torrey 2010). The affordable care act also provides for preventive care; children and adults will also access testing and screening services without requiring them to incur any extra cost on top of their insurance premiums. This will cover conditions and diseases like HIV, Diabetes, high blood pressure, cholesterol and cancer among others. However, exemptions for these may apply to policies that may have been purchased before the act was passed on 23rd March in 2010. Health reforms acting as a minimizer of uncertainty Health care reforms have had extensive influence in several spheres of social economic lives of many Americans. The availability of government health insurance poses a dilemma more so to employers. There has been uncertainty in making business decisions because employers are still not sure how these will affect them as a whole. Firstly, all employers are faced with the dilemma of whether to continue providing their workers with insurance, or they should let them purchase the government’s subsidized insurance (Accounting Today, 2010). Thus, the future is uncertain, and it is predicted that many firms will opt to discontinue paying the health insurance for their staff and pay fines, which are relatively low in comparison. However, posterity may hold many unexpected changes and between now and 2014 when the individual coverage takes full effect many analysis will have to carried out by the affected institutions in this respect. Medical science and technology is a crucial factor in health care reform; the reason so many people have suffered in the past is that many diseases are difficult to treat hence extremely expensive! However, the future of medical reform will be profoundly influenced by developments in medical technology, which will make access to medical care considerably easier, and hopefully more affordable. Among the technologies that are believed to hold promise in improving the health care in America; the leading one is known as Nanotechnology. The science of nanotechnology involves the construction on miniature machines, which would be implanted in the human body, to detect problems by acting as Monocle laboratories (World Health Education Initiative, n.d.). These would have the capacity to handle cells and platelets in the body on individual terms resulting in a giant leap in development of medical science. In the long term, such technology would reduce the need and cost of surgery, the development of minimum invasion surgery means time spent in the recovery ward recuperating after surgery would reduce, and this translates to lower medical bills. Chip technology is expected to be fully viable by the year 2020, with the processing power of a human brain. Presently, there exist chips that are able to help deaf people hear and give some degree of sight to blind people. These technologies will enable curing of chronic conations such as Lyme disease, cancer, HIV and other conditions that create problems in the acquisition of insurance cover. Currently, according to nano.org, a doctor can prod a patient with some gadget, takes his or her blood pressure and prescribes drugs often depending on their subjectivity, which may or may not work. However, with the technology of diagnosing illnesses, doctors will be able to make accurate diagnosis. In addition, many of the tools basic to doctors like blood pressure machines and stethoscopes will appear even archaic (World Health Education Initiative, n.d.). Therefore, the future of health care reforms cannot be predicted effectively until the November elections are done. While the Democrats will undoubtedly continue implementing what they have initiated and supported although, it is possible a republican victory could lead to drastic changes. This is because they have bitterly oppressed the Obama initiated health reform bills and won a sweeping victory in the 2010 elections, in that front. Ron Paul the congressman for Texas was particularly vocal on this and claimed it was a matter of government mandate and the state was virtually forcing people to buy insurance (Taylor, 2012). Nonetheless, in the event of a republican victory it will not be possible to outlaw the current system since that would cause the 35 Million Americans already insured to lose their cover (Oberlander, 2010). Besides, economic factors may render any drastic move to change the system as counterproductive in the end. It is noteworthy that while the American public considered the issue of healthcare, after the bill was enacted it went down on the scale of priorities among the public (Bastasch, 2012). This implies that, despite the politician’s attention, it might not weigh very heavily as a determinant for which way they vote. There is also the problem of insufficient medical staff to cater for all the patients since the current staff especially doctors are already overworked under the current circumstances. Intersection with retail industry The health care industry will be encountering a massive cooperation with the retail industry. The approach is tending towards ensuring healthcare organizations as well as the patients in a more efficient and convenient manner. New approaches to analytics are dedicated towards changing the processes of transactions. The locations and organizations will be aligned to the practicability of the retail models. The provocative and forward looking thinkers are also in the process of embracing the retail approach. And this is happening with the rising competition and legislative movement which are leading to the change in the thinking process (Roney, 2012). In true retail market suppliers who will not embrace the concept of the standardized information on the cost, quality and service will be placed at a disadvantageous position. The standardized information has been adapted towards increasing the efficiency and reducing the costs in developing standards, achieving greater coordination as well as collaboration across as well as within the organizations and also enhancing the participation of the public in the standard development and access to standards. The health care providers will be liable to make the data available and also refer their patients to the hospitals or other physicians at a juncture when they will be evaluating the treatment alternatives. The standardized measures will also enable the consumers in choosing medical services which will be aligned with their every need. Various clinics have been established which deal with routine needs like that of the school physicals and that of sore throat treatment. In the future they will be executing properly in maintaining various ongoing needs of the patients with chronic conditions (Bernstein & Kopper, 2008, p.20). Health care reform and ancillary service lines Reforms in health care will also lead to the influence of different types of organizations that will be considered for the purpose of acquisition. In the present times the common types of consolidations can be said to be that of the joint ventures between the hospital as well as the health systems, takeovers of freestanding hospitals along with different types of affiliations and mergers. With the anticipation of these types of activities Mr. Thomas Jeffry who is a partner in the healthcare and life sciences practice groups of Arent Fox which is a law firm emphasizing on the life sciences, real estates and finances believes that the hospitals will be be looking towards acquiring additional ancillary service lines like that of post-acute care and home health which have been already started. Perceptions are also generated pushing the hospitals in considering alternative transactions with the policies like that of the recent CMS rules regarding the lower admission rates for receiving Medicare and Medicaid reimbursements. This is a positive side (Roney, 2012) Drive towards minimizing incarceration African Americans have the least life expectancy than the other sects of the society. There is a high rate of incarceration among the Afro- Americans due to drug abuse and other types of crime committed by them. This is a crucial parameter to understand the inequalities in health. Those who are incarcerated cannot access routine health care and simultaneously do not get the social safety of cash benefits, food and housing assistance and health insurance. Thus there are huge health risks if someone is incarcerated (Katzen, 2011, Pg. 221). The best way to resolve this issue is to stop incarcerating people. Instead they can impose fines on the offenders or send the drug addicts to the rehabilitation centers. But the politicians fear that their vote banks may diminish if they start to show mercy towards the criminals. So other reform systems must be considered rather than thinking about decreasing the number of prisoners. Some steps can be taken like improving the condition of the prisons to make them a healthier place, so that the adverse effects of incarceration could be minimized. Again, when prisoners are released they should get easy access to health care (Katzen, 2011, pg. 241) Most Americans who are below 65 years of age are either dependant on their “current employer, former employer or their spouse’s employer” (Rappaport, 2011, Pg. 28) to get medical coverage. If a person wants to buy a health insurance policy on his own, it becomes extremely difficult as it is very expensive and limited. If there is a family member with a serious health issue, it gets even more difficult to get insurance. The new law, however should change the current condition in the following few years. Americans aged between 55-64 years are expected to benefit the most from this change. In 2014 around 6 million Americans aged 55-64 are expected to be working part time or seasonally. They will not get any “employer-sponsored health coverage” (Rappaport, 2011, p. 28). Conclusion In conclusion, health reforms in America are dynamic, and will evolve continuously in the face of the myriad of social, economic and political factors. Currently, despite the controversy on its appropriateness, there is no question that the health care reforms have achieved what has never done before, the possibility of having all Americans under some form of cover whether they can afford it or not. Future American generations will no doubt benefit from the developments that have been made in the health sector and its future potential. References Accounting Today.(2010).Health care reform's effect on business. Retrieved from http://www.accountingtoday.com/news/Health-Care-Reform-Effect-Business-55678-1.html Amadeo, K. (n.d). What is Obamacare? About.com.Retrieved from http://useconomy.about.com/od/healthcarereform/f/What-Is-Obama-Care.htm Bastasch, M. (2012). Opposition to Obamacare softens. Poll.The Daily Caller.Retrieved from http://dailycaller.com/2012/07/02/poll-opposition-to-obamacare-softens/ Bernstein, A & Kopper, D, G, (2008), Health Care’s Retail Solution: A consumer-focused cure for the industry, A strategy+business reader. Retrieved from http://www.boozallen.com/media/file/health-care-retail-solution-sb.pdf Emanuel, E, J & Liebman, J, B, (2012). The End of Health Insurance Companies, Retrieved from http://opinionator.blogs.nytimes.com/2012/01/30/the-end-of-health-insurance-companies/ Oberlander, J. (2010). Beyond repeal- the future of health care reform.NEJM.org.Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMp1012779 Roney, K, (2012). 3 Predictions for the Future of U.S. Healthcare: Retail Models, Population Health & Service Line Acquisitions, Retrieved from http://www.beckershospitalreview.com/hospital-transactions-and-valuation/3-predictions-for-the-future-of-us-healthcare-retail-models-population-health-a-service-line-acquisitions.html Taylor, R. (2012). Ron Paul opposition to Obamacarehighlights Libertarian alternatives in medicine. Policymic. Retrieved from http://www.policymic.com/articles/10566/ron-paul-opposition-to-obamacare-highlights-libertarian-alternatives-in-medicine Torrey, T. (2010). Understanding healthcare reform. About.com.Retrieved from http://patients.about.com/od/patientempowermentissues/a/hcreform-hub.htm World Health Education Initiative. (n.d.). Healthcare reform: A vision of the futureRetrieved from http://www.health-care-reform.net/future.htm Read More