Health Care Innovation Essay Example for Free

Health Care Innovation Essay I will compare the current health care system with the new Patient Protection and Affordable Care Act (ACA) that became law on March 23, 2010. The current system, which is being phased out between 2011 and 2018 is increasingly inaccessible to many poor and lower-middle-class people. About 47 million Americans lack health insurance, an increase of more than two million people from 2005 (Rover, 2011) the increasingly complex warfare between insurers and hospitals over who pays the bills is gobbling up a great deal of money and the end result is that the United States pays roughly twice as much per capita for health care as Canada, France, and the United Kingdom yet experiences slightly lower life expectancy than those countries. President Barack Obama campaigned for the need to reform the American health care system, stating that the cost of health care was a â€Å"threat to our economy† and that health care should be a â€Å"right for every American. † (Rover, 2011) Thus began the passage of health care reform. On March 23, 2010, the Patient Protection and Affordable Care Act became law. Private and Parochial schools have been competing with public schools for as long as I can remember. These schools have to show that they are worth paying for or they do not get customers. The health care industry, on the other hand does not have government competition. The old health care system gave insurance companies all the power. It is more along the lines of, pay us outrageous fees or you die. Even if you have their coverage they still look for ways to drop you from their insurance. I feel that under the new health care reform laws I will not have to worry about getting laid off and losing my health insurance coverage again. There are 92 provisions in the ACA (Affordable Care Act) that are being mplemented between the years 2011-2018. This paper, however, will only cover the provisions I feel are of concern to most lower to middle class Americans, or should I state â€Å"financially struggling like myself†. Furthermore, the ACA has a broad range of provisions that aim to advance a framework and foundation for redesigning the healthcare delivery system to one that is person-centered, offers individual control, improves quality, and integrates care across settings and providers (Shugarman, L. R. , Whitenhill, K. 2011). Key provisions undergird health and long-term care reform by improving the continuum of care within four domains: long-term care insurance, home and community-based services (HCBS) expansion, care coordination, and workforce reinforcement. Since the recession began in December 2007 nearly 7 million Americans have lost their jobs. In addition, there were an estimated 43 million uninsured prior to that; Many of whom lost the only health insurance coverage they had for themselves and their families. Former employees are given the option to buy temporary insurance through companies such as Cobra which contains provisions giving certain former employees, retirees, spouses and dependent children the right to temporary continuation of health coverage at group rates. However, this insurance is costly, well above the financial means of someone without a job. The typical cost for basic family coverage can be around $1,309. 00 per month. A cost that is nearly impossible to cover when you are unemployed or underemployed. Under the ACA, the following provisions would be considered pros for the average American: (a) Coverage will expand to cover nearly 95 percent of legal U. S. residents. Plus, preventative care will be free. (b) Increased regulation will stop insurance companies from rigging prices, for instance there was a recent 40% insurance premium increase in California. (c) Insurance companies will have to accept everyone. No more pre-existing condition exclusions. They can’t place limits on coverage anymore, either. (d) Cheaper prescriptions for seniors. e) Ensuring Free Choice. Workers who cannot afford the coverage provided by their employer may take whatever funds their employer might have contributed to their insurance and use these resources to help purchase a more affordable plan in the new health insurance exchanges. (f) Eliminating Annual Limits on Insurance Coverage. The law prohibits plans from imposing annual dollar limits on the amount of coverage an individual may receive. (g) Insurers must now reveal how much money is spent on overhead. (h) Makes Care More Affordable.  The act includes tax credits to make it easier for the middle class to afford insurance will become available for people with incomes above 100 percent and below 400 percent of poverty (i) Chain restaurants will be required to provide a nutrient content disclosure statement alongside their items. You will see calories listed both on in-store and drive-through menus of fast-food restaurants. (Affordable health care for America, 2010) Under the ACA, the following provisions would be considered cons for the average American: (a) Cuts in Medicare.  The elderly on Medicare will see their benefits changed dramatically. The biggest item being used to pay for the new program is more than $500 billion in cuts to the Medicare program at a time when 72 million baby boomers become eligible for it in the next decade. The second biggest move to pay for this is by raising and expanding the Medicare tax. (b) No new incentives for primary care physicians (c) More taxes, the government has to pay for healthcare reform somehow. Taxing businesses is a big strategy. Families earning more than $250. 00 a year will have to pay higher Medicare taxes, also, this isn’t a tax, but employers will be fined $3,000 per employee if they don’t provide affordable medical coverage. (Drea, 2010). However, the provision that is causing the most concern is the insurance mandate. Within this mandate everyone is required to be insured or else pay a fine. There is an exemption for low-income people. This mandate takes effect in 2014. (Right To Health Care, n. d) I personally feel the ACA will benefit most Americans for several reasons. First, if you do not have health insurance, you will have a choice of high quality, affordable coverage for yourself and family. Second, the reform will finally bring skyrocketing health care costs under control. Third, the reform will provide every American with some basic protections that will finally hold insurance companies accountable since they will not be able to discriminate against persons with pre-existing illnesses or conditions. Lastly, Americans can now purchase their health insurance coverage with the bargaining power that was only reserved for larger companies, instead of individual policies which are extremely expensive. Bear in mind that from 2000 to 2006, health care premiums increased 87% compared to overall inflation (an increase of 3. 5%) and wages (3. 8%). A ‘Public Entity’ would help keep costs from skyrocketing (Right to Health Care, n. d). Working Americans may be experiencing something akin to sticker shock. The average cost of a family policy now exceeds $13,000 a year, having doubled over the last decade, according to a survey by the Kaiser Family Foundation. Similar increases over the next decade would translate to the average policy for a family costing in the neighborhood of $24. 000 a year. (Right to Health Care, n. d). I really had not paid that much attention to the new health reform act, prior to a tragedy that happened to my best friend’s family recently. One of her sisters had been covered by her employer sponsored health care plan for the last 10 years. For 8 of those years she was the picture of health, no major illnesses or accidents requiring the use of her insurance other than the occasional checkup. About 2 years ago she decided to up her yearly deductibles and co-pays from $1,200 to $6,000 in favor of a lower monthly premium to help make other household bills easier. At that time there was no reason for her to feel anything bad would happen; Had she been covered under the new ACA she may not have had to worry about paying high medical bills. Unfortunately last spring my best friend’s sister was diagnosed with bi-polar disease; a few weeks later coincidentally she also discovered she had breast cancer. Late this past summer, my best friend’s sister committed suicide. I am not saying that her health insurance situation was the main reason for her decision to take her own life, but I know her family tried many times to convince her she needed more help for her major depression. Her response was always that she could not afford it. The emotional trauma associated with her two illnesses and the constant worry over the medical bills only added to her anxiety and depression. Fear of hospital bills should not deter anyone from seeking medical care. My best friend is carrying around a lot of guilt that she could have and should have done more for her sister by insisting her sister get the medical care ecessary and not worry about how it would be paid for. Since my best friend’s sister’s death, I have come to realize that not being able to afford health care insurance could be the difference between life and death for many. How appalling to live in a country with such great wealth, yet millions face financial ruin if they are uninsured or insured and their current insurance provider decides to drop them. I am not saying that the new health care reform laws will be fix all our problems, but I feel it’s a good start, and only time will tell.