For some time now, healthcare reform in the United States has been a contentious issue. Most stakeholders agree that as compared to other developed nations, the U.S. is spending so much on healthcare, yet its quality and access worrying. The most prominent issues in the debate have been the need to increase insurance coverage (more especially among the low income earners), reducing the cost of healthcare on state and federal governments, the effects healthcare reform has on its quality, Medicare fraud and the shortage of doctors and nurses. This paper addresses the effects of these reforms to healthcare utilization as well as how the current healthcare system relates to universal healthcare.
Currently, many U.S. citizens are uninsured and lack access to basic medical care. The aim of healthcare reform is to change this situation so that care is available and is accessible by all. It also aims at overhauling the insurance system so that it becomes more affordable and that not only the low income earners but also the jobless are covered. According to the New York State Insurance Department (2012), health reforms anchored on the current insurance system look to provide more people with coverage, legal protection and insurance information. Although they may appear relatively straightforward, healthcare reforms are not easy to implement because of the system’s minutiae.
Effects of Reform on Access to Care
Although percentages vary from one state to another, recent health reforms have generally led to an increase in the number of people who access healthcare. Results from a recent research at the Harvard medical school (published in the American Journal of Preventive Medicine) show that Massachusetts health reform has “effectively increased access to healthcare and reduced disparities” (Logue, 2011, p. 1). The researchers discovered that since 2006, (the year in which the Massachusetts healthcare reform was enacted), there has been a 7.6 percent increase in the number of residents with health insurance. Conversely, there has been a 4.87 percent decrease of those not accessing healthcare because of prohibitive costs.
The researchers also discovered another encouraging factor; that the increase was significantly evident among minority groups. What makes this encouraging is the fact that most of the people who lack access to healthcare services come from disadvantaged groups. The results from this study can be used as a precursor to what is expected at the national level.
Effects of Changes on Utilization
The National Bureau of Economic Research (2012) has found out from research results that health insurance cover has a significant impact on healthcare utilization. It cites Maestas, Dobkins and Card’s study, “The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare,” (NBER Working Paper10365), in which the authors found out that insurance coverage for individuals aged over 65 years increased from 90 percent to 98 percent. Consequently, this has led to utilization of healthcare, especially among educated minorities.
Most people, especially those from disadvantaged groups, are likely to ignore the need to seek medical attention because of high costs. This, therefore, implies that when such individuals have insurance cover they are more likely to see a doctor. The National Center for Policy Analysis (2011) offers two viewpoints over this matter in regard to the emergency department (ED) visits. It states that ED visits are likely to increase because of reduced costs, however, it also offers that physician appointments might be more difficult to obtain because of the increase in the number of visits.
In another way, ED visits may reduce because a majority of patients may have access to preventative healthcare, therefore, taking care of health problems before they can degenerate to warrant ED visits. All the same, researchers have not found conclusive evidence to support either argument. This could mean that none of those factors affect the rate of ED visits or they exerted equal opposite influence to make the rate of ED visits remain unchanged (NCPA, 2011).
The term “Universal Healthcare” refers to the situation where all citizens of a particular country or state have access to basic healthcare services irrespective of their socio-economic status. The current healthcare system in the U.S. may not be a true reflection of the concept of Universal Healthcare. Many scholars argue that, for an industrialized nation, the U.S. system leaves a lot to be desired in terms of coverage of its citizens.
According to Chua (2006), the U.S. is the only “industrialized nation that does not offer any form of universal healthcare to its citizens”. As opposed to other developed nations, quality healthcare in the U.S. is a privilege to those who can pay for it. The author offers the opinion that the American healthcare system is more of an “economic good” rather than the “social or public good” it should be.
Contrary to popular opinion, Chua states that, “80 percent of the uninsured are hardworking Americans who are employed or come from working families” (2006, p. 2). Most of these individuals lack insurance cover either because their employer does not provide it or because the employer’s premium share is too costly. Some employed persons might lack insurance cover due to the fact that they are not eligible because of factors such as being on a part time job or not having worked long enough.
From the above facts, most of which are from relevant researches, it can be deduced that healthcare reforms are most likely to positively affect access and utilization of health services. The reforms are most likely to benefit minority groups, who bear the brunt of poor healthcare access. This will, therefore, acts as a step towards the realization of Universal Healthcare.