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ANSWERED!! Should government continue to take an aggressive role in reshaping the health care system or should the economy be allowed to continue exerting market-driven reforms?

 Should government continue to take an aggressive role in reshaping the health care system or should the economy be allowed to continue exerting market-driven reforms?

 Should government continue to take an aggressive role in reshaping the health care system or should the economy be allowed to continue exerting market-driven reforms?

You are responsible for minimally at least 3 posts for each question in your discussion boards; your initial post and reply to two of your classmates. Your initial post(s) should be your response to the questions posed in the Discussion Question. You should research your answer and cite at least one scholarly source when appropriate, and always use quality writing. The discussion board is never a place to use text language or emoticons.

You will also be asked to respond to your classmates. This is designed to enhance the academic discussion around the topic. It is all right to disagree with something posted by another, however your responses should always be thoughtful and respectful and reflect your opinions professionally.

Discussion Question: OPTION 1

With so many different stakeholders in the health care system, many with powerful political lobbies, it is understandable that the government has been unable, until the Patient Protection and Affordable Care Act of 2010, to effectively address the problems of cost, access, and quality. Despite this recent legislature, employers and the public have deep concerns about the ever-increasing costs of health care.

Physicians, hospitals and other providers continue to voice displeasure with managed health plans’ requirements and restrictions, while employers and the insured are railing against potential huge premium increases. Should government continue to take an aggressive role in reshaping the health care system or should the economy be allowed to continue exerting market-driven reforms? Please take a stance of either pro-government or pro-free enterprise factions and explain how the public will fare in each situation. How are the problems of cost, access, and quality likely to be addressed in each circumstance?

OR: OPTION 2

The practice of medicine, long valued for individual entrepreneurship and physician control, has undergone dramatic change. Physicians now face vexing oversight of case and utilization management and loss of control over the allocation of health care dollars. Managed care organizations control health costs by arbitrarily refusing reimbursement for certain medical procedures and reducing payments for others. Since medicine is now a less attractive career option, will fewer high performing individuals choose to become physicians? What are the implications for the quality of care?

OPTION 1 Expert Answer and Explanation

Healthcare Regulation

The government should still implement aggressive policies that can be used in reshaping the healthcare system due to the following reasons. First, the role of government in reshaping healthcare has, on many occasions, made health services accessible to more people. For instance, Tomaszewski (2017) report that the Affordable Care Act has provided health insurance for more than 20 million Americans.

Second, the act made it possible for American citizens to get more insurance packages for their dollar. Thus, currently, even people in low-income communities can get a certain level of coverage through the act. Through cost-sharing reduction, the ACA has provided millions of American families to buy affordable health cover.

Third, Shaw andTewdwr-Jones (2017) argue that if healthcare is left for the private sector, many people will not have equal access to care. Private stakeholders in the healthcare sector came into the industry for business, and thus all their actions are based on profits. Therefore, when left drive the sector, people from low-income communities will not get quality care.

The regulations implemented by the government ensure that the drugs and other healthcare services are available to the public at a regulated price. Shaw andTewdwr-Jones (2017) mention that government regulations prevent hospitals and other healthcare stakeholders from overcharging the public.

Lastly, the government should be allowed to reform the sector because it can ensure that people delivering the services are qualified and have the required knowledge and certification. However, Porter and Kaplan (2016) mention that the government should always consult the private sector when it wants to develop and implement healthcare reforms. The authors mention that the ACA has failed to achieve its goals because the other stakeholders were not involved.

References

Porter, M. E., & Kaplan, R. S. (2016). How to pay for health care. Harv Bus Rev, 94(7-8), 88-98. Retrieved from https://www.semanticscholar.org/paper/How-to-Pay-for-Health-Care-Bundled-payments-will-Kaplan-Porter/e9f5dceed5def3c8bd81bceb06495500fd4a6fef

Shaw, K., & Tewdwr-Jones, M. (2017). “Disorganised Devolution”: Reshaping Metropolitan Governance in England in a Period of Austerity. Raumforschung und Raumordnung-Spatial Research and Planning, 75(3), 211-224. https://link.springer.com/article/10.1007/s13147-016-0435-2

Tomaszewski, K. A. (2017). Personal Health Budgets–Should Patients Be Able to Manage their Care in a Way that Suits Them? A Concise Narrative Review. Horyzonty Wychowania, 16(40), 147-157. https://www.ceeol.com/search/article-detail?id=719275

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Should government continue to take an aggressive role in reshaping the health care system or should the economy be allowed to continue exerting market-driven reforms?

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FAQs

Impact of affordable care act on health care organizations

The Affordable Care Act (ACA), also known as Obamacare, had a significant impact on healthcare organizations in the United States. Some of the key impacts include:

  1. Increased patient volume: The ACA increased the number of insured individuals in the United States, leading to a significant increase in patient volume for healthcare organizations. This put pressure on healthcare organizations to increase capacity and efficiency to handle the additional patient load.
  2. Changes to reimbursement models: The ACA introduced new reimbursement models that incentivized healthcare organizations to focus on quality of care and outcomes rather than volume of services provided. This shift required healthcare organizations to invest in new technology and infrastructure to collect and analyze data on patient outcomes.
  3. Expanded coverage for preventive care: The ACA mandated coverage for preventive care services, such as vaccinations and screenings, with no out-of-pocket costs for patients. This led to an increase in demand for these services, which required healthcare organizations to adjust their operations to accommodate the increase in volume.
  4. Increased emphasis on population health: The ACA placed a greater emphasis on population health and the management of chronic diseases. This led to the development of new care models, such as accountable care organizations (ACOs), that focused on coordinating care across multiple providers and settings.
  5. Changes to regulatory requirements: The ACA introduced new regulations related to healthcare delivery, such as the meaningful use requirements for electronic health records (EHRs). These regulations required healthcare organizations to invest in new technology and infrastructure to comply with the new requirements.

Overall, the impact of the ACA on healthcare organizations was significant and multifaceted. While the law brought many challenges, it also created opportunities for healthcare organizations to innovate and improve the quality of care they provide.

How does the aca impact individual consumers with purchasing insurance

The Affordable Care Act (ACA) had several impacts on individual consumers with purchasing health insurance. Some of the key impacts include:

  1. Insurance Marketplaces: The ACA established Health Insurance Marketplaces, also known as exchanges, where individuals can purchase health insurance coverage. These marketplaces offer a variety of health plans that meet certain minimum requirements and are required to cover essential health benefits.
  2. Subsidies: The ACA also created premium tax credits and cost-sharing reductions to help make insurance more affordable for low- and moderate-income individuals and families. These subsidies are available to individuals who purchase insurance through the Health Insurance Marketplace and meet certain income and other eligibility requirements.
  3. Consumer protections: The ACA introduced several consumer protections, such as the prohibition of denying coverage to individuals with pre-existing conditions, requiring insurers to cover essential health benefits, and capping out-of-pocket expenses.
  4. Mandate to have insurance: The ACA requires most individuals to have health insurance or pay a penalty, known as the individual mandate. The mandate was later repealed, but some states have their own mandates in place.
  5. Expansion of Medicaid: The ACA expanded Medicaid eligibility to individuals with incomes up to 138% of the federal poverty level in states that chose to participate in the expansion. This provided coverage to millions of low-income individuals who previously did not have access to affordable health insurance.

Overall, the ACA has provided more options for individuals to purchase affordable health insurance, with subsidies available to make coverage more accessible. The law also introduced several consumer protections to ensure that individuals have access to essential health benefits and are not denied coverage based on pre-existing conditions. However, the individual mandate was repealed, which may impact the affordability and availability of coverage for some individuals.

How is aca funded?

The Affordable Care Act (ACA) is funded through a combination of sources. Some of the key sources of funding include:

  1. Taxes: The ACA created several new taxes to help fund the law, including a tax on high-income earners, a tax on certain health insurance plans, and a tax on medical devices.
  2. Medicare savings: The ACA included several provisions aimed at reducing costs in the Medicare program, such as reducing payments to Medicare Advantage plans and hospitals, and increasing efficiency in the program.
  3. Fees: The ACA also created several fees that are paid by various healthcare providers, such as pharmaceutical manufacturers and health insurers.
  4. Individual and employer mandates: The ACA included an individual mandate, which required most individuals to have health insurance or pay a penalty, and an employer mandate, which required certain employers to provide health insurance to their employees or pay a penalty. These mandates were later repealed, but some states have their own mandates in place.
  5. Savings from other programs: The ACA included provisions aimed at reducing costs in other healthcare programs, such as Medicaid and the Children

What does the affordable care act cover?

The Affordable Care Act (ACA), also known as Obamacare, includes several provisions that aim to make healthcare more accessible and affordable for individuals and families. Some of the key provisions of the ACA include:

  1. Essential Health Benefits: The ACA requires all health insurance plans sold on the individual and small group markets to cover essential health benefits, which include services such as doctor visits, hospitalizations, prescription drugs, and maternity care.
  2. Preventive Care: The ACA requires health insurance plans to cover preventive care services such as immunizations, cancer screenings, and annual wellness visits without charging patients a copayment or coinsurance.
  3. Pre-existing Conditions: The ACA prohibits health insurance companies from denying coverage or charging higher premiums based on pre-existing conditions.
  4. Medicaid Expansion: The ACA provides federal funding to states that choose to expand their Medicaid programs to cover more low-income individuals and families.
  5. Marketplace Subsidies: The ACA provides tax credits and subsidies to help low- and moderate-income individuals and families purchase health insurance through the health insurance marketplaces.
  6. Young Adult Coverage: The ACA allows young adults to stay on their parents’ health insurance plans until they turn 26.

It’s important to note that the specific benefits and coverage provided by the ACA may vary depending on the individual’s state of residence and the health insurance plan they select.

Benefits of the affordable care act

The Affordable Care Act (ACA), also known as Obamacare, has several benefits that aim to make healthcare more accessible and affordable for individuals and families. Here are some of the key benefits of the ACA:

  1. Increased Access to Healthcare: The ACA has increased access to healthcare for millions of Americans by expanding Medicaid eligibility and creating health insurance marketplaces where individuals can purchase affordable health insurance plans.
  2. Essential Health Benefits: The ACA requires all health insurance plans sold on the individual and small group markets to cover essential health benefits, which include services such as doctor visits, hospitalizations, prescription drugs, and maternity care.
  3. Preventive Care: The ACA requires health insurance plans to cover preventive care services such as immunizations, cancer screenings, and annual wellness visits without charging patients a copayment or coinsurance.
  4. Protections for Pre-existing Conditions: The ACA prohibits health insurance companies from denying coverage or charging higher premiums based on pre-existing conditions.
  5. Marketplace Subsidies: The ACA provides tax credits and subsidies to help low- and moderate-income individuals and families purchase health insurance through the health insurance marketplaces.
  6. Increased Transparency: The ACA requires health insurance companies to provide clear and easy-to-understand information about the benefits and costs of their plans, making it easier for consumers to compare plans and make informed decisions about their healthcare coverage.
  7. Reduced Healthcare Costs: The ACA has helped to slow the growth of healthcare costs by encouraging more efficient and coordinated care, promoting the use of preventive care services, and reducing waste and fraud in the healthcare system.

Overall, the ACA has had a significant impact on the healthcare system in the United States, improving access to care, increasing transparency, and reducing costs for many Americans.

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