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Role of the Federal Government in Addressing Key Healthcare IssuesEssay

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¶ … Federal Government in Addressing Issues of Access, Quality and Affordability (in Healthcare)

Prelude

ACA (Patient Protection and Affordable Care Act) was signed in 2010 and is the most detailed healthcare reform legislation in United States history after the Medicare and Medicaid of 1965. ACA has taken American healthcare in a new direction which stresses on primary care and health care services. It also focuses more on uninsured citizens by providing them healthcare. As per IOM (Institute of Medicine) report, 44,000 deaths have been reported due to failure in medical practices. As per 2001 IOM report, there were flaws in American healthcare system. 50 million Americans have no access to health insurance and healthcare facilities (Kaiser Family Foundation, "Five facts"). The present healthcare system is failing largely due to rising health costs (Kaiser Family Foundation, "Snapshots").

ACA has instigated reforms in the healthcare system by initiating primary healthcare services. APRN's have a successful history of primary and preventive healthcare (Keeling). Hence with ACA's initiative, the APRN's have a huge opportunity in their hands to take the steering wheel in strengthening the preventive services sector. For this opportunity to work, the nursing workforce should be competent and armed with doctoral education (Cleary & Wilmoth 2011; Lathrop & Hodnicki, 2014)

The government's role

A prime feature of the Affordable Care Act is the foundation of Health Insurance Marketplace where customers can buy their own preferred health insurance plans. When their earnings meet certain criteria, they can attain the desired health insurance. From October 2013, around 8 million Americans have subscribed to health insurance plans which suit their needs (Burke et al., 2014)

The prime motive of the Affordable Care Act is to cut down the prices of health insurance market by surging competition whilst improving the options, quality, coverage and affordability of these healthcare plans. This marketplace helps people compare the prices and qualifiers can attain financial coverage. Hence the consumers have a broader array of options at their disposal taking premiums and types of coverage in consideration (Burke et al., 2014)

Marketplace is a relatively new market, which will blossom and expand over time and competition will work differently in this scenario. The theory is that heightened competition drives down the premium rates in a market. A different theory of competition will have its own set of results. Hence, healthcare plans are different from one another and appeal to different customers. This develops customer loyalty since their relationships remains steady for a long time whilst owners of healthcare plans exert control over the pricing scheme.

One consequence of this form of competition is that pricings of different healthcare issuers will be different; offering different packages and premiums relative to competitors. Here, one will have to look into probable effects by making use of premium measures for reevaluating the results of multiple issuers (Burke et al., 2014).

ACA has extended its healthcare services via healthcare insurance expansion to 32 million uninsured Americans (Congressional Budget Office, 2012). Health Insurance Marketplace is a state owned Health Benefit Exchange that's allows people to buy their own health insurance plans and people who earn 400% and less on FPL (Federal Poverty Level) are eligible for this form of health insurance plan consisting of tax credits and cost sharing subsidies. State owned Small Business Health Options Exchange permits purchasing group insurance and accommodates tax credits for enterprises accommodating health insurance for their employees. Any enterprise having 50 and more employees are subjected to get fined if they don't offer healthcare insurance (Lathrop & Hodnicki).

Preventive services and primary care are provided via Medicaid and Medicare. State Children's Health Insurance Program has been reinstated and Medicaid caters to all individuals below / at 133% of FPL. ACA has imposed fresh constraints on health insurance plans demanding increased coverage and access to preventive services. ACA has raised the Medicaid payouts to qualifying doctors providing primary care services.

Nurse practitioners, who are included in non-physician providers, are also eligible for the increased payouts provided that they are working under a doctor's supervision. This clause can impose a financial penalty on many nurse practitioners providing quality care in various states in the absence of doctor's collaboration. Additional funding has been allocated to National Health Service Corps for promoting nursing and medical education which can boost the number of primary care personnel in deprived areas. Funding for more community health centers is also approved (Lathrop & Hodnicki, 2014).

The role I believe the federal government should play

As per ACA regulations, millions of Americans should enroll in health insurance though the American healthcare isn't ready to handle a massive intake of Americans just yet. With ACA's pressure, the present situation will worsen with more burnouts and job dissatisfaction as shortage isn't met acutely yet. Healthcare is a labor intensive industry and the destined aim of cutting down costs, satisfaction and quality health can be met when health care industry is appropriately able to accommodate an ever increasing population (Institute for Healthcare Improvement, "The IHI"). In order to implement solutions, modernization of medical training and education, quality medical care is needed whilst policies should be devised to retain the healthcare employees (Anderson, 2014)

Improve Education

The problems faced by medical field can't be addressed by public policy. Problems lie in the professional training along with terms and conditions of training and education (Anderson, 2014).

Educational financing should balance specialty practices and primary care. It needs to increase the number of graduates in the field and provide incentives to the faculty. In case of medical students looking to ease their financial burden of medical education, they can serve people who have no access to medical services / care. The policymakers should devise policies which make medical field more appealing by lessening tort liability and restrictions imposed by debt load (Association of American Medical Colleges, "Medical School Education") (Anderson, 2014)

Congress needs to reassess the present medical graduate program. Residency must be available for expected medical students incoming. Slots should be opened for rural and untapped areas to fulfill the shortages in healthcare (Anderson, 2014)

Lifting barriers to access

The cost and ineffectiveness of the healthcare system needs to be addressed which poses a barrier to quality patient care. As per a national survey, doctors and nurses jointly noted that with a wider pool of nurse professionals, the quality of care and access could be improved. As per a report from Massachusetts, with more NP's and PA's, lifting the restrictions would result in fiscal savings between $4.2 billion to $8.4 billion in the next decade. Nurses must partner / collaborate with other professionals in the field to boost productivity (Anderson, 2014)

As per Dr. Darrel E. Kirch, MD, chief executive officer of the American Association of Medical Colleges, the medical community should train an extra 4000 doctors / year (Association of American Medical Colleges, "Report Shows"). The models of healthcare demand a reassessment with apparent shortage of personnel and facilities along with an aging population (Anderson, 2014)

Promoting efficient care delivery

The building blocks of healthcare industry is human capital. Health care services are labor intensive, hence recruiting and retaining competent employees is imperative. On the whole, the employees should be empowered with innovation in role and task allocation (American Hospital Association). With boosted productivity and efficiency, employees can deliver stellar patient care (Anderson).

Systematic analysis will be required to attain operational efficiencies of medical professionals (Institute for Healthcare Improvement, "Gap Analysis"). To enhance work flow and coordination, professionals need to focus on team-based collaboration. Health professionals should be aware of their own job description and assign tasks to necessary personnel (Anderson, 2014)

Nurture the work environment

Increasing retention means increasing incentives. Incentives consist of a mixture of public policies for instance

Lessening liability by tort reforms

Federal tax rates

Medicare payment reforms

In case of private sector, healthcare organizations need to implement best practices for hiring and retaining employees (American Society of Healthcare Human Resources Administration). Retaining the talented individuals will be a huge undertaking for human resource department which will take in consideration incentives such as:

Education

Benefits

Career advancement profit sharing

Interventions are needed for evading excessive work load and manage stress to ensure replacements and work related issues (Anderson).

Last but not the least; the employees shouldn't have to follow the debauched directives of their bosses and letting go of their own moral conscience. Congress should enact a legislation which establishes rights of health care employees for their conscience's well-being. Apart from that, legislation must be enacted in states which put a limit on the amount of workload on the employees in state hospitals and privately owned hospitals for that matter (Anderson, 2014).

Works cited

American Hospital Association. Workforce 2015: Strategy Trumps Shortage. 2010 Jan. Web. 4 thMarch 2015

American Society of Healthcare Human Resources Administration. Attracting, On boarding and Retaining Employees Within the Health Care Industry, e-News Brief, (2011 Jan 12) web. 4 March 2015.

Anderson Amy. The Impact of the Affordable Care Act on the Health Care Workforce.… [END OF PREVIEW]

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