Health Care Reform - Research Paper Example

?Running head: HEALTH CARE REFORM Health Care Reform Insert Insert Insert 27 September Table of Contents 0INTRODUCTION……………………………………………………..3 1.1 Background…………………………………………………………3 1.2 Purpose Statement…………………………………………………4 1.3 Research Questions………………………………………………..4 1.4 Purpose of the Research…………………………………………..5 1.5 Delimitations and Limitations………………………………………5 1.6 Significance of the Study…………………………………………...6 2.0 LITERATURE REVIEW……………………………………………….6 2.1 Shortcomings of the Literature Review……………………………7 3.0 METHODOLOGY………………………………………………………8 3.1 Theoretical Framework……………………………………………...8 3.2 Type of Design……………………………………………………….9 3.3 Site selection and Research Participants………………………….9 3.4 Data collection Strategies…………………………………………..10 3.5 Data Analysis Strategies……………………………………………10 3.6 Methods of Achieving Validity………………………………………11 4.0 FINDINGS………………………………………………………………11 4.1 Relationship to Literature……………………………………………11 4.2 Relationship to Theory………………………………………………11 4.3 Relationship to Practice……………………………………………..12 5.0 CONLUSION…………………………………………………………...12 6.0 REFERENCES………………………………………………………...13 7.0 APPENDICES…………………………………………………………16 Health Care Reform 1.0 Introduction 1.1 Background Good and healthy life constitutes components that every human being would want to have in his or her lifetime. Unfortunately, human life is characterized by different aspects that make attainment of quality and good health a challenge. Humans require healthy lives in order to be able to carry on with their daily activities and as a result, there have been concerted efforts to ensure good and quality health is provided to majority of people in different parts of the country. It is in this sense of realizing good and quality lives for people that health care field developed and remains one of the fundamental fields that unite economic, political, social, and even religious forces. Numerous challenges have been experienced in the field of health care as the need for satisfaction of unlimited human health needs against limited health resources become inevitable in the modern world. This situation has led to experience of numerous conflicts, concerns, dissatisfactions and sometimes criticisms with regard to provision of health care services in the society. Therefore, health care reforms have become characteristic of health care for a long time, as the need and desire to improve health care remain paramount. Health care reforms in the larger society for a long time have been premised on the need to increase coverage, minimize and distribute cost and spending on health care, and improve overall quality of health care (Fernandez, 2010). 1.2 Purpose Statement Health care in the larger American society and even in other societies constitute the largest spending sector in terms of resources (Fernandez, 2010). Compared to other sectors of the economy, health care comes out as the largest spending sector that sometimes lead to strain on the economy of the country (Fernandez, 2010). Provision of healthcare facilities hinges on three key aspects, which include coverage, cost and spending, and quality (Fernandez, 2010). Coverage of health care facilities remains one of the pertinent issues health reformers still have to contend with. On the other hand, cost and spending on health care has been estimated to impact the economy in great measures as increases in health spending become evident. Cost and spending on health care further affects government’s tax policies, which further trickles down to the employers and households. Lastly, health care quality in midst of government reduced spending remain challenging issues as provision of quality health at reduced resources remain dilemma among stakeholders. Interdependence of these factors has led to creation of great inconvenience in the provision of health care and this has motivated the need for health care reforms in the American society. Research in the field of health care reforms remains one of the avenues of addressing issues in health care sector. Given this scenario, this research paper is premised on the need to evaluate health care reforms in the recent times and the efficacy of the proposed reforms in addressing current challenges being experienced in provision of health care facilities in USA. 1.3 Research Questions Research questions constitute that part of research paper that provides an overall guidance for the research work (Hall 2008). It constitutes key areas that the research aims to answer through literature review and data collection and investigation techniques. The aim of this research paper is to evaluate the impact of recent health care reforms on the economy and society of USA. In doing so, this research will be guided by the following research questions: What factors influence the recent health care reforms in USA? How do politics and economic-health issues affect recent health care reforms in USA? What is the economic impact of recent health care reforms to Americans? 1.4 Purpose of the Research In doing any research in any given field, there is always motivation as to why the research has to be undertaken. The motivation in undertaking any research work is usually inscribed in the overall objective of the research. Thus, research objectives constitute all those reasons why the research is necessary and has to be undertaken and what will be the impact or benefit of the research. The objective of this research paper is to generate useful information concerning impact of recent reforms on economy and society at large. Such information can be beneficial in decision-making process especially with regard to future health care reforms. 1.5 Delimitations and Limitations This research paper will largely evaluate the recent health care reforms under President Barrack Obama administration as well as how they impact economy and larger society. This will make the focus of the paper to be limited to these particular reforms and none other earlier reforms. Limitation of the research paper may be evident in resources allocated to carry out the research including time which may be inadequate given extend and content of this research paper. Another limitation may arise from research instrumentation, whereby the selected samples may not provide the exact information, concerning extends to which health care reforms impact society. 1.6 Significance of the Study Strain on the economy and tendency of the government to reduce health care budget requires efforts that identify appropriate solutions to emerging health care issues. To achieve maximum benefits that address health care coverage, cost and spending, and quality, there is need for updated information that is reliable and valid. Therefore, key significance of this study is to generate information regarding health care reform that is premised on aspects of validity and reliability will little bias hence possess capability to inform decision-making process in health care sector. 2.0 Literature Review The history of health care reforms in USA is almost synonymous with the development and growth of health care sectors. Reforms in the sector have been inevitable especially given the growing health needs among increasing populations. Health care needs, political lobbying, coupled with economic situations and dynamics among the population are considered as key elements that in the past have influenced health care reforms and are likely to persist into future. In the recent past, the Patient Protection and Affordable Care Act (ACA) was signed into law by President Barrack Obama in 2010 and the Act will fully become operational by the year 2014 (Hardcastle, Record, Jacobson and Gostin, 2011). The Act contains numerous provisions regarding health insurance reform systems for both individuals and the population at large. The presence of this Act continues to draw one of the fiercest debates in USA pitting Democrats and Republicans policy makers. However, even as the debate rage, some observation has been made by health care professionals who ascertain that purpose of health reform should rest on the need to improve overall state of health in the country (Hardcastle, Record, Jacobson, and Gostin, 2011). As such, health reforms should not just address health care services but also to integrate public health in the larger reform system. One striking feature of the ACA is the provision for evidence-based preventive services without cost sharing (Cogan, 2011). The essence of this provision requires that patients should have access to preventive health measures without requiring patients to pay for the services when provisions of the services are provided (Cogan, 2011). From the public point of view, this provision scores highly especially among disadvantaged groups who for a long time have been unable to access health care facilities effectively. However, to other group of citizens, mostly the employers and politicians, this provision is going to exert burden to taxpayers, as more dollars will be required to sustain the provision. When more dollars become inevitable, tax will be raised, employers will be forced to pay more and even government health spending will have to increase slightly (Davis and Somers, 2011). 2.1 Shortcoming of Literature Review ACA remains one of the substance legislation that Democratic government is recognized with. Nevertheless, given operations of the Act is likely to kick off in 2014, numerous amendments and legal disputes are going to characterize the Act. One area the Act does not provide genuine background information have to do with mandatory purchase of insurance coverage. The issue that remains painstaking has to do with economic impact of the provision to different sectors of the society. This shortcoming of the ACA motivates desire to carry out research that provides recommendations which future policy makers can integrate in the process of improving the Act. 3.0 Methodology This section will explain the research methodology that will be utilized. The aim of this research paper is to evaluate the impact of recent health care reforms on the economy and society of USA. As a result, the research methodology to be utilized will be chosen in correlation with the research questions and purpose of the research (Strauss and Corbin, 1998). 3.1 Theoretical Framework Research is based on theoretical frameworks or models that perform the role of enhancing understanding of research project and in providing a clear road map for investigation of key variables. Theoretical framework in health care reforms is premised on understanding and explaining inter-linkages among variables of economic, political and health (Okma, 2010). Accordingly, Okma (2010) observes that health reform involves decision-making opportunities over allocation of resources and financial risks manifested in funding, contracting, ownership, and administration of health care. Both economic and political theories are integrated in this study, whereby economic concepts characterize health care system in terms of funding, contracting, and provision of health services. On the other hand, political concepts characterize health care system in terms of main actors’ behaviors government, patients, the insured health insurers and providers of health care services (Okma, 2010). 3.2 Type of Design As this study will utilize both constructionist and positivistic paradigms, the focal point will be to derive objectivity and in-depth analysis of the study. In so doing, quantitative and qualitative approaches are applied. Through a combination of these research designs, data to be retrieved will be gauged using both strength of qualitative and quantitative designs, which include the strength of validity and reliability found in quantitative approach, while the qualitative design offers in-depth analysis of data. In this manner, it is expected that a more robust and meaningful conclusion can be gauged by the research. Research objectives and research questions are developed in order to set the focus of the study. 3.3 Site selection and Research Participants The aim of research project is to evaluate impact of ACA in the federal republic of USA and therefore achieving objective results will require selection of site (s) that is (are) widely representative. In this case, the research project will be carried out in four USA states that will be selected through probability sampling process. According to Babbie (2010), sampling is appropriate for the next step of research and this research will adopt multistage sampling that uses stratified random sampling process. Research participants to be included in the research project include samples from health care providers, government representatives, and health care insurers. Selecting key respondents from these categories will also utilize random sampling process which according to Yates and Yates (2004) possess strength of having capacity to avoid bias in the selection process. 3.4 Data collection Strategies Data will be collected from both primary and secondary sources, where in the case of the primary data collection, surveys and case study interviews will be conducted among the sample respondents. There will also be administration of semi-structured questionnaires among sample respondents. Secondary data will be collected from available researches done by various scholars in the topic. Secondary data collection sources will include among others the analysis of Health Reform Surveys in different states and analysis of findings from the Uniform Data System (Ku, Jones, Shin, Byrne, and Long, 2011). 3.5 Data Analysis Strategies The instrument to be utilized is a self-developed questionnaire, which will be composed of ten items with additional eleven open-ended interview questionnaires. The first set is gauged to inquire the selected government representatives and also selected health care providers opinion and perception on how recent health care reforms are going to impact the various sectors of economy. Four likert scales will be used to assess the level and strength of response on each item. On the other hand, the second set is for the survey of health care insurers who also are affected by ACA provisions. The eleven-item questionnaire will supplement information for the answers derived from the interview with government and health care providers. Data will be analyzed using Microsoft Excel, 2010 version. Various pivot tables in form of frequencies, mean, and mode will be used for cross tabulation. In addition, graphs of comparison will be used and other statistical data will be accomplished using different Function tools within Excel. Data analysis will be in accordance to stated research questions. Determination and analysis of categories of respondents will largely be demonstrated through use of mean tables, graphs, and pie charts. Percentages will be calculated with regard to responses on any given variable being investigated. 3.6 Methods of achieving Validity Objective results from any research constitute the strength exhibited in validity and reliability of study. Valid and reliable results can only be realized through adoption of appropriate research instruments and observing of ethical issues. Research instruments should be premised on the research questions and research goals and objectives. Obtaining objective research instruments require application of fairness through random selection of techniques. Moreover, research participants consent has to be sought and assurance for anonymity and confidentiality of information need to be made to ensure less biased information is generated from respondents. 4.0 Findings 4.1 Relationship to Literature Research findings are likely to answer literature shortcomings identified through literature review. Findings will possess capability to ascertain whether ACA provisions are going to impact American society economically and from this, recommendations will be drawn for future adoption and application. 4.2 Relationship to Theory Theoretical framework for this research project is ingrained in both economic and political models. The understanding is that genuine health care reforms are likely to succeed when viable cooperation and interdependent of economic and political aspects are integrated. Therefore, research findings are likely to ascertain this relationship and how well the theoretical framework can be enriched by research findings and recommendations. 4.3 Relation to Practice Health care reforms incur multiple effects in the society where different actors are affected. Health practitioners are not immune to health care reforms and the direction the reforms assume, practitioners are likely to be affected. When this occur, there is always paramount need to integrate professional needs with external environment needs appropriately to ensure health care system remain stable and functional. Therefore, research findings in this project will largely propose how well the health care practice can productively be integrated in health care reforms proposed. 5.0 Conclusion Affordable Care Act (ACA) possesses numerous benefits to Americans as far as health care is concerned. It can be seen that with implementation of Act’s provision, health care provision in the country is going to realize some level of equity. However, the biggest issue of the Act, which will need concerted effort in resolving, has to do with the impact it is going to pose to the economy of the society. With abolition of cost-sharing health care, there should be some economic wisdom explanation on how funding of the provision will be realized with less government funding if not the bulky of funding the Act will be transferred to already burdened employers and other tax payers. References Babbie, E. R. (2010). The Practice of Social Research. OH: Cengage Learning. Retrieved September 27, 2011, from http://books.google.com/books?id=QySynvetGQIC&pg=PA199&dq=study+population&hl=en&ei=1OsyTu_DIs6w8QPdnMihDg&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCsQ6AEwAA#v=onepage&q=study%20population&f=false . Cogan, J. A. (2011). The Affordable Care Act’s preventive services mandate: Breaking down the barriers to nationwide access to preventive services. Public Health Reform, pp. 355-365. [Attached notes]. Davis, C. S. & Somers, S. (2011). National health care reforms and public’s health. Journal of Law Medicine and Ethics, pp. 65-68. [Attached notes]. Fernandez, B. (2010). Health care reform: An introduction. NY: DIANE Publishing. Retrieved September 27, 2011, from http://books.google.com/books?id=zr0BwuvHarUC&printsec=frontcover&dq=health+and+health+care+reforms+in+USA&hl=en&ei=OcKBTt3BEaHY4QSBs-yLAQ&sa=X&oi=book_result&ct=result&resnum=5&ved=0CEgQ6AEwBA#v=onepage&q&f=false. Hall, R. (2008). Applied social research: planning, designing and conducting real-world research. Sydney: Palgrave Macmillan Australia. Retrieved September 27 2011, from http://books.google.com/books?id=5friXw4uxLUC&pg=PA7&dq=doing+social+research&hl=en&ei=u1pETqOnNsz0sgb7lsXMBw&sa=X&oi=book_result&ct=result&resnum=5&ved=0CEIQ6AEwBDgK#v=onepage&q=doing%20social%20research&f=false. Hardcastle, E. L., Record, L. K., Jacobson, D. P, & Gostin, O. L. (2011). Improving the population’s health: The Affordable Care Act and the importance of integration. Public Health Reform, pp. 317-327. [Attached notes]. Ku, L., Jones, E., Shin., Byrne, F. R & Long, S, K. (2011). Safety-net providers after Health Care Reform. Health Care Reform, vol. 171, no. 15, pp. 1379-1384. [Attached notes]. Okma, K. G. (2010). Six countries, six reform models: the healthcare reform: experience of Israel, the Netherlands, New Zealand, Singapore, Switzerland and Taiwan: healthcare reforms ‘under the radar screen’. NJ: World Scientific Publishers. Retrieved September 27, 2011, from http://books.google.com/books?id=NuE7fHE4xPcC&pg=PA11&dq=theoretical+frameworks+of+health+care+and+reforms&hl=en&ei=0kmCTpaBG8_2sgaA1YG9Dg&sa=X&oi=book_result&ct=result&resnum=3&ved=0CD4Q6AEwAg#v=onepage&q&f=false. Strauss, A. L & Corbin, J. M. (1998). Basics of qualitative research: techniques and procedures for developing grounded theory. NY: SAGE. Retrieved September 27, 2011, from http://books.google.com/books?id=wTwYUnHYsmMC&printsec=frontcover&dq=qualitative+research+techniques&hl=en&ei=PPoyTtDgKY_C8QOh0_WgDg&sa=X&oi=book_result&ct=result&resnum=2&sqi=2&ved=0CDAQ6AEwAQ#v=onepage&q&f=false. Yates, S. J. & Yates, S. (2004). Doing social science research. NY: SAGE. Retrieved September 27, 2011, from http://books.google.com/books?id=Ct2Sy4H4HZ8C&printsec=frontcover&dq=doing+social+research&hl=en&ei=PlZETpSKH8nCtAaHg53mBw&sa=X&oi=book_result&ct=result&resnum=2&ved=0CDEQ6AEwAQ#v=onepage&q&f=false. Appendices Research Time-line framework Milestone Description Due date Remarks 1 Stage 1: Area of interest identified 05.09.11 2 Stage 2: Specific topic selected 15.09.11 3 Stage 3: Topic refined to develop dissertation proposal 26.09.11 4 Stage 4: Proposal written and submitted 20.10.11 5 Stage 5: Collection of data and information 03.12.11 6 Stage 6: Analysis and interpretation of collected data/information 03.01.12 7 Stage 7: Writing up 20.01.12 8 Stage 8: Final draft prepared – submission of dissertation 04.02.12 9 Final Deadline – six months from classroom date. 15.03.12 Read More