Making Public Policy in Healthcare Essay Example

Introduction

The control of the healthcare systems by both government and private bureaucrats hinders medical work which then frustrates the public. It is ironic that the U.S. has the most expensive healthcare in the world and yet its citizens are among the unhealthiest compared to other countries. Most of them do not have insurance, those who have a cover are usually underinsured, and those with access to expensive care end up using vast sums of money on additional plans that offer no significant betterment of life. Over the last decade, changes in the existing healthcare systems such as the Medicaid and Medicare have seen a substantial improvement in the quality and accessibility of care. This is more so after the introduction of affordable care. However, these attempts for change have not been without their fair share of rejections and defeat. Discussed below are some incentives if integrated into the system could help curb the problem of costs and coverage of healthcare in the U.S.

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

Save 25%

Application of Big Data Analytics to Healthcare

Big data in healthcare refers to electronic sets of health data of high complexity and volume that they cannot be managed by traditional data management methods and tools or hardware and software. The diversity of the data types of big data in healthcare and the speed at which its management is required can be overwhelming. Information relating to patient well-being and healthcare comprise of big data in the healthcare industry (Raghupathi, 3). This includes clinical decision support systems made up of written notes by physicians, prescriptions, pharmacy, insurance, medical imaging, laboratory, and other administrative data; machine-generated data, for instance from monitoring vital signs, social media posts, blogs, and web pages; patient data in electronic patient records (EPRs); and other information that is less patient-specific such as news feeds, articles in medical journals and emergency care data.

This vast array of data is an opportunity for the improvement of care coverage and reduction of costs. When the connections are made and trends and patterns within the data understood, the potential for improved care, reduced cost of care, and saving lives is discovered (Raghupathi, 3). This large packets of data in healthcare are analyzed to provide more profound insights into the patients' condition resulting in better-informed decisions. Care providers and other healthcare stakeholders can develop insightful and thorough diagnoses and treatments which translate to better quality of care at reduced costs and overall improvements in outcomes (Raghupathi, 3). For example, big data analytics allows for the analysis of patient characteristics, the costs and possible consequences of care to identify the most suitable clinically and cost-effective treatments.

Care providers can quickly identify patients who merely need lifestyle changes or preventive care. Big data analytics enhances disease profiling on a large scale for the support of preventive initiatives and identifying predictive events; collection and publication of data on medical procedures which enable patients to select care protocols or regimens with the best value; its integration in to healthcare systems also helps to identify, predict, and minimize fraud through the verification of the accuracy and consistency of the claims (Raghupathi, 3). It is a source of information for third parties such as pharmaceutical companies selecting patients for clinical trials. Monitoring treatments and drug adherence by care providers promote individual and population wellness benefits.

A National Health Program

It is evident that the American healthcare system is wanting. With millions of people uninsured, skyrocketing costs of care, and expanding bureaucracy, reforms attempting change have only managed to exchange old problems for new ones (Himmelstein, 102). Basic a plan as a national health program is the system needs to make a complete and tangible turnaround. The program would have six primary objectives to fulfill. One, everyone would be fully covered under one comprehensive public insurance program; nursing homes and hospital would receive an annual amount to cover their expenses from the program; capital costs would be funded through separate appropriations; funding for the program be from a single pool of funds; pay for physicians and ambulatory services through global budgets, per capita basis, and fee-for-service payments; costs maintenance through improved health planning, saving on bureaucracy and billing, and establishing overall spending limits (Himmelstein, 102).

Access to care, its expenses, and inefficiency is a predominant thorn in the system. This program would have a federal mandate and ultimate funding by the federal government while being primarily administered at the state and local level (Himmelstein, 102). This would remove existing financial barriers to accessing care, improve healthcare facilities distribution, cost control by enhancing health planning and containing bureaucracy, minimize economic incentives of insufficient and excessive care, and eliminate administrative interference and expenses. As everyone will be under a single public cover for all necessary medical services, a board of experts determines which services are ineffective or unnecessary and are removed from the program reducing excessive costs (Himmelstein, 102). Deductibles, copayments, and alternative covers would be eliminated.

The unbearably high costs of care have been reported to be the greatest hindrance to the accessibility of care. The program improves care coverage and overall quality of care. As the program establishes that everyone will have a right to comprehensive healthcare, a national healthcare program would be used as proof of entitlement to all necessary medical care exclusive of deductibles and copayments. Fee-for-service practitioners and institutions that global budget are places where the card would be used (Himmelstein, 102). Health maintenance organizations (HMOs) members could receive non-emergency treatment through their HMOs, but they could also easily transfer to non-HMO options. This would eliminate the economic threat of illness and give patients a wide range of practitioners to choose from for better care at affordable costs.

Adjustments in Healthcare Policies

Initially, when healthcare reforms such the Medicare and Medicaid programs were introduced, their objectives are, but somewhere along the way of implementation, the focus is lost. Changes should be made in healthcare policies to ensure improved quality of care at reduced costs. Bureaucratic and government interferences in the administration and implementation of healthcare reforms represent some of the most common hindrances to the development and improvement of the quality of care. The administration should be left to state and local levels, and the only government involvement should be through funding and federal legislation.

It should be made mandatory policy that each person can only be subscribed to one healthcare program. This eliminates the extra costs of unnecessary services that could be avoided. Also, copayments and deductibles should be removed to ensure equality in the affordability and accessibility of care. Incentives such as canceling off a portion of medical school students loans by the government for doctors and other healthcare practitioners to provide care in remote areas for a given time would improve healthcare coverage.

Healthcare programs should allow parents to accommodate their children in their insurance plans even after the children are above the age of 21. This would significantly reduce the cost of accessing care and increase coverage as it would appeal to a large portion of the population. No one wants to spend extra money if they can avoid it. The patients should be allowed a wide range of practitioner choice and healthcare planning which affects the overall effectiveness and quality of care. Care for people living with conditions such as dementia, osteoporosis, and other chronic illnesses should be expressly provided for in the healthcare plans together with regular care plans. Healthcare services for these conditions are usually over-specialized and need to be re-balanced to enhance efficiency. Emphasis should be put on primary and community care to improve the coordination and integration of care, increase capacity, and reduce costs associated with care coverage. This addresses the problem of both coverage and the cost of care.

Conclusion

The above proposals attempt to make significant but fundamental changes in the healthcare system as a way of eliminating the prominent issue of coverage and cost of care in the U.S. For instance, the integration of big data analytics targets the use of already existing patient data to determine cost-effective treatment plans. National healthcare program improves coverage by ensuring that everyone is insured under a single comprehensive program at reduced costs. Changes in healthcare policies increase the accessibility of care and improve their overall quality.

Works Cited

Himmelstein, David U., and Steffie Woolhandler. "A national health program for the United States: a physicians' proposal." N Engl J Med 320.2 (1989): 102-108.

Raghupathi, Wullianallur, and Viju Raghupathi. "Big data analytics in healthcare: promise and potential." Health information science and systems 2.1 (2014): 3. doi: 10.1186/2047-2501-2-3