Current Healthcare Reforms in the USA - Research Paper Example

Module Current Healthcare Reforms in the USA The healthcare industry is quite a crucial sector in the nation, with healthcare reform policy proposals and implementation drawing much debate across all sections of US society. Discussions and debate in the public domains are accompanied by political considerations, where healthcare policy is a key component of election politics in the US1. It thus forms an important area for study; hence justifying the scope of this paper. The focus of the study will be an analysis of the current healthcare reform in the US (essentially within President Obama’s administration), discussing the achievements and failures, and finally, establishing a set of recommendations that should be integrated into the substructure of healthcare reform. Healthcare Reform Timeline under the Obama Administration and accompanying Politics Healthcare reform was part of Obama’s top agenda during the campaigns in presidential elections,2 followed by a raft of activities during the term that eventually led to the signing into law of bills that saw healthcare reform roll out. The driving concept for the government’s efforts towards healthcare reform had always been to seek to provide affordable and quality healthcare to all Americans and to reduce the growth in healthcare spending3. Cause for concern was and still is the ever-growing concern on the millions of Americans living without health insurance coverage, continual increase in cost and spending on healthcare and finally shortcomings in quality which is regrettable for a developed nation like the US. On the backdrop of this, President Obama signed into law two bills in 2010 that define his administration’s policy in healthcare reform; the Patient protection and Affordable Care Act (PPACA) signed March 23, 2010 and the Healthcare and Education Reconciliation Act of 2010 on March 30, 2010. An overview of PPACA indicates that its overall approach to expansion to insurance coverage access revolves around requiring most US citizens and legal residents to have health insurance, creation of state-based American Health Benefit Exchanges via those individuals who can purchase coverage, with premium and cost-sharing credits available to individuals/families with income between 133-400% of the federal poverty level and expansion of the Medicaid program to 133% of the federal poverty level4. In terms of addressing quality issues, PPACA directs federal healthcare spending to community-based healthcare centers and seeks to transform information management in healthcare into use of Electronic Medical Records (EMR)5. Obama’s healthcare reform policy has not been short on political debate dividing opinion into two clear sides along the Democrat and Republican stances. The President’s Democratic Party supports PPACA with the agenda of ensuring healthcare insurance is availed to all Americans, ensuring that employers are responsible for staff health cover, extension of insurance cover subsidies to middle-income individuals who do not have employer insurance and expansion of Medicaid to even more Americans. On the other hand, the Republican Party is largely opposed to Obama’s healthcare reform policy on the basis of rise in taxation due to the government’s plans to subsidize healthcare. The party is also opposed to government spending which would subsidize abortion which they are against in the first place. In addition, the government’s healthcare reform package draws opposition from the Republicans from point of view that it leads to too much involvement of the government in healthcare which was against neo-liberal ideas of the free market6. Strengths in the current Healthcare Reform Policy The very first achievement to be realized upon full implementation and practice of PPACA would be an increase in the number of individuals who access medical cover. The exact figures quoted are a massive 32 million who, at the time of passing the bill, were individuals within the working age bracket who had no medical cover. The law now expands Medicaid – the insurance program for low income individuals that is federal funded- alongside providing subsidies that would help low earning individuals and businesses to access priced health insurance coverage. The previous healthcare legislation was ineffective and restrictive towards small business and their workers since they experience high broker fees, high fixed administrative costs and adverse selection. Due to these, small firms end up paying about 18% more per worker than their large counterparts for similar insurance policies. This ultimately translates to reduced provision of insurance cover to workers among these firms and thus compounds the problem. The 2010 healthcare reforms would reverse this scenario and ensure that these categories of individuals who run into millions are not excluded from healthcare.7 The new healthcare laws also score big in terms of catering for individuals who can currently access medical cover through their employers. For this group (totaling about 176 million individuals), PPACA directs regulatory protection from practices by insurance that prevents particular individuals from being left out of cover. Specifically, the Act reigns in on insurance companies to cover individuals with pre-existing medical conditions and cater for children regardless of their health problems. It also allows young adults to access parental insurance plans up to the age of 268. This is important in the achievement of universal healthcare for all besides also keeping in touch with other developed countries that have worked a way out towards achievement of universal healthcare9. Another aspect that earns a plus for healthcare reforms is in terms of computerization of health records which improves the quality of healthcare and ultimately the economic considerations. There is wide consensus that emphasis on Health IT is an integral aspect of meaningful healthcare reform as it allows a national system based on accepted, standardized and interoperable methods for application of data exchange in the healthcare setting. It is stated that application of Electronic Health record (EHR) has the ability to maintain well-organized and precise methods of data compilation, storage, scrutiny, and distribution as opposed to the manual operations. They result in increased efficiency in the healthcare setting, reduced errors such as in diagnosis and dosages and thus better outcomes for patients leading to higher quality of healthcare. They also have attractive return on investments (ROI) in the long term due to increased efficiency and patient/customer confidence10. Weaknesses in Healthcare Reform Policy One of the areas that failed to receive commensurate attention in the healthcare reforms instituted in 2010 is in regards to healthcare disparities that have historically pervaded the healthcare sector in the US. This is especially in respect to racial disparity where differences are starkly observable in overall health status, access to healthcare services, participation in healthcare research and receipt of healthcare financing. Some of the factors that influence health disparity in terms of race include the common socio-economic differences, the institutional racism in the healthcare industry, inadequacy of legal protection against racial inequity and the continual failure of healthcare reform policy to respond to historical and contemporary racial discrimination and disparity. PPACA is entrenched in vagueness in terms of addressing racial disparity in the healthcare setting. A number of provisions that may impact the lives of individuals do exist; for instance, expansion of access to health insurance cover through Medicaid and health exchanges, workforce emphasis on health coverage, community healthcare centers and specific provisions for disparity. However, without taking away from these, the implemented healthcare reforms do not explore far enough into the issues. The reforms do not expressly and explicitly set out to stamp racial discrimination from the healthcare industry and fail to specify definitions of discriminatory practices and remedial actions towards them11. Another aspect upon which the implemented healthcare reforms fall short is in terms of medical malpractice reforms. Discussions of the macro-and micro-economic cost of medical malpractice and in terms of overall quality of healthcare have been undertaken. In terms of direct costs to the healthcare industry, the impact of malpractices on the GDP and healthcare sector is under 1%; arguably of little significance since many multiples of this go into medical costs. However, in keeping to the fashion of this paper in regards to sensing the subtle considerations in healthcare, it is noted that millions of dollars are unnecessarily lost in defensive medicine. This refers to those costs that do not directly go into patient welfare, instead, being used to insulate medical practitioners from potential liabilities that may accompany adverse outcomes amongst patients. The annual figures indicate a glaring 10% of all healthcare costs translating to whooping $250 million dollars per year. The explanations put forth for the failure of healthcare reforms to address medical malpractice costs include; first, other concerns within the healthcare industry warrant more attention than health service malpractice. The second explanation is political and economic, where the trial lawyers involved in the cases form a key part of the Democrat brigade and thus influence policy12. Recommendations Based on this discussion and the emerging issues, a number of recommendations geared at either achieving quality or economic or a combination of both in terms of results can be established. First, health care reforms should incorporate sections that expressly deal with disparities of all kinds in the healthcare sector. Stating what racial discrimination amounts to and providing evidence-based strategies to deal with it are some of the basic ways to address healthcare disparities. The other angle of improvements that can be instituted in healthcare reforms concerns dealing with malpractices. Here, research should also be used to develop evidence-based policies that would minimize medical malpractice. Conclusion President Obama signed into law the Patient Protection and Affordable Care Act (PPACA) on March 23, 2010 and the Healthcare and Education Reconciliation Act of 2010 effectively ushering in healthcare reforms in the US. The gist of the healthcare reforms is expansion to include more access of Americans to medical coverage alongside improvement of quality of healthcare services and to reduce the growth in healthcare spending in a bid to address the concerns of the millions of Americans living without health insurance coverage, continual increase in cost and spending in healthcare, and finally, shortcomings in quality. Political tension on the introduced healthcare reforms pervade, with the Democratic Party in support while the GOP opposes. The reforms score highly in terms of being inclusionary and embracing electronic health records. The policies have, however, failed to address concerns on racial disparities in the healthcare industry and medical malpractice reforms. Based on this, recommendations on healthcare reforms that could potentially result in quality and economic gains are suggested, centered on placing emphasis on the two issues and implementing evidence-based solutions. 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