Access to health care services is an intrinsic need that every human being deserves in order for them to lead more productive lives. In reality, however, there are a number of hindrances that prevent nations from providing these services to all their citizens. Health care reform is among the most hotly contested topics in American debates. In the past, the American health care system was highly lateralized towards the privately insured employment sector and the publicly insured group consisting of retirees, low-income earners, and armed forces personnel. Health care was thereby only accessible to a select group of individuals who could successfully acquire health insurance. The Patient Protection and Affordable Care Act of 2010 (better known as the ACA) sought to change this and make medical insurance accessible to all. Although it still faces massive opposition today, the Act remains the best way to ensure that access to health care services becomes an inalienable right for every American, regardless of their financial situation.
The commoditization of health care meant that it got treated as a product that people purchased when they needed it, as opposed to the reality that health care access is a fundamental human need. Over 45 million Americans were still uninsured in 2010, and were thereby susceptible to increased morbidity and higher mortality rates (Kocher, Emanuel, & DeParle, 2010). The financial burden of utilizing health care services made these individuals less likely to adhere to their prescribed medications, effectively reducing their chances of recovering from their illnesses (Kocher et al., 2010). This lack of adherence also increased their chances of developing additional complications that would later become more expensive to manage, increasing their economic burden as the diseases progressed. The financial responsibility of utilizing health care services also deterred uninsured Americans from accessing preventive care (Kocher et al., 2010). An efficient health care system would enable such individuals to obtain medical services that were otherwise out of their reach.
Previous health insurance models concentrated their attention on providing and improving access to personal care (Hester, Stange, Seef, Davis, & Craft, 2015). In this system, the community’s health care needs received little attention. The primary factor driving this was the privatized nature of health care provision, whose profit-centric business model prevented institutions from sharing their best practices (Kocher et al., 2010). The private health insurance model also suffered from administrative inadequacies such as excessive paperwork, which required millions of workers to sort out and contributed to increased health care costs (Kocher et al., 2010). Even insured Americans faced financial barriers when accessing health services depending on the insurance coverage that they had (Kocher et al., 2010). As a result, people who got comprehensive insurance policies from their employers were less likely to switch employment options because of the minimal chance of obtaining comparable coverage elsewhere (Rice, et al., 2014).
The Affordable Care Act (ACA) sought to ease health care access for Americans by introducing various subsidies and cost-cutting measures. Rather than scrapping the health insurance model, the ACA contracted Accountable Care Organizations and community integrators to provide low-cost medical insurance whose premiums depended on the community’s health care needs. Preventive care was one of the Act’s primary objectives in an effort to reduce the prevalence of preventable ailments (Hester et al., 2015). Government subsidies allowed individuals to access free screening through nonprofit community initiatives, thereby providing early disease detection before illnesses progressed to chronic levels (Hester et al., 2015). The ACOs that provided health care services were also incentivized to provide quality care and were rewarded when patients did not re-consult for the same illnesses (Hester et al., 2015). Compared to the profit-based private health insurance model, the ACA model ensured that health providers strove to provide holistic care.
Access to patient-centric health care services reduced the economic burden of disease by reducing the amount spent on the treatment of recurrent illnesses. Chronic diseases were also covered effectively by the ACA, since it initiated home-based care for high-risk ailments such as diabetes (Hester et al., 2015). Individuals with an illness history benefitted from the Act since they did not have to pay the higher insurance premiums that the previous health care model demanded (Rice, et al., 2014). The number of uninsured individuals also saw a sharp decline due to the ACA’s provision that children would remain covered under their parents’ insurance until they turned 26 (Rice, et al., 2014). The increase in low-cost, preventive, patient-centric health services with reduced re-admission rates meant less spending on health care, which saw these savings re-invested in community health initiatives (Hester et al., 2015). This way, the ACA ensured that the model could achieve autonomy and obtain the ability to fund itself in later years.
The traditional privatized health insurance system was highly inefficient and favored a profit-centric approach as opposed to a patient-centric one. High insurance premiums also prevented many individuals from accessing health care services while imposing a substantial economic burden on insured individuals. The introduction of the ACA stabilized the health care landscape by subsidizing premiums and incentivizing the provision of quality care. Under the ACA, more individuals can now access health insurance and quality health care services. The ACA’s focus on preventive care also reduces the economic burden of illness since diseases get treated before they become complex and demand more expensive treatment. Standardized insurance premiums under the ACA also ensure that individuals with a disease history do not pay more for access to the same services. The ACA’s community-centric approach is, therefore, the best plan for providing universal health care and reducing disease prevalence in America.
Hester, J. A., Stange, P. V., Seef, L. C., Davis, J. B., & Craft, C. A. (2015). Toward Sustainable Improvements in Population Health: Overview of Community Integration Structures and Emerging Innovations in Financing. Atlanta, GA: CDC Health Policy Series.
Kocher, R., Emanuel, E. J., & DeParle, N. M. (2010). The Affordable Care Act and the Future of Clinical Medicine: The Opportunities and Challenges. Annals of Internal Medicine, 536-539.
Rice, T., Unruh, L. Y., Rosenau, P., Barnes, A. J., Saltman, R. B., & van Ginneken, E. (2014). Challenges Facing the United States of America in Implementing Universal Coverage. Policy & Practice, 894-902.