Regulations are laws, principles or rules that govern people’s conduct. The government uses regulation to influence the interaction and behavior of people and at the same time shape incentives. Regulations fall under various categories including; codes of practice, accreditation programs, principal acts, agreements and policy guidelines. In the field of health care, regulations can be imposed on the practice itself, health insurance firms, health care providers, health insurance bodies and health care professionals (Novak, Berg and Wilson, 2010).
Role of governmental regulatory agencies and its effect on the health care industry.
The role of governmental regulatory agencies in healthcare is to oversee the monitoring of both institutions and practitioners within the health care industry. These agencies also offer information relating to changes within the industry. In addition, governmental health care regulatory agencies ensure the safety and compliance with legal frameworks governing health care practice in order to promote the provision of quality services. To achieve this, governmental regulatory agencies develop rules and guidelines to govern the activities of the health care industry. The Regulatory agencies fall under federal, state or local levels of mandate. In addition to mandatory oversight regulatory agencies, there are also other agencies involving voluntary participation such as those dealing with accreditation services. These accreditation agencies promote quality through certification of facilities and individuals on the basis of qualification to provide certain health care services (Lockwood, 2014).
The main aims of regulation include; quality enhancement, cost control and expansion of access to health care. These objectives are often confrontational with each other as promoting one works to oppose the promotion of the other. For instance, while medical accreditation helps to promote quality, the move reduces the number of players in the industry. This makes those few that remain in operation to hike prices of their services, hence limiting access for those unable to afford.
Health care regulation is very essential as it ensures that the public remains protected from health risks. The system of regulation, however is influenced by various forces including agencies, regulations and statutes which are subject to change with time. In addition, the process of regulation is complex as it is not only the interaction between the healthcare industry and the government but it also involves various government levels of regulators resulting in confrontational situations that require compromise to allow the system to work. It is the responsibility of government regulators come up with regulations based on candid evidence while at the same time considering the views of all the parties affected by their actions (Field, 2007).
Effects of government regulation on the health care industry.
The process of regulation despite its complexity has succeeded in supporting and nurturing the health care industry as a whole. Physician competence has improved through licensure and this consequently leads to enhancement of public confidence in health care provision. In addition, the food and drug administration (FDA) process has led to improved safety in drug prescription. As a result, the health care industry has earned more respect leading to the expansion of its product markets. Moreover, the financial base of the industry has been enhanced through regulatory programs related to funding, for example, Medicare (Field, 2007).
Health care regulation has its shortcomings when it comes to its effect on the health care industry. The confusion brought about by different licensing arrangements makes the operation of health care institutions difficult. Regulation also acts as a barrier to the establishment of new facilities for health care provision. In addition, regulation increases the time for approving new drugs delaying the introduction of new medicines that could help save lives. Moreover, regulation encourages monopoly power as free entry and exit into the health care market is limited (Novak, Berg and Wilson, 2010).
Examples of laws and regulations currently faced by the health care industry.
Health Insurance Portability and Accountability Act (HIPAA)
The HIPAA aims at improving insurance coverage for healthcare by promoting its portability and continuity. It also combats abuse and fraud within the health care delivery system. In addition, the HIPAA is mandated to encourage the utilization of savings accounts for medical purposes. Another objective of the Health Insurance Portability and Accountability Act is to ensure the accessibility of services for long-term care as well as their coverage. Moreover, the HIPAA aims to ensure the simplification of health insurance administration (Indian Health Service, 2006).The HIPAA also protects the privacy of patients regarding their health information through setting up of standards to govern the disclosure of their information by healthcare providers.
Effects of HIPAA to healthcare providers
Protection of the privacy of patient information prevents health professionals from exchanging medical data hence hindering the timeliness and quality of care. With the enactment of the HIPAA, accountability has increased as advanced technologies are used to detect and identify persons who are accessing information at various levels. Application of the Act is sometimes difficult for professionals as health information is complex in nature and, therefore, misinterpretations lead to delayed health care provision. In addition, the costs involved in the efforts by healthcare providers in their effort to comply with the HIPAA regulations are usually high, sometimes requiring infrastructural investments. Moreover, the HIPAA regulations have been known to inhibit research as access to and sharing of medical information is not allowed especially when human subjects are involved (Dorward, 2014). I have been able to observe this effect of the HIPAA in my community especially concerning the privacy of patients’ medical information. In this era of HIV/AIDS the application of the HIPAA privacy regulation has been very significant owing to the stigma associated with the disease. Using human subjects for research on the disease has been difficult and in my opinion, I believe this has contributed to the delay in finding cure for the disease.
Another effect of the HIPAA has been a continuity of coverage. This effect has helped many families in my community as people have the right to acquire health coverage when they lose the previous. Those who change their status after getting married or when new dependants come to existence gave benefitted a lot from the HIPAA regulation.
Occupational Safety and Health Administration (OSHA).
The Occupational Safety and Health Administration (OSHA) is a regulation that was designed to make sure that all workers work under healthy and safe conditions at their place of work. Under the OSHA regulations, all employers are required by law to provide a working environment that is free of hazards that could harm employees physically or cause death. It is a requirement under OSHA that all organizations that fall under OSHA regulation ensure compliance with its workplace standards as stipulated under its occupational guidelines. These companies must keep records of the activities that are of relevance to the safety and health of employees. These records include those pertaining to OSHA regulations compliance, research, injuries, deaths and injuries in the course of duty, and records on potential hazards at work (Inc., 2014).
Effects of OSHA on healthcare providers
The safety of healthcare professionals has improved and injury rates reduced under the OSHA regulation. The OSHA regulations have also empowered healthcare professionals as they are able to voice out their grievances related to safety at work, and hence their unions have been able to attain the attention of employers to get them to address their concerns effectively. Through this empowerment, health professionals especially in the business of health care provision have gained more leverage with respect to top management (Silverstein, 2008). The effect of OSHA on employee empowerment is evident in my community, characterized by employee industrial strikes. Employees from many hospitals, including nurses and doctors, have staged demonstrations on the basis of poor working conditions.
While the OSHA regulation has achieved many benefits, the regulation has, on the other hand, resulted in job instability as employer –employee contracts have become short-term and independent contracting has increase. This scenario has led to stressful situations among employees, in this case, the healthcare professionals (Silverstein, 2008). I have seen this effect in my community. For instance, I have come to realize that very few companies in my locality are hiring staff on permanent contracts. Employment is now on short-term contracts that are renewed every few months and I believe that employers are adopting this approach to reduce liability that happens to be greater when the employment is on a permanent basis.
Dorward, L. (2014). The Positive and Negative Effects of HIPAA Employment Laws: Retrieved from. http://smallbusiness.chron.com/positive-negative-effects-hipaa-employment-laws- 18500.html
Inc. (2014). Occupational Safety and Health Administration (OSHA): Retrieved from. http://www.inc.com/encyclopedia/occupational-safety-and-health-administration- osha.html
Indian Health Service. (2006). Laws, Acts and Regulations Affecting Health Care: Retrieved from. http://www.ihs.gov/businessoffice/ROM/Part1/ROM_P1_2.pdf
Field, R. I. (2007). Health Care Regulation in America: Complexity, Confrontation and Compromise: Oxford university.
Lockwood, W. (2014). What Are Health Care Regulatory Agencies: Retrieved from. http://www.ehow.com/about_5187634_health-care-regulatory-agencies_.html
Novac, J., Berg, C. and Wilson, T. (2010). The Impact of Cost of Health Sector Regulation: ACHR.
Silverstein, M. (2008). Getting Home Safe and Sound: Occupational Safety and Health Administration at 38: American Public Health Association.