The Health Care System in the USA - Term Paper Example

Introduction The need to transform the health care system within the US is apparent because there are challenges in meeting high quality standards and reducing the costs of care. Research evidence shows that other industrialized countries have a higher living expectance as compared to the US (Bodenheimer & Grumbach, 2012). Disparities in access to quality care have been reported extensively in the US. These disparities emanate from differences in ethnicity, race, income and insurance status. The high number of uninsured people and the underinsured demonstrate the necessity of evaluating the health care policies, which affect quality and cost of care, in order to assess the challenges and how they can be overcome. Government Policies Affecting the Cost of Health Care The health insurance policies play a significant role in determining the cost of care. This is depicted by the reality that there are differences in the cost of health insurance by the government and private providers (Weeks, 2012). For example, the private insurance policy has resulted in increased costs of health insurance and health care in private hospitals than public hospitals. The private insurance policy provides that individuals can take personal insurance which includes ambulance cover, general treatment cover and hospital cover (West, 2014). Disparities in access to ambulatory services are ambulatory services are attributed to the high costs, which are associated with private ambulance covers (Leigh & Wheatley, 2010). The cost of care is described as the main factor which affects the delivery of health care services (Bodenheimer & Grumbach, 2012). The costs of health insurance are spelled out within the insurance policies. High costs of health insurance cause individuals that cannot afford it to wait with illnesses until the point when they are less treatable (Wood, 2013). The private insurance policy limits the services that can be covered. For instance, there are inclusions and restrictions to specific services, which mean that patients incur greater personal expenses. Optional treatments, which are not covered by Medicare, are also based on the personal expenses of patients. Long stay patients also pay more because long term care is not covered by Medicare (Weeks, 2012). These are provisions within the public and private health insurance policies, which contribute to the high costs that are, associated with care processes within US health facilities (West, 2014). The Affordable Health Care policy as provided within the Patient Protection and Affordable Care Act also plays a role in influencing health care within the US. This policy is based on the foundation of reducing costs. Nonetheless critics argue that the main provisions within the Act will result in disruption of health insurance coverage and an increase of health care costs (Bodenheimer & Grumbach, 2012). The policy will have significant impact on the cost of care because it would result in an increase of the health insurance tax. This would be challenging to the low income communities. Additionally, this policy will result in an increase of the minimum essential benefits. This would result in higher costs to the ordinary American. The pharmaceutical policy provides guidelines on the production and sale of various medicines (Leigh & Wheatley, 2010). The pharmaceutical industry within the US is dominated by private investors. The owners of these companies are often driven by the need to make more profits. As a result, they have caused significant cost challenges in purchasing these drugs (Weeks, 2012). The unemployed or low income earners have been affected more by the high costs that are associated with prescription drugs. The co-payments that are related to prescription drugs have also resulted in heightened costs of care (Carley, 2013). This demonstrates that there is need to change the pharmaceutical policy so that the poor do not get disadvantaged. Government Policies Affecting the Quality of Health Care The public health policy is an important policy in health care, which have impacted significantly on the quality of care that is provided to the public. This policy is implemented by the Department of Health and Human Services (Leigh & Wheatley, 2010). Through the public health policy, vaccination programs are implemented, which are aimed at ensuring high quality of care for children. Regardless of the provisions of this policy, access to high quality public health services has disparities. For instance, individuals who do not have proficiency in English language and immigrants have limited access to public health services (Bodenheimer & Grumbach, 2012). This demonstrates the challenges that face the public health care and the quality of preventive services that are offered to specific communities. It is because of this that there is low satisfaction on the quality of public health care services among low income communities and the uneducated groups. Healthy Americans policy, which led to the enactment of the Health Americans Act affect the quality of care that is provided to Americans. Through this policy, the universal health care was established. Therefore this policy plays a role in ensuring that health care services are provided to all without bias (Weeks, 2012). Nonetheless, the policy faces challenges in meeting its goal because individuals still experience discrimination by health care providers on the basis of their ethnicity, gender and race. It is because of this that access to high quality of care has not been enhanced. The Health Americans Act has not been successful in promoting cost effective and high quality care processes (Leigh & Wheatley, 2010). The emergency medical treatment policies were designed to promote access to high quality emergency care within US hospitals. The hospitals and providers are mandated by this policy to provide citizens with emergency treatment even though they were unable to pay (Bodenheimer & Grumbach, 2012). Discrimination against patients who would not afford emergency care has however been reported. In order to improve the quality of emergency care this policy focuses at ensuring that hospitals screen patients and treat them with efficiency or speed in all emergency departments. The policy also provides that hospitals should arrange for the referral or transfer of patients when necessary so that they can access high quality care in a facility with the necessary resources (Bodenheimer & Grumbach, 2012). Current and Future Challenges The current state within the US health care system is characterized by reform. This is demonstrated by the reforms in health care, which are proposed within the Patient Protection and Affordable Care Act (Bodenheimer & Grumbach, 2012). However the implementation of these reforms poses significant challenges to the US health care system. The reforms of this act are aimed at ensuring that health care insurance is more affordable and the quality of care is enhanced. The proposals within the Act have however been criticized by the huge spending of the government, which results in negative financial implications on the taxpayers. Nonetheless, it is expected that the rate of the uninsured rate will be lowered with the implementation of the Act. The current health care system is challenged by the disparities that exist in care processes. For instance populations within rural areas are reported to have limited access to high quality health care services as compared to urban populations (Weeks, 2012). This is associated with the fact that rural populations have a higher rate of poverty. Poorer health is recorded among residents of poor neighborhoods. Through the reform proposals within the Patient Protection and Affordable Care Act, it is anticipated that it would bring about positive change in reducing the apparent disparities in care (Leigh & Wheatley, 2010). This would however be possible once the once the Act’s implementation challenges are overcome. Conclusion The health care policies within the US are designed with a goal of promoting health care services and systems. Nonetheless, challenges in implementation are attributed to the problems which currently face the US health care system. The Patient Protection and Affordable Care Act represent the most notable reform proposals in the health care processes. The Act and the policies associated with it are however ambitious in their cost reduction goal and as a result resulted to an increase in health insurance tax. Access to high quality of primary care, public health services and emergency care has challenges that would be overcome through effective implementation of health care reform. References Bodenheimer, T., & Grumbach, K. (2012). Understanding Health Policy: A Clinical Approach. New York: Mcgraw-Hill Medical. Carley, M. (2013). It's Time To Support Obamacare. Fairfield County Business Journal, 49(39), 4 Leigh, W., & Wheatley, A. (2010). U.S. Healthcare Reform, 2009-2010: Implications for African Americans. Review of Black Political Economy, 37(3/4), 191-201. Weeks, W. B. (2012). Cap And Trade A Mechanism To Reduce Healthcare Costs. Hfm (Healthcare Financial Management), 66(11), 156-158. West, E. (2014). Consumer Subjectivity and U.S. Health Care Reform. Health Communication, 29(3), 299-308. Wood, G. (2013). Bracing for Obamacare. Corridor Business Journal, 10(23), 26 Read More