Free «Health Law and Regulations Paper» Essay Sample

In the United States, health care and education exemplify the two most essential and, at the same time, most problematic aspects of government regulation. Billions of dollars are spent annually on the national system of health care. Numerous agencies are responsible for regulating and monitoring the quality of health care services provided. Not surprisingly, health care is often claimed to be the most heavily regulated industry in the U.S. (Manchikanti, Caraway, Parr, Fellows & Hirsch, 2011). Still, the role of governmental regulatory bodies in the health care system should not be ignored. Regulatory bodies are expected to correct the existing and emerging market imperfections for the sake of better quality, increased consumer satisfaction, and reduced costs. Today, the health care system is facing the new Obamacare law and health care standards that have the potential to enhance the quality and efficiency of health care at all levels.

Needless to say, regulation greatly impacts all major and minor aspects of the American health care system. Regulation governs and pertains to all aspects of the national system of health care, from financial inflows to the quality of patient-physician communication (Manchikanti et al., 2011). Numerous government agencies at the federal, state, and community levels manage their areas of responsibility within the health care industry. One of the main questions is whether it is feasible at all to have the health care industry so heavily regulated. On the one hand, government regulations and regulatory agencies increase the burden of costs on American taxpayers: the costs of government regulation and oversight in healthcare are estimated at $1 trillion annually (Manchikanti et al., 2011). At the same time, the role which regulatory agencies play in the development of the health care system should not be disregarded. According to Poterba (1996), government agencies help address the existing and emerging market imperfections. The main sources of such imperfections may vary, from asymmetric information in physician-patient communication to uncertainty with regard to the future health care trends (Jacobson, 2001; Poterba, 1996). Most patients possess limited information about the essence and benefits of various medical treatments (Poterba, 1996). In these situations, regulatory agencies help patients make the most rational treatment choice. Simply stated, regulatory bodies and governmental organizations set the rules of fair game for health care providers and customers (Brown, 1992).

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Despite the presence of complex regulations affecting health care, government official seem never satisfied either with their quality or with their content. Today’s system of health care is facing two major regulatory changes and laws: first, the notorious Patient Protection and Affordable Care Act was signed by President Obama; second, this August, Department of Health and Human Services introduced new health care standards for physicians. The ACA (also called Obamacare) is described as a profound structural reform of the health insurance market with no exceptions and exclusions (Manchikanti et al., 2011). The first law will certainly impact local insurers. Each and every insurer in our locale will have to review their policies to bring them in accordance with the new standards of practice. The most serious is the elimination of the pre-existing condition requirements, which means that the insurer will face additional costs and, at the same time, reduce the risks of insurance discrimination. The insurer will have to spend 85% of all premiums collected from large groups on medical care improvements (Manchikanti et al., 2011). As a result, they will be much more limited in their financial decisions. At the same time, with all laws and regulations followed, insurance premiums will help improve the quality and efficiency of health care. In the meantime, the new standards of information processing proposed by HHS (2012) will greatly simplify the relationship between the patient, the health care facility, and the insurance provider. HHS (2012) was finally been able to establish and implement a standard health plan modifier. This way, the amount of time spent on paperwork will be reduced. These rules and regulations will facilitate the analysis of the patient’s eligibility for coverage and his/her insurance status (HHS, 2012).

Excessive regulation is never good, and the ACA is not a perfect approach to health care reform. One of the most cited cases of Obamacare impacts on health care is that of the Dickinson County Healthcare System in Michigan. The new regulations require that only one hospital serves a large area that may cover hundreds of miles (Kessler, 2012). Most rural hospitals included in the local health care system operate at a razor-thin profit margin (Kessler, 2012). With the proposed tax and premium cuts, these hospitals will hardly survive. As a result, local residents will have to drive hundreds of miles looking for quality medical care. Meanwhile, the health care system is at the point when cutting costs is necessary and inevitable.

Personally, I have not still felt the impacts of the discussed regulations. I am a person who has health care insurance and never had any serious problems with health. However, I can say that many uninsured individuals in our community feel optimistic about the proposed changes. Unlike insurers and hospitals, they welcome the reform, which will let them obtain primary care without any difficulty. Still, one of the main questions is whether there are any limits to government regulation in health care. Some scholars and health care practitioners suggest that complex regulatory efforts will not help reduce costs or improve outcomes (Manchikanti, 2011). However, health care cannot be effective without constant control and oversight on the side of the existing regulatory agencies, which bring clarity to the complex relationships between customers and health care suppliers.


Health care remains one of the most highly regulated industries in the U.S. Numerous governmental and private agencies regulate the quality and efficiency of medical care provided to patients. Despite the heavy costs of governmental regulation in the U.S. health care industry, the presence of regulatory agencies is both necessary and inevitable. Only governmental agencies can correct the biggest market imperfections affecting the health care industry. These range from the asymmetrical information between customers and health care service suppliers to the lack of information to make the best treatment choice. The overall complexity of the health care industry further justifies the costs of the numerous regulatory efforts made by governmental agencies. Today, health care institutions face numerous laws and regulations, the most important being the so-called Obamacare. Insurers and health care providers will have to undergo profound structural changes to meet the new regulatory requirements. However, health care cannot be effective without constant control and oversight on the side of the existing regulatory agencies, which bring clarity to the complex relationships between customers and health care suppliers.


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