Current and Future State of Healthcare Legislation Analysis

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Current and Future State of Healthcare Legislation Analysis

The healthcare system in the United States has evolved from a modest structure of itinerary doctors and simple remedies to a scientifically and technologically complex system controlled by bureaucracy and government. The healthcare system has seen an emergence of healthcare programs such as medical insurance, public institutions which train and offer subsidized health care services and corporations aimed at making profits.  This paper compares the current and the new healthcare environment in the U.S. as well as the emerging trends especially after the adoption of the Affordable Care Act of 2010. Furthermore, it compares the U.S. health care system with the health systems of other highly industrialized countries like Canada and Germany. Finally, the paper discusses how the changes in the healthcare environment influence a manager's operations in the healthcare system.

The Current and the New Healthcare Environment in the U.S.

Global spending on healthcare is at an all-time high due to increasing communicable and infectious diseases, poverty levels, and an aging population. An estimated amount of 6.45 trillion dollars is spent on global healthcare and the U.S. health care system accounts for 44.3 per cent of this figure ("Worldwide Spending on Healthcare"). The 2013 budget allocated 2.9 trillion on health care, which was 17.5 percent of its GDP. Public healthcare system alone cost the government 883 billion dollars ("Worldwide Spending on Healthcare"). The Federal Budget attributed the largest line item subsidies to healthcare products and services. Estimates predict that the U.S. will spend 4.6 trillion on healthcare in 2020, which is 20 percent of its GDP ("Worldwide Spending on Healthcare").  Such statistics highlight the fact that the U.S. spends more per capita on health care that any other nation.

The huge funding in the U.S health care system does not reflect positively on its state. The country was ranked 38th in health outcomes when compared to other nations (Braithwaite 321). Shortages in practicing physicians and large numbers of uninsured citizens have plagued the health care sector. In fact, the decline in physicians is gradually rising due to voluntary retirement and an aging population of the profession (Cutler 337). Among the developed countries, the U.S. lags behind in the number of beds per capita (Cutler 341). Many reasons for these poor results in the health care system have been well documented. The poor quality of clinical outcomes, the overly influential pharmaceutical companies and the uneven distribution of profits have been attributed to the decline of the country's healthcare system.

The adoption of the Affordable Care Act of 2010 aimed at improving the U.S. healthcare system. The law restructured the provision and management of health care, encouraged cooperation among the industrial players, changed the insurance coverage plans and reshaped health care subsidies. The ACA promoted transparency and adaptability in the system and made use of patient data to provide an expanded medical coverage plan for the citizens ("Medicaid Expansion Under The Affordable Care Act" 1219). Many of the insurance provisions came into effect after 2013. A total estimate of 16.4 million people has gained coverage since 2010, mainly comprising the lower middle-class population. The ACA provided incentives to reduce medical care admissions, reduce hospital-acquired conditions and top pay for value programs for hospitals and physicians. Furthermore, it has made positive changes in the health care workforce like increasing training programs of medical courses and increased payment rates for primary care physicians.

The Affordable Care Act has influenced some recent health care trends in the U.S. Affordable Care Organization have been formed to provide mandated health care by receiving incentives. Health platforms that sustain critical health approaches and accept a broad range of disabilities have been designed and integrated with the health care system. Industry collaboration between different groups has been encouraged through incentive and disincentive provision ("Medicaid Expansion Under The Affordable Care Act" 1219). New health delivery models have come up that drives physicians to provide and consumers to purchase premium services not covered in the ACA but nonetheless demanded in the market. Bundled payments influenced by tight cost regulators and outcomes as well new protocols have also emerged. ("Medicaid Expansion Under The Affordable Care Act" 1219). Finally, the health ecosystem has changed due to changes in structural healthcare provider systems. Even though the act has been partially rescinded many times by the Supreme Court and Congress, it is expected that these trends will hold.

Figure 1.0 highlights the trends brought by the Affordable Care Act

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Comparison of the U.S. Health Care Environment with other Industrialized Countries

The U.S. health care environment has often been often compared to the environment of other industrialized countries. America, though behind in medical insurance coverage and shortages in practicing physicians, is relatively stable due to the advanced state of technology. It is the world leader in medical innovations, and the large numbers of medical technology have improved the quality of American lives (Ruggie 525-528). Regarding the reimbursement process, the country uses a multiparty system unlike Canada and Germany (Ruggie 525-528). The government and commercial health insurance companies reimburse health care providers. Ideally, the fee-for-payment plan is becoming less popular, and a prepaid health plan is being adopted. The government has a fixed amount of the reimbursements for Medicare physicians. The doctors are required to treat all Medicare patients for all services and even if the patients are charged a fee, they are reimbursed up to 80 percent (Ruggie 525-528). Hospitals are also reimbursed based on the services provided to Medicare patients.