GCU HLT605 Week 2 Public Health Reform Paper

GCU HLT605 Week 2 Public Health Reform Paper

Doctors treat individual patients one-on-one for a specific disease or injury. Thus, patients need medical care only part of the time namely, when they are ill. Public health professionals on the other hand, monitor and diagnose the health concerns of entire communities and promote healthy practices and behaviors to assure our populations stay healthy. Thus, communities need public health all of the time in order to stay healthy. The United States Public Health Service comprises of several national agencies such as “The Centers for Disease Control; The National Institutes of Health; The Food and Drug Administration; The Health Resources and Services Administration; The Alcohol, Drug Abuse, and Mental Health Administration; and The Agency for Toxic Substances and Disease Registry.”

GCU HLT605 Week 2 Public Health Reform Paper

Public health overview

Per, The Institute of Medicine (1998) “The federal government plays a large role in the public health system in America. It surveys the population’s health status and health needs, sets policies and standards, passes laws and regulations, supports biomedical and health services research, helps finance and sometimes delivers personal health services, provides technical assistance and resources to state and local health systems, provides protection against international health threats, and supports international efforts toward global health.”

The federal government role includes regulating state commerce and levying taxes for the purpose of paying for the overall welfare of the public, such as labeling hazardous substances, providing hazardous substance cleanup services focused programs even financing personal health services through Medicaid and Medicare programs, are based in its power to tax and spend for the general welfare (I.O., 1998 GCU HLT605 Week 2 Public Health Reform Paper). The model used to manage the health programs of the federal government is through the use of grants mostly to the state and local city governments but also with illegible private organizations and providers.

By taking the money from the federal government the state and other private organizations and providers are bounded by contracts to adhere to the policies and standards established by the federal government. This partnership has proven to inspire a myriad of innovative ideas as the different agencies compete and coordinate efforts related to specific public health issues. The contractual collaboration allows the federal government to exercise authority through the roles of ownership of the oversight, setting of policies and providing of technical assistance to help create successful programs and outcomes even though they are not providing direct care.

The constitution allows individual States to create and enact public health laws that reflect the morals, safety and overall wellbeing of their residents. The enforcement of the state laws is done by the use of their local police force. The unfortunate thing per The World Health Organization (2013) America has poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions even though they spend more on health care. GCU HLT605 Week 2 Public Health Reform Paper

Strength of the Affordable Care Act

Even though everything had pros and cons the Affordable Care Act is no different. Some of the strengths of the Affordable Care Act includes: Being allowed to keep your children on your health insurance plan until the age of twenty-six increases the number of healthy enrollees and the profits for insurers by 3 million over the next decade but most of all it is peace of mind for parents. Especially relieving to those parents with children entering college.

Preexisting conditions are no longer a reason for insurance companies to deny anyone coverage or in event and enrollee get sick they cannot be dropped or have premiums increased. This is answered prayers to may cancer patients. Insurance plans were mandated to cover mental health, addiction, and chronic diseases and remove the limits on lifetime and annual coverage limits (Amadeo, 2018 GCU HLT605 Week 2 Public Health Reform Paper). You saw the positive reimbursement difference for mental health patients after the 2010 Affordable Care Act was enacted because mental health patients could not be denied coverage.

Weakness of the Affordable Care Act.

One of the weakness of The Affordable Care Act is that it failed to address the existing problems related to the cost of healthcare. The law seems to think subsidizing premiums for Americans who were unable to afford health insurance without correcting the already overpriced insurance structure as an answer to healthcare access. The hope was that with an increase in the insurance pool it will be big enough to lower healthcare cost lower than if left the pool for people to buy insurance only when they got sick.

To put things in prospective, the 2010 Affordable Care Act per Brill (2017 GCU HLT605 Week 2 Public Health Reform Paper) “was more conservative and more pro-private sector than what Richard M. Nixon proposed in the 1970s, or what Republican Gov. Mitt Romney implemented in Massachusetts in 2006, in fact is was more of what long standing Republican alternative to the healthcare reform proposed.” GCU HLT605 Week 2 Public Health Reform Paper

Failing to put laws in place to manage the healthcare cost allowed drug companies, medical device makers and hospitals to abuse this loop hold by overpricing for services and creating the current problem of increasing of insurance plan premiums causing  even some insurers to abundant the market because they are unable to afford the high costs. The polarized political atmosphere does not help in the fixing the healthcare cost problem because the current proposal by the Republicans still does nothing to address healthcare costs. GCU HLT605 Week 2 Public Health Reform Paper

In fact, the proposal locks out millions of poor people who are unable healthcare in order to provide the tax cuts for the wealthy. The proposal on the table presented insurers to create low cost inferior healthcare plan options instead of attempting to cap the inflated cost. The result was that the healthier people who did not need full coverage opted for the less costly plan along with those who actually need full coverage but can only afford the low-cost plan. This ends up being a negative outcome for both the insurer and member because as the cost escalates the insurer risk losing the member and the member’s general health declines due to inability to pay for care.

A few solutions to correct the current healthcare cost includes: changing the rates charged from 3:1 (older adult to younger adult) to 5:1 and then offered subsidizes that allow older adults on a fix budget to afford healthcare. This will also encourage younger adults to enroll in insurance.  Allowing for the implementation of competitive bidding for medical devise and equipment can save the Government at least $50 billion dollars over the next decade if Medicare is allowed to negotiate the prices (Brill, 2017 GCU HLT605 Week 2 Public Health Reform Paper). The money saved can be reallocated to other needed areas like providing support for increase premium for older enrollees. Medicare bundled payments have worked well in surgery cases where savings was realized without harming quality of care.

This same model can be extended to other areas such as knee and hip replacements or cardiac surgery because savings happen by holding one of the treating entities responsible for the entirety of a patient’s care during an episode by ensuring that the patient receives high-quality and efficient care from the other participants in the delivery chain. Simplifying the medical billing alone can save 20% of healthcare cost, helping payers and providers achieve a win-win (FACS, 2017 GCU HLT605 Week 2 Public Health Reform Paper).

Lesson learn

Given the pros and the cons of the Affordable Care Act one can conclude that there is more benefit in improving the plan as oppose to dismantling the plan. GCU HLT605 Week 2 Public Health Reform Paper

GCU HLT605 Week 2 Public Health Reform Paper References