Healthcare Public Policy - Essay Example

number Introduction Policy Policy can be defined a collection of principles that is used to base decisions thus leading to the achievement of rational outcomes. Policy is often used to denote the protocol or procedure followed by governments and not what has been done already. The generation of policy mostly occurs at the highest management level of an organization. Policies normally assist in decision making in both the subjective and objective cases. Public policy Public policy is the attempt by the governing body of a state to address an issue that affects the public by instituting decisions, actions, laws and/or regulations that address the problem in question. Public policy addresses a wide range of issues ranging from crime to education to health, and social welfare. Many policies are similar in countries with similar structure of governments and ideals. Creation of public policy is a long well checked and all- inclusive process that ensures that only the best policies are formulated. Some scholars have simply defined public policy as the action, laws measures of regulation, and funding priorities covering a given topic put into action by a government or its proxies. Public policy is in many cases enshrined "in constitutions, acts of parliament, and judicial decisions. Public policy is divided into domestic and foreign policy. Domestic policy Domestic policy is the area of public policy concerned with government programs, laws, and administrative decisions that cover the happenings within a country’s borders and that attempt at bettering the lives of the citizens within the country. Health care Health care is an important sector that affects the whole population and which governments ought to give due weight when formulating policies on the same. It is the duty of every government to ensure that the general populace is in good health. This ensures not only people having faith in the government, but also maximum productivity in all other sectors. In formulating policy, the government must consider accessibility to health care where all citizens need to be in a position to physically access health facilities. The government must also consider the affordability of the same and ensure health care is not too costly for the general populace. The government must also ensure that the quality of care for its citizenry. Recent times have seen many governments attempt to reform their health sector. Among the reforms that have been attempted most is broadenings section of the population that accesses health and medical care coverage through use of either public sector or private sector insurance programs or companies respectively. The governments have also put in place measures to expand the choice of health care providers such that consumers have the opportunity to choose. Efforts to improve quality of health care through use of up-to-date equipment and proper training of Health care providers have been put in place. Various attempts have also been put in place to ensure reduced costs of health care. The United States is one of the countries that have put in place innumerable measures to ensure that its citizens get high quality, easily accessible and affordable health care. Health care in the United States. There are a wide range of health care providers in the United States. The United States domestic policy makers place a great emphasis on the country’s health care systems. The United States government is ranked fourth in the world in the per capita spending on health at $3,426 behind. The only countries ahead of the US in this respect are Monaco, Norway and Luxembourg, all of which have a higher GDP per capita than the US. However the efforts have not had enough effect as the country is ranked 50th in the world life expectancy at 78.49. This falls behind the life expectancies of most developed and some developing countries. Life expectancy is one of the biggest indices of health care quality. The country has higher infant mortality rates than most developed countries. Independent statistics on health care are a source of shame to the country. A report released by the Institute of Medicine (IOM) in 2004 revealed that the United States is one of the few industrialized nations where access to health care is not guaranteed to the general population. A different independent report released the same year by OECD observed that all OECD countries had achieved a near- universal insurance coverage (at least 98.4% of the population insured) apart from Turkey, Mexico, and the United States by 1990. As late as 2011, only 83.9% of the US population was insured. The OECD report also placed the death rate resulting from hemorrhagic strokes in American hospitals at 25.5% while the average for OECD countries was 19.8%. The IOM report observed that lack of health insurance is responsible for close to 18,000 avoidable deaths annually in the United States. A 2009 Harvard university study put the number of annual deaths occurring due to failure to have health insurance at over 44,800.It therefore follows that the policies formulated are not effective enough and more effective policies need to be put in place. Health care facilities are mostly private sector businesses. The government, however, provides the bulk of Health insurance services for the public sector employees . Around 63% of healthcare provision comes from programs like the Medicare, TRICARE, Medicaid, the Veterans Health Administration, and the Children's Health Insurance Program. The majority of the population below 65 years of age is insured by their employer, family member's employer, or their own insurance while the rest are uninsured. The government has put in place programs that cover 27.8% directly and help a section of the poor, disabled, elderly, children and veterans to pay for their health care. The government has put up independent agencies to ensure quality in mental health, increase coverage and bridge the demographic differences of health care provision. Health care reform in the United States Health reform has a long history. Major reforms taken over time in the history of the United States include the enacting of a legislation introducing Medicare by President Lyndon Johnson in 1965. The legislation covered hospital and senior citizens general medical insurance that was to be paid by Federal employment tax deducted from the retiree over their working life. At the same time, the legislation established Medicaid thus permitting the Federal government to be a partial financer to a program intended for the poor with the rest of the funds being paid for by each individual state. The Consolidated Omnibus Budget Reconciliation Act of 1985 amended an earlier legislation and gave a section of the employees a leeway to access health insurance coverage after they left employment. The 1997 State Children's Health Insurance Program was established with an aim of providing health care insurance to children in families ranked below the federal poverty line. The last milestone that has been made is the 2010 enactment of the Patient Protection and Affordable Care Act that was aimed at eliminating insurance company practices deemed as not being consumer- friendly. Such practices included pre-condition screening, premium loadings, policy revokes on technicalities when there was imminent projection of illness, annual coverage caps and also lifetime coverage caps. The legislation also set a minimum ratio of spending on direct health care to premium income. It also created price competition through creation of standard coverage levels aimed at enabling the consumers to compare and contrast different insurance service providers. The government has in recent times taken many other steps to ensure that the desired standards of health care are met. Some of the steps taken were through legislative acts. Some of these measures include: Establishment of Centers for Medicare & Medicaid Services (CMS) which were put in place by the Affordable Care Act. These centers give a new lease of life to Medicare sustention, Medicaid, as well as the Children’s Health Insurance Program (CHIP) and also provide health care systems for every American. The Innovation Center conducts tests on innovative care and also on payment models thus encouraging widespread adoption of procedures that deliver better quality and affordable health care. The year 2010 was an important year in the medical history of the US. The year witnessed the passing of various important legislations aimed at reforming the sector. The acts were aimed at various goals. One of the aims of the same was to expand Medicaid and subsidize insurance. The law has included health-related provisions expected to take effect over several years, which includes expanding Medicaid eligibility up to people up to 133% up from 200% of the federal poverty level (FPL). Guaranteed issue, individual mandate, community rating. Starting in 2014, it will be illegal for insurers to deny coverage to applicants who are sicker, or imposing any special conditions like higher premiums and/or payments). Expenditure on health care are highly concentrated where the most expensive accounts for 50% of total health care spending of 5% of the population and the bottom 50% of health care spenders account for 3%, only which meaning that insurers' gains to be gotten from avoiding the sick significantly outweigh possible gains gotten from managing their care. Consequently, insurers devoted their resources to making such avoidance as opposed to providing care. This, of course, is against the insured’s interests. The health insurance industry had diverted their role from providing health security to becoming risk differentiators since the 1970s. They put effective policies in place that ensured that they insured the healthy and excluded the sick or those considered likely to become sick and subsequently less profitable. This legislation effectively puts this behavior to an end. Health insurance efficacy The Acts passed in 2010 compel insurers to cover for more costs, instructing them to ensure that at least 80% of the premiums are spent on medical care and/ or "quality improvement" while requiring that they offer full coverage for immunizations and screenings, and also through prohibition of annual and lifetime caps. There are conflicting views on the effect of expanding insurance coverage. Some argue that this will lead to improved health while, others provide studies that prove that the contrary is true. While a study carried out by Harvard University and published in the American Journal of Public Health claimed that at least 44,800 excess deaths annually are associated with failure to have insurance cover in the United States, other studies failed to find the correlation. A broader 1997 study estimated that the number of people who die annually in the United States for lack of medical care was almost 100000. A good proportion of these people are insured. There have been reports that expanding psychiatric drugs coverage has made the health of many children worse as they incur costly and terminal side effects like diabetes. Many of these studies however fail to give the full information- that such instances of "expanded coverage" base their findings on narrow and non-representative subpopulations that do not reflect the most likely net benefit for numerous subpopulations with hypertension, diabetes, and other terminal illnesses who would benefit greatly from expanded coverage. Conclusion While the United States government has done a lot in bettering health standards in the country and ensuring high quality Medicare, there remains a lot to be done. Contemporary issues in the health sector that were hitherto unobserved have arisen and need to be considered when formulating health policy. The government also needs to include more health expatriates in health policy formulation as opposed to use of politician who have limited know how in the sector. Works cited Johnson, Avery . "Recession swells number of uninsured to 50.7 million". The Wall Street Journal: September 17, 2010. Web. 26, Sep. 2011             Read More