Healthcare system in the USA

Healthcare is critical to the promotion and maintenance of a healthy population. The federal government and the Department of Health set the rules and policies that govern the healthcare delivery system in the United States. The healthcare policies are designed to assist in the delivery of healthy, accessible, affordable, and high-quality healthcare. Since it collected funds from the federal government and distributed them to the states with the intention of assisting pediatric, education, public health, and maternal health, the Social Security Act was created and has had a major impact. It's worth noting that the Medicaid and Medicare programs were initiated from the social security Act and other essential components governing the United States healthcare. Moreover, the Health Insurance Portability and Accountability Act, also referred to as HIPPA has been widely used in the country. It was introduced in 1996 with the intention of providing the medical insurance coverage for the people who may experience a change in employment or loss of a job. Moreover, the people with preexisting conditions or limited job benefits and those with mandate enrolment periods as well as employment and family changes. It is also notable that the change mandating the electronic records and keeping the information of the patients confidential is covered by this Act. The Affordable Care Act of 2010 was passed with more regulations to help in the declining numbers of the American citizens who were still not insured and was meant to reduce the cost of delivery of healthcare. The policies which were passed were sufficient to help in the regulation of the delivery of services in the health sector as well as their enforcement. The healthcare delivery system in the United States is bound by many pros and cons, which influence the affordability, access, and quality of healthcare provided to the citizens. The disparities in the healthcare delivery of services within the United States have due to high costs of delivery, poor quality of services offered and characterized by a lower life expectancy among the developed nations.

impact of the Affordable Care Act of 2010 in the Healthcare Organization and delivery of services.

The healthcare system in the United States has been experiencing lots of problems ranging from the delivery of services to the management systems. The delivery stem in the nation comes with many problems which affect the patients and since they require various services from the healthcare facilities. They come across the healthcare settings and the poor delivery system in healthcare as they navigate across the various departments within the health sector. They end up in frustrations since their needs are not satisfied, neither is the little services they get quality (Betancourt, et al n.p). The bad patient experience has raised eyebrows, with the healthcare considering to undertake reforms and refurbishing the whole delivery of services to meet the needs of all the stakeholders. The poor delivery system has also resulted in inadequate communication and unaccountability of the patients and their needs for the health providers with multiple vendors. They end up to wasting resources, experiencing errors and duplication of their information, which is undesired. Moreover, it reduces the general quality of care which arises from the lack of quality improvement infrastructure, clinical information systems, and peer accountability.

The affordable care act, which was passed in 2010, was initiated and replaced the Healthcare Organization and delivery through several ways. One of the major problems with the healthcare coverage is that there are little coverage and very little improvement from the initial system. The ministry of health has estimated that more than 30 million of the population may not have access to healthcare coverage in 2016. Moreover, the nation is experiencing significant coverage gaps, especially in the states due to the Medicaid eligibility (Lillie-Blanton, Marsha, and Catherine, 332). Due to this reason the population is left without a choice to make and leaves out the other 6 million uninsured adults who do not have access to proper Medicare as a result of lack of expansion. The other group of people is classified in the group of the coverage gaps, which consists of undocumented residents as well as the people who lack proper coverage. A more important change in the delivery reform will consist of a shift in the care management system as well as infrastructure systems, which is integrated and collaborative.

Literature review

The United States Health Care System is not funded only by the contributions from the taxpayers but is also classified as a Universal Healthcare. This may be seen as an advantage for the people who are already receiving health insurance coverage through employment. In the contrary, the people experiencing the loss in coverage since they cannot afford the expensive COBRA care as well as the individuals who cannot afford the insurance premiums and their deductibles end up being disadvantaged. The basic idea of universal healthcare provision is therefore intriguing. The coverage of health care has a significant impact on the accessibility and affordability of the health services (Betancourt, et al n.p). The distribution of services has also led to the variation in the access to healthcare delivery system. The rural areas, for instance, rely mainly on the local hospitals due to the proximity of the basic acre as well as the cost, which increases steadily with the further increase in distance from the point of service of Medicare. The areas with lower populations are at a disadvantage due to the increased cost of medical facilities for the smaller health facilities, thus it is difficult to invest a lot in such areas. The local hospitals are advised to make collaborations with the larger corporations as a way of meeting the costs of the Medicare, which then affects the populations since it takes time for the collaborations to agree and pass the regulations (Lillie-Blanton, Marsha, and Catherine, 332). An example of this phenomenon is the Bemidji Local Merit Care Hospital which was acquired by Sanford since Sanford had a wider network and better access and financial abilities. Moreover, the quality and experience of the medical experts in the rural areas are difficult to maintain, just like for urban areas due to the outsourcing of resources.

Supply and demand

Healthcare in the United States is a public service which is determined by the forces of demand and supply of the delivery of services. The population in the urban areas is greater than the rural areas, and hence the availability of the delivery of health services is better in the urban areas. Other factors which determine the demand and supply of the delivery of services within the United States is the technology, professionals and the quality of services offered. The access to quality healthcare is greatly influenced willingness to pay for the health insurance. The health insurance may be costly especially when funded or deducted directly from an employer. The access to healthcare is determined by the factors which influence the provision of services directly. Health equity is the allowance for every person to get the access to health coverage and acquire the highest level of health services, holding all other factors constant (Betancourt, et al n.p). Equity, however, differs as the equal means for every person is different and the additional services for one facility may be different from another. The minorities and the people living in the rural areas with a lower socioeconomic status suffer such challenges. Regardless of the access to potential insurance, the facilities where the population gets access to healthcare is different and it draws some people back from seeking the regular health services.

Cost per capita

The cost per capita and the financial strain indicates the American healthcare system as one of the most expensive globally. The cost per capita in the US is more than double or triple that of the developed nations with a higher life expectancy. However, the cost of health per capita is believed to yield more benefits than the other services, but the quality of services in the United States is still doubtful. The cost of health per capita according to the increase in population ages (Lillie-Blanton, Marsha, and Catherine, 332). The idea of health insurance helps to meet the costs of the household expenditure and came into practice at the beginning of the twentieth century. The social security Act of 1935 was critical since it helped to raise allocate the federal funding for the health programs in the United States. The SSA was initiated through the Medicaid program as well as the Medicare.

The Medicare is funded by the government and provides the insurance coverage to the elder citizens beyond the age of 65 years as well as some younger individuals with disabilities. The program has various classes of people classified into various groups, A, B, C, and D, which all vary in the health coverage (Boulware, et al 248). The program, however, aims at meeting the healthcare needs of their citizens.

The Medicaid is also a federally funded program where all the medical coverage is provided for the Americans with low income or the people who require public assistance. The eligibility and benefits are contained the Medicaid regulations for every state. The main goal of this programs is to make the health services affordable and accessible for the vulnerable populations. The Affordable Care Act of 2010 expanded the program through the liberation of the income requirements for the quoted groups, and hence increase the health coverage for them (Lillie-Blanton, Marsha, and Catherine, 332). Since this program is state-controlled, it has not been effective since the funding from the state is dissolved into various unimportant mini-programs which have been set up by the respective states. Despite the adoption and implementation of this program, the health sector has seen a significant increase in the number of uninsured population.

The Affordable Care Act

The Affordable Care Act also termed as Obamacare was initiated in 2010, with the main aim of increasing the healthcare coverage for the uninsured population. It was focused on improving the accessibility, affordability, and quality of healthcare in the United States. One of the most notable elements and the addition of the Act is the extension of the vulnerable population and those at a high risk being insured. The population who were previously uninsured due to the high premium costs of insurance would be included in the program to help them acquire proper insurance plans. The Medicaid programs through the funding from the federal would allow the people to get more coverage as well as those with preexisting conditions allowed to be included in the program (Betancourt, et al n.p). The increased funding from the state was channeled to the program as preventative measures emphasized as well as the increase in accessibility for the program. Initially, there was an estimate of 47 million who were uninsured as the program was being launched, but the problematic clause in the ACA is the individual initiative. It requires the population to acquire the health coverage individually, with a penalty to pay, for those who do not get the health insurance program. This causes more financial hardship with the health implications of the insurance premiums increasing. Despite the positive contributions of the affordable care act, it has however caused a financial strain on the government and the uninsured individuals as well, thus affecting the quality of services offered in health facilities. It thus requires more renovations and provides better quality care and one which is affordable to the American people.

Quality of healthcare

The United States has some of the most technologically equipped health system and the provision of health services. The country has however continued to underperform when compared to the other developed nations, with the cost per capita failing to demonstrate a higher life expectancy and the health facilities having a higher expenditure. The United States has deployed highly skilled and qualified personnel to access the sophisticated medications and technology, hence all the problems and disparities associated with the health department are not associated with the healthcare professionals (Lillie-Blanton, Marsha, and Catherine, 332). The Agency for the Healthcare Research and quality has formulated quality indicators and guidelines for the healthcare delivery system. The structural indicators involve the factors which rely on the composition of nursing care. Some of the structural indicators include staffing, certification, level of skills for the nursing professionals and the educational levels.

Recommendations

As there is a debate on the quality of services and the delivery system reform, the government through the department of health should seek ways of increasing the value of the current system, through the use of different approaches to reform and improve the health sector. Some of the intervention programs like the Chronic Disease Management, Health Information Technology as well as the Primary Care coordination can help to lower the cost of health and growth. Moreover, the implemented reforms are heterogeneous and will improve the system in value at the same time reduce the cost of health (Boulware, et al 252). The interventions in the delivery system will lower the cost of healthcare, with more savings by the patient and a risk-adjusted accountability put in place. The requirements and incentives of this guideline should be tied to quality improvement of the services.

The delivery system adjustments will be most effective when they are induced to ensure real credibility from the health providers to the patients as a way of improving the outcome. Multiple approaches to the reforms in the delivery system will help to minimize the costs of healthcare as well as ensure improved quality healthcare. For instance, the impact of a single management disease management initiative will be limited to the populations with multiple chronic illnesses as well as the ones who require multiple cares (Betancourt, et al n.p). In addition, the ability to coordinate the care will not have any impact without the use of an electronic system of medical records and will involve a more integrated decision support by the health providers as well as by the patient.

The care system should be split into a smaller number of delivery systems, which will be easier to manage and will adopt a “do it all” system. Large systems require a lot of work and cause the duplication of services in multiple locations, which does not work efficiently for the patient. Every center should focus on delivering excellent services in the same conditions. the complex and indigenous systems should be used in tertiary care centers, with more predictable and less heterogeneous conditions (Lillie-Blanton, Marsha, and Catherine, 332). This will help to address the community setting and cost issues in the delivery systems. The integrated systems will help the patients move to the right location and enhance quality and cost.

Healthcare systems should focus on getting the right care for the patients in the correct location, as well as enlighten them to be less concerned with the geography. During the times when the length of stays in hospitals was double digits, the patients would choose any all care location close to their homes (Betancourt, et al n.p). Since hospitals are generally single digits, the distance to home is less and it gives them good value, with the systems steering the patients to better deliver care. The availability of low-cost travel options, which are also easy should be feasible for most families and the population in general.

Generally, the initiatives put in place by the federal should be properly integrated into the healthcare system in the United States and implemented so as to yield the expected outcome such as a higher life expectancy.

Conclusion

The United States healthcare system is filled with many disparities ranging from accessibility, affordability to the delivery of services. The financial strain of acquiring healthcare is very high and the cost per capita of the United States is the highest in the world, yet the life expectancy levels in the nation are still low. Regardless of the high costs, the outcome of the patients is still short of what the other developed nations have achieved. The disparities the health sector and the access to healthcare facilities is still problematic to millions of the population as they struggle to get good healthcare and satisfiable delivery of services. However, the federal and the states have initiated the steps to improve accessibility, affordability, and quality of healthcare delivery to its citizens. The United States has the most advanced and technologically invested healthcare system, and should continually strive to improve the quality of the delivery of services to its citizens, as well as make it affordable. The existing programs and initiates when properly utilized and managed will produce an effective system, with proper output and returns.



































Works cited

Betancourt, Joseph R., et al. "Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and healthcare." Public health reports (2016).

Boulware, L. Ebony, et al. "Race and trust in the healthcare system." Public health reports (2016).

Lillie-Blanton, Marsha, and Catherine Hoffman. "The role of health insurance coverage in reducing racial/ethnic disparities in healthcare." Health Affairs 24.2 (2005): 398-408.