Citizens Without Coverage in America, GCSE Coursework Example

Problem Statement

Today’s health care system is far from being fair, according to several critics. The Patient Protection and Affordable Health Care Act, designed to reduce health deficit and decrease the number of uninsured people in the country has partially fulfilled its promises. According to Mason et al. (2012, p. 466), the provision of individual mandate forces people to buy health insurance or pay a penalty. According to the latest report of the Department of Health and Human Services (2014), the rate of growth in the percentage of people insured is steady. The brief states that a recent study by Gallup “has found a 3 percentage point decrease in the uninsured rate for adults from the third quarter of 2014 to March 2014” (Department of Health and Human Services, 2014, p. 7). This growth means that the demand for nurses, doctors, and generally health care services is likely to increase over the time, as higher insurance coverage means more visits for check-ups and more regular visits to health care facilities. The question is how America’s health system will be able to deal with the increased demand and effectively serve the public. At the same time, those who are still uninsured will need to pay higher prices, and demand more services, as they are less likely to participate in prevention programs.

Policy Analysis

According to Mason et al. (2012, p. 154), “in recent years, health policy in the U.S. has focused on the needs of those who demand health care services”.  Increasing the demand from insured and uninsured citizens is likely to increase the pressure on service providers. Facilities that provide their services through health insurance coverage payments will be forced to either increase their costs by employing more staff to meet the demand, or to increase their efficiencies. This means that in order to make their operations more competitive and effective, companies will need to either increase operations costs by employing more staff, or invest into tools and systems that make their operation more efficient. It is evident that increasing efficiencies would have a positive implication on patient outcomes and quality of service, therefore, the government should have effective policies and provisions in place to incentivize health care providers’ investment in technologies and systems that improve the overall quality of healthcare.

Demand and Solutions

The Joint Commission on Accreditation of Healthcare Organizations (2003) predicted that in the near future there would be a nursing crisis in the developed world, and in particularly in the United States. Health care providers are required to implement changes in order to make their services available at a more competitive price for health exchanges. The changes proposed by the authors of the Joint Commission on Accreditation of Healthcare Organizations (2003) are increasing retention, providing safer work environment, creating and managing safe staffing levels, improving work flow, and managing talent. The main problem identified is that “hospitals have few incentives to invest in nursing staff, and to improve patient safety and health care quality. They are reimbursed for the nursing care provided in their institutions through patient bed and board charges. In other words, they are paid the same whether, for instance, their medical/ surgical nurse-to-patient ratios are one-to-four or one-to-ten. There are no incentives or even expectations built into the payment system — either through public or private payers — that encourage an optimal number of nurses or even safe care” ( Joint Commission on Accreditation of Healthcare Organizations, 2003, p. 34). In order to help health care providers improve the quality of service, and the health of America, the Federal Government needs to put incentives and provisions in place.

Conclusion

Increasing demand for health care, due to higher health insurance take up rates is likely to create extra pressure for providers. It is the government’s responsibility to incentivize companies to improve the quality of care and service delivery.

References

Department of Health And Human Services (2014) Health insurance marketplace: summary enrollment report for the initial annual open enrollment period. Retrieved from http://aspe.hhs.gov/health/reports/2014/marketplaceenrollment/apr2014/ib_2014apr_enrollment.pdf

Mason, J., Leavitt, J. K., & Chaffee, M. W. (2012). Policy & politics in nursing and health care (6 th ed.). St. Louis, MO:: Elsevier Saunders.

Joint Commission on Accreditation of Healthcare Organizations (2005) Health care at the crossroads: Strategies for addressing the evolving nursing crisis. Retrieved from http://www.jointcommission.org/assets/1/18/health_care_at_the_crossroads.pdf