- BHA FPX 4112 Assessment 3 National Health Insurance in the United States.
Slide 1: Medicare and Medicaid
• Discuss the impact of Medicare and Medicaid on the healthcare system.
Medicare and Medicaid further created access to care for the more seasoned, low-income families. Because of Medicare and Medicaid, the standard of care was moved along. Medicare and Medicaid have done more than any other program to change the presence of Americans for the better. Medicaid is a social welfare program, while Medicare is a social insurance program. Because of Medicaid, more adolescents could have their well-kid physicals with vaccinations. More pregnant women were able to have safe pregnancies and conveyances. More than that, Medicaid dealt with the health of considerably more low-income individuals, thus improving access to care and closing the income disparity gap.
Medicare further created access to care for Americans beyond 65 and 65 years old, for those under 65 with disabilities, for example, End Stage Renal Disease. As mentioned, Medicare is a social insurance program that Americans pay into through manager deductions. Once a person reaches retirement age, they are then qualified for Medicare. Explore our assessment BHA FPX 4112 Assessment 2 The Supply and Demand of Health Care for more information.
Slide 2: Coverage for All:Single-Payerr System
• Determine the Feasibility of expanding Medicare and Medicaid into national health insurance available for all Americans.
How about we initially discuss the obvious: Universal Health Coverage for Americans would save lives! When ranked with other equally advanced nations, it has been established that the United States was placed last in access to care, results, administrative proficiency, and value (Nutty et al., 2021). Australia, Germany, and Switzerland ranked most significantly in value, meaning these nations had the least income-related disparities compared to the United States. Allow me to state another obvious fact: I am not using any means; I am the only one who thinks that health should not depend on wealth. How can the nations that are financially equal to the United States achieve such certain outcomes, and the US continues to debate whether universal coverage is economically feasible?
Feasibility of Medicare for All
Medicare for all! A single-payer healthcare system is one in which the government pays for health care for each inhabitant. The energy proposal, known as “Medicare for Al,” is expanding Medicare for more than individuals aged 65 and older and those with End Stage Renal Disease (ERSD) (Inhabitants Count, 2022). Is this something that the United States can afford to do? The short answer is yes. Like comparable nations that can make do with a single-payer system, they can achieve this system through trial and mistake and various methods.
According to Healthcare Management, other created and comparable nations use a sliding scale strategy based on their occupant’s income, private/public funding, and business contributions (2022). It is also recommended that assuming control was taken from private insurance and pharmaceutical companies, which would allow the public authority to take over costs and open additional funding. Healthcare Management also recommended that if numbers are taken a gander at as they are before long, it is agreed that it is not financially feasible. However, while taking a more profound leap into other programs and tax breaks, the spending plan could easily be managed (Healthcare Management, 2022).
The 11 states that have not expanded are:
Kansas, Texas, Mississippi, Tennessee, Alabama, Georgia, Florida, Wisconsin, Wyoming, and North Carolina
Slide 3: Access to Care
• Identify access, utilization, technology, cost, and growth concerns from national health insurance.
The BHA FPX 4112 Assessment 3 National Health Insurance in the United States explores how the 2020 pandemic increased Medicaid selection as many individuals lost their positions or were furloughed. However, Medicaid was an important safety net for Americans during this economic notch. Individuals already on Medicaid faced practically no change in their access to care. Interestingly, states with additional expansive guidelines experienced smaller cost-related barriers to care increases compared to rising joblessness (Benitez et al., 2022). This was largely because, as individuals lost their coverage due to business cutbacks, they were easily transitioned into Medicaid.
For the majority of the southern states that have denied Medicaid expansion, they are home to an estimated 92% of the 2.5 million individuals “who fall into the Medicaid coverage gap and would be qualified for coverage”; however, only if their state would approve expansion (Jones, 2019). Sadly, too many political factors, such as race, class, and political party, prevent the expansion of Medicaid, making it unthinkable (Jones, 2019). In Mississippi, a childless adult would be denied Medicaid regardless of how unfortunate they are, and parents need to earn under 26% of the federal poverty level to qualify. Expansion would increase the number of Americans without health coverage.
However, disparity gaps in the healthcare systems are so outrageous, especially in the South, that access to care would be a major challenge.
Slide 4: Advantages
• Analyze the pros of national health insurance in the United States and determine the Feasibility of national health insurance
The road to universal healthcare for Americans is daunting and complicated. However, we should consider several advantages of moving from a market-based system to a universal one. First, the disparities between Americans are genuine. Low financial organizations are linked to an increased risk of type 2 diabetes, obesity, and poverty.
To no access to preventative care. Therefore, our most memorable advantage is healthier occupants by addressing chronic diseases that have the potential to be manageable. Our second advantage is decreasing the cost of healthcare at a federal level. Americans would have access to care for chronic diseases and preventative care, thus reducing the economic strain on the US LastUS; another advantage would be the regular visits to the Emergency Department would decrease as inhabitants with chronic diseases, for example, diabetes, which accounts for 55% of emergency care would have better access to their maintenance drugs (Zief et al., 2020).
Slide 5: Disadvantages
• Analyze the cons of national health insurance in the United States and determine the Feasibility of national health insurance in the United States based on the pros and cons.
Universal Coverage, as mentioned, is a heavily debated topic in the United States; therefore, it makes ideal sense to discuss the disadvantages. Savants argues that comparing the United States to other created nations is arguably flawed, as the United States is significantly more geographically large, heavily populated, and ethically and racially interesting, more so than comparable nations with universal coverage.
Therefore, it is not yet a realistic comparison and thus not financially realistic. The first argument recommends that Americans who were previously uninsured would increase medical care costs to manage those with untreated chronic diseases. Secondly, proposed funding, such as tax hikes, would not be sustainable, as specialists project that the initial 10 years would cost the United States 32 to 44 trillion, with a yearly cost of 1.1 to 2.1 trillion.
Beyond the financial weight, our last argument would include the potential for general system inefficiency. This would include prolonged wait times to access care and the fear of the public authority meddling in patient care (Zief et al., 2020).
Slide 6: Reimbursement on a National Health Coverage and Feasibility
• Apply national health insurance reimbursement methods to the United States health care system. Moreover, Determines the Feasibility of the reimbursement methods in the US HealUScare System.
At this second, the United States runs on private, government, and self-pay insurance. The primary goal for universal coverage is to guarantee healthcare for each inhabitant, which is not easy. The American Academy of Family Physicians or AAFP Foundation maintains bipartisan solutions determined to obtain universal healthcare coverage. The following reimbursement strategy model proposal they are according to the following:
A pluralistic healthcare system approach involves competition based on the quality of care, cost, and administration and must include guaranteed coverage for each inhabitant.
The Bismarck model approach involves statutory health insurance for different nonprofit payers. It should cover an administration-defined benefits package for all legal occupants. Physicians and other clinicians operate independently in a mix of public and private arrangements.
Proposals for Healthcare Models
A single-payer model approach that is clearly defined in its organization, financing, and model of conveyance of health care administrations would be publicly financed and publicly or privately administered, with the public authority collecting and providing the funding to pay for health care given by physicians and other clinicians who work independently or in private health systems.
A public option approach that is a publicly administered plan straightforwardly competing for customers with private insurance plans could be national or regional in scope. Physicians and other clinicians would continue to operate independently.
A Medicare/Medicaid buy-in approach would expand upon existing public programs by allowing individuals to purchase health care coverage through these programs. In such a scenario, there must be at least Medicaid-to-Medicare payment parity for the administrations given to primary care physicians’ patients.
Each proposal by the AAFP accompanies their arrangement of advantages and challenges, similar to how each proposed solution will affect access to care, level of patient, physician satisfaction, level of tax inconvenience, and finally, yet not confined to the impact on equitable availability (AAFP, 2022)
Slide 7: How to transition into National Health Coverage (Practices and facilities will change)
• Apply the operational practices of national health insurance to the United States health care system.
• Explain how the practices of physicians, hospitals, insurers, patients, and the public authority would each change to transition to national health insurance. Include the Feasibility of the changes
• Determine the Feasibility of those operational changes in the United States health care system.
There will certainly be obstacles to the introduction of national health insurance. Americans without quality care would flood offices, making it more challenging for many to see their primary doctor. However, this would undoubtedly fail, as additional individuals would become healthier and able to manage their health.
However, how does this affect private practices and hospitals? The World Health Organization (WHO) suggests a smooth transition into Universal Healthcare Coverage would require strong, individual-focused primary healthcare (WHO, 2022). This is especially important as there would probably be a
Decreased reimbursement leads to rationing, lower-paid physicians, and hospitals, and warns that universal coverage alone does not guarantee better quality and access to care.
Slide 8: Conclusion
Studies suggest that more Americans are unsatisfied with the quality of care they get. On the contrary side of the range, Americans with employer-based health insurance are more satisfied with their quality of care. However, those with employer-based health insurance with a high deductible plan are just as dissatisfied as those without coverage. Relying essentially on research and considering the pros and cons, Universal Healthcare is years away from becoming a reality. The United States is facing many crises and cannot begin to entertain the chance of expanding its healthcare spending plan, a subject discussed in the BHA FPX 4112 Assessment 3 National Health Insurance in the United States.
The United States cannot decide whether we are in a recession or improving. One thing for sure is that the US healthcare system is doing its bhealthcareping back into pre-pandemic shape that nearly obliterated hospitals. A harsh reality that slapped each American in the face is that on the off chance that you are not covered with a health plan, and regardless of whether you are, a decision must be made whether or not to pay your bills or go to the doctor. A single-payer system is desperately needed at this point, and it appears worlds away from becoming a reality for Americans.
References
AAFP. (2022). Health Care for All: A Framework for Moving to a Primary Care-Based Health Care System in the United States. https://www.aafp.org/about/policies/all/health-care-for- all.html
Ammula, M., & Guth, M. (2021). Building on the Evidence Base: Studies on the Effects of Medicaid Expansion, February 2020 to March 2021. https://www.kff.org/medicaid/report/building-on-the-evidence-base-studies-on-the- effects-of-Medicaid-expansion-February-2020-to-march-2021/
Benitez, J., Williams, E., & Rudowitz, R. (2022). Medicaid Enrollment Among the Unemployment During the Covid-19 Pandemic and Beyond. https://www.kff.org/medicaid/issue-brief/medicaid-enrollment-among-the-unemployed- during-the-covid-19-pandemic-and-beyond/
Citizens Count. (2022) Single Payer Health Care in NH? https://www.citizenscount.org/news/single-payer-health-care-nh? gclid=CjwKCAiAkfucBhBBEiwAFjbkr2UJbPFKXibvuIjB8cR0KmbwBVkikhGjaE8pyI ZlB8hd4G7KNT1-UhoCZo8QAvD_BwE
Doty, M., Fields, K., Shah, A., Schneider, E., Tikkanen, R., Williams II, R. (2021). Mirror, Mirror 2021: Reflecting Poorly. Health Care in the U.S. CoUSed to Other High-Income Countries. https://www.commonwealthfund.org/publications/fund- reports/2021/aug/mirror-mirror-2021-reflecting-poorly?
Healthcare Management. (2022). Can the US government afford a Single-Payer Health System? https://www.healthcare-management-degree.net/faq/can-the-u-s-government- afford-a-single-payer-health-system/ – :~:text=The%20numbers%20involved%20with%20a,the%20right%20systems%20in%20place.
Jones, D.K., (2019). Will the Deep South Ever Expand Medicaid? Would it Matter? The Milbank Memorial Fund. (vol. 97) doi: 10.1111/1468-0009.12430
Ku, L., & Brantley, E. (2021). The Economic and Employment Effects of Medicaid Expansion Under the American Rescue Plan. https://www.commonwealthfund.org/publications/issue-briefs/2021/may/economic- employment-effects-Medicaid-expansion-under-arp
WHO. (2022). Universal Health Coverage. https://www.who.int/health-topics/universal-health- coverage – tab=tab_1
Zieff G, Kerr ZY, Moore JB, Stoner L. (2020). Universal Healthcare in the United States of America: A Healthy Debate. Medicina (Kaunas). 30;56(11):580. doi: https://10.3390/medicina56110580. PMID: 33143030; PMCID: PMC7692272.