Whether or not there is need for heath care reform is an issue that has attracted a heated debate in both the public and the political arena. This is especially so in the United States where there have been numerous proposals by the political leaders on the kinds of reforms that are necessary in the health sector. The current president of the United States Barrack Obama, who is currently leading the debate, has argued that the proposed reforms would give the families the kind of security that they deserve. He has strongly advocated for the Affordable Care Act which holds the insurance company accountable, lowers the overall cost of health while also seeking to empower the Americans in making decisions related to various health issues. To him, the proposed reforms will improve the general quality of life. This write up will, in trying to analyze the proposed reforms, seek to answer the question of whether health care reform is really necessary.
Key words: Health Care Reforms, reforms, insurance cover, premiums.
Do We Need Health Care Reform?
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Halvorson (2007) defines health care reform as a general term that refers to the creation or the necessary changes in the health care sector. It therefore affects the ways in which the governments provide or seeks to provide the health care services. Halvorson (2007) states that the major aim of coming up with health care reform is to increase the capacity and the effectiveness of the health care centers. Any health care reform must also seek to improve on the current quality of the health care services while reducing their costs. The debate on the need for heath care has been characterized by various myths and facts which seek to either justify or disapprove the need for healthcare reforms (Halvorson, 2007). This paper will seek to analyze the various myths and facts about the proposed health care reforms in the United States, while also examining whether we really need the health care reform.
Myths Bout Health care reform
Some of the myths advanced by those who oppose the need for reform include the arguments: that such reforms will use the tax collected from the citizens to fund abortions, that the reform will negatively affect the businesses, that the reform unlike what is portrayed will not be effective in reducing the cost of health care, that any such health reform will handover health care to the government, that it gives the employees the rights to stop offering insurance to their workers immediately the law is enacted in 2014 and finally, that the individual responsibility requirement in the Affordable Care Act is a against the constitution (USA.gov, 2010).
Facts about Health Care Reforms
The USA government through its publications has, in countering the myths, produced certain facts about the proposed reforms. According to the USA.gov (2010), the program has assisted over 5,000 businesses financially by taking over to provide health insurance to their retirees who have passed the age of 55 but for various reasons are not eligible for Medicare. The governments has also emphasized that the reforms have proved effective in reducing the cost of medical services. According to USA.gov (2010), this is indicated by the increasing number of people who have Original Medicare. These groups of people have received a number of free preventive services.
According to USA.gov (2011), records have shown that by the end of August 2011, more than 1.2 million of the Americans with Original Medicare had started utilizing the newly introduced free annual wellness visit. The government has stated that there are adequate measures in the provision like the $250 dollars grants included in the Affordable Care Act which is meant to help the states ensure that the insurance companies remain accountable. The government maintains that the Affordable Care Act will help the states to stop any possibility of the insurance companies from unjustified increase in premium. USA.gov (2011) has also noted that this Act has provided about one million young adults with coverage while also enabling the children to be covered by the health insurance plans of their parents.
Why reform is Necessary
In proposing various provisions for health care reform, the policy makers have tried to identify some gaps in the health care sector. They have also proceeded to propose various reforms that can help address these gaps. First, the government has identified the need for a provision aimed at giving the small business some percentage of tax credits. According to the USA.gov (2011), this provision has and will continue to help reduce the cost of the employee coverage through the provision of tax credits to small businesses. USA.gov (2011) has also stated that the reform would also help eliminate the initially witnessed discrimination against the children with pre-existing conditions. It seeks to accomplish this through compelling the relevant plan to provide coverage to this group of children.
The USA.gov (2011) has also noted the need for a reform which can helped those who are uninsured with pre-existing conditions from America. It has noted that such a provision should cover the uninsured up to the time when the exchange has been made available. This means that the Interim High-Risk Pool will highly be subsidized unlike the present condition. Such a provision will help reduce the cost of the insurance services as well as its accessibility.
The USA.gov (2011) has also identified the need to end the recession. This is necessary because it will help in eliminating the possibility of the insurance companies to ban the sick people from getting coverage. Such a reform would also ensure the continued provision of rebates to Medicare beneficiaries who are just about to hit the donut hole. According to the USA.gov (2011), a reform is also necessary to help reduce the cost of the preventive services or even to look into the possibility of providing it for free. This requires a policy that addresses the removal of the co-payments while also exempting such services from any deductibles under the Medicare program.
The USA.gov (2011) has also identified the need for a reform aimed at extending the coverage of young people up to those who are 26 years old through the parents’ insurance. The government has equally identified the need for specific reforms intended to help those who are seeking to retire before they reach the official retirement age benefit from the possibility of having a temporary reinsurance program. This would be useful in reducing the overall cost of premiums for both the employed and the retirees who fall between the ages 55 to 64. Such reforms should also seek to ban lifetime limits on coverage by denying the insurance companies the possibility of life time coverage (USA.gov, 2011).
The USA.gov (2011) has also identified the need to ban the restrictive annual limits on coverage. This needs a reform to eliminate any possibility of limiting the annual coverage to help promote the accessibility of various need care in all new plans and grandfathered group help plans. The preventive services should be covered without people having to be charge co-payments or paying for any other deductibles.
The USA.gov (2011) has also noted the need for a reform that would give the consumers power to appeal various decisions made by their health insurance plans. Such a reform should also ensure that there is value for all the payments to premiums. The provision should be backed up with certain conditions like that compelling any insurance company which fails to meet the required thresholds will be charged rebates by the policy holders.
The present funding to the community health centre is also very low thereby rendering them ineffective. Reform is therefore necessary to increase the funding obtained by the community health centers. This would greatly increase the capacity of these centers (USA.gov, 2011). The government has also observed that the number of current primary care practitioners is also very low. There is therefore the need for reform to provide a way in which the number of primary care practitioners can be increased. Currently, the various health care centers have very few doctors, nurses, nurse practitioners, and physician assistants. This issue needs an urgent policy reform.
Another existing challenge that can effectively be addressed by reforms is salary based discrimination. This would require a reform prohibiting various health plans from denying the insurers coverage based on the amount of money people earn. Such a reform will ensure that all people have accessible to coverage irrespective of the amount of salaries they earn (USA.gov, 2011).
Another challenge that needs to be addressed is the amount of the insurance information that is available to the public. These can be addressed through a reform providing for the issuing of aid to individual states. It will empower the states to establish additional health insurance offices. This will increase the effectiveness of the insurance companies by increasing the number of complaints and appeals that the companies receives and the amount of the information available to the general public (USA.gov, 2011).
Finally, there is need for various measures that can hold the insurance companies accountable for hiking there rates. For this to be addressed effectively there is need for creation of grant programs that can support the various states. This can only be possible by coming up with reforms that make it mandatory for the insurance company to submit their justification whenever they intend to increase their premiums. With these requirements the insurance companies will have no otherwise but to reduce the amount they charge for their premiums of be expelled from the industry (USA.gov, (2011).
In conclusion, it is true that the proposed reforms will improve the general quality of life. The Affordable Care Act will obviously make the insurance company more accountable while allowing the citizens to enjoy a reduced insurance cost. The need for reform in the Medicare is such urgent and should be addressed immediately.
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