The Current State Of Our Health Care Delivery

The Affordable Care Act is the new health reform law that was signed into action on March 23, 2010. The Affordable Care Act attempts to reform the healthcare system by providing Americans with affordable health insurance. It helps put individuals, businesses, and families in control of their own healthcare. By the sound of it, it really looks like this is something that will positively impact the lives of Americans, and make it easier for individuals to obtain health insurance. Unfortunately, what many Americans are unaware of is that there are so many underlying issues that make the Affordable Care Act not so affordable. Issues such as penalties and taxes that certainly rack up the cost on individuals, businesses and even hospitals that make it difficult for people and businesses to be in “control” of their health care.

If one cannot afford the price of an Affordable Care Act policy they can be assessed fines or penalties based on their income or a set fee, it has caused taxes to be higher and some of the funding for Obamacare comes from already established government insurance that is mainly for the elderly or retired. When it first came out the whole thing was the butt of many jokes as when people tried to enroll, the website crashed or it took people over an hour to sign up and some people found the whole process to be complicated. In order for some companies to be able to afford the premiums for Obamacare they have resorted to having to cut hours from their employees to under 40

There are many challenges that are defining the future strategic direction of health care such as information technology advancements, access to health care, maintaining a skilled workforce, proposed health care reform and legislation, and rising costs. I will look at these challenges and how an organization may adapt its direction and strategies in accordance with these challenges.

People living with HIV and AIDS have always had a difficult time obtaining access to health coverage (Sorian, 2010). Medicaid, Medicare, and the Ryan White HIV/AIDS Program have provided a critical safety net (Sorian, 2010). But today, nearly 30% of people living with HIV do not have any health insurance coverage, and many others have limited coverage (Sorian, 2010). In addition, people living with HIV and AIDS have faced hurdles to getting quality care from qualified providers (Sorian, 2010).

The Affordable Care Act is supposed to be designed to make insurance costs affordable for Americans, rather than what the law offer for Americans to pay. The law states that everyone must have health insurance, or they will be subject to penalty. Sireesha Manne, a staff attorney at the New Mexico Center on Law and Poverty stated “For those with very low wages trying to raise kids after paying for housing, electricity, food, and transportation, and child care, asking people to pay another $50 to $100 a month that’s just out of reach.” A concern regarding the Affordable Care Act, is that even with the federal financial assistance available under the law, health insurance will remain unaffordable for a significant number of low-income families. Although the Affordable Care Act is to be cost effective, the prices and premiums are still exceedingly high for Americans with low and moderate income.

A less-known consequence of this mandate, one that is rarely mentioned in the public or media discussions on the plan is “individual mandate”, the requirement that each person must either purchase insurance coverage or pay an “uninsured tax” as a penalty for not maintaining health coverage. The law actually fines those who choose to not to carry any kind of insurance for every month not insured in the form of an added tax, and the amount of that tax is growing annually. In 2014, the rate was about $95 per adult and $50 per child per year. For a family of four that is $290 a year just in an extra tax. “The fee increases each year until it ends up being about the price of getting the cheapest health plan”. For example, in 2015 the rates will jump drastically to $325 per adult and $162 per child per year (Obamacare

According to Joe Conason, "America 's current health care system wastes considerably more than a trillion dollars every year. We know that because countries such as France, Germany, Japan and Finland, with comparable standards of living to ours, spend roughly half what the United States spends annually on health care per citizen, while covering everyone and achieving better results." (Conason, 2009) The United States healthcare financial systems are severely flawed - affecting the overall cost control, services, and care made accessible to its clients. The rising costs in healthcare are reaching new highs, and with rising costs, there doesn 't seem to be much change in the quality of the care being given. Clients coming in and out of these

The total cost for healthcare in the US is around 16 percent of Gross Domestic Product, known as GDP. What we pay to doctors and insurance companies directly are included in this, as well as what we pay indirectly to Medicare and other programs. 16 cents of every dollar spent on groceries or clothes that will go to healthcare. This is very high in comparison to most other developed countries that pay between 9-12 percent of GDP. The difference in GDP is almost 5 percent, which works out to be more than half the annual federal deficit. The biggest fear associated to the Affordable Care Act is likely about the financing and “job-killing taxes”.

The health care system of the United States is dysfunctional and broken. While many upper and middle class Americans have nothing to worry about since they can afford health care insurance, the lower class are neglected and pushed to the side. Including funding and performance, the costs of the health care insurance has caused current political evaluations. Yes, Medicaid does cover the poor Americans, but you do not receive the same treatment and coverage as someone with insurance. Most Americans are aware that there are many problems with the current health care system in the United States. There are little to none access to these affordable health care insurances and the prices are rising

One of the greatest changes in healthcare in the past ten years has been the rise of managed care, much to the displeasure of many patients and physicians alike. Managed care arose out of concern about spiraling healthcare costs and was designed to encourage physicians to give patients treatments that were cost-effective out of their own financial interests. "The consumer strategy was directed at imposing some barriers to use by levying various forms of co-insurance. The most common approaches used either deductibles (where the consumer paid the first portion of the bill a technique familiar in other types of insurance) or co-payments (where the consumer paid a portion of the bill and the insurance company the rest) or a combination of both' (Kane et al 1994). Managed care has given health insurance companies an increasingly significant voice in how treatment is administered and allocated. Managed care has proliferated in the past decade despite considerable criticism of the practice of 'nickel and diming' patients as well as the considerable bureaucratic red tape it is has generated. Also, research indicates that healthy, well-insured patients tend to over-consume care without meaningful co-pays but poorer, sicker patients can be deterred even by moderate co-payments and suffer negative health consequences (Kane et al 1994). However, managed care has not gone away and is a reality that all healthcare

The future of America’s health care system looks bright with new innovations coming about. Advancements in technology, patient care, and access to care are all important factors to create a health care system suitable for American citizens. New health care reforms help shape our health care system to provide better care to all citizens. To implement these new reforms, the plan must be financially viable and be understood by those it effects. To improve the current health care system, new reforms should include ways to insure more citizens in a cost effective manner, offer insurance at an affordable rate, improve efficiency of the health care system, and provide higher transparency to the public.

Primary care is the backbone of many industrialized nations, but is the US one of them? Unfortunately, the answer is no. The US lags behind such developed nations in its accessibility of primary care by a huge difference. The United States healthcare system fails to ensure the timely preventative and primary care for its residents. The current estimates indicate that there is merely one physician for every 2,500 patients. Not only Medicare beneficiaries, but also privately insured adults struggle in accessing the right primary care physician at the right time. Moreover, maldistribution of physicians only exacerbates the problem, especially for those residing in health professional shortage areas (HPSA).15 Approximately, sixty-five million Americans live in designated primary care shortage areas.13 Such underserved population faces higher disease and death rates and health disparities that then result in higher rates of hospitalizations and emergency department visits—in other words, expensive medical bills.21 More governmental control on the geographic location of primary care physicians can be a first-step to fixing the shortage problem.

The patchy and skewed state of the U.S. health care system has become an advocate for payment and delivery system reforms. Traditional fee-for service (FFS) payment structures increase volume rather than quality care, and lead to a provision of medical services across the disjointed provider scenery. Despite several attempts to recover care delivery, health care costs continue to escalate. The Accountable Care Organization (ACO) model seeks to reverse the trends by stimulating a synchronized restructure of the payment and delivery systems to attract higher quality, lower cost care.

The future and direction of health care has been the topic of discussion amongst politician and U.S citizens today. There are several challenges surrounding the future and strategic direction in which health care should be heading. Accreditation, quality of health care and organization’s compliance; access to health care, maintaining a skilled workforce, information technology and pay for performance are some of the challenges that currently presenting itself in healthcare today. If health care is not dealt with appropriately it will have a significant effect an impact on the strategic direction in the future and direction of care.

The current state of United States’ health care system is one of the most polarizing subjects of debate among scholars and other health care professionals across the globe. This can be attributed to the fact that at one extreme end, there are some who argue that that Americans have the best system of health care in the world (MePhee, 2013). Perhaps the availability of the state-of-the-art facilities and free medical technology that have become highly symbolic of the various industries in the United States have motivated the idea of the country’s health care system being unparalleled to others. However, there is a common belief that the fight for universal health care can only be successful if its current state of health care is described as a failure in the modern era as emphasized by MePhee (2013).