Primary Care Policy

“There are three basic goals for a National Health Care System; 1) keeping people healthy, 2) treating the sick and 30 protecting families against financial ruin from medical bills”, (Physicians for a National Health Program, 2016). No truer statement could there possibly be written or proclaimed as there is a crisis in healthcare costs across the United States. United States, one of the most developed western country, yet we suffer from – higher infant mortality rates, have shorter life spans and are affected by more chronic disease and or illness – than our contemporaries all while spending the most for insurance per capita and less annual doctor visits with less physicians, (OECD Health Data 2015). There is a question to be answered, “why”, why are we trailing our contemporaries and more important than that is, is our National Health Care system really working for us? The year 2010 was the beginning of change in the United States where we transitioned from primarily private insurance and welfare to a universal healthcare model, under President Obama with the signing into Law of the Affordable Health Care Act March of 2010. The purpose of the Affordable health care act is to ensure that all Americans have access to affordable healthcare, however in 2016 we are still questioning we’ve been successful based on funding, government sponsored healthcare programs, effects on the current HCO, elderly, military and accessibility.

I will compare the current health care system with the new Patient Protection and Affordable Care Act (ACA) that became law on March 23, 2010.   The current system, which is being phased out between 2011 and 2018 is increasingly inaccessible to many poor and lower-middle-class people. About 47 million Americans lack health insurance, an increase of more than two million people from 2005 (Rover, 2011) the increasingly complex warfare between insurers and hospitals over who pays the bills is gobbling up a great deal of money and the end result is that the United States pays roughly twice as much per

The purpose of this paper is to review and discuss the current level of national healthcare expenditures and to determine if we as Americans are spending too much on healthcare. The author of this paper will provide examples and solutions where we as a nation should add or cut from the healthcare expenditures. This paper will also detail how the general public's healthcare needs are being paid for, the biggest economic healthcare challenge, why the challenge should be addressed, and how this challenge to be financed.

The Supreme Court 's favorable ruling on the Affordable Health Care Act allowed for healthcare to be available for many Americans who would otherwise not receive medical benefits. This is because it increases the number of people covered by Medicare/Medicaid, and lowers the cost of insurance through employers. While this idea is good in theory, paying for it is a challenge due to the fact that it will only add to the nation’s already enormous debit of several trillion dollars (Mulvany, 2012). From 2010-2019, the United States is predicted to spend around 400 billion dollars on healthcare. This prediction has prompted lawmakers to reduce spending on Medicare, Medicaid and other welfare programs. The spending cuts will result in less people getting the care they need due to the limited availability of money for care and the increase in the number of beneficiaries receiving

America spends 2.5 times more on healthcare than most developed countries yet still ranking 51st in life expectancy in the world (Baum, 2015). The Affordable Care Act (ACA) was implemented January 1, 2014 by President Obama to expand coverage to millions of individuals in need. It consists of two separate pieces of legislation: the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (Centers for Medicaid and Medicaid Services, 2016). Although the ACA will give health benefits to millions of uninsured Americans, hospitals are receiving less compensation because of the high demand of health care from over qualified recipients. Through the Children’s Health Insurance Program and also the Social Security Act, states are able to pilot a test approach that could extend coverage up to 200 percent of the poverty line (Sommers, Kenney, & Epstein, 2015). Such a large increase in the size of the population that is now eligible to apply for the ACA comes with a sizable amount of fiscal responsibility from the states and puts an immense strain on the amount of money guaranteed to pay for the services provided (Sonier et al., 2013). Given the lack of funding from the Medicaid program, absence of reimbursement strategies, and budget of healthcare in America’s Gross Domestic Product (GDP),

America faces a choice, keep The Affordable Care Act (ACA), also known as Obamacare, or scrap it and come up with something better. The ACA in its entirety leaves room for improvement. It could do better, much better, if it weren’t for matters of political expediency. Currently the United States spends more on health care than any other country. According to a Huffington Post article (2013) the U.S. spends about 17.2 percent of their GDP on medical care. Health care per capita is approximately $8,608, second only to Switzerland, which spends $9,121.

The single most important impetus for healthcare reform throughout recent history has been rising costs (Sultz, 2006). In the book called The healing of America: a global quest for better, cheaper, and fairer health care, Reid wrote that the nation’s health care system has become excessively expensive, ineffective, and unjust. Among the world’s developed nations, the US ranks near the bottom for healthcare access and quality. However, the US ranks at the top for health expenditure as a percentage of the Gross Domestic Product (GDP) and average of $7,400 per person (Reid, 2010). Therefore, Americans are spending

Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster

Health care in the United States is driven by a patchwork of services and financing. Americans access health care services in a variety of ways — from private physicians’ offices, to public hospitals, to safety-net providers. This diverse network of health care providers is supported by an equally diverse set of funding streams. The United States spends almost twice as much on health care as any other country, topping $2 trillion each year. (WHO.INT 2000) However, even with overall spending amounting to more than $7,400 per person, millions of individuals cannot access the health care services they need.(Foundation 2009) So when the Patient Protection and Affordable Care Act (a.k.a the Affordable Care Act or ACA) was passed in the summer

The fact is that the U.S. spends more money on health care than any other country in the world, even when adjusting for relative wealth, according to a 2008 study by Mkcinsey Global Institute (MGI). In 2012 that number was about 2.6 trillion dollars or 18.6% of their gross domestic product (GDP) (13), in other words the U.S. spent about 8,915 dollars per person on health care, or more than twice what they spent on food and more than China spent on all goods and services combined (See Figure 1, MG1 2008). The amount spent on health care is expected to continue to rise , though that rise has slowed in the last three years, estimates suggest it could reach nearly 4.8 trillion dollars by 2021; which would be roughly one fifth of the U.S. GDP (15)

The main cause for the healthcare reform bill is the rising cost of health insurance for the American citizens. From the 1960s to the 1980s healthcare spending went from $28 billion to $255 billion. By the beginning of 2000, healthcare spending increased to $1.4 trillion. The United States economy has slowly declined due to several factors, the cost of health care is one. Presidents, state representatives, hospital and insurance executives, and economists have tried to attack this huge deficit. There are several things that can be done in order to reduce rapidly increasing health care spending. Some actions that could benefit the United States economy is the stop of wasteful

Healthcare spending growth rate trends show astounding estimates. Since 1960, spending has risen from $27 billion ($143 per capita, 5.1% pf GDP) to amazing $1,678.9 billion ($5,670 per capita, 15.3% of GDP, 2003 data) (HHS, 2005). Recent research estimated that by 2013, healthcare spending will be as high as 18.4% of the Growth Domestic Product. It is important to note that the gradual move from hospital to ambulatory setting has resulted in much higher spending on outpatient hospital services and prescription drugs. The spending growth for these two trends is much higher than the overall healthcare cost growth, which, in fact, increases faster than such important economic indicators as GDP growth, inflation growth, and population growth rates.

Finally, the impact of the ACA on the cost of the health care system will be evaluated. Overall, health care spending in the U.S. has continued to grow but at a much slower rate. The Centers for Medicare and Medicaid Services reported that health care spending grew at the lowest rate ever recorded (Hartman, Martin, Lassman, & Catlin, 2014). This was in part due to the ACA. Other factors included slow economic growth and increases in private health insurance spending. Additionally, a greater number of high-deductible insurance plans and an increase in the share of health costs for which the patient is responsible have also increased. It is also possible that people not accessing health care is a factor, in addition to cost controls (Fernandez as cited in Ungar & O’Donnell, 2014). There is also the possibility that spending will grow faster as the economy continues to improve (Ungar & O’Donnell, 2014). The growth of health spending has slowed, however the impact of the ACA on this is unclear. According the the Centers for Medicare and Medicaid Services, the law is at least in part responsible for this. However, faster growth may return as the economy grows.

While the ACA has implemented measures to increase the numbers of nurse practitioners in primary care areas by funding graduate nurse education, financial incentives for nurse practitioners to work in MUAs, and increased funding for FQHCs and NMHCs that support the nurse practitioner role as a primary care provider. A common barrier cited and discussed among policymakers is the mixture of state level regulations and federal policy demonstrating an obstacle to the full and efficient utilization of nurse practitioners.

The healthcare system plays a key role in the economic stability of our country, as every year trillions are spent in attempt to combat disease and health issues that plaque humanity. As it makes up a significant amount of the expenditures in the economy, so the costs associated with health care of those in pain from illness and injury, including lost productivity, increased need of assistance in living and also the cost of death in some cases, is important to the economic stability and over all standard of living in our country. The key to economic prosperity is balancing the need for care with the costs of illness to keep as many people healthy and well without breaking the bank of collective society. The costs of healthcare have been increasingly problematic in recent years with so many issues surrounding the current system. With the “total health care spending in the United States expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970, meaning that health care spending will account for nearly 20 percent of gross domestic product (GDP), or one-fifth of the U.S. economy, by 2021” (Aetna). With this in mind it is apparent that as we look at the trillion-dollar industry of the medical community it seems that it needs to be a major focus of our nation as a whole and with the many issues come many creative solutions. First let us analyze the reasons behind the current cost and the major problems facing this industry and than discus what