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Impact of ACA on health insurance
How will the ACA impact healthcare supply and demand
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Recommended: Impact of ACA on health insurance
Macro-Trend: Federal & State government policy: The Affordable Care Act The purpose of the passage of the Affordable Care Act, is to allow greater access to care, by granting healthcare coverage to the United States universal population. As a result, expanded coverage brought about the inability for the healthcare community to absorb the augmented demand of approximately 11 million individuals nation-wide. The affordable care act ultimately shifted the patient vs provider ratio, otherwise known as the supply vs demand table, wherein demand is expected to increase by 15-24 million in the next 5 years (Carthon, Barnes & Sarik, 2015). The demand placed on the healthcare industry due to the shortage of Family Practice Providers combined with
The aim of affordable care act (ACA) was to extend health insurance coverage to around 15% of US population who lack it. These include people with no coverage from their employers and don’t have coverage by US health programs like Medicaid (Retrieved from, https://www.healthcare.gov/glossary/affordable-care-act/). To achieve this, the law required all Americans to have health insurance which is a reason of controversy because, it was inappropriate intrusion of government into the massive health care industry and insult to personal liberty. To make health care more affordable subsidies are offered and the cost of the insurance was supposed to be reduced by bringing younger, healthier people to the health insurance system. This could be controversial, if older, sicker people who need the coverage most enter the market but younger group decline to do so. The insurance pool will be unbalanced and the cost of coverage will rise correspondingly.
The Affordable Care Act (ACA) was passed in 2010 with the goal of expanding healthcare coverage to all Americans by reforming insurance policies and practices (Tillett, 2011). The ACA upsurges the demand for an increase in primary care providers in order to supply quality care to the much larger population that will have coverage and therefore acquiring healthcare. The Institute of Medicine (IOM) through its report The Future of Nursing: Leading Change, Advancing Health has generated a solution to the shortage of primary care providers by promoting a transformation of the nursing profession to fill the gap.
For decades, one of the many externalities that the government is trying to solve is the rising costs of healthcare. "Rising healthcare costs have hurt American competitiveness, forced too many families into bankruptcy to get their families the care they need, and driven up our nation's long-term deficit" ("Deficit-Reducing Healthcare Reform," 2014). The United States national government plays a major role in organizing, overseeing, financing, and more so than ever delivering health care (Jaffe, 2009). Though the government does not provide healthcare directly, it serves as a financing agent for publicly funded healthcare programs through the taxation of citizens. The total share of the national publicly funded health spending by various governments amounts to 4 percent of the nation's gross domestic product, GDP (Jaffe, 2009). By 2019, government spending on Medicare and Medicaid is expected to rise to 6 percent and 12 percent by 2050 (Jaffe, 2009). The percentages, documented from the Health Policy Brief (2009) by Jaffe, are from Medicare and Medicaid alone. The rapid rates are not due to increase of enrollment but growth in per capita costs for providing healthcare, especially via Medicare.
The Affordable Care Act or “Obamacare” was designed to assure that all Americans regardless of health status have access to affordable health insurance. The Affordable Car Act was signed into law March 23, 2010. The primary goal of this act was to decrease barriers for obtaining health care coverage and allow Americans to access needed health care services (Affordable Care Act Summary, n.d). After the legislation is fully implemented in 2014, all Americans will be required to have health insurance through their employer, a public program such as Medicaid and/or Medicare or by purchasing insurance through the health insurance marketplace exchange (Affordable Care Act Summary, n.d). I will identify three parts of The Affordable Care Act that I believe are important. First, I will talk about the requirement that insurance companies are no longer able to deny coverage to individuals with pre-existing conditions. Secondly, I will explain why physician payments are being shifted to value over volume. Lastly, I will discuss Medicaid expansion and why some states are not expanding at all.
The ability of the Affordable Care Act to mitigate the current pressure of the uninsured on our healthcare system is unknown. Yet, the prediction is that it will greatly reduce the effect on emergency room systems throughout the nation. This reduction will be greater in the south and southwest regions of the United States (The Henry J. Kaiser Family Foundation, 2013 p. 4). The potential is there, however, the willingness of the population is yet to be seen. What does the future hold? Only the future knows.
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
The Affordable Care Act benefits to reconstruct the healthcare system by giving more Americans access to superiority, reasonable health insurance and supports to curtail the growth of healthcare spending in the U.S. People with health insurance will have access to a number of new benefits, privileges, and defenses which ensure that they can get treatment when they need it. This helps over 32 million Americans afford health care who could not get it before. It not only helps the consumers but also our budget and economy on a more stable path by reducing the discrepancy by more than $100 billion over the next ten years. Since there are millions of people with health insurance, it will also increase the demand of healthcare provider as more jobs will be open which will help our economy (Mowrey, 2013).
It is no secret that the current healthcare reform is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify ways to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal.” (Bailey, Jones & Way, 2006, p. 381).
The ACA expanded Medicare/ Medicaid, strengthened employer based care, and included an individual mandate. Before the ACA there were 32 million people uninsured and “approximately half, or 16 million, will gain coverage through an expansion of Medicaid” (Barr, 2011, p. 292). To improve the cost of care the ACA required employers with more the 50 employees to offer plans and individuals would have to purchase plans from the government. “ACA does not address directly the issue of disparities in access of care based on a patient’s race or ethnicity, it does impose on providers the responsibility for collecting data on the race or ethnicity, primary language, disability status, and similar demographic characteristics of patients cared for” (Barr, 2011, p. 293). The ACA strives to give health coverage to all but the power still lies in the private sector.
Health care reform is needed for four reasons. First, health care costs are rising. In 2011, the average cost for a family of four increased 7.3%, to $19,393. By 2030, payroll taxes will only cover 38% of Medicare costs. Second, health care reform is needed to improve the quality of care. Because of these reasons, President Barack Obama signed The Affordable Care Act, also known as ObamaCare, into law on March 23, 2010 and upheld by the Supreme Court on June 28, 2012. The goal is to give more Americans access to affordable, quality health insurance, and to reduce the growth in health care spending in the U.S. The Affordable Care Act contains ten titles that span over 1000 pages, but most of its key provisions are in first Title; The first title is about 140 pages long. The purpose of the law if to expand the affordability, quality, and availability of private and public health insurance through consumer protections, taxes, insurance exchanges, and other reforms.
Healthcare is a dynamic, ever-changing environment. The complex circumstances around daily conversations that encompass life-threatening decisions are critical. In order to deliver high quality care, individuals must be able to communicate effectively. In the perfect world of communication, everyone receives the exact same information and is able to respond the exact same way. Unfortunately, communication breakdown is a prevalent issue among hospitals. On any given day of the hospital arena, multiple interactions take place. Some of the dialogue is planned, and some is not. While hospital departments are living in different silos within the same organization, the cultures may vary among the employees. Hospital leadership fosters the importance of collaboration within the organization and depends on the employees to ultimately drive the process. In order to overcome communication barriers in the workplace, conversations must occur. Engaging in daily face-to-face meetings with employees increases positive work culture, morale and overall productivity.
Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.
With the United Nations listing health care as natural born right and the escalating cost of health care America has reached a debatable crisis. Even if you do have insurance it's a finical strain on most families.
Such as the notion of being “over covered”, studies show that 30% or more of U.S health care spending is on unnecessary care, since over-coverage reduces the cost of risky behaviors, such as unhealthy eating and smoking, people who are over covered have less incentives to make healthy lifestyle choices. Approximately 70% of all health care costs are directly related to personal behavior, costs that could have been prevented. Another interesting thing I learned was the idea that in the market for healthcare supply drives demand. In principles, we learned that as supply increased prices would fall. Title five of Obamacare talks about subsidizing education for healthcare workers, creating scholarships and loan repayment programs for physicians and nurses as well other healthcare professions. The government also tried this back in the 70’s with the idea that if there are more doctors there will be an incentive to lower the costs to compete for patients. This did not work out as expected, in healthcare supply drives demand, so when the supply increased, so did demand and, unfortunately so did the prices. When supply is high, doctors may lower their criteria for certain procedures, increasing the number of procedures done, as well as prescribe more visits to patients so that doctors continuously have
What will US healthcare look like in 2050? According to Getzen (2013), trends in better health will lead to greater need for long-term care and chronic care for the aging population while correspondingly trending toward less acute illnesses (p. 438). Personalized prognostic healthcare will lead to healthier longer lives (Lawrence, 2010). Physicians will become leaders of teams within healthcare organizations rather than the independent practitioners we are familiar with today (Getzen, 2013, p. 438). Thus, the concept of the primary care physician will become a thing of the past (Lawrence, 2010).