Essay Example on Healthcare Industry: Transparent Care or Costly Medicine?

Introduction

The adoption of new technologies by the healthcare industry is touted as revolutionary. However, while this has led to the improved capacity for early diagnosis, accurate disease identification, and proper care, the costs of medication mask such gains. Increasingly, the healthcare industry is becoming less transparent in its costs of medical care. The annual reduction in Medicare margins demonstrates how existing strategies have failed to ensure quality healthcare. Changes in the modern healthcare setup aims to help realize patient-centric care. Consequently, patients need to have a positive attitude regarding the process. Involvement in healthcare can only exist when their have no worry about how to finance their care. Holistic medical care arises when the patient's wellbeing is attended to appropriately, which will only be possible when the costs are lowered. Unfortunately, the present healthcare setup is more commercialized and less about the care of the patient. Reduced costs, as envisioned in the bill, will allow healthcare providers to compete on quality of care.

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Bill- Significance and Rationale for Selection

The Lower Health Care Costs Act (S. 1895) is a healthcare bill sponsored by the Republican Senator for Tennessee, Lamar Alexander (Congress, 2020). The bill aims to initiate an industry-wide change that will necessitate reduced cost of healthcare. Lower healthcare costs are essential for more durable, more cohesive, and happy families. Healthcare costs must be brought down and stay low for various other reasons. Foremost, dynamics in food production and work environment are making it hard to maintain healthy lifestyle behavior. Hence, increasingly, more people are getting related to people suffering from chronic diseases.

While more and more approaches made to manage such conditions, the attendant costs have long-lasting impacts on families. At a personal level, this bill is significant because reduced cost of medication would translate to increased savings. As for nursing and the industry, the bill is significant as it indicates a commitment to establishing universal healthcare that caters for all. Senator Lamar Alexander's bill is also significant to the broader health care environment. Patients frequently complain about issues related to out-of-pocket healthcare payments. One of the common issues is a matter of surprise billing. Sometimes, patients are referred for specialized medical care in out-of-network institutions by their in-network providers. While in most cases, such skilled care is necessary, patients incur massive premiums through their insurers. Lower healthcare costs will help to stem the practice.

The second issue is transparency in healthcare costs. The current healthcare system is characterized by opaqueness in the costing of healthcare services and the cost drivers. The significance of this bill would be that it starts by recognizing the actual cost and the drivers of those costs. Hence, it will ensure some level of transparency regarding how much one should pay about medication (Congress, 2020).

The third significance of the bill to the healthcare environment is that it would lead to an increase in prescription drug competition. Capping the cost of medication would have a ripple effect on the entire industry. Besides healthcare providers, patients would benefit from low-cost generic and biosimilar drugs to patients. The present environment allows pharmaceutical companies to provide medications that offer the highest profit to them with little regard for the cost incurred by the patients. Reducing the cost of healthcare will increase the power of the consumer. Presently, the healthcare environment is shifting towards evidence-based care, and healthcare providers are required to put patients at the center of attention. However, high costs have led to healthcare inequities (Hardardottir et al., 2019). Reducing the cost of healthcare will help to ensure that presently underserved communities receive better healthcare services.

Healthcare cost is a significant factor in influencing nursing. Some of the cost-related issues affecting nursing quality and community-wide reach are inaccessibility, fragmentation, disparities, and suboptimal outcomes. The changing social and disease-type demographics imply that the nurses have to be more proactive in providing community-wide access. However, it is impossible to realize the equality of nursing care and services in an environment characterized by such factors. The nurse plays a central role in cost-conscious care.

It is noteworthy that the focus of the nursing profession is on being able to provide high-quality patient care that is uniform. As the most significant portion of healthcare workers, nurses contribute significantly to the bottom line of healthcare organizations. Hence, any readjustments to the healthcare industry would have a direct impact on them. Further, reducing the cost of healthcare would impact them either positively and negatively, depending on the approach taken.

Cost-conscious, as anticipated in the bill, would impact on the delivery of nursing professionals. An industry-wide approach may not affect the role of the nurse as it retains their ability to access training and professional resources to deliver high-quality care. However, if ta balance is not realized, their responsibilities may be curtailed. Further, ensuring that the cost of care is affordable will make access to healthcare services attainable by presently sidelined groups, particularly the minority groups.

More people accessing high-quality healthcare would translate to increased demand for nurse professionals. The nurse professionals will also have a higher rate of absorption into the work environment, and their role would have a more significant impact on the broader community. Therefore, in general, a bill that seeks to reduce the cost of healthcare increases the part of nursing professionals. However, empowering them to sustain the desired high quality of care requires an industry-wide adjustment approach (American Nursing Association, 2020).

The Position of Nursing and Other Organizations Regarding This Bill

The American Heart Association (AHA) applauded the sponsors of the bill for playing a pivotal role in protecting patients. According to the AHA's principles for improving the healthcare system, policy strategies must be put in place to ensure that quality care is available, affordable, and accessible (American Heart Association, 2020). It notes that, whereas more Americans have seen increased insurance coverage over the past decade, there are still challenges with more people who cannot access medical insurance and those whose medical cover is inadequate. The association, therefore, acknowledges the effort made by Senator Lamar Alexander in initiating policy discussions about the best approach to realize high-quality healthcare accessible to all.

Similarly, the American Nursing Association (ANA) perceives the bill positively and recognizes its role in ensuring that the nursing profession realizes its goal of quality healthcare accessible to all. The ANA believes that every citizen is entitled to quality healthcare and that it should be affordable and accessible (American Nursing Association, 2020). One way that it advocates for such an environment is through its reaction to political policy. It thus promotes for policymakers to recognize the value of nursing and the unique perspective that nurses seek to offer.

Literature Review

The cost of healthcare remains an area of study. Anderson, et al. (2019), not in their study that the U.S. healthcare costs are currently more than 15 percent of the country's gross domestic product (GDP). The high healthcare prices are the product of the market and non-market factors that influence prices, as well as other factors that make healthcare access in America more difficult than in other developed countries. Healthcare insurance is notoriously expensive and complicated in America than in other countries. Basic coverage costs hundreds of dollars a month, while government programs such as Medicare and Medicaid only cover specific population segments.

Multiple studies have examined the factors that drive up healthcare costs in the U.S., (Erickson et al., 2017; Papanicolas et al., 2018) identify six factors. According to Papanicolas et al. (2018) administrative costs are a key factor that drives healthcare costs up. There is no proper transparency in how healthcare institutions price their services, a trend that is reflected across the industry. Almost a quarter of the healthcare costs are administrative (Erickson et al., 2017).

The second factor that raises the price of healthcare is the cost of drugs. In the majority of developed countries, governments play a central role in regulating the cost of drugs. However, the U.S. government remains reluctant to follow that route. For instance, in drafting Part D of Medicare, legislators denied Medicare the powers to negotiate for cheaper drugs (Papanicolas et al., 2018). The third factor leading to a higher cost of healthcare is the use of defensive medicine, where doctors carry out multiple tests even when they already know the diagnosis.

Salmond and Echevarria (2017) offer an industry-wide perspective, noting that the nursing profession also finds itself at the center of the high healthcare cost. There are two perspectives to this correlation (Salmond and Echevarria, 2017). Foremost, in a bid to guarantee high-quality medical services offer an expensive mix of treatments. Unlike other developed countries, U.S. nursing practitioners are more inclined to use costly therapies.

The other perspective of their involvement in the cost-determination is through wages and work rules (Salmond and Echevarria, 2017). Professionals treat more people in the U.S. The specialists command high reimbursements. The present system also places much emphasis on referral decision-making that serves to raise the cost of healthcare. The nature of branding in the healthcare industry masks the real cost of medication and related resources. There have been instances where prices are drafted based on who the payer is.

Various studies have also identified differing strategies for realizing healthcare equity. Studies such as that by Huang, Yue, He, and Yang (2018) prefer that proper information dissemination strategies be ensured so that individuals play the leading role in leading healthy lifestyles. However, others like Salmond and Echevarria (2017) argue that the present strenuous socioeconomic environment does not allow citizens to live healthy lifestyles and that the healthcare system needs to be structured to address the healthcare needs of the citizens.

It is noteworthy that these studies advance the discussion towards universal healthcare properties. Such policies help to implement recommendations of scientific studies. There is also the convergence of thought regarding the complexity attached to the realization of an affordable, accessible healthcare system. The studies note that such a restructure must affect all the significant aspects of the industry. Further, they indicate the severe imbalance between the powers of healthcare providers and the patients.

Personal Opinion on the Bill

The Lower Health Care Costs Act is a long-overdue policy process. The high costs of healthcare in America are mostly unjustified. The government recognizes that the population is overburdened, hence its investment in healthcare initiatives such as Medicaid and Medicare. However, these programs do not cover all the critical population segments. Coupled with it is the issue of unpredictable billing. Medical costs in America seem to be pegged on who pays for the services. That healthcare institutions overpric...