Risk Management in Healthcare Market: US ACA in Retrospect - Essay Sample

Introduction

In the article "Information Asymmetries and Risk Management in Healthcare Markets: The U. S Affordable Care Act in Retrospect" by Mendoza (2017), there is provision of a better understanding of the United States Affordable Care Act in contemplation. The article addresses what needs to be considered by the government of President Trump in their efforts to alter or repeal the Affordable Care Act. The article compares distinct forms of asymmetries that result from the allocation, production, and the use of health insurance and looks into the literature on moral hazards, adverse selection and the mitigations that are analyzed against the salient ACA reforms (Mendoza, 2017). The article suggests that when health care is overly utilized, it cannot be considered wasteful, necessarily, even if it ends up costing more insurers on a short time basis (Mendoza, 2017).

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I Agree With the Author That the ACA Was an Answer to Health Care Accessibility

The Patient Protection and Affordable Care Act have expanded access to health insurance in America. Studies have indicated that there have been significant reductions in the rate at which poor people and those living in Medicaid expansion states have been uninsured. The law has also been linked with increased healthcare access, affordability and the utilization of preventive and outpatient services among populations with a low income. Since the ACA was initially opened in 2013, an estimate of twenty million uninsured adults obtained coverage, and more than fifteen million new people enrolled in the Medicaid and the Children's Health Insurance Program (Blumenthal & Collins, 2014). Previously, individuals that were eligible for Medicaid had not signed up for healthcare coverage until the implementation of the ACA. When the ACA was enacted in 2010, the main goal was to reduce the number of uninsured patients, make coverage more affordable and to expand access to care (Blumenthal & Collins, 2014). The law accomplished these by expanding eligibility for Medicaid and by creating new marketplaces where people that lacked employer coverage would purchase policies directly from insurers.

I Believe That ACA Will Improve Patient Care

I believe ACA will enhance patient care. There has been significant progress by the ACA towards its goals in expanding coverage for millions of low-income Americans, some of whom would have remained uninsured. As much as not all people can experience the advantages of the law and the fact that some disparities have come upon the basis of the state, on whether Medicaid should be expanded, ACA has been of great benefit to patient care (Blumenthal & Collins, 2014). The impact of ACA has been assessed in multiple dimensions including; timeliness of care, access to a doctor, possessing a usual source of care, access to medications, accessibility and primary, preventive and speciality care. ACA is working; it has reduced the number of uninsured people and has improved accessibility to coverage for newly insured people (Blumenthal & Collins, 2014). There has been a significant improvement in the health status, both mental and physical health due to better access to care, and from reductions in financial stress of low-income families and individuals.

What I Think President Trump Should Do With the ACA

President Trump should maintain his promise to voters of the provision of a healthcare system that provides for all Americans by retaining the Affordable Care Act. Any attempt to repeal and replace the Affordable Care Act will lead to higher insurance charges on sick people, and the health laws will not cover most of the essential health benefits. President Trump should not repeal the ACA mandate since its removal means that a few people will be able to obtain treatment for chronic diseases and even gain preventive care, an aspect that will worsen inequality in health care. President Trump should focus more on expanding the ACA since it brought many customers to the health service industry (Blumenthal & Collins, 2014). The differences that exist between how the American health care system should work and the patients that rely on the Affordable Care Act need a thorough evaluation since the platforms in which these get implemented is a matter of life and death.

The Strategies I Would Recommend to Deal With the Economic Realities of Health Care Based on My Research

Around the globe, the healthcare industry continues to struggle with issues of costs and uneven qualities, despite there being well trained and hard-working physicians. Most policymakers have tried implementing strategies of enforcing practice guidelines, implementation of electronic medical records, and reducing errors, to curb the struggles of quality and costs (Ginter, Duncan & Swayne, 2018). The strategies that I would recommend for dealing with the current healthcare economic realities include:

• Maximization of value for patients-this involves the achievement of the best outcomes at the lowest costs. Instead of focusing more on what physicians and clinicians do, there should be more attention paid to what patients need. Systems should be implemented where; certain medical conditions services are concentrated in health delivery organizations, and in right geographical areas to deliver high-value care (Ginter et al., 2018). This strategy requires a restructuring of how delivery in healthcare is measured, reimbursed and organized.
• Healthcare providers need to implement strategies that transcend traditional cost reductions and respond to the new payment models. Improvement of patient outcomes by healthcare providers will result in a growth in market share (Ginter et al., 2018). Improving efficiency in the provision f excellent care will enable providers to be competitive in the case of increasing more value.
• Most healthcare providers that focus on the current broken system will experience a lack of actual outcomes. They might be unable to maintain ongoing costs that are in the face of excellent transparency. Most organizations, which will be able to measure the value agenda, will be rewarded with stable financial outcomes and excellent outcomes in the value that they deliver to patients.

References

Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act-a progress report.

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations. John Wiley & Sons.

Mendoza, R. L. (2017). Information Asymmetries and Risk Management in Healthcare Markets: The US Affordable Care Act in Retrospect. Journal of Economic Issues, 51(2), 520-540.