Preventative Care and Health Care Reform - Essay Example

Preventative Care and Health Care Reform Preventative Care and Health Care Reform Health care reform in the U.S has been an ongoing debate that goes back as far as 1965 when President Lyndon Johnson’s government passed into legislation Medicaid and Medicare. (Georgetown Law Publications, 2010). The current issue dubbed ‘Obamacare’ is the latest in the series of reforms in the U.S health care system. Obamacare, officially titled The Patient Protection and Affordable Care Act, PPACA was effected on March 23, 2010. The greater purpose of the current healthcare Act in the U.S is to ensure that all Americans have access to affordable, quality health care and coverage. Other purposes of this Act are to; • Protect Americans from filing for high medical expense triggered bankruptcy • Make it possible for persons with pre-existing medical conditions to access medical coverage • Allow Americans freedom to choose preferred medical covered and preferred doctors under the choice of coverage • Make it possible for Americans to maintain coverage despite being out of work or despite changing jobs • Decrease the long term health cost hikes for government and for businesses • Improve the quality of health care accessible to Americans and ensure all-time safety of patients • Set aside funds for preventative care and wellness services for Americans Current health care costs in the U.S are the highest relative to other industrialized countries with nearly the same or even lower GDP than the U.S. Aside from most of health care services in the U.S being from the private sector, another major factor that has been put forward for the expensive healthcare is prioritizing of reactive rather than preventative healthcare. The previous health care system mainly focused on medical care and coverage for a greater percentage of costly medical conditions that could be treated for less only if preventative care is applied. Where there have been options for care and coverage, additional out of pocket costs resulting from co-pays, deductibles, and co-insurance have all but discouraged Americans from adopting preventative care services (Kaiser Family Foundation 2011). On the specific purpose of setting aside funds for preventative care services, the U.S health care reform has a first objective of reducing high costs of over 75% of the U.S health care spending on treatment of chronic diseases (HealthCare.Gov, August 01, 2011). The second objective of preventative care is to save more lives of people through encouraging the adaptation of preventative care as a vital means to lowering the U.S chronic disease related death rate of 7 out of 10 Americans. Many Americans only seek medical attention when their conditions are far along thus costly treatment is unavoidable, and there are increased chances of patient deaths (HealthCare.Gov, August 01, 2011). Coverage under preventative care services is for adults and children with a focus on key medical issues faced by women and children. 35 preventative services as per the health plans effected on September 23, 2013 deal with prevention care for women and for children, routine vaccinations for children and adults, and evidence-based preventative services including counseling and screenings for threatening conditions like cancers, HIV, diabetes, and depression (Kaiser Family Foundation 2011). The U.S health care reform having been pushed for the last 3 years since 2010 has received a lot of criticisms for the problems it has failed to consider (New England Journal of Medicine, October, 2012). First, although the variation in adoption of preventative care services will exist from state to state, premiums charged for the services may generally increase. This is because for insurance companies, the avoided expenses of later-stage disease treatment will not be as high to cover the expenses from coverage of preventative care services. Thus, premiums will still be increased for Americans seeking health care. Some preventative care services can be harmful when exposed to patients with low risks of developing particular diseases. Some preventative care services are proven to decreasing overall health care costs for patients, but many other services do not offer the same benefits. For instance immunizations for children and tobacco use screenings can decrease overall health care costs but other services only increase the health care costs over a patient’s lifetime. Whilst being beneficial to the middle to low income Americans, the U.S health care reform puts upper class Americans at a disadvantage. At this disadvantage are employers who, because of their large workforce present insurers with higher risk relative to insured individuals. Such risk is forwarded to employer’s insurance costs and consequently employees are also affected by the high premiums they have to pay. Alternatively, employees may consider going for lower and cheaper quality insurance which does not offer the employees quality coverage. Private health care plans that took effect in August 2012 obligate insurance companies to cover contraceptives use for women and also for teenagers as a means of pregnancy prevention (HealthCare.Gov.,2011). This is one of the most controversial plans for the current health care system with substantial public opinion objecting to the use of contraceptives on religious grounds. Religious institutions as well as religious employers have expressed their lack of support for this health care plan. Furthermore, the objecting employers threaten not to pay for contraceptive coverage for their employees. Because of the U.S health care reform, businesses that hire full-time staffs have to insure them or face hefty fines. The plans here are meant to push employers to get coverage for their staffs however it raises the problem for employees who may be out of work or hired part time by employers who are running away from the fines. With fewer workers and less staff on full time employment, employers are able to escape the fins that do not include the first 30 staffs that are not covered. For consumers, the health care reform in the U.S also presents a problem since coverage costs for employers may be transferred to them in the form of expensive products. Public interest on health care reforms in the U.S is also from seniors who are on Medicare. The Obama health care plans intend to cut Medicare funds by over $700 billion to direct the funds to the new health care program (New England Journal of Medicine, October, 2012). Seniors on Medicare are afraid that they will no longer be able to access quality care of afford their medical costs. After passing of the Obamacare bill, roles on implementation of the bill’s requirement fell on the federal, state, and local governments. The Obamacare act on U.S health care reforms gives the role of implementing the passed plans to the state and local governments. The outlined requirements of Obamacare must be fulfilled under the watch of state governments from setting up of exchanges for Americans to expansion of Medicaid to low income Americans. The oversight by the state governments however is that; should the Medicaid expansion be voted against in the state senate, low income Americans will not receive the Medicaid program thus they will have no access to affordable, quality care. The federal government role also falls on setting up exchanges in various states should the state governments not be able to or be opposed to the health care reform plan. The federal government will also oversee the funding of the rollout of the Obamacare plans. An oversight with the federal government’s role is on funding where even though re-investing of funds from Medicare into the Obamacare plan may be effective in lowering government healthcare spending, it could still leave the country in dent as the government will still have to spend substantially on healthcare. Obamacare undoubtedly has its shortfalls however it is recognized that some of the plans that have come into effect are already having an influence on the U.S health care system. In terms of utilization of resources, healthcare reforms have impacted utilization of preventative care services mostly for those who already have health insurance. Although the utilization of these services is not at recommended rates by health experts, evidence shows that insured individuals are more likely to go for cancer related screenings, mammograms, and health checkups. The variations in the utilization of preventative care services are based on cost-sharing policy whereby Americans are turned off by even the slightest levels of con-insurance and copays. Decreased out of pocket costs have also been recorded as part of the impacts that Obamacare has had on patients. Obamacare, following the September 23, 2013 ruling on health care plans preventing pullout by health insurance companies set limits for medical expense payments by insurance companies to no less than $2 million per year (HealthCare.Gov.,2011). Later on in January 2014 the limits will be completely scrapped off. Free preventative care for seniors was passed into law as from 2011 as well as free cancer screenings, wellness visits, vaccines and personalized prevention plans for patients. In terms of access to care, expanded coverage through changes in the health insurance coverage plan has also been of impact to Americans. Young adults aged up to 26 can now be covered under medical insurance plans originating from their parents. More insured Americans who previously lost medical cover under their parents at the age of 20 and below for others now have access to medical coverage for a longer period. Children under 19 years and with pre-existing conditions can now get insurance cover despite it being at higher premiums as compared to other healthy children in the same age range (Georgetown Law Publications, 2010). Quality care impact as a result of U.S health care reforms has resulted from better coordinated health care. The training of more primary care physicians as required in the Health Care reform bill. The quality care will cover the primary care physicians’ shortage in many American hospitals. Additional and advanced resources such as better equipment and extensive medical research for preventative care have improved the delivery of health care services (New England Journal of Medicine, October, 2012). It is evident that the U.S health care reform has not been wholly accepted by its beneficiaries. Various reform proposals and legislations have been forwarded to address the shortfalls of the current healthcare plan. One proposal from the federal government advocates is on the use of health savings accounts, HSA’s to reduce costs of health insurance. This proposal’s objective is on making patients more conscious to health care costs thus leading them to demand less of for-profit health insurance products. This, it is expected will push insurers to get into the competition to offer affordable coverage to patients. A disadvantage to this is that uninsured patients will have more out of pocket costs. An advantage is that more healthcare costs relative to unhealthy behavior will be incentive for Americans to maintain healthy lifestyles. Evaluation of this proposal can be through continuous evaluation of statistics showing average amounts that upper, middle, and lower income Americans pay for insurance coverage. Another reform proposal also from the federal government is on increasing numbers of insured Americans. This reform’s objective is to give tax and subsidiary incentives for large employers to insure their staffs. The advantage is on staffs being covered by their employers while the disadvantage is that employers may be discouraged from growing their firms for fear of obligation of larger employers to insure their staffs. Evaluation of this proposal can be done through continuous evaluation of the numbers of insured Americans in the current health care plan. Preventative care and health care reform in the U.S has not completely been successful hence it is in need of recommendations for improvement. Amendments on the healthcare bill are needed on a continuous basis, and keen observation should be done on its impact on the healthcare system once all the plans take full effect in 2014. Expert committees should then be put in place to oversee the approved recommendations for improvement. Reforms on tort laws in the U.S are needed in relation to the medical industry. A large part of health care costs arise from legal lawsuits that are filed by patients against physicians. The consequence of loss of quality medical experts has led to decrease in the volumes of quality care givers, and it has decreased access to quality care for patients. Health care in the U.S is closely linked to the workplace where most Americans are insured under their employer separation of health care from the workplace will go a long way in ensuring that coverage is portable and continuous irrespective of employment status. Employees can only then be free of worry of losing medical benefits once they are out of a job. ‘One-size-for-all’ plans in the current health care reform plans should be abolished thus allowing for freedom of choice of health plans that are ideal for each individual. If adopted, this can reduce costs for patients as they will only have to go for health plans that are personalized. Health care reform plans in the U.S can be altered to allow for access to quality care from other markets outside the U.S. By so doing, patients can be able to access even higher quality care and at lower costs than are required in the U.S health care system. Health savings accounts should be unlimited and free when rolled over. This will allow for beneficiaries of a health savings account originator to benefit from the funds should the originator die. Given these recommendations, the U.S healthcare reform could be on its progress to being one of the best health care systems not only for foreigners but for local Americans both in quality and in affordability. References Bernstein, J, Chollet, D, & Peterson, G. (2010). Encouraging Appropriate Use of Preventative Health Services. Retrieved on May 2, 2013 from: http://www.mathematicampr.com/publications/PDFs/Health/reformhealthcare_IB2.pd Fuchs, V & Emanuel, E. (2005). Health Care Reform: Why? What? When? The People-to- People Health Foundation, Inc. Retrieved on May 2, 2013, from: http://content.healthaffairs.org/content/24/6/1399.full HealthCare.Gov. (2011). The Health Care Law & You. HealthCare.Gov. Kaiser Family Foundation (2011). Preventative Services Covered by Private health Plans under the Affordable Care Act. The Hendry J. Kaiser Family Foundation. Retrieved on May 2, 2013 from: http://www.kff.org/healthreform/upload/8219.pdf Kaiser Family Foundation (2010). Health Reform Issues: Key Issues bout State Financing and Medicaid. The Hendry J. Kaiser Family Foundation. Retrieved on May 2, 2013 from: http://www.kff.org/healthreform/upload/8005-02.pdf New England Journal of Medicine. (2012). Replacing Obamacare with Real Healthcare Reform. N Engl J Med. Read More