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One post written in response to fellow learners’ post between 100-150 words. Response is substantive insightful and contain at least one reference.

STUDENT’S POST

1. What are the key functional components of the US healthcare system?

The key functional components of the US healthcare system are financing, insurance, delivery, and payment. Financing may be employment-based, private, or public (government financed). Insurance “determines the package of health services that the insured individual is entitled to receive” (Shi & Singh, 2019, p.6). Delivery includes the personnel who deliver the care and bill for them. Payment is how providers are reimbursed for their services: insurance companies, copays, and tax revenues (Shi & Singh, 2019). 

2. Choose one other first-world country and compare/contrast their healthcare system to that of the US.

In 1966, Canada created the National Health Insurance System (NHI), known as Medicare. There are 13 plans and taxes that the government finances. Private providers deliver healthcare in private nonprofit hospitals/clinics. Many Canadian employers offer supplemental private insurance coverage on top of the government plan. Access to medical care is a national law in Canada. Also, most provinces have regionalized healthcare in order to address local needs and improve participation in healthcare decision-making by the residents (Shi & Sing, 2019). 

There are many differences between the Canadian and US healthcare systems. I list a few below:

1. In contrast to the US healthcare system, the NHI requires tighter governmental control of the quad-functions (financing, insurance, and payment) (Shi & Singh, 2019).

2. Access to medical care is a national law in Canada. The US has attempted to provide more coverage and issue fines for people without insurance as a part of the Affordable Care Act, but we remain to have 33.2 million uninsured (CDC, 2020). 

3. The main access to healthcare is through employers in the US. However, this is not mandatory, so many full-time employees do not have access to healthcare. Every Canadian has access to healthcare. (Shi & Singh, 2019)

4. An agency that aids in cost control and resource allocation does not administratively control the US healthcare system, unlike the Canadian system (Shi & Singh, 2019). 

5. The US healthcare system spends more than the NHI on administrative costs (Shi & Singh, 2019). 

6. NHI is a single-payer system. The government is the single-payer. The US healthcare providers collect money from insurance companies, patients, and the government. This is a billing nightmare and leads to random billing practices and extremely high administrative costs (Shi & Sing, 2019).

3. Summarize current reform efforts taking place at a national and global level. In what ways could these efforts improve healthcare outcomes?

“The Affordable Care Act (ACA) is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care” (Obama, 2016, Abstract section). In the US, the ACA changed coverage provisions by making reforms to the insurance market, offering financial help to low and middle-income individuals to purchase an insurance plan (20 million people), giving federal support to states expanding coverage to low and middle-income residents, and improving existing insurance coverage. The ACA has also sparked the movement away from fee-for-service to a quality-based repayment system (American Public Health Association [APHA], 2021; Obama, 2016). 

There are many ways the ACA has and will continue to improve healthcare outcomes. The availability of affordable, non-employer-based insurance plans allows more people to receive healthcare. This encourages more primary care visits, which ultimately decreases the cost of long-term care. The move away from fee-for-service to quality healthcare decreases excessive billing and improves outcomes. If we can expand the ACA and integrate the bundled payment models while basing payment on results, this has the potential to drastically decrease costs while improving outcomes (Obama, 2016). 

4. In what ways does/does not current healthcare reform address population needs, social justice, ethics, and technology in our current system (pick one)?  

Population health needs literally mean the health of the population. We can also expand upon it to include defining and measuring health outcomes and distribution, tracking the patterns that determine and influence the health outcomes, and creating policies that affect them (Kindig & Stoddart, 2003). The ACA addressed population needs by increasing the number of people that have access to care by making it more affordable (and imposing fines for not paying into the system). A few goals of the ACA are to increase benefits and lower consumer costs, fund public health and preventative measures, improve the infrastructure of our healthcare system, and improve the quality of healthcare delivery (APHA, 2021). These measures directly address the needs of the population. 

Unfortunately, in 2018, a tax law was enacted that repealed the mandatory purchase of health insurance, creating increased premiums and increasing the number of uninsured individuals. While the ACA has achieved insurance coverage for 20 million people, there are still 29 million that lack coverage (APHA, 2021).

References

American Public Health Association. (2021). Health reform. https://apha.org/topics-and-issues/health-reform

Centers for Disease Control and Prevention. (2020). Health insurance coverage https://www.cdc.gov/nchs/fastats/health-insurance.htm (Links to an external site.)

Kindig, D., & Stoddart, G. (2003). What is population health?. American Journal of Public Health93(3), 380–383. https://doi.org/10.2105/ajph.93.3.380

Obama B. (2016). United States health care reform: Progress to date and next steps. JAMA316(5), 525–532.  https://doi.org/10.1001/jama.2016.9797 (Links to an external site.)

Shi, L. & Singh, D. A. (2019). Delivering health care in America (7th ed.). Burlington, MA: Jones & Bartlett Learning.

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