Reviewing the existing health insurance standards in the U.S. reveal various opportunities that can be explored to improve the quality of care administered to patients across the country. Notably, health insurance reform aspires to expand the number of care providers to allow consumers to choose their preferred health institutions. It also intends to increase access to health specialists to enable individuals to receive quality care for different ailments. Therefore, insurance reform in the U.S. will decrease healthcare costs and provide more care regimens to the public because of the efficiency of the system to address different medical problems affecting individuals in their immediate environment.
Understanding the National Health Insurance
The U.S. has the highest healthcare cost per person despite a significant portion of its Gross Domestic Product (GDP) being allocated to the health sector to provide quality care to the public. In this regard, many individuals have expressed their support for different health programs that can lower the cost of healthcare upon implementation, a move that has exposed individuals to a series of conversations and debates regarding the most appropriate approach that should be used to respond to the health crisis (Sommers, Gawande, & Baicker, 2017). In this regard, many countries, including Canada and the UK, have a systematic health system that resolves issues affecting the overall experience of individuals and reduces their inability to access quality care on demand. Significantly, health insurance increases the population that can access health programs in the country because of the government’s involvement in providing health services. However, the adoption of an elaborate and adequate health insurance program in the U.S. has become problematic because of the divided nature of policymakers on the healthcare issue.
In 2010, the Affordable Care Act, popularly known as Obamacare, was adopted to increase uninsured people without access to healthcare in the country. The health insurance program covers ten health services that are not limited to doctor’s assistance, prescription drug coverage, and mental health services. Since the population of non-elderly individuals with employer-sponsored cover had fallen from 66% in 2000 to 56% in 2010, the health insurance program was timely. It would help individuals access quality care at low or zero costs (Jung & Tran, 2016). However, the Republicans attempted to repeal the affordable care act citing no reduction in care price even after its implementation. Besides, the leftist movement argued that it was challenging to enroll for the program because of the challenges in accessing the website, among other utilities meant to facilitate the sign-up process. From this observation, reforming the affordable healthcare act will have a significant impact on the cost of healthcare in the U.S. while still maintaining the desired quality features that should be extended to consumers.
Strengths and Weaknesses from the Stakeholder Perspective
Upon implementing healthcare reform in the U.S., the health system will become more efficient and people-centered because of the increased incentives associated with helping the people access quality treatment for different medical problems. Notably, health facilities will be renovated to cut operating costs associated with non-performing structures and equipment. In the same vein, nurses call centers will be installed to reduce the number of trips made by nursing practitioners to the wards, allowing them to respond to critical cases on demand (He & Nolen, 2019). Health insurance reform will lead to the development of a new model of care that will focus on the specific patient needs instead of the services rendered. From this realization, the government will now hold health facilities to account for their treatment approaches and the high mortality rates associated with specific health resources in different parts of the country. Even as the country still debates health insurance reform, health facilities will have access to additional financial resources that will help resolve issues affecting individuals in their immediate environment.
Nonetheless, health providers have expressed their sentiments over the increased patient population after successfully implementing the health insurance reform in the country. The administrative costs that emerge when handling patients may interfere with the operational performance of selected facilities because of the payment approach of the federal administration. Although health insurance reform will improve coverage, accessibility may become a problem for patients because of their inability to access on-demand treatment using insurance (McKillop, Waters, Kaplan, Kaplan, Thompson, & Graetz, 2018). In this regard, balancing the population gap between health practitioners and patients should be addressed before implementing the insurance reform. The adoption of health insurance reform will lead to a decrease in tax breaks, Medicare reimbursements, and other incentives that are critical to the operational performance of healthcare facilities. Hence, many stakeholders are not optimistic about the impact of health reforms until specific issues are addressed before implementing the proposed changes.
Summary of the Anticipated Costs and Benefits
Health insurance reform in the U.S. will see 24 million people purchase insurance coverage through the window created by the new insurance exchanges. An additional 16 million individuals will enroll in the health insurance program through Medicaid or the Children’s Health Insurance Program (CHIP). However, 3.5 million people are expected to stop purchasing insurance outside the new exchanges (Sommers, Mcmurtry, Blendon, Benson, & Sayde, 2017). About 4.5 million individuals will terminate their employer-sponsored programs in line with the new reforms. From this realization, the proposed health insurance reforms will affect different population groups, including those from low-income backgrounds, that it is supposed to help. Expanding Medicare is poised to yield better outcomes than introducing insurance reform because of its ability to accommodate different individuals. On the contrary, employers will benefit from insurance reform because of the availability of a cheaper insurance option that people can use to access quality healthcare from designated health providers (Zhang & Baranek, 2016). In the same vein, patients with existing medical problems have been protected (since 2014) from high premiums or denied coverage because of the inclusive nature of the proposed health reform. Therefore, addressing the different aspects that influence health challenges affecting individuals is an important aspect that can resolve the challenges triggering outcomes, which hinder individuals from discovering their potential.
Insurance reform in the U.S. will decrease healthcare costs and provide more care regimens to the public because of the efficiency of the system put in place to address different medical problems affecting individuals in their immediate environment. By improving the reduction of healthcare costs through insurance reform, the government will broaden its spectrum to accommodate many people who succumb to their illnesses due to their inability to afford different treatment regimens. For this reason, evaluating the opportunities that can be exploited in the American health sector can provide viable solutions that correspond to the changing needs of individuals in their immediate environment.
He, H., & Nolen, P. J. (2019). The effect of health insurance reform: Evidence from China. China Economic Review, 53, 168-179.
Jung, J., & Tran, C. (2016). Market inefficiency, insurance mandate and welfare: US health care reform 2010. Review of Economic Dynamics, 20, 132-159.
McKillop, C. N., Waters, T. M., Kaplan, C. M., Kaplan, E. K., Thompson, M. P., & Graetz, I. (2018). Three years in–changing plan features in the US health insurance marketplace. BMC health services research, 18(1), 450.
Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health—what the recent evidence tells us. N Engl J Med, 377(6), 586-593.
Sommers, B. D., McMURTRY, C. L., Blendon, R. J., Benson, J. M., & Sayde, J. M. (2017). Beyond health insurance: remaining disparities in US health care in the post‐ACA era. The Milbank Quarterly, 95(1), 43-69.
Zhang, W., & Baranek, G. (2016). The impact of insurance coverage types on access to and utilization of health services for US children with autism. Psychiatric Services, 67(8), 908-911.
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