Health Policy and Reforms

                                   Health Policy And Reform

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A CASE ON  INSURANCE COMPANIES

Health Policy and Reform is formulated to tackle problems and changes that arise in the country. It identification the problem, study it and commencement of designing a model that will be used in the policy-making process. If all Americans join the system, the pre-existing condition will not exist. This is because the Government will deny the insurers the freedom to set pre-existing conditions. Insurance premiums will not be increasing. The insurance companies covering the individuals will garner profit although they will be closely to avoid damaging the system. The insurance companies will refer ‘sick people’ as those who want constant care because of their recurring illnesses. They will have higher premiums than the rest.

CONSEQUENCES OF ADDITIONAL 50 MILLION ENROLEES

Medical practices in America are set to change after the large additional number of enrollees in the system. The institutions workload is set to increase immensely leading to increased workers stress levels which will, therefore cause an increase in workers’ demands. With increased workload and reduced workforce ensuring quality care in the industry will be very hard. Paperwork is set to increase and therefore there will be a significant reduction of time that is spent with patients and increased provision cost for quality care. Dissatisfaction among health personnel will be due to the increased stress levels by the workers. These new regulations enacted will lead to lower reimbursement rates and therefore investments in new staff, technology and institutions will be hard to break even.

IMPACT OF MEDICAL PRACTICES REFUSING TO TREAT MEDICAID PATIENT

Doctors who refuse to treat Medicaid patients show a lack of support by the health workers. Those patients insured under Medicaid may die in the process. People looking for those services will have little confidence on those nursing facilities and hence lose trust on the health care system. This will be a failure in implementation of the Act by the Government.

HOW NURSING FACILITIES WILL PREVENT HEAVY OVERLOADING

There is influx of tens of millions of uninsured patients who are turned into paying patients. Many doctors are forced to close their list to new patients. However, doctors are advised to set appointments to patients although this will increase the waiting time a bit longer.  There are efforts to tackle this problem. For instance, Physicians are told to share some responsibility to midlevel staff. A model for scheduling fixes  is to be designed so that urgent patients are given appointments first. There should also be an extension of office hours to meet the demand. Patients can connect to the physicians through virtual care. Practices should also drop insurers who do not satisfy them.

HOW MEDICAID OPERATE FROM STATE TO STATE

States rolled out eligibility requirements from January 2011. However, all parents, childless adults, and children from January 2014 were eligible if their income was at least 133% FPL and had previously not qualified to access Medicaid are eligible to access it. In 2014-2016, the Government will be pay for new enrollees. States that would have covered less new enrollees in the year 2016 to 2014 will receive more assistance than expansion states. The states are to keep income eligibility level the same throughout to September 30, 2019.

PROVISIONS OF PATIENT PROTECTION AND AFFORDABLE ACT

The Act ensures that every American access quality health services which is affordable and the healthcare sector will be transformed to contain its cost. The Act   is said to cover 94% of all Americans as determined by the Congressional Budget Office. It has nine provisions each addressing a constituent of reform:

1. The Act ensures that there is quality and affordable healthcare for all Americans. Affordability is achieved by removing the pre-existing conditions that were used to discriminate people. All Americans are required to join the system and they must have coverage. There will be tax credits for families and individuals who cannot afford.
2. The Act will extend eligibility for Medicaid to lower income earners. The Government will pay for the cost of expansion. Children’s Health Insurance Programs will also be enhanced. The Act will also make enrollment easy and the Community first choice option will avail to those who are qualified.
3. The Act will enhance the efficiency and quality of health services by improving the infrastructure, linking payment services to services outcomes and creation of new patient care models.
4. The Act will ensure that chronic diseases are prevented and public health is also improved. The services will be catered for by the establishment of Prevention and Public Health Investment Fund.
5. The Act will ensure that there is innovation in workers training, recruitment, and retention. There will also be the establishment of new health workers Commission this aims to increase the number of personnel in the workforce.
6. The Act will ensure that there will be integrity and transparency in the projects financed by the Federal government.
7. The Act ensures that access to medical therapies will be improved.
8.  The Community Living Assistance Services and Support will purchase the long term Insurance program which will be established by the Government for their benefit.

1. The excise tax will be high for Employer -Sponsored Health Coverage that is above $8500 for a single cover and $2300 for family cover.

EFFECTS OF NEW ENROLEES ON NURSING FACILITIES

With the increased enrollees each day, nursing facilities continue to experience more workload.  More paperwork cuts the time medical workers spend with patients. Low reimbursements deprive the institutions of investing in new technology, more employees and additional training and workshops which willl automatically lead to poor quality care.  Quality care issue will only balance if the reimbursements will keep pace with the requirements of labor cost in the nursing facilities.