BHA-FPX 4112 Assessment 3 National Health Insurance in the United States

BHA-FPX 4112 Assessment 3 National Health Insurance in the United States

National Health Insurance in the United States Sample Paper

Introduction

  • The United States does not have a universal health insurance coverage
  • Nearly 92% of the population had insurance coverage in 2018.
  • About 27.5 million people (8.5% of the population) have no access to insurance coverage, thus are uninsured (Keisler-Starkey & Bunch, 2021 BHA-FPX 4112 Assessment 3 National Health Insurance in the United States).
  • Medicare and Medicaid Acts of 1965 remain the only government-initiated insurance programs accessible to the public.
  • US citizens can access private insurance coverage in the form of employment-based plans, direct purchase, and TRICARE.
  • Alongside Medicaid and Medicare, the Civilian Health and Medical Program of Hd Department of Veterans Affairs is a public insurance coverage.
  • The US spends almost twice the OECD average expenditures for healthcare ( Nunn, Parsons & Schambaugh,  2020).

BHA-FPX 4112 Assessment 3 National Health Insurance in the United States

The Impact of Medicare and Medicaid

  • The US government enacted Medicare and Medicaid in 1965 through the social security act
  • Before 1965, only employees accessed employer-sponsored health insurance introduced in 1920s
  • Medicare ensures a universal right to healthcare for persons aged 65 and older
  • Medicaid provides cover to low-income families, the visually impaired, and individuals with disabilities.
  • Medicaid and Medicare inspired the enactment of Children’s Health Insurance Program (CHIP) of 1997.
  • The Affordable Care Act (ACA) of 2010 required states to expand  Medicaid to address the problem of uninsured population.

Impact of Medicare and Medicaid Continued

  • Medicare and Medicaid policies have significantly reduced the number of uninsured and underinsured populations.
  • Some states operate the Children’s Health Insurance Program (CHIP) as an extension of Medicaid.
  • Many states expanded Medicaid in 2014 to incorporate additional provisions, including:
  • Extending coverage to young people.
  • Expanding Medicaid eligibility to accommodate the uninsured population.
  • Open health insurance marketplace (Tikkanen et al ., 2020).

The Feasibility of Expanding Medicare and Medicaid

  • Every American should have equal access to affordable healthcare services regardless of their socio-economic or demographic diversities
  • Over 28.7 million people (8.9 % of the total population) have no access to health insurance covers .
  • The number number of uninsured people is set to increase to 37.2 million by 2028 due to affordability issues and complexities in the US insurance markets.
  • Expanding Medicare and Medicaid would fulfill the triad goals of accessibility, affordability, and equity (Shrank et al., 2021)
  • Expanding Medicare and Medicaid will enable states to collaborate with the national government to strength insurance marketplaces to provide people with multiple options.

The Implications of National Health Insurance

  • The national health insurance has implications on care accessibility, utilization, technological advancements, cost, and economic growth.
  • The United States does not have universal health insurance cover.
  • Not all Americans are eligible to Medicare and Medicaid insurance covers-an aspect that limit accessibility and care utilization.
  • Medicaid expansion has ushered an era of technological advancements to accommodate increased demand and enhance processes (Suennen et al., 2021).
  • An absence of a universal health care results in poospending patterns, increasing the cost of care and hampering economic growth (Zieff et al., 2020).

Pros and Cons of National Health Insurance in the US

Pros

  • Medicaid expansion provide opportunities for increased insurance coverage
  • Medicare and Medicaid address health disparities by promoting accessibility, equity, and affordability (Shrank et al., 2021).
  • Medicaid expansion facilitates technological advancements (Suennen et al., 2021).
  • National government’s involvement in controlling national health insurance reduce competition for private insurance providers, reducing the likelihood of manipulating consumers.

Cons

  • Lack of competition in Insurance marketplaces hamper the cost-effectiveness of Insurance premiums

Pros and cons of National Health Insurance Cont’d

  • Lack of a universal health insurance exacerbates disparities within social determinants of health
  • The United States spends far more per Capita on health care than other wealthy countries without the plausibility of improving care (Crowley et al., 2020).
  • Variations in deductibles, copayments, premiums, and coinsurance among insurance providers increase their costs, limiting affordability.
  • Healthcare reimbursement models for the national health insurance remain a primary concern.
  • Policymakers in the healthcare sector should reform the national insurance by changing reimbursement models and encouraging market competitiveness.

Necessary Reimbursement Changes for the National Health Insurance

  • Up to today, the US uses the national health insurance model to fund the Medicare coverage.
  • Private insurance and out-of-pocket models are common reimbursement models in US.
  • The Bismarck system (social insurance model) applies to the employer-sponsored insurance in the country.
  • Policymakers should change these models to accommodate advanced reimbursement systems such as the single-payer model, capitation, and the bundled, value-based payment system.

Operational Changes for Transitioning to Universal Healthcare Insurance

  • Transitioning to universal health care significant upfront cost rated to physical and infrastructural change (Zieff et al., 2020).
  • Healthcare professionals should collaborate with hospital insurers, patients, and governments to ensure effective transitioning.
  • The state and federal government should collaborate to address healthcare disparities.
  • Transforming outpatient specialist care is essential for enhancing care coordination and address disparities.
  • Capitating payment for healthcare insurance is a step towards achieving value-based purchasing system (Shrank et al., 2021).

Conclusion

  • Every American should have access to affordable and quality care
  • Medicaid and Medicare are the primary public insurance coverage that cater for older adults, low-income families, and people with disabilities.
  • The absence of a universal health insurance leads to high premiums, coinsurance, and copayments, contributing to inequalities and inaccessibility.
  • The country should transform the existing reimbursement models to accommodate advanced options such as single-payer model, capitating payment, and value-based purchasing.
  • These options require interdisciplinary and stakeholder collaboration.

BHA-FPX 4112 Assessment 3 National Health Insurance in the United States References

Also Read: BHA-FPX 4112 Assessment 2 The Supply and Demand of Health Care