Application: The Impact of the Affordable Care Act on North Carolina’s Uninsured Population
Although there is often political pressure to create programs that increase access to services, these programs often are unfunded mandates. The expansion of insurance coverage is directly linked to health care costs, and controlling these costs presents a tremendous challenge. This week’s readings present information on cost evaluation; potential trade-offs related to cost, quality, and access; and financial and economic principles that apply to cost evaluation in delivering health care services.
An example of the difficulty of addressing these competing interests can be seen in a case study concerning “The Impact of the Affordable Care Act on North Carolina’s Uninsured Population”. This Assignment focuses on ethical, financial, and quality of care aspects surrounding the issue.
� Read the case study about “The Impact of the Affordable Care Act on North Carolina’s Uninsured Population” on pages 202–203 in Health policy and politics: A nurse’s guide (Laureate Education, Inc., custom ed.).
� Reflect on what you have learned from the readings and media segments about health care financing as you read the case study.
To complete this Assignment, write a 3- to 5-page paper that addresses the following:
� Explain the impact of the Affordable Care act on the population that it affected.
� Explain the impact of the economics of providing care to patients from the organization’s point of view.
� How will patients be affected in relationship to cost of treatment, quality of treatment, and access to treatment?
� What are the ethical implications of this act for both the organization and the patients?
The impact of the Affordable Care Act on North Carolina’s Uninsured Population
Around 16.5 percent of the inhabitants of north Carolinians reported that they were not in a position to see the doctor. That was in the year 2007(Dinan, Simmons & Snyderman, 2010). The reasons they gave were that the costs involved were very high and they could not afford them. Between the year 2003 and 2009, there was an increase of the health insurance premiums for North Carolina’s families. That was an average cost of $13087. On the other side the premiums of the single policy holders increased by 37% between the two years. 47% of the in habitats of North Carolina have their health insurance covered via employment. Around 4% of the residents in the North Carolina purchase the individual private policies while 32% of the population has their health insured by the public programs such as medic aid and Medicare (Hofer, Abraham & Moscovice, 2011). In Carolina the affordable care unit helps the families by assisting them pay the premiums in their health insurance. They also give them health coverage options which are affordable. The low and middle level income earners are the ones who benefit most from the insurance premiums. The residents who did not have the access to the health insurance have been reduced. The affordable care act has made changes to the insurance laws to the favor of the health insurance holders. For instance, the insurers are supposed to give the parents to take the option of continuing to pay the insurance for their children until they reach 26 years. This law will be acted upon whether the children are full time students or not. Moreover, the insurers are not allowed to levy lifetime dollar limits. The act has also prohibited the insurers that offer child- only coverage from leaving out the children with the preexisting conditions. The act requires the insurers to spend some amount of the premiums they collect on improving the quality of the services they provide and on medical expenses rather than using them on the administrative costs or holding them as profits (Hofer, Abraham & Moscovice, 2011). The affordable care act comprises of improved consumer protection rights. It also includes the creation of consumer ombudsman programs. The children, the elderly and the lower income earners are the ones who will benefit from the above benefits which have been imposed by the affordable care act. This act provides access to the online market place. The individuals and the small businesses compare, select and buy the private health insurance policies (Dinan, Simmons & Snyderman, 2010). Under the affordable care act, the employers who have got less than 50 full time workers will be favored as they will not be required to pay the health insurance cover for their employees. The affordable care act is encouraging the small business owners to provide the health insurance through offering small business health care tax credits. Most of the small businesses already were offering the health insurance packages to their employees before the affordable care act was implemented. There were some small businesses owners who did not offer the health insurance cover to their employees before the passing of the affordable care act. Small business health options program have been established by the affordable care act to give the employers an opportunity to compare and go for the insurance plans which are of high quality and which best suits the employees (Dinan, Simmons & Snyderman, 2010). . The expansion to the access to health care access will lead to a lot of congestion in the supply of services. There will be shortage of the health care providers. The shortage will worsen the condition of the patients as despite having the heath covers, the patients will be very many. The falling of the premiums will directly affect the insurance companies. They will not have enough capital to expand their businesses. The affordable care act has not led to any meaningful result on the employer sponsored insurance premiums. The revenue increases as the spending cut also increase. That reduces the federal deficit by more than $ 100 billion (Dinan, Simmons & Snyderman, 2010). The spending which is used on health care is very high and this will affect the financial wellbeing of the companies as well as the country at large. The growth rate of the overall economy will be at risk (Dinan, Simmons & Snyderman, 2010). With newly insured people getting into the health care system, there will be increased number of people claiming compensation which may lead to delays in compensation. This is because the premiums paid have decreased and the health insurance companies are not in position to pay the compensations. There should be plans by the health insurance companies to reduce the compensations since the premiums have been reduced in order to be in position to provide compensations without delay. The United States of America will face a shortage of primary care providers. According to a survey which was recently conducted, more than 90000 physicians will be needed and the number will grow to 130000 by the year 2025(Dinan, Simmons & Snyderman, 2010). The American journal of medical quality published a report which claimed that there is a projected shortage of registered nurses which would spread across the United States of America by the year 2030 (Dinan, Simmons & Snyderman, 2010). That may lead to an effect in the career generally where many people may not choose the career in medicine. The shortage may result due to a high number of doctors retiring from their careers. The medicals services which will be offered by the health care providers will be very poor. The poor services will result due to the working overtime.
This will be due to the large number of patients. Working overtime hinders provision of good services to the patients. There is link between over time working and the provision of health care to the patients. The over worked health care providers are not able to take good care of the sick patients and thereby these patients end up getting sicker or even dying. That increases the burden of the nurses making them work for extra hours. Working overtime means that the health care providers are not cannot get offs which are required. They end up being very fatigued. They are therefore not alert in their work and the patients are not attended as required. The patients will be taking a lot of time in the health care centers. That may even lead to corruption as the patients corrupt the few physicians so as to be attended. The cost of treatment may be low. That will lead to money crises in the health centers (Dinan, Simmons & Snyderman, 2010).
The ethical standards of the doctors may be very poor. The doctors should be trust worthy. The patients may be at a very high risk if the doctors do not attend them. The medic aid will lead to low doctor pay out. The low payout may lead to the doctors taking advantage of the large number of patients by charging them a lot of money before attending them. Many of the patients will be the low class and middle class earners and may not afford to pay the charges before. They may end up receiving poor services from the physicians (Far, 2012). The medical care providers may also take advantage of the large number of patients where they may set up their own medical clinics and charge a lot of money. The patients may not have otherwise but to attend these clinics. Taking of bribes is an example of the unethical practice which the health care providers may be involved in.
To conclude, the affordable care act was passed in order to make the health coverage available to the poor, specifically, the adults living below poverty line. It was also aimed at expanding the Medicaid to all the adults. The laws have been implemented in 2014. Though the low class earners and other people who are not insured may reap some benefits from the affordable care act, the benefits come hand in hand with some negative impacts. Before the implementation of this act the consequences should have been considered too.
Hofer, A. N., Abraham, J., & Moscovice, I. (2011). Expansion of coverage under the Patient Protection and Affordable Care Act and primary care utilization. Milbank Quarterly, 89(1), 69-89.
Dinan, M. A., Simmons, L. A., & Snyderman, R. (2010). Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform. Academic Medicine, 85(11), 1665-1668.
Far, C. T. S. (2012). Historical trends. MEDICINE.