ACA Tax Credits & Out-of-Pocket Limits: Healthcare Benefits for Middle-Class Americans - Essay Sample

Introduction

American citizens highly benefit from federal support in terms of healthcare services. According to Healthcare (2020), the Affordable Care Act (ACA) plays a vital role in providing tax credit services for insurance to middle-class level society. Middle-class citizens with income falling below 400% of the poverty line benefit from the tax credits. On the contrary, a family is offset with $ 14,300, while the Affordable Care Act limits out-of-pocket of up to $7,150 to an individual, making healthcare accessible to millions of Americans. Switzerland citizens are faced with the burden of paying every expense from their pocket, making it cumbersome for many Swiss citizens to cater to their medical expenses.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

According to Sturny, (2020), access to medication in the US has improved the lives of many Americans, enabling them to live longer and have healthier lives. Patients have the opportunity to access medicines in various ways in the US. Patients in the US have the chance to access the medication they need in different ways. One of the conventional means through which Americans access medical services is via health insurance cover, a plan that gives them exclusive access to the medical services in the United States. On the contrary, the mandatory privet healthcare system in Switzerland permits the Swiss citizens to access medication through their privet insurance plans or even through their pockets, making it costly.

New medicines are an integral part of our health care system and can help patients live longer and healthier. Patient access to the medication they need is critical both for individuals and for our health care system more broadly. In the United States, patients can access medicines in several ways, including through health insurance coverage

The Requirements to Get a Referral to See a Specialist

According to HHS (2017), Swiss citizens have a free access without referral to specialists in the country. The referral applies to the citizens who are not enrolled in a gatekeeping managed care plan. Most of the specialists in Switzerland tend to be highly concentrated in the urban region within the proximities of the acute-care hospitals in the nation. Additionally, the system allows specialists to see privet patients as well as MHI patients.

In the US, Specialists can work with both privet and public hospitals. Insurance plans such as the Health Maintenance Organization (HMOs) mandates that a primary care doctor make every referral. As a result, this plan limits the patient's choice of specialist. However, other programs, such as Preferred Provider Organizations (PPOs), give the patients access to a diverse pull of specialist referrals. Patients trying to access referrals find it challenging to access the services since most of the specialist thinks that Medicaid patients have lower reimbursement rates.

Coverage for Pre-Existing Conditions in the Two Healthcare Systems

Under the Affordable Care (ACA), the coverage of pre-existing conditions in the US is widely covered by the Act, reducing the potential possibilities of insurance plans overcharging the patients. Through this, health insurance coverage in the US includes patients with their pre-existing conditions without increasing an additional charge (Healthcare 2020).

Pre-existing conditions in Switzerland are treated much differently, as every patient with a pre-existing condition has to be over changed for their premium, making it expensive for many patients. The Unemployed and retired with pre-existing conditions are profoundly affected since they have to pay from their pockets.

Financial Implications for Patients With Regard to Healthcare Delivery Differences

Despite the milestone steps achieved in healthcare, patients are the primary stakeholders who are financially impacted, as the healthcare expenditures are occasionally rising. As a result, this has profoundly affected different classes across the various healthcare system.

As (Peter G Peterson Foundation, 2019) concluded, healthcare in Switzerland is driven by the increasing number of sophisticated services and prices offered. In this case, each service has distinctive pricing, which has yielded to the final amount that should be faced by the ordinary citizen. An increase in either of the services may result in a tremendous rise in the final pricing of the services to the patient. The increased services may be unaffordable, especially to the unemployed and the retired community.

Spending on healthcare is profoundly higher compare to other OECD nations, which should significantly lower the pricing of service to ordinary citizens. However, despite the efforts on expenditure, pricing in the United States is substantially higher than the pricing in Switzerland (Gottlieb et al., 2019). Through this, the pricing of the services in the healthcare system has forced the unites States to have lower hospital stay duration than other advanced nations.

The higher pricing is pushing the patients to be discharged earlier, as a way of fighting the increased pricing posed by every service. On the contrary, the US has fewer angioplasty surgeries and knee replacements compared to the advanced nations, despite the country having significant advancement in healthcare, and heavily investing in the sector.

The consolidation of hospitals in the United States has posed a significant challenge, especially for unemployed and retired. The pricing is higher than any other developed nation, which is affecting the middle class and the unemployed in society. The consolidation of the hospitals has played a critical part in the lack of completion in the US, which does not force the hospitals to lower their pricing per service, like Switzerland, where pricing is slightly affected by the competition.

According to Stark et al., (2019), the lack of competition in the US has paved the way for exploitation, a cost that has forced many patients to pay unwillingly, despite the governmental input in the sector. For instance, the United States spends over $750 per person on administrative costing, which is three times higher compared to Sweatband's administration cost on the healthcare system, and five-time more than the average expenditure on administration on wealthy countries.

As a...