Patient Protection and Affordable Care Act - Research Paper Example

 Health care proposal In the recent past, the US Department of Health has witnessed a growing concern on the need to promote comprehensive health care through addressing health care services financing. Due to the growing concern, Obama administration has come up with a new package called Patient Protection and Affordable Care Act 2010, which was passed and signed on March 23, 2010, this proposal seek to address the inequality that has existed in health care insurance cover over many decades. Proponents have seen it as a new dimension of improving access and enhancing universal health care access. However, some leading stakeholders such as U.S chamber of commerce, Eagle Forum, National Retail Federation, among other corporate bodies have opposed this new health care financing proposal because of future uncertain sustainability. Overview of Proposed Reforms Patient Protection and Affordable Care Act, 2010 will go down in history as a major health care reform bill that has been signed into law. It has a comprehensive coverage that would see 31 million Americans currently uninsured getting a medical cover. If this new proposal, the government will incur approximately $848 billion over the next 10 years, consequently, there will be a gradual increase in taxes and revenue is proposed to reduce the total cost of this cover by $131 billion within the same period (Eaton 2010). The proposed reform aims at achieving a number of strategic health care goals. Firstly, it aims at ensuring that every US citizen can access, quality and affordable health care. In essence, this is an important component of the entire reform agenda. In light of the increase burden of increase burden of disease and skyrocketing prices of health care services, the government undertook this deliberate strategy to ensure that there is universal health care insurance cover. Today, majority of US citizens continues to battle with out-of-pocket financing, which is prohibitively expensive (Junior 2010). Secondly, it aims at improving quality and efficiency of health care by establishing a vibrant health care workforce that would meet the growing demand for health care services. In addition, there is growing body of evidence showing an increase in the burden of chronic diseases, this proposed health care financing in its full implementation will see the middle and elderly persons receive a comprehensive cover that focuses on affordable health care services for chronic diseases. United States (2010) states that the Congressional Budget Office (CBO) has determined that the fully paid patient protection scheme in the end will ensure that more than 94% of Americans will be covered within $900 billion limit set by President Obama. In reality, this is an important milestone that is first to be proposed in the history of US health care reform agenda. This proposed patient protection insurance will transform health insurance policy in the United States through encouraging shared responsibility in financing health sector. Despite American health care costs, claiming approximately 15% of the GDP, this new proposal will seek to add more expenditure to the health sector (Eaton 2010). In 2009, the U.S had the highest costs of health care as compared to the economic production. Evidently, there were an estimated 312 million US citizens without an insurance cover as by September 2011; this makes approximately 15.6% of the entire population. Some critics of health care systems countered that for the four out of ten US uninsured citizens come from potentially productive household and may have voluntarily opted to adopt “pay-as-you-go basis.” In addition, about 77 million elderly population is reaching retirement age by 2015 (Skidmore 2011). Thus, combining combined with significant annual increases in healthcare costs per person will have a deleterious effect on the economic growth of household. Furthermore, the objective of this proposed health care financing scheme has been anchored on the premise that achieving Healthy People 2020 goals is dependent on designing an economically appropriate health care financing scheme (Harmon 2011). Proposed Changes in System Framework According to the new proposal, the Act will eliminate discriminatory practices of existing health care insurance cover that has been blamed by analysts as a tool enhancing inequality and exclusion based on socioeconomic status. However, experts warn that achieving quality and affordable health care for all Americans will take time. In addition, the new proposal identifies a number of intended changes in the system framework and policy stipulation. Firstly, the new proposal extends dependent coverage up to 26 years. This change would ensure that youths who are still in school and recent graduates from colleges are covered (United States 2010). Secondly, the new proposal will eliminate lifetime and unreasonable annual limits on benefits. Besides, there will be prohibited rescissions of health insurance policies. Unlike the previous medical covers that only covered up to age of 18, the new proposal aims to protect the vulnerable youths from excruciating costs of medical care. More importantly, the cover seeks to provide assistance to those uninsured with pre-existing medical conditions, this is a contrast of the existing medical cover that prohibit advancing care for persons with pre-existing conditions. As a new financial framework, there would be expanded medical cover and substantial change in health care insurance policy to accommodate these reforms (Eaton 2010). Moreover, the proposed reforms will offer consumers with an opportunity to make door-to-door comparisons when shopping for health insurance. In order to attain this goal, the new proposal envisions developing uniform document needed for an insurance policy. The new proposal seeks to secure consumers access to appeal process and provide consumers with place to seek assistance when navigating through the appeal process in accessing insurance coverage. Other important changes to the modern health care system include creating a temporary re-insurance program to facilitate support for early retirees. In addition, as demand for insurance cover increases, the new proposal has created an internet portal that would assist Americans I identifying coverage alternatives insurance options. Lastly, the new proposal introduces a lower health system administration costs and simplification of health financing systems in hospitals. The new proposal seeks to further subject its provisions through flexible modalities that will see new adjustments in the system. The overall changes lean towards increasing access to health services and ensure affordable health care. Strengths of Proposed Reform Harmon (2011) states that in line with universal health care reforms, this new proposed Affordable Care Act will increase insurance coverage by over 10% with subsequent increase in affordability of health care services. Secondly, this Act will ensure vulnerable members of the community, such as elderly and disabled person have free access to health care as opposed to initial discrimination witnessed in the past decades. Moreover, a single insurance cover will expand coverage of children up to the age of 26 years; this ensures that the young population is protected from adversity of footing health care bills. The American Health Benefit Exchange provision of the proposal envisions that small employers should obtain insurance coverage under worker compensation scheme; this is a vital component that would protect the wellbeing of employees. In addition, this proposal ensures the medical cover is easy to obtain through provisions in Simplifying Enrolment. Under this provision, individuals will be able to enroll in Medicaid, CHIP and Exchange through state-run websites. Another strength of the new proposal is the Community First Choice Option (CFCO) stipulation that obliges states to offer community-based attendant services and support of Medicaid beneficiaries with disabilities (United States 2010). In essence, it facilitates a gap in health care disparity by ensuring that the vulnerable groups are protected. Besides, the Act presents an important milestone development by establishing a national commission to review the health care workforce and projected workforce needs. It recognizes the importance of nurturing a competent and vibrant workforce. The proposal is comprehensive; it aligns healthcare needs with existing resources and gears combination of competent workforce and quality care towards patients. It is a proposal that recognizes the essence of equity in resources and collective responsibilities of citizens towards shouldering the burden of health care. As an important pillar of this proposal, it aims at recruiting more workers to bridge demand and supply of healthcare services gap. As it is now, the demand is overwhelming to the existing workforce. When this proposal comes into full force, it will put pressure on existing hospital resources and staff (Junior 2010). Challenges of the Affordable Act 2010 Junior (2010) states that one of the greatest challenges on the shared responsibility. Under this Patient Protection Act, there would be a tax increase to help finance increased medical insurance claims. While this is a noble idea, increasing individuals’ tax would be deleterious given the recent increase in cost of living. Secondly, there will be an increase in demand for health care services that would put pressure on the hospital supplies as well as the medical staff. Despite the existence of a comprehensive increase in workforce plan, health, economic analysts argue that this is a myriad given the recent government attempts to reduce the wages and salary burden (Junior 2010). Besides, Affordable Care Act 2010 has received political connotation. In dubbing it, “Obamacare” analysts argue that it was translated as a campaign tool that would be used to propel sitting president for the second term (Skidmore 2011). Some critics argue that the tax burden is not consummated with the projected increase in insured individuals. Because of political connotation, there have been issues raised on whether the rising unemployment and aftermath of 2008/09 economic crisis would support this huge burden. However, ACA was enacted with a clear goal of increasing the quality and affordability of health care through expanding the number of persons insured either private or public. Sadly, Harmon (2011) observes that political division saw ACA petitioned in 2012, however the June 28, 2012 Supreme Court ruling upheld the ACA’s individual mandate as an exercise under congressional tax power. Today, over 20 million Americans have joined health insurance cover population under the ACA. In health care economics, this percentage is substantial and poses threat to the existing capacity of health institutions. As evident by National Federation of Independent Business v. Sibelius, a number of court cases have derailed the enforcement of this policy; challenging constitutionality of ACA has been the greatest challenge towards achieving its main objective. According to National Association of Community Health Centers (NACHC) 2010, there was an immediate increase of 14% in hospital visits as compared to previous years rate of 6% (United States 2010). In health economics, one of the principle is that consumers tend to utilize health services more if payment is not through out-of-pocket means. In line with health economics, there has been a 14% increase in demand for health services after partial enforcement of the Affordable Patient Act (Eaton 2010). United States (2010) observes that the Act is a 10-year strategic plan that aims at achieving a cumulative effect of increasing accessibility. The effects have been felt in the form of pressure on existing hospital hospitals. For this proposal to attain meaningful health service efficient, the state governments should facilitate equipping hospitals with prerequisite facilities and a workforce that would match the growing demand. Recent studies have shown that with future full enforcement of the Act, there will be demand-supply mismatch if deliberate step of expanding existing facilities and creating new medical centers is not undertaken. Comparative Analysis of the Act and Previous Approaches Skidmore (2011) observes that unlike the previous mode of financing health care services, the new Act envisions that by 2020, every American citizen would be covered by comprehensive universal care. A landmark strategy will put the US health care reform in line with Healthy People 2020 and Millennium Development Goals (MDGs) that anchor universal health care access. Secondly, the Act focuses on strengthening the quality of health care through establishing infrastructure and building capacity of health care workforce. This is a strange development because initial medical insurance covers focused on the accessibility of health care services. There was no indication of stipulation on quality or workforce; it was purely ensuring the holders of the card have access to hospital. Beside the increase, coverage to include jobless and vulnerable members of community is a unique feature of the proposed insurance cover. Although this has elicited mixed reactions, the American government has embarked on a path towards collective shouldering burden of care through collective financing. The increase in tax burden and expansion of health care are tied at the hip and Obama’s administration. Affordable Care Act and Market Justice ACA proposal has profound impact on the insurance market and health care services. Notably, there has been a consistent growth of above 10% every year in the number of hospital visits. As noted, consumers have a tendency to increase utilization of medical services when insurance cover is used (Eaton 2010). Besides, the Act established state-controlled health insurance exchanges regulated through online markets (United States 2010). In the new insurance markets, individuals and small companies can now access private insurance plans through an elaborate online scheme, this has eliminated intermediaries in selling medical insurance cover. Skidmore (2011) observe that insurance exchanges incorporate a method designed to create a market for private insurance companies. This would address market failures such as medical bankruptcies, coverage limits, inflation and high number of uninsured persons. Entry of many private insurance companies will create a competitive market and subsequent improved insurance services for consumers. Several plans are incorporated in the ACA to enhance affordability. For instance, the Act provides for regulated subsidies to eligible persons and purposeful of current health care systems with a view of ensuring that there is a value for each insurance cover advanced to the uninsured persons. In addition, the Act will ensure there is prices, regulations and provide transparent medical loss ratios in order to ensure value for each cover. Personal Stand In my view, the ACA act is timely and seeks to respond to important issues of health care financing. Despite being driven solely by enhancing affordability and quality care, this proposal offers a broad-based definition of quality health care. Putting political interpretation aside, this ACA 2010 is in line with the Health People 2020 that is driven by expanding health care insurance policies. In essence, this ACA proposal is the answer to the growing burden of disease on the household economy. Arguably, it responds to immediate concern of regulating health care financing through establishing a uniform and equitable medical cover. It is one of the greatest steps towards achieving the universal health care. Conclusion Affordable Care Act 2010 is a proposed long-term health services financing scheme that is driven by intentions to expand the proportion of Americans insured. Over the past, there have been efforts to reform the health sector across the globe. The purpose of these reforms is promotion of universal access to health; the greatest barrier has been increased cost of medical care in hospitals. In response to this concern, ACA now focuses on universal medical insurance through shared responsibility. Although a myriad of challenges exists, it is a proposal worth implementing. References Eaton, T. A. (2010). The Impact of the Patient Protection and Affordable Health Care Act of 2010 On State Workers? Compensation Systems. Harmon, A. G. (2011). Bounty Hunters and Whistleblowers: Constitutional Concerns for False Claims Actions After Passage of the Patient Protection and Affordable Health Care Act of 2010. Junior, L. M. (2010). Adverse Reactions: Structure, Philosophy, and Outcomes of the Patient Protection and Affordable Care Act. Skidmore, M. J. (2011). The History and Politics of Health Care in America: From the Progressive Era to the Patient Protection and Affordable Care Act. United States. (2010). An Act Entitled The Patient Protection and Affordable Care Act. Washington, DC: U.S. G.P.O. Read More