This research paper explores the reforms made in the health care sector to ease service delivery and access to health care and include: insurance reform; quality of health care; cost and efficiency; reform of health service provider’s incentives; and tax reforms. Health care reform eliminates the disparities in provision of health care and ensures smooth running of operations in the health care sector
These reforms aim to make insurance rules and regulations more flexible and thus more accessible to the public and to reduce the manipulative tendencies of many insurance companies.
Quality of Health Care
Reforms aim to increase the quality of healthcare citizens receive. They address factors like shortages and remuneration issues of health care providers, and ensuring that health practitioners provide quality service by allowing the public to sue for negligence in the event that it occurs.
Cost of Health Care
They should also include adjusting the cost of accessing health care without undermining efficiency through the provision of incentives to subsidize the cost of health care.
The government should intervene by providing incentives to subsidize the cost of health care.
Tax Reforms in Insurance
The taxation in premiums in medical insurance should be lower than those for other policies to make it more accessible to the public.
Conclusion- summary of health care reform and their effects on health care provision.
Health care reform has been an issue of political concern in many countries as governments seek to increase access to health care to its subjects (Fernandez, 2009). Health care reform is about the general rules and policies that the government and parties in the health sector should introduce to make delivery and access to health care affordable and easier in a given country. Health care reform eliminates the disparities in provision of health care and ensures smooth running of operations in the health care sector. This research paper explores the reforms made in the health care sector to ease service delivery and access to health care and include: insurance reform; quality of health care; cost and efficiency; reform of health service provider’s incentives; and tax reforms.
Health care reform seeks to increase the number of citizens that receive health care. This increase is possible through public sector and private sector insurance programs (Forman, 2010). The insurance companies provide cover to citizens to caution them against the high medical costs in hospitals. However, most of the insurance companies have strict rules and restrictions regarding their policies, which make it difficult for people to access them. The aim of the insurance reform is to lessen the rules applied by insurance companies so that people can access them. Many insurance companies put restrictions on the types of conditions they can cover. Some insurers refuse to cover certain terminal illnesses such as cancer and HIV/ AIDS, while others increase the amount of premiums if they have to cover these conditions. Other insurers demand high premiums from women and some may even cancel a cover despite the client having paid high premiums. These insurers cancel the policies if presented with expensive medical ailment.
The aim of the insurance reform is to deal with the manipulative insurance companies and ensure citizens have a medical insurance cover. The reforms will also ensure that employers provide a medical insurance cover for their employees. For example, in the U.S. the government fines employers that do not provide a minimum standard of medical insurance cover for their employees. Additionally, the employees should purchase their own private medical insurance covers that can assist them in case of an emergency. “In the U.S., it is mandatory for employees to purchase a private medical cover in addition to the one provided by the employer” (Kronenfeld & Kronenfeld, 2004, p. 123). The objective of these reforms is to ensure access to health care for all citizens.
The laws imposed on the insurance companies will allow government to tax certain expensive insurance policies. The money from the taxation will provide medical cover to poor citizens that earn lesser incomes so that they can purchase their own insurance cover. To further reform the insurance sector, governments should ensure that few insurance companies do not dominate the industry. Few insurance companies can create monopoly and charge high premiums thus, hindering access to suitable health care because people will not have the money. However, the government can intervene by licensing a non-profit insurance company that can provide medical cover to citizens. Reforms in the insurance sector are vital because they allow people to save for an emergency. The government should take the onus and control the operations of these companies so that they provide medical covers justly. The citizens will thus be able to access cover for all conditions and improve access to health care.
The health care service providers are vital in the health care because they are at the center of service provision. The government should take the responsibility of reforming the health care providers by dealing with the shortage and remuneration issues of health care providers (Jacobs & Skocpol, 2010). Most health care sectors, especially the public sector, experience shortages of nurses and doctors and this impede the provision of quality services. Health care providers shy away from these facilities because of the poor remuneration they get from the government for their services. The shortage of physicians can be a great obstacle in providing quality health care.
The government can change the situation in health care facilities by hiring more staff. The array of health care specialists will give clients variety to choose from and improve health care delivery. The service providers will also require adequate remuneration and other incentives to boost their morale as they provide the services. The number of health care specialists should also be a matter of concern so that clients with serious medical conditions can have access to the specialized treatment. Statistics indicate a shortage of about 40,000 primary health care doctors by the year 2020 (Forman, 2010). Most countries expect to experience this great number because of the drop in the number of medical students opting to train in the field of primary care. The number of registered nurses and doctors is also reducing because of students choosing other fields of study. Consequently, this situation may affect access and delivery of health care to citizens. The government and other stakeholders can intervene by encouraging enrolling in the medical schools and taking up those courses. This enrollment will ensure that the number of graduates that can provide specialist health care increase.
Quality health care is a matter of concern in most countries. Some health care providers have been neglecting quality in health care provision costing people’s lives. The government and stakeholders in the medical field can take strict measures to ensure provision of quality health care services. The medical boards can withdraw the licenses of the health practitioners that are negligent in their duties thereby causing death or deformation of a client’s health. To ensure quality, the government will allow citizens to sue health care providers that are negligent in their duties with clients. These reforms will ensure that the health care practitioners are careful in their work and have minimal cases of preventable deaths or health malformations. The result of careful practices is improved access to quality health care in the facilities.
The objective of health care reform is to ensure provision of care to all citizens irrespective of their background. Thus, it will be necessary for the government and stakeholders in the medical field to change the administration of health care facilities to ensure fair provision of services to all (Sage, 2011). Some health facilities discriminate clients based on their age, social cultural background, financial stability and the type of medical condition. Other health care facilities cannot offer health care before the patient pays a certain amount of money despite the patient’s condition being an emergency. It is essential that this situation change to allow access to health care for all citizens in a country. Reforms in the health care facilities should deal with the bureaucracy in provision of services. Health care facilities should act on all emergencies without demanding prior payments from patients.
Reforms in health care will ensure that facilities provide health care services to all irrespective of their medical conditions and age. Some facilities analyze the medical conditions of patients before they decide to serve them. The elderly face discrimination in most facilities because their conditions require much care, which some facilities are not willing to offer. The government should take strict measures on these facilities and their administration to ensure that they offer their services to all without discrimination (Jacobs & Skocpol, 2010). The facilities should change their constitution and include everyone in their provision of their services because health care is about saving lives. Health care providers should learn the ethical principles related to their work to ensure that they treat all clients equally. This training is part of the reforms that health care facilities should embrace to ensure effective provision of care.
The reforms in the health care should also include adjusting the cost of accessing health care without undermining efficiency. The government should intervene by providing incentives to subsidize the cost of health care. Many low-income earners cannot access quality medical care because of the high cost associated with the care. They end up receiving poor services from facilities, which could deteriorate their health. The health care reforms should attempt to decrease the cost of care especially for the poor. The government can provide drugs to the public facilities to reduce the cost of patients purchasing these drugs at chemists (Sage, 2011). Additionally, the government should provide subsidized services at the public facilities to ensure the poor can afford them. The health care providers should also be sufficient in these facilities to ensure quality as patients have many professionals to serve them. These reforms will go a long way in improving health care provision.
One of the sensitive areas in health care reform is the insurance companies. Debate ranges on about the taxation of premiums contributed to the insurance companies meant for covering medical care of clients. The government insists on the taxation of these premiums because sometimes not all clients get sick so they do not use the medical cover. The government argues that without taxation of these premiums, some companies will be making profits at the expense of the clients. On the other hand, insurers claim that those premiums should not be taxable because sometimes they face expensive medical bills to pay for their clients. Thus, if taxed, insures may not be able to cover their client’s medical bills. I believe that the taxation rate of insurance premiums for medical cover should be lower than that of other premiums. This will ensure that insurers can provide medical cover for clients without hitches. Changes in the taxation rates will assist employers determine the amount of cover they can expect for their employees (Forman, 2010. These reforms will make health care affordable and accessible to all.
Health care reforms aim at achieving effective provision of health care services. These reforms attempt to reduce the cost of delivering and accessing health care. They ensure that most citizens of a country can access an insurance cover for their medical care hence reducing cost. Besides, the reforms ensure that patients have many health care practitioners from which they can choose. The government and stakeholders in the medical field should be at the forefront in advocating for these reforms to transform the health care sector. In the end, these reforms should ensure accessible and affordable health care.
Fernandez, B. (2009). Health care reform: An introduction. CRS Report for Congress.
The report analyzes the concerns raised by Congress on the need to reform the health care
sector. It analyzes issues such as cost, quality and spending. The report provides
information the scope of reform in the health care sector.
Forman, L.E. (2010). Health care reform. Minnesota: Abdo Consulting Group, Inc.
Provides an evaluation of the U.S. health care system, the reforms in the health care
sector and the plans for improving the health care provision. The book is useful because it
provides information on the necessary reforms that the health care sector should adopt.
Jacobs, L.R. & Skocpol, T. (2010). Health care reform and American politics: What everyone
needs to know. New York: Oxford University Press.
Discusses the effects of politics in health care reforms. The book describes the timeline of
health reforms and how politics affect them. It provides useful information on the need
for reforms in health care.
Kronenfeld, J.J. & Kronenfeld, M.R. (2004). Healthcare reform in America: A reference
handbook. California: ABC-CLIO, Inc.
Describes the health care reform in America and the government’s role in ensuring strict
adherence to the reforms. Useful in providing information on health care and the reforms
embraced to ensure quality health care services.
Sage, W.M. (2011). Brand new law. The need to market health care reform. University of
Pennsylvania Law Review, 159(6), 2121-2146.
The author describes the benefits of accessible health care and health care reforms. The
journal is useful because it outlines the necessary reforms in health care and the need for these reforms in a country.