Financial Factors that Influence Healthcare

With all the technological advancements in the medical field, the United States has yet to provide free healthcare to it citizens. Healthcare in the United States is still treated as a privilege, in which only a select few that can afford it have access to it. Those who are unable to afford it, are essentially left with no health insurance leaving them unprotected. Many individuals are deprived of their right to healthcare simply because of the way that the healthcare system is setup. This paper will discuss how financial factors like funding sources, reimbursement methods, economic factors, business influences, and cost attainment have influenced the healthcare system today.

The Affordable Care Act

President Obama enacted The Affordable Care Act (ACA) or commonly known as Obamacare in 2010. It was established to provide comprehensive and affordable health insurance to all the citizens of the United States. ACA essentially allowed more uninsured Americans to become insured by creating online markets where people could shop for their own insurance. Through ACA, millions of people were able to get affordable health insurance for themselves and their families. Most importantly, ACA helped eliminate the part in the previous healthcare system that allowed insurance companies to decline people with pre-existing conditions like cancer, diabetes or asthma. ACA practically helped set motion so that health insurance companies’ protocols through several regulation changes ensuring millions of citizens the opportunity to obtain health insurance.

The ability to fund healthcare services is a major contributing factor in the quality of care a person receives. In the United States, health insurance is funded by a combination of public and private funds. Programs like Medicare and Medicaid are jointly funded by the government and taxpayer dollars. These programs help support people older than 65 years old and those have very low income. Another source of funds for health insurance companies is through private funded healthcare. Private funded healthcare includes self-paying for treatment without insurance and insurance provided to an individual by an employer. Also, it is important to recognize that someone’s socioeconomic status influences the type of care one receives. A person who has access to more money can afford better care because it allows access to better physicians and quicker treatment. Unfortunately, for someone who is not fortunate enough to have the same financial means it could mean putting off seeing a physician simply because they don’t have health insurance or enough money to pay a copayment. Hence, having access to health insurance is imperative so everyone can receive the quality care they deserve.

Funding for Affordable Care Act

The Affordable Care Act is paid for by cuts in government spending and tax increases. Another way that ACA is financed is by imposing penalty payments for those who choose not to buy it. As well as penalizing employers who do not provide health insurance for the workers. Regardless of how it is funded ACA is a beneficial program that provided many uninsured Americans more benefits and various protections making health insurance of greater quality for Americans.

Everyone likes to get reimbursed for the services they provide to others. Hospitals and physicians are no different. Physicians get reimbursed through insurance companies or government agencies.

Economic Factors

The single most determining factor for patient treatment is their socioeconomic status. It is known that individuals who have lower economic status are more commonly affected and at greater risk for health conditions that lead to higher mortality and morbidity rates. It is no secret that people with lower socioeconomic status often delay seeing doctors because of factors like accessibility to facilities and transportation to the doctor’s office. These are just some of the factors that can deter individuals from receiving appropriate care. There is no doubt that those individuals with a lower socioeconomic status are impacted more profoundly that those who have a higher socioeconomic status.

Disparities in the United States are all too real in our society. Health disparities are very common especially for immigrants, Hispanics, and African Americans. ACA was implemented to reduce these health disparities by providing affordability and availability. ACA helped those who belong to minority population gain access to healthcare as well as those who had preexisting conditions who were previously denied. The Affordable Care Act was established diminish the healthcare gap and make healthcare a right to all Americans instead of a privilege to those who have the means to afford the coverage.

Healthcare for all its intent and purposes is first and foremost a business. Like a business, it will always be chasing more money. With, health insurance companies will cater towards those individuals that can afford to pay more because it will garner more revenue. Under ACA, companies must provide health insurance to employees if the company has more than 50 workers. Health insurance premiums have steadily been raising year after year and it has become increasingly difficult for businesses to provide health insurance to the workers so unfortunately some people are being let go.

Cost Containment

Cost containment methods in healthcare are always being pursued by insurance companies and hospitals. Before the Affordable Care Act, insurance companies centered cost containment methods on lowering providers payment rates. Now, cost containment methods are aimed to encourage providers to find ways to deliver quality care without needless use of services. By cutting the use of unnecessary services to treat patients it is saving the hospital millions of dollars. In addition, Medicare was a key provision that was targeted to help produce savings, by providing regulatory framework for containing costs in Medicare. This was done by setting a per capita target for spending growth and developing a plan to monitor and maintain spending. By having these sort of cost containment methods there is less strain on the healthcare system.

Since the passing of ACA nurses have been granted more opportunities to help their patients receive the best possible care. Nurses are responsible to ensure that all healthcare services that a patient needs remains affordable to them. Nurses also need to ask if patients can afford their home medications. If not, nurses should work together with social workers to view what other options or resources a patient can utilize so that the medication or medical supplies that is needed is made affordable. Most importantly, the nurse is an advocate for patients who are unable to afford a medication.

Conclusion

The Affordable Care Act changed the lives of millions of people in America. It allowed millions on uninsured Americans to become insured by making it more affordable to everyone. The ACA is not without flaws and sure there is some tweaking that can be done to the bill, so it does not discriminate against those who are high earners but overall it is on the right track for providing affordable healthcare to all citizens. A good healthcare system both affordable and able to provide quality care. In an ideal world, health insurance would be free for everybody because being able to see a doctor should not be a matter of being able to afford it, everyone should have access to quality care regardless of their socioeconomic status.