Healthcare is a controversial issue in US politics and public policy. Many Presidents before Obama established various health care reforms. There have been several proposals made to facilitate healthcare reforms during President Obama’s administration. Many of the reforms are intended for facilitating changes within the health care industry. Some of the proposals include increasing coverage and reducing medical costs. Other proposals within the reform also relate to health care providers and cover many issues related to health care provision. Thus, the health care reforms in Obama’s administration have been established to facilitate change within the health care system in America (Gibson & Singh, 2012).
The Patient Protection and Affordable Care Act (PPACA) or the Affordable Care Act (ACA) was the first reform proposed during Obama’s administration. President Obama signed this reform into law on Marin 2010. It was also referred to as Obamacare. This reform intended to facilitate major changes within the healthcare system. The ACA provided a timeline of how the reforms would be implemented (Gibson & Singh, 2012).
Features of the proposed health care reform plan
President Obama made various recommendations about the plan in 2009. Thus, the recommendations were budgetary in nature and sought to set aside over $600 billion over a period of 10 years to be used in the financing of the reforms in the existing health care system. Moreover, the recommendations were in a document that also identified the principles of the reforms. The policies were wide and varied with different objectives. For instance, one of the objectives within the policy was to protect families’ financial health. Just like the reform plan, the financial health of families was considered important. Moreover, the policy intended to make health coverage affordable so that a higher number of Americans would access health coverage. It also sought to guarantee choice. This would be achieved through the establishment of exchanges managed by either the state or the federal government (Vivar, 2011).
The policy considered universal cover as an important aim for the reforms. Thus, it was meant to cater to everyone without special requirements. Patient safety and care were also regarded as important in the policy. The policy also sought to provide portability of coverage. Thus, it would become easier for people to change their current health plans and choose different health plans that they would consider beneficial. Moreover, the policy also wanted to ensure that there was long-term fiscal sustainability after the implementation of the reforms (Vivar, 2011).
The health care reform was comprised of three features. One of the features was that the plan would guarantee that there would be an affordable, quality, and portable health care plan for all. This feature would involve improving the existing health care plans. Such plans are usually offered by employers, private individual health cover, and through Medicaid and Medicare (Andersen, Rice, & Kominski, 2007). The current market state would be changed whereby there would be a greater focus on personal choice. Those who would require a health plan would find a wider choice to select from. This feature also guaranteed cover for those who lacked cover from their employer and were not qualified for Medicaid or State Children’s Health Insurance Program (SCHIP). This would involve a new public program that would also be open to small employers who do not provide a private plan. Under this feature, the policy would establish a national federal exchange. This is where individuals would choose an insurance cover that suits them. The policy also contained a provision that required employers to either contribute towards a public plan or provide medical insurance. This would lead to an increase in coverage (Daschle & Nather, 2010). The eligibility for government programs would also be increased, making it easier for more people to access medical cover. This feature also made it compulsory that children from all families should be insured.
The second feature involved the modernization of the existing health care system. Using modern means, the health care system would improve in quality and become cheaper. Though reduction of costs was seen as the main objective, the government also intended to contain costs. This would prevent increasing costs or ensure that insurance providers would not charge exorbitant costs. This feature would also guarantee transparency when it came to quality of care and medical costs. This would be important so that individuals would find it easier to choose a medical cover while aware of all the costs involved. Patient safety was also important, and the use of modernized techniques would provide a reporting mechanism when consumers were faced with risk while accessing medical assistance. The reforms would also lead to changes in the established medical malpractices systems (Bodenheimer & Grumbach, 2012). This would be done by providing better legal support through anti-trust laws to prevent insurers from overcharging physicians for insurance arising from malpractices.
The third feature involved strengthening public health and promoting preventive mechanisms. Within the policy, it was vital for the insured individuals to go for checkups regularly. This was meant to promote prevention and many health issues that may arise to be avoided before they become severe. In the end, it would strengthen public health as many people would be covered and go through constant medical checkups. Employer wellness programs would also be created. This would enable employees to gain from medical cover through their employment (Bodenheimer & Grumbach, 2012). Obesity in schools would also be dealt with together with the prevention of diseases within the larger society.
Funding for the program would come from the federal government through taxation. Funding would be conducted through an exchange whereby the government would provide subsidies for the health cover that an individual would choose. States were also allowed to opt out of the Medicaid expansion. In this situation, the state would no longer receive federal subsidies for medical cover. A budget had already been made that would cater for all states, but the estimated costs of insurance coverage were reduced by $84 billion through a Supreme Court ruling (Vivar, 2011).
An objective analysis of the pros and cons
The proposed Health Care Reform plans had many pros and cons when considered in detail. The major advantage was that it would lead to an increase in the access to health care for a larger percentage of the population. This reform will result in many changes that are required for the existing health care systems. With its implementation, the costs of medical cover will reduce and the government will require smaller budgetary allocations for the health care systems (Bodenheimer & Grumbach, 2012).
The proposed plan will have various cost effects among the consumers, taxpayers, insurance companies, government, and other payers. The group of taxpayers that will be affected most by this reform is the wealthy. Wealthy consumers will have higher Medicare taxes, thus they will pay more for their health care coverage. In comparison, poor taxpayers will have lower taxes. This is also used as a strategy by the government for deficit reduction. In addition, new fees will be introduced annually. This will affect many stakeholders within the healthcare industry who are comprised of manufacturers, importers of brand-name pharmaceuticals, health insurance providers, and certain medical devices (Gibson & Singh, 2012).
The government is seen as a significant beneficiary from this initiative. The government expects to save up to 40% on medical costs due to the reforms because the reforms encourage constant doctor visits by those who are insured. Moreover, it will result in early diagnosis of diseases and health complications, thereby reducing costs in the end. Medical expenses will become cheaper as medical conditions will be dealt with early enough (Andersen, Rice, & Kominski, 2007).
The impact of the plan on the quality of care delivered unintended consequences
President Obama held the opinion that the current health care system was rationed. This was based on various factors like income, pre-existing medical conditions and the job an individual held. Thus, it led to lack of coverage for many people and exorbitant premiums for people with pre-existing medical conditions. Some scholars argue that rationing is a necessity within an economy (Vivar, 2011). It provides a way to distribute the limited resources that exist. Advocates have emerged calling for restrictions on health cover in cases where life cannot be improved. One such instance was by the Republican Secretary Peter G. Peterson who also recommended that spending cuts and tax increases should be done to finance the costs for medical cover. Rationing arises from increased governmental control on health plans. This will be vital in determining the extent to which an individual will be covered (Vivar, 2011).
Potential response of the three stakeholders
The responses from the various stakeholders about the plan will be wide and varied. While some will be impressed by the benefits that will arise from the health plan, others will not be satisfied with the results that will arise. The various stakeholders comprise of various individuals, ranging from health care providers and health care consumers to current health care payers.
Healthcare providers, comprised of physicians and hospitals, will also be affected by the reforms. Increased coverage will result in increased demand for care. Thus, health care providers will deal with more individuals than before. The reforms also require constant medical checkup, resulting in more work for the hospitals and physicians. More people will access urgent care services once they are covered without the need for a specific doctor or appointment. There will also be an increase in the number of patients changing insurance because the reforms have made it easier for individuals to consider a wider choice of insurance covers (Bodenheimer & Grumbach, 2012). There will also be increased complexities involved, especially because of insurers using different medications for their health plans. When an individual chooses a different health plan, they will have to consider the medications that will be provided under the new insurance cover.
Health care consumers are seen to be the main beneficiaries of the health care reforms. Many of the benefits arise from the cheaper health care services and the ease of accessing medical cover. Many health care consumers who have been insured pay a large premium to be covered. Thus, the insurance companies take advantage of the consumers. Moreover, those who have medical conditions that are considered chronic in nature are forced to pay more in comparison to those who do not have underlying medical conditions. Thus, the reforms will facilitate equality within such a scenario because any individual can access cover without consideration of their medical condition to determine the costs (Daschle & Nather, 2010).
The uninsured will also gain immensely from the reforms. This will mean that many individuals who were not able to access medical cover will now have a choice. Moreover, the reforms will lead to a cheaper form of medical coverage because most of the costs will be covered by the state. Many people who are poor and cannot afford insurance will be assured of a proper medical cover in case they are faced with any medical condition, thus they will respond positively towards the reforms (Vivar, 2011).
Insurance companies can be considered as the most affected. For them, the reforms signal the end to profitability. Many insurance providers will lose a large number of their former clients because more people will be covered after the reforms. Insurance companies tend to be expensive and charge a lot for their services. Health care consumers will be exposed to a wider choice following the establishment of the exchange. Potential customers will avoid insurance providers who were costly. Thus, insurance companies will be against these reforms based on the market risks that arise (Daschle & Nather, 2010).
Profitability can also be achieved, despite the misgivings raised by insurance companies. A potential response is that many insurance providers will support the reforms. This will be the case where an insurance provider is a small entity with few clients. The reforms will lead to an increased coverage, thus insurance providers will be able to cater for more people, thereby increasing their profits. Employers will not easily accept the reforms because they are also expected to contribute towards financing the reforms. Thus, many of them will be forced to cater for the health cover that their employees have (Vivar, 2011).
The health care reforms established by Obama are important for the health of the American people. I support this plan because the reforms are beneficial to many stakeholders within the country. For a start, many individuals who were initially not insured will access medical cover. The reforms will also lead to increased choices for the covers that are available, thereby attracting more people to access medical cover. Insurance companies have been taking advantage of their customers for many years. This scenario is worse when an individual looking for medical cover has underlying medical conditions. The insurers tend to consider such a person as a high-risk person, thus they charge higher fees in comparison to a healthy person who wants a general medical cover. Thus, I support this plan because the reforms will ensure equality when it comes to access to medical cover.
In conclusion, the health care reforms signaled the beginning of new developments within the existing health care system. The reforms will be advantageous to many people because they will lead to easier access to medical cover. Many stakeholders are involved within the reforms and will be affected differently. These include health care providers, consumers, and payers. In addition, implementation of the reforms on health care will play an important role in solving the limitations or problems in the existing health care system.
References
Andersen, R. M., Rice, T. H., & Kominski, G. F. (2007). Changing the U.S. health care system: Key issues in health services policy and management (3rd ed.). San Francisco, CA: Jossey-Bass.
Bodenheimer, T., & Grumbach, K. (2012). Understanding health policy: A clinical approach (6th ed.). New York, NY: McGraw-Hill Medical.
Daschle, T., & Nather, D. (2010). Getting it done: How Obama and Congress finally broke the stalemate to make way for health care reform. New York, NY: St. Martin’s Press.
Gibson, R., & Singh, J. P. (2012). The battle over health care: What Obama’s reform means for America’s future. Lanham, MD: Rowman & Littlefield Publishers.
Vivar, L. M. (2011). Obama’s health care reform 2010: From change to concession? Munich: GRIN Verlag.