The Ideal Nature of the Health Care Reform - Essay Example

Health Care Utilization The essay aims to address the following objectives to wit to delineate the different ways on how the recent health care reform measures have expanded or inhibited access to care; (2) to discuss on how those changes to access might influence utilization; (3) to explain the concept of what universal health care and how current care reflects or contrasts with this; (4) to identify the different stakeholders involved in the movement towards a system of universal health care; and (5) to identify new roles that are emerging in the industry today because of health care expansion. Health Care Utilization Introduction Health is a basic necessity and must be provided equally to those who need it regardless of race, locality, gender, or social status in life. Health care has become effective in treating diseases and disorders, in saving lives, and in improving the quality of life; however, the cost of health care has also become expensive for Americans. President Barack Obama believes on the provision of accessible and quality health care to all Americans; thus, on March 23, 2010, he made the Patient Protection and Affordable Care Act into a law (Jacobs & Skocpol, 2012, 1). The ideal nature of the health care reform under the Obama administration is the center of debate as the Patient Protection and Affordable Care Act was viewed as expansive, ambitious, and unconstitutional. Expanded or Inhibited Access to Care? The best way to gauge the effectiveness of the current health care reform is to compare it with the previous legislations and provisions. To determine the different ways on how have recent health care reform measures expanded or inhibited access to care, we will discuss thoroughly the revolution of health care in the United States. First, previous health care is based on an insurance model as old as the Hammurabi’s code. There is a basic insurance policy where premiums from policyholders are pooled (Jacobs & Skocpol, 2012, 3). When somebody gets sick, the cost of the medical care will be paid from the pool. Therefore, this model inhibited access to care because majority of the benefits goes through the sickest patients while the healthiest members got the least. Second, the Bureau of Veterans Affairs worked on expanding a fully nationalized health care because of increasing number of commercial insurance companies (Parks, 2012, 3). The bill works by getting reimbursements from public and private insurers with charges and co-pays that don’t apply to all veterans. There are coverage limitations, however, health care has been expanded to a number of veterans, administrators, doctors, nurses, and other health care professionals and has shown good marks in term of patient satisfaction and overall health care (Parks, 2012, 4). Third, the introduction of the Medicare and the federal Medicaid program has provided medical benefits to the impoverished and children. Again, from the sickest down to the veterans, care is expanded to include the poor, the disadvantage, and children. Debates uproar on the side of the physicians due to the beginning of socialized medicine and on the side of the patients in fear of losing the right to choose their own physicians. On the other note, both public and private insurers were struggling with the rising health care costs and the efforts to insure all Americans that they introduced the Consolidated Omnibus Budget Reconciliation Act (COBRA) to allow workers to have medical coverage for 18 months even after leaving the job (Parks, 2012, 5). COBRA mandates hospitals to treat patients regardless of their abilities to pay; thus, Medicare Catastrophic Coverage Act was signed into law to set ceilings on health care costs. As you would notice, every time that health care is being reformed, a new set of population is being added to the list of insured Americans. Therefore, one might say that the current health care reform program (which is the Patient Protection and Affordable Care Act of 2010) will expand access to care of not only policyholders, sickest patients, veterans, poor and disadvantage, children, any sort of patients, or those who are within the coverage of ceiling. It will also expand access to care of racial and ethnic minorities in U.S. who are hindered by some key health equity concerns and eventually, all Americans (Williams, 2011, 147), Impact of Changes to Access to Utilization The current health care changes access to utilization to address health care disparities; however, the ten major titles of the Patient Protection and the Affordable Care Act does not specifically relate to eliminating health care disparity which has resulted to deficiency in health care delivery (Williams, 2011, 148). Access and utilization of health insurance were modified and broadened but not the health care itself. In fact, aside from racial and ethnic minorities, the lack of primary health care professionals, enormous medical errors, and financial engineering were not addressed (Gibson & Singh, 2012, 51). Imagine these three as aspects that the current health care delivery system are lacking. Although all Americans will be covered because of present health insurance system, there would be a few medical practitioners and health allied professionals who will take care of the patients. Federal costs to health care have been reduced but having access to basic medical care is hampered. Hospitals are confronted with enormous medical crisis because the current financial engineering will allow them to have more profit due to increasing volume of available medical services. To sum it up, the current U.S. health care reform focused mostly on extending insurance coverage, decreasing the growth of costs through improved efficiency, and expanding prevention and wellness programs. Concept of Universal Health Care The concept of universal health care has three features: political process, growth in incomes and concomitant rise in health spending, and increase in the share of health spending (Savedoff et al., 2012, 924). The political direction of the universal access to health care is always driven by social factors; thus, programs and regulations are always directed across the populations. Federal budget has also been increased to allow more people to access and buy more health services. Rather than operating on a Hammurabi’s Code financial engineering, funds to medical services are pooled from citizens’ taxes instead of individualized pay-out. From the term itself, universal health care works on the principle of providing health care services to everyone in the society. Stakeholders of the Universal Health Care The different stakeholders of the universal health care are patients, health practitioners, monitoring agencies, payers, and other stakeholders (see the concept map above). Health practitioners regarded lifestyle as a central issue in public health and lobbied for personal accountability for a healthy behavior. They took part in direct provision of care and believe that it is not only the responsibility of the federal state but the whole society to provide equitable access to care. Their responsibilities are regulated by their respective professional and licensing bodies or associations. Patients are the recipient of care and the stakeholder paying for services. They were also the stakeholders involved in evaluating the effectiveness of the health care reform program. The monitoring agencies refer to the government and the federal ministry of health. These stakeholders are in-charge for the creation of legislation, programs and policies and for the delivery of health services. Other stakeholders might include protective associations and societies, labor unions, medical schools, students of health care, etc. References Gibson, R. & Singh, J.P. (2012). The Battle Over Health Care: What Obamas Reform Means for Americas Future (p. 1-223). MD: Rowman & Littlefield Publishers , Inc. Jacobs, L.R. & Skocpol, T. (2012). Health Care Reform and American Politics: What Everyone Needs to Know (Revised and Expanded Edition) (p. 1-197). NY: Oxford University Press. Parks, D. (2012). Health Care Reform Simplified: What Professionals in Medicine, Government, Insurance, and Business Need to Know (2nd ed.) (p. 1-183). NY: Apress Media LLC. Savedoff, W.D. et al. (2012). Universal Health Coverage 2: Political and economic aspects of the transition to universal health coverage. The Lancelet, Vol. 380, 924-932. Williams, R.A. (2011). Health Care Reform Simplified: What Professionals in Medicine, Government (p. 1-421). NY: Springer Science+Business Media LLC. Read More