Health System Reform in the United States: Impact of Rising Premiums and Opportunities for System Improvements to Enhance Access to Healthcare Services
Ken Russell Coelho
DHSC 7010: Healthcare Delivery Systems
Dr. Ana Maldonado
A course assignment presented to the College of Graduate Health Studies in partial fulfillment of the requirements for the Doctor of Health Science Degree A. T. Still University
September 16, 2016 Health System Reform in the United States: Impact of Rising Premiums and Opportunities for System Improvements to Enhance Access to Healthcare Services
Problem of Rising Health Insurance Premiums
Rising health insurance premiums have made healthcare unaffordable in the United States. Health insurance premiums in this country have undergone a steady rise over the past few years while incomes have remained the same. More than 50% of individuals with low incomes holding private insurance in the United States are unable to afford their healthcare costs (Collins, Gunja, Doty & Buetel, 2015). In addition, costs related to healthcare are equally unaffordable to 25% of working-age individuals who hold private health insurance policies (Collins et al., 2015). According to the Kaiser Family Foundation/Health Research and Educational Trust (Kaiser/HRET) survey on employer health benefits, employer-sponsored health insurance plans have also had moderate rises in premiums in 2013 for both individuals and family coverage (Claxton et al., 2013). While
I will compare the current health care system with the new Patient Protection and Affordable Care Act (ACA) that became law on March 23, 2010. The current system, which is being phased out between 2011 and 2018 is increasingly inaccessible to many poor and lower-middle-class people. About 47 million Americans lack health insurance, an increase of more than two million people from 2005 (Rover, 2011) the increasingly complex warfare between insurers and hospitals over who pays the bills is gobbling up a great deal of money and the end result is that the United States pays roughly twice as much per
Healthcare in the United States has reached a level of complexity which has perplexed Presidents, Congressional members and private industry for over a century (Palmer, 1999). While the healthcare system has evolved over the last century, policy decisions which have attempted to effectuate changes to cost, quality and access have been
Health care reform in the United States is a hot topic and the source of legislation meant to make health care obtainable to Americans. Recent presidential elections have been platforms used to promote health care reform yet no one can agree on what the resolution will be. This paper will discuss ways recent health care reform measures have expanded or inhibited access to health care. This paper will discuss how changes to access may lead to influences in utilization. Concepts of what universal health care may be and how current care reflects or contrasts
Americans to the coverage rolls” (HHS, 2013). This shows that on the potential positive side of
Money plays a huge role in access, therefore it is a vital issue to discuss. Within the current system, lack of money results in lack of health care, which leaves thousands of people without any health care coverage. Between 2001 and 2005, the number of people paying for health insurance increased 30%, however income only raised 3% (Health Care Problems). Adequate income is a necessity and unfortunately that is not present. According to the National Conference of State Legislatures, the average annual premium across the country is $16,000. Currently, the average annual income in the United States is $51,107. Mint Money Management suggests that about 4-6% of one’s total income should be spent on insurance, including life, disability, and health insurance. However, the averages in the United States show that the average person spends about 31% of their income on health insurance, which is not financially beneficial. When this rise in health insurance is not parallel to the inflation of income, innocent people are left without a method to achieve health care. There is a program for those who can’t afford health insurance out of pocket nor have access to it, and that is called Medicaid. Issues still exist with the program. There is only so much funding, which leaves many still uninsured. Additionally, people with Medicaid have difficulty
The negative impacts of healthcare reform to health systems are significant in that health systems are preparing their resources on developing Accountable Care Organizations (ACO) for bundled payments and population-based reimbursement. In this economy the impact to health systems may require healthcare systems to figure out ways to continue to keep positive financial performance due to the cost-reduction of healthcare reform. For some time now, health systems have subsidized their losses from the Medicare and Medicaid systems by contracting with commercial payers for their premium rates. As a result of the healthcare reform, cost shifting will shrink. Another negative impact over the next few years will be the large shift in health plan enrollment. Less people will be covered by highly
Substantial increases in health care costs has put significant strains on federal, state, and household budgets as well. Quality of health care varies widely, even after controlling for cost, patient preferences, and sources of payment (ATR, 2015). Many Americans lack health insurance coverage which also put a burden on the health care system itself, onto the consumers, and the tax payers as well.
America spends 2.5 times more on healthcare than most developed countries yet still ranking 51st in life expectancy in the world (Baum, 2015). The Affordable Care Act (ACA) was implemented January 1, 2014 by President Obama to expand coverage to millions of individuals in need. It consists of two separate pieces of legislation: the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (Centers for Medicaid and Medicaid Services, 2016). Although the ACA will give health benefits to millions of uninsured Americans, hospitals are receiving less compensation because of the high demand of health care from over qualified recipients. Through the Children’s Health Insurance Program and also the Social Security Act, states are able to pilot a test approach that could extend coverage up to 200 percent of the poverty line (Sommers, Kenney, & Epstein, 2015). Such a large increase in the size of the population that is now eligible to apply for the ACA comes with a sizable amount of fiscal responsibility from the states and puts an immense strain on the amount of money guaranteed to pay for the services provided (Sonier et al., 2013). Given the lack of funding from the Medicaid program, absence of reimbursement strategies, and budget of healthcare in America’s Gross Domestic Product (GDP),
Looking back at our former healthcare system, we see that it was far from flawless, some say it is due to the government, while others claim the health insurance and the healthcare system in general is to blame. So it 's no wonder that the healthcare system is constantly fluctuating. These fluctuations have let us to a system that was very flawed and in dire need of rectification. Furthermore, the health insurance market wasn’t readily accessible to the middle and lower class, due to high costs, bizarre prerequisites, and complicated terminology.
Health care in the United States is driven by a patchwork of services and financing. Americans access health care services in a variety of ways — from private physicians’ offices, to public hospitals, to safety-net providers. This diverse network of health care providers is supported by an equally diverse set of funding streams. The United States spends almost twice as much on health care as any other country, topping $2 trillion each year. (WHO.INT 2000) However, even with overall spending amounting to more than $7,400 per person, millions of individuals cannot access the health care services they need.(Foundation 2009) So when the Patient Protection and Affordable Care Act (a.k.a the Affordable Care Act or ACA) was passed in the summer
Health care reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished.Future reforms of the American health care system continue to be proposed, with notable proposals including a single payer system and a reduction in fee for service medical care.
There is an ongoing debate regarding the potency of the new health care reform—Patient Protection and Affordable Care Act—from the outset of its proposal. Many attempts had been presented in the past years but the root of the issue remains prevalent today, that there is a lack of quality in its delivery and the cost of care is continuously increasing beyond national economic edges. In this manuscript, we will discuss several factors that can positively sway the long-term significance, impact, and structure of the United States health care system. Many are wondering whether the Universal Coverage, to which will give more control and
The unprecedented rise in the cost of health care is challenging businesses, households and government alike. Meanwhile, nearly 50 million did not have coverage in 2010. Furthermore, while health care costs are steadily increasing, higher cost does not necessarily translate as better quality, and some care providers are actually able to offer high-quality care while reducing cost. Something has to give, but reforming our health care system is a complex task. Any reform measures should address several important problems in our current system: ensuring that all Americans have access to care, and not just emergency care but prevention services and care for chronic conditions; bringing costs under control; and maintaining or improving quality of care. While some reform proposals are more dramatic than others, any significant effort to fix the problems will involve substantial change and affect everyone— one reason why the topic is such a magnet for controversy. But with spiraling prices, millions uninsured and worsening health care performance compared to other countries, we’ve reached a point where kicking the issue down the road for others to address, as we’ve done for many decades, would be economically disastrous and morally irresponsible.
There are many issues that are causing changings in the healthcare system. Population aging, rapidly increasing costs of healthcare and the growing burden of chronic disease are challenges to health systems worldwide. To meet these challenges will require new approaches to healthcare delivery and comprehensive population health management. Many states are not prepared to tackle this issue yet. The US has the most expensive healthcare system in the world with health status indicators that are only average in comparison
While the U.S. health care system has much to brag about, there is still room for significant improvement. When we compare ourselves to other industrialized countries (for example, Canada and Great Britain), this gives us something to aim for and seek improvements in our current system. “Medicare, Medicaid, the Children’s Health Insurance Program (CHIPs), and Affordable Care Act (ACA-Obamacare) marketplace subsidies — together accounted for 25% of the U.S. Federal Budget in 2015, or $938 billion. Nearly two-thirds of this amount, or $546 billion, went to Medicare, which provides health coverage to around 55