United States Health Care Reform Analysis

Subject: Healthcare Institution
Pages: 2
Words: 653
Reading time:
3 min


The health care system in the US addresses the citizens’ access to the relevant services, financing of the workforce, and the development of related industries. Executing such a vital segment is challenging, and the regulations such as private insurance or unequal costs result in additional obstacles to the government’s way to improving the nation’s well-being (Pacheco et al., 2020). However, several legislations such as the Patient Protection and Affordable Care Act (PPACA) could significantly change the industry. This paper aims to explore the US health system’s features in policy-making and discuss the conditions related to passing PPACA.

The US Health Care System’s Non-Centralized Governance

The non-centralized governance of the US healthcare system is a feature that distinguishes the institution from many other nations. The characteristic defines the financing, which is more private than publicly sourced, and that condition makes the access to treatment costly, unequal, and comprehensive to administrate (Bodenheimer & Grumbach, 2020). The system that combines financing from the government and the private sector creates additional opportunities for innovating and improving the services; however, it makes access less affordable for most citizens. The insurance that provides money for the health care sector to operate can be individual, private, employment-based, and government-financed (Bodenheimer & Grumbach, 2020). Consequently, the cost of services included in these segments varies and may not be sufficient for specific individual needs.

The diverse and decentralized financing system challenges policymakers who aim to reform it to make it efficient for more citizens. The feature is significant in policy-making because all novel regulations must comply with public and private sectors’ needs and requirements to be passed and established. For instance, the Affordable Care Act signed by Barack Obama in 2010 aimed to expand access to health care and make the Medicare and Medicaid programs affordable for low-income populations (Abimbola et al., 2019). However, the reform’s effectiveness is still unclear, and the insurance-based frauds still find ways of taking advantage of private financing and regulations’ prevalence.

Challenges of Passing The PPACA

The PPACA is one the most significant reforms established to regulate the US healthcare system, improving it from the citizens’ perspective. Furthermore, passing it revealed different challenges and drawbacks of the policy-making process that must be revised and improved. Indeed, the health insurance was regulated by various policies set by The National Association of Insurance Commissioners (NAIC), yet with the PPACA, it received generalized legal coverage (Bodenheimer & Grumbach, 2020). Passing the Act in 2010 was comprehensive because NAIC included representatives from 50 states, and the new laws could not fulfill the interests of all. As the US policy-making process can be performed on a state or local level, submitting PPACA meant that dozens of regulations must have been revised, taking time and taxpayers’ money to process (HealthCare.gov, n.d.). Furthermore, the Act meant increasing payments for the high-income population, and that condition met disagreement, forcing the affected people to use their authority to disrupt the legislation by using the weak points of policy-making.

Health reform in the US is difficult when it addresses a broad scope of problems and addresses all the diverse nations. Moreover, the insurance regulated both privately and publicly does not provide all populations with an equal level of certainty and protection, forcing many citizens to pay for health care out of their pockets (Pacheco et al., 2020). The notion that treatment, examinations, and medications are expensive regardless of the government’s attempts to regulate them makes the new Acts receive low national support.


Health care reforms require addressing the interests of all stakeholders, and in the case of regulating the costs, the challenge is especially difficult. The non-centralized governance combined with public and private insurance creates additional development opportunities; however, it also severely influences the equality of services affordability. Passing the PPACA in 2010 revealed policy-making problems such as the prevalence of local regulations, the political influence of authoritative citizens, and the lack of supporters.


Abimbola, S., Baatiema, L., & Bigdeli, M. (2019). The impacts of decentralization on health system equity, efficiency and resilience: a realist synthesis of the evidence. Health Policy and Planning, 34(8), 605-617. Web.

Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.

HealthCare.gov. (n.d.). Understanding the Affordable Care Act. Web.

Pacheco, J., Haselswerdt, J., & Michener, J. (2020). The affordable care act and polarization in the United states. RSF: The Russell Sage Foundation Journal of the Social Sciences, 6(2), 114-130. Web.