Global Perspective on Health Policy
A macro perspective on health policy issues has been addressed in this paper. This paper identifies how health insurance problems became a policy issue and how this issue resulted in the creation of health care policy.
Controversial issue in health and how this issue has resulted a policy's creation
The American health insurance system is riddled with drawbacks, for instance, continuously escalating premiums, and finding decent coverage. Employers seldom provide health insurance; as well, car insurance and house insurance is not covered by employers (nor should they be). One deficiency of employer-provided health insurance is that there are fewer options to choose from while selecting from the sponsored health plans. This holds true for the various companies which provide various kinds of insurance for house and cars. This is because the health insurance market is not the same as the automobile and/or home insurance market. In case of health insurance, an employee has 2-3 plans provided by the employer to choose from irrespective of the plan meeting / not meeting the needs of an employee and might well be the products of just one insurance company. Another demerit of obtaining an employer-based health insurance policy is that in event of resigning from the job, the employee's health insurance is revoked, which may be a grave matter in this present market (Basu, 6).
In case of unavailability of a new job with health insurance, or during a period of hiatus, the individual will have to browse through the local marketplace for suitable health insurance. With an existing medical condition in previous employment, premiums are much higher while applying for a new health insurance, in comparison to the previous health plan during employment. The reason in this case is that pre-existing medical conditions are in a higher risk category. The health insurance application could also be rejected in this case (Basu, 6).
As a result of the above challenges related to health insurance, the Obama Administration introduced the Patient Protection and Affordable Care Act. The act proposed to have each American's health protected with basic care and have this entrenched in law. Popularly known as the Affordable Care Act and nicknamed Obamacare, the law was passed and signed by the president in March 2010. The Act did away with the exemption for previously existing medical conditions that barred insurers from covering persons based on their medical history and other conditions. It also extended insurance to over 30 million Americans previously uncovered through expansion of Medicaid and provision of federal subsidies enabling lower and middle income Americans to access private health insurance covers (HealthCare.gov).
The Patient Protection and Affordable Care Act (ACA) was promulgated in effect on March 23, 2010. One of the primary aims of this act was to manage health insurance. ACA provides health insurance consumers and providers with new ways to hold insurance companies liable. Notable characteristics of this law regarding insurance are:
Insurance choices: The primary objective of this law is to open up health care coverage to a majority of American citizens, allowing them to purchase a health insurance by law (HealthCare.gov, 2012a). The citizens can choose from Medicaid
Medicare
State based insurance coverage
Private insurance (Lachman, 248)
Insurance costs: Insurance companies are accountable under ACA. Furthermore, it is supposed to assist in keeping medical costs down for individuals; this is turning out not to be the reality.
Value for individual's premium dollar is a 'given' under the ACA. According to ACA bylaws, the insurance companies selling insurance to individuals and groups are to spend at a bare minimum 80% of their premiums on medicinal care and improving the quality of health.
Lifetime and annual limits: ACA has put restrictions and discontinued the annual dollar limit which puts constrictions on its benefits.
Rate review: Insurance companies will need to furnish proper documentation for their increases in rates for health insurance (Lachman, 248).
Rights and Protections: Under ACA guidelines, the consumers are in charge of personal healthcare instead of the insurance corporations. These rights and consumer safeguards are provided under ACA. Preventive care. The consumers won't need to pay any co-insurance, co-payment or any deductible prior to healthcare services such as counseling, vaccinations, and screenings.
Doctor choice and access to ER: Consumers can select any healthcare provider of their choice. Moreover, they can also use out-of-network providers without needing to obtain prior consent from their physician.
For people 65 and above: Under ACA, a broad range of preventive health care services exist for elders with no sharing of cost (Lachman, 248).
2. Steps in the state and federal policy...
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