System WhitePaperMeredithIveyAppalachianState University Healthcare is a universal factor ineach country’s government, as it gives its’ citizens the ability to obtainmedical services in order to keep them well, or get better. The United States’healthcare system is referred to as the Affordable Care Act. The current healthsystem consists of Medicaid, Medicare, the Children’s Health Insurance Program,and the Veteran’s Health Administration. The primary focus of the health systemin the United States is to make medical care available to everyone who needs it.
Medicare provides financial health assistance to individuals who are primarilyof the geriatric population, and Medicaid provides assistance to individualswho are below the poverty line and cannot afford medical services otherwise.Both Medicare and Medicaid cover both acute medical services, as well aslong-term services, such as skilled nursing care. The Affordable Care Act,according to the Henry J. Kaiser Family Foundation (2013), “focuses onprovisions to expand coverage, control health care costs, and improve healthcare delivery system.” The overall goal for the AffordableCare Act is to provide affordable health care services to all who need it. TheAffordable Care Act, in regard to providing all citizens with the care thatthey need at an affordable cost, can be a great thing.
However, it is importantto understand what is working with this program, and what is not working. Justlike in any healthcare system, there are various strengths and weaknesses tothe system. The United States healthcare system is not an exception. Theoverall positive to the Affordable Care Act is that it allows all individualsto get the healthcare services that they need, at a price that they can afford.Other positives of the healthcare system is that it provides pediatric care,maternity care, mental health care, as well as preventative services (Lalli,2013). For example, the Affordable Care Act allows all uninsured children tohave access to healthcare services. According to RoseSchneider Krivich andGretchen L. Schwenker (2013), “ThePatient Protection and Affordable Care Act (ACA), popularly known as Obamacare,will dramatically improve access to health insurance for children.
In 2010, itwas estimated that there were more than 8 million uninsured kids in the UnitedStates. Older children aged 13 to 18 years comprised a greater percentageof the uninsured when defined by age, and other factors of race/ethnicity andincome level also played a role. The ACA provides the opportunity to reach manymore children from all backgrounds. More importantly, under ACA mandates,preventive health services are set to become available to millions ofchildren.” The ability for children to receive the services they need to getand maintain a healthy lifestyle is very important, as they are the individualswho will keep the population alive in years to come.
Anotherexample is the Affordable Care Act’s effect on Maternity and New Born services.Before the Affordable Care Act came into light, women rarely had maternityinsurance when it came to their insurance plans. According to Louise Norris, writerfor healthinsurance.
org, “In 2013, the National Women’s LawCenter reported that just 12 percent of individual market plansincluded maternity benefits. And that was despite the fact that ninestates required maternity benefits to be included on all individual plans.”Therefore, only a mere 2 percent of insurance plans covered maternity servicesfor women.
Once the Affordable Care Act came in to place, maternity care becameone of the primary benefits that must be listed on insurance plans. Therequirement of insurance companies to provide some form of coverage for bothmaternity and newborn services, as well as pediatric services, allows for thenation to grow in a healthy way. Althoughthe Affordable Care Act provides the United States with some positive features,it also shows some negative features as well. One of the biggest arguments withthe Affordable Care Act is the increase in premiums with insurance companiesand how much money is spent within the healthcare system in comparison to othercountries (Senger, 2012). According to the Editorial Board of the New YorkTimes (2017), “The United States spends much more on medical care than otherrich countries, like Britain, Australia, and the Netherlands, according to arecent Commonwealth Fund report, yet its citizens live shorter lives and sufferfrom more illnesses and injuries than people in other industrialized nations.
“As shown in the statement from the New York Times, it is very clear to see thatthe United States expenditures in health care are greater than those of othercountries. Additionally, The Editorial of the New York Times (2017) alsodiscusses how the United States does not offer a universal form of healthcarefor its citizens, ensuring that all individuals are covered. Another weaknessshown within the Affordable Care Act is that the healthcare system has caused avast number of individuals to lose their current healthcare insurance plan.According to Glenn Kessler of the Washington Post (2015), premiums haveincreased as high as 50 percent and millions of individuals have lost theirhealth plans. The purpose of the Affordable Care Act was supposed to helpindividuals obtain health insurance, not lose it.
So,now that some of the pros and cons of the Affordable Care Act are visibly seen,how can we potentially make the health system better? A single-payer systemcould be very beneficial for citizens within the United States as it enablesall of its citizens to receive health care services. According to thePhysicians for a National Health Program (2016), “Single-payer national health insurance, also known as”Medicare for All,” is a system in which a single public or quasi-public agencyorganizes health care financing, but the delivery of care remains largely inprivate hands, Under a single-payer system, allresidents of the U.S. would be covered for all medically necessary services,including doctor, hospital, preventive, long-term care, mental health,reproductive health care, dental, vision, prescription drug and medical supplycosts.
” Looking back at the firststatement from The Editorial from the New York Times, in regard to healthexpenditures and citizens in the United States exhibiting more illnesses andinjuries, the single-payer system could assist in helping this problem. Asingle-payer system allows for individuals to receive care, which in return,potentially decreases the amount of illnesses and injuries presented in theUnited States. Another factor that couldinfluence our health care system in a more positive way is finding a systemthat has all citizens pay for their health insurance, but at a lower cost. Thisincludes Medicaid and Medicare individuals as well.
If all citizens pay in tothe system, the rates for health insurance, including premiums and deductibles,could potentially be more attainable. This also could enable all citizens to beable to receive some form of healthcare. In addition to a single-payer systemand creating a way for all citizens to pay for their insurance at an affordablerate, decreasing the use of unnecessary services and treatment techniques invarious healthcare settings would be beneficial as well. Decreasing unneeded servicesand treatments within a facility can allow the United States to decrease theiroverall expenditures in healthcare. Chris Flemming (2011) states, in hisarticle “Reducing Health Care Costs While Improving Care,” that challengingmedical specialists to come up with a “Top Five” list could assist in cuttingout unneeded expenditures in their respective fields. Flemming states, “Theselists would consist of five diagnostic testsor treatments that are very commonly ordered by members of that specialty, thatare among the most expensive services provided, and that have been shown by thecurrently available evidence not to provide any meaningful benefit to at leastsome major categories of patients for whom they are commonly ordered.
In short,the Top Five list would be a prescription for how, within that specialty, themost money could be saved most quickly without depriving any patient ofmeaningful medical benefit” (2011). Flemming (2011) proceeds to discuss that ithas been found that producing a Top Five list could help cut costs by as muchas $6.75 billion every year. The United States currently spends around 3trillion dollars on health care service, and cutting out 6 billion dollarsannually by decreasing unneeded services and treatments will enable the UnitedStates to not only decrease their healthcare expenditures, but to also providecare to patients with treatments that are guaranteed to benefit them. The healthcare system is not amatter that can be taken care of overnight, and it is not something that can befixed with just a few minor tweaks. It is going to take a lot of suggestionsfrom various sources, and it ultimately comes down to what works and what doesnot. Implementing a single-payer system, decreasing unneeded services andtreatments in the system, and creating a system where all citizens pay for theirinsurance at an affordable cost are not the only suggestions that can aid withreforming our current health care system, but they are a great place to start. ReferencesCenters for Medicare and Medicaid Services (2017).
NationalHealth Expenditure Data. Retrieved December 6, 2017 from https://www.cms.
gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.htmlFleming, Chris (2011). Reducing Health Care Costs WhileImproving Care. Health Affairs. Retrieved December 6, 2017 from https://www.healthaffairs.
org/do/10.1377/hblog20111109.014987/full/The Editorial Board (2017).Looking Beyond the Obamacare Debate to Improve Healthcare. The New York Times. Retrieved December 6, 2017 from https://www.nytimes.com/2017/08/26/opinion/sunday/obamacare-universal-health-coverage.
htmlKessler, Glenn (2015). Factchecking the Obamacare rhetoric, pro and con. The Washington Post. Retrieved December 5, 2017 from https://www.
washingtonpost.com/news/fact-checker/wp/2015/06/26/fact-checking-the-obamacare-rhetoric-pro-and-con/?utm_term=.88237e477f0aThe Kaiser Family Foundation(2013). Summary of the Affordable Care Act. Retrieved December 4, 2017 from https://www.kff.
org/health-reform/fact-sheet/summary-of-the-affordable-care-act/Krivich, R.S., Schwenker,G.L.
(2013). Obamacare: What’s in it for kids? Modern Medicine Network. Retrieved December 4, 2017 from http://contemporarypediatrics.modernmedicine.com/contemporary-pediatrics/content/tags/affordable-care-act/obamacare-what-s-it-kidsLalli, Frank (2013). TheHealth Care Law’s 10 Essential Benefits. AARP.
Retrieved December 4, 2017 from https://www.aarp.org/health/health-insurance/info-08-2013/affordable-care-act-health-benefits.htmlNorris, Louise (2016).
How Obamacare changed maternity coverage.Retrieved December 4, 2017 from https://www.healthinsurance.org/obamacare/how-obamacare-changed-maternity-coverage/Physicians for a National Health Program (2016). What is SinglePayer? Physicians for a National HealthProgram.
Retrieved December 5, 2017from http://www.pnhp.org/facts/what-is-single-payerSenger, Alyene (2012). Five Devastating Effects of Obamacare onYoung Adults.
The Heritage Foundation. RetrievedDecember 5, 2017 from http://www.heritage.org/health-care-reform/commentary/five-devastating-effects-obamacare-young-adults