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Final Paper Health Care Reform

Is healthcare a right or a privilege? Discuss the history of healthcare in the US (Medicare, Medicaid, COBRA, SCHIP, and ACA).

How has access to care affected American citizens?

Discuss the Affordable Care Act and Medicaid expansion. How could Medicaid expansion have benefited the State of Florida?

What does the future of the healthcare delivery system look like to you? If you were apart of the Healthcare Reform committee, what would you propose to be changed, included, or excluded from the Affordable Care Act?

HSA 1100 – US HEALTH CARE DELIVERY SYSTEMS

Health Reform Paper Rubric

Healthcare Delivery Systems Health Reform

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University

Course

Professor Name

Date

 Healthcare Delivery Systems Health Reform

The U.S. healthcare system faces a lot of challenges including high costs, a shortage of healthcare professionals, and inequalities in healthcare access for specific population groups such as those living in poverty and racial minorities. These challenges have negative impacts on patient outcomes. Various healthcare reforms such as the introduction of Medicare and Medicaid and the implementation of the ACA were meant to improve affordability and access to healthcare. However, high healthcare costs are still a significant issue (Campbell & Shore-Sheppard, 2020). The purpose of this paper is to discuss whether healthcare is a right or a privilege, the history of healthcare reforms in the U.S., the impacts of access to care, the ACA and Medicaid expansion, and the future of healthcare delivery. Healthcare is a right, not a privilege and although reforms such as Medicaid expansion have improved access to healthcare, more steps need to be taken to improve affordability for average and low-income individuals and families.

The Right to Healthcare and the History of Healthcare in the U.S.

Healthcare is a human right and all people should have access to it regardless of their religion, race, socioeconomic status, and political beliefs. All people should be able to access healthcare when they need it without the risk of experiencing financial hardships (Peled-Raz, 2017). The history of Medicare and Medicaid dates back to 1945 when President Harry Truman called for the development of a national insurance fund that would be open to all American citizens. Truman’s vision included the provision of healthcare insurance to all people that would cater to essential healthcare services. However, he was not successful in passing the bill and it took 20 more years before a national health insurance system was developed. In 1965, President Lyndon Johnson signed legislation that led to the implementation of Medicare and Medicaid. Older adults were enrolled for Medicare and more than 19 million people signed up within the first year. Medicare was later expanded in 1972 to cover individuals with end-stage renal disease and those living with disabilities. Medicaid initially provided insurance for people who required cash assistance although currently, it covers more people including low-income families, people needing long-term care, and pregnant women (Centers for Medicare & Medicaid Services, 2021).

The Consolidated Omnibus Budget Reconciliation Act (COBRA) was implemented in 1985 and it provides temporary health plan coverage continuation for retirees, family members, and certain employees at group rates when they lose coverage. In 1997, the State Children’s Health Insurance Program (S-CHIP) was implemented to facilitate access to insurance for children from low-income families who were above Medicaid eligibility. The ACA was implemented in 2010 as a comprehensive healthcare reform to increase the number of insured individuals, improve access to care, and reduce the cost of care (Medicare Resources, 2022).

Impact of Healthcare Access

The ACA improved access to care by improving insurance coverage for low-income individuals and preventing insurers from discriminating against people with pre-existing conditions. The main impact of a high number of insured people was increased demand for healthcare services, especially within the primary care system. More people had access to screening services which are essential for the early detection of diseases. Additionally, access to care is essential for improving the quality of life and increasing life expectancy for all American citizens (Campbell & Shore-Sheppard, 2020).

The ACA and Medicaid Expansion

One of the key provisions of the ACA that improved access to healthcare was Medicaid expansion. The expansion extended Medicaid eligibility to adults whose income levels were up to 138 percent of the national poverty level. Before ACA was implemented, non-disabled adults without minor children could not qualify for Medicaid. Medicaid expansion, therefore, improved coverage for low-income adults (Campbell & Shore-Sheppard, 2020). However, some states such as Florida chose not to expand Medicaid. Notably, Florida would have benefited greatly from Medicaid expansion. According to Norris (2021), Medicaid expansion would reduce the number of uninsured Florida residents by more than 800,000 and add more than 60,000 healthcare jobs. More jobs in other sectors such as retail, construction, and insurance sectors would also be added. Additionally, Florida State would have access to financial benefits including savings gained from substituting state funds with Medicaid funds and gains from increased hospital tax and provider revenues.

The Future of the Healthcare Delivery System

In my opinion, the healthcare delivery system’s future does not look very bright since the cost of healthcare is still high. If I were part of the Healthcare Reform committee, I would focus on expanding coverage for moderate-income individuals. The rationale behind this is that according to Calsyn (2021), the cost of healthcare has become too high for middle-income families which do not have employer-sponsored insurance and do not qualify to receive premium tax credits. Therefore, provisions that improve access to tax credits for individuals whose incomes exceed the current eligibility threshold should be implemented. For those who are already eligible, tax credits should be increased to further improve affordability.

Conclusion

Healthcare is a human right because all people should access it regardless of their backgrounds. Healthcare reforms such as the ACA were implemented to improve healthcare access. However, the affordability of healthcare is still a significant issue for middle and low-income individuals. Improving access to tax credits for middle and low-income individuals would improve the affordability of healthcare.

References

Calsyn, M. (2021). How States Can Build on the ACA To Improve Affordability and Lower Health Care Costs. https://www.americanprogress.org/article/states-can-build-aca-improve-affordability-lower-health-care-costs/#

Campbell, A., & Shore-Sheppard, L. (2020). The Social, Political, and Economic Effects of the Affordable Care Act: Introduction to the Issue. RSF: The Russell Sage Foundation Journal of the Social Sciences, 6(2), 1. https://doi.org/10.7758/rsf.2020.6.2.01

Centers for Medicare & Medicaid Services. (2021). History. https://www.cms.gov/About-CMS/Agency-Information/History.

Medicare Resources. (2022). A brief history of Medicare in America. https://www.medicareresources.org/basic-medicare-information/brief-history-of-medicare/.

Norris, L. (2021). ACA Medicaid expansion in Florida. https://www.healthinsurance.org/medicaid/florida/.

Peled-Raz, M. (2017). Human rights in patient care and public health—a common ground. Public Health Reviews, 38(1). https://doi.org/10.1186/s40985-017-0075-2