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The Various Health Systems - Report Example

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Summary
The paper "The Various Health Systems"  discusses that the withdrawal of the hospital from the plan signifies the uncertainty currently being experienced in the health insurance market and can set the tone for withdrawal by other hospitals from the plan…
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Extract of sample "The Various Health Systems"

Health Management

Introduction

The population health is a crucial sector in the performance of the country as it impacts the productivity of the population thus influencing the growth of the country. The various health systems available in a country that are crucial in shaping the population health are however faced with several ethical issues making it difficult to ensure country’s growth. The paper will discuss Obamacare and the various ethical issues surrounding the health system.

Identification of healthcare system in the news recently

The Affordable Care Act, also known as the Obamacare has been in the news for a long time. The discussion surrounding the matter has been based on the need by the Republicans to repeal the Act citing that it is not the best care plan for the Americans. The Affordable Care Act (ACA) was created with the goal of making the large number of Americans, who were unable to afford health insurance, have access to high-quality care plan (Tanner, 2013). It provides that the businesses with at least 50 employees who are employed on a full-time basis should offer health insurance to at least 95 percent of the full-time employees and their dependents up to the 26 years of age (Brown, 2015).

Reason it is on the news

The ACA has been criticized in that it has increased health insurance cancellation in many states since many Americans continue to lose their jobs due to this health system. The cancellation has resulted in only one or two insurers offering coverage in at least 70 percent of the total United States counties (Brown, 2015). That has, in turn, resulted in the decline in the choices available to the residents of that county and also decline in competition. Another point of criticism for the healthcare system is that it has increased the premium rates where the average family premiums have increased by 32 percent from 2010 to the year 2016 (MacKinnon & Fiala, 2017).

Ethical issue surrounding Obamacare

Firing full-time employees

Obamacare is faced with several ethical issues with the main issue being that it has resulted in many businesses firing the full-time employees and hiring those who work on a part-time basis (Tanner, 2013). The change has resulted in the reduction in the premium cost that the business incurs since it can now only pay the premium for fewer employees (Pozgar, 2013). That falls within the provision by Obamacare that businesses are not eligible to pay insurance coverage for the part-time employees. The strategy had helped reduce the operating costs of the businesses although it has resulted in huge job losses. The State of Illinois recorded a total job loss amounting to 63,000 jobs (MacKinnon & Fiala, 2017).

Effects on the employees

Ethics and morality determine what is perceived as right and what classifies as wrong. With the massive job loss, questions are asked regarding the ability of the employees who now have to work on the part-time basis, to provide for their family (Desjardins & McCall, 2014). Apart from reducing the operating costs relating to insurance expenses by replacing the full-time employee with part-time workers, the strategy can also help reduce the salaries expenses thus presenting the further economic advantage to the business (Desjardins & McCall, 2014). The employees are affected in two ways. One way is by losing their wages and remuneration whereas the other is by losing health insurance that was previously provided by the business.

Although the intention of firing the employee is made with the best interest of the company, it presents the ethical issue on the kind of impact it has on the employees’ lives and that of their family. There is a conflict between the interests of the business and that of the employees who as it presents financial benefits the former and causes psychological, emotional and physical harm to the latter (MacKinnon & Fiala, 2017). Managers are therefore required to make strategic decisions that will incorporate the economic, legal and ethical implication on not only their business but also the employees.

Application of system theory

The system theory is one of the main organizational theories that define the system as a set of different part resulting in the formation of a whole complex organ (Cropf & Bagwell, 2016). Using the systems theory, the Affordable Care Act is seen as a component of different part thus making a complex whole. One of the key aspects of the law is the individual mandate that states that all Americans are required to acquire health insurance or else they will be required to pay fine (Cropf & Bagwell, 2016). The fine is supposed to be in the form of tax penalty ensuring that even the healthier individuals are enrolled to the health plans thus using the strategy to subsidize the coverage for the sick (Pozgar, 2016). The system theory can be employed to explain why it is difficult for the new administration to repeal the law as it is made up of various laws that once removed or changed, it can lead to total collapse of the law (Pozgar, 2016).

Fraud prevention

The Affordable Care Act has helped deal with ethical issues relating to fraud by increasing the number of prosecutions. The Fraud Prevention and Enforcement Action Team provide that once an individual is kicked out of the program, they are kicked out of all other healthcare program such as Medicaid and Medicare therefore reducing the number of fraudulent cases (Taner, 2013).

Strategies to rectify the ethical issues

Various strategies can be employed to help deal with the various issues that are associated with it. One such would be increasing the spending of the federal government to help reduce the costs incurred by individuals and family cover (Cropf & Bagwell, 2016). Another strategy is by raising the fines so that the number of healthy people enrolled in the plan can be increased so that the price of premium can be lowered.Communication on the various issues arising as a result of Obamacare should be encouraged to enable the collaboration between players thus ensuring integration of various components that can help in dealing with the ethical issues.

Legal, ethical and operational implication of Obamacare

The legal implication of the Affordable Care Act is that every United States citizen is required by law to be under health insurance coverage. The law also strengthens the already existing health insurance programs such as Medicare and Medicaid. It strengthens Medicaid to cover all families with income that is below 133 percent of the federal poverty level (Rosenbaum, 2011). The law also provides that families with income between 133 and 400 percent of the federal poverty level are to receive subsidized insurance (Rosenbaum, 2011).

The ethical implication of the law is making it possible for low income earning families to afford health insurance coverage thus ensuring these families receive healthcare services. The law also impacts the employers by requiring them to offer coverage to full-time employees and also encouraging them to provide wellness facilities and activities to help promote the health of individuals (Rosenbaum, 2011).

The operations of the healthcare institutions and healthcare executives are also impacted by requiring them to expand the community health centers to facilitate the provision of care services to the expanded target market. The Affordable Care Act also makes direct investment in healthcare impacting the operations of healthcare providers, health institutions, and the management (Rosenbaum, 2011). Such investment includes broadening coverage for preventative healthcare services and increasing health care services in areas that do not receive sufficient services.

Decision traps

One decision trap for the citizens is confusion on how much tax one is supposed to pay in case one fails to buy Obamacare insurance (Tanner, 2013). The policymakers are also confused on whether the insurance results in the reduced deficit. The healthcare providers also have confusion on the requirement to computerize all the medical records as required by Obamacare (Tanner, 2013).

Connecting Obamacare with Hospital

Northwell Health, a not-for-profit institute, is the largest New York State healthcare provider serving more than 2 million individuals (Hale & Polsky, 2017). The hospital has been affected by the uncertainties surrounding the Affordable Care Act and expressed the plans to shut down and withdrawal from the plan in 2018. CareConnect, which is the insurance subsidiary of the hospital announced the plan on 24th August 2017 that it would shut down and subsequently withdraw from the state insurance market in 2018 (Hale & Polsky, 2017). The company however announced that the current policyholders, estimated to be 126,000 would remain covered in the plan until their transfer to new plan that will determined by the date of expiry of these plans (Hale & Polsky, 2017). The management of the company expressed concerns on the formula of the plan stating that they are subjecting the company to losses. The withdrawal of the hospital from the plan signify the uncertainty currently being experienced in the health insurance market and can set the tone for withdrawal by other hospitals from the plan. The Federal government should hereby make efforts to maintain a stable insurance market by putting in place policies that will help in regulating the marketplace (Hale & Polsky, 2017). Such policies will play a huge role in reassuring the customers who in turn will retain the coverage till the next year.

Conclusion

By making the suggested recommendations, the Affordable Care Act will be able to improve the delivery of the health services thus positively impacting the population health.

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