Affordable Care Failure

Improved Essays
The United States - The Patient Protection and Affordable Care Act (ACA) of 2010 established “shared responsibility” between the government, employers, and individuals for ensuring that all Americans have access to affordable and quality health insurance. However, health insurance coverage remains fragmented, with numerous private and public sources as well as wide gaps in coverage rates across the U.S. population. The Centers for Medicare and Medicaid Services (CMS) administers the Medicare program (a federal program for those age 65 and older and the disabled, including those with end-stage renal disease) and works in partnership with state governments to administer Medicaid and the Children’s Health Insurance Program (a conglomeration of …show more content…
In 2014, state- and federally administered health insurance marketplaces were established to provide additional access to private insurance coverage, with income-based premium subsidies for low- and middle-income families, and federally subsidized expansion of Medicaid eligibility was made available in states choosing to participate. While it is too early to measure the impact of all of the various components of the ACA, studies already have found evidence that the number of uninsured adults has declined by about 9.5 million from July–September 2013 to April–June 2014 (Collins, Rasmussen, and Doty, 2014). Early evaluations of Medicare ACOs have also found promising results with regard to quality improvement and savings (CMS, 2014b). As of January 2015, Medicare will pay for doctors to coordinate the care of patients with chronic conditions. To be eligible for an extra $42 per patient, doctors will have to draft and help carry out a comprehensive plan of care for each patient who signs up for one. Under federal rules, those patients will have access to doctors or other health care providers on a doctor’s staff 24 hours a day and seven days a week to deal with “urgent chronic care …show more content…
Many provinces and territories have established regional health authorities that plan and deliver publicly funded services locally. Generally, these authorities are responsible for the funding and delivery of hospital, community, and long-term care, and mental and public health services. Health care providers are almost entirely private. Federal government co finances provincial and territorial programs, with conditions on adherence to the five underlying principles of the Canada Health Act, the law that sets pan Canadian standards for medically necessary hospital, diagnostic, and physician services. Principles state that each provincial health care insurance plan needs to be: publicly administered, comprehensive in coverage, universal, portable across provinces, and accessible (meaning that there are no user fees). Federal government also regulates the safety and efficacy of medical devices, pharmaceuticals, and natural health products; funds health research; and administers several public health functions. At the national level, several intergovernmental nonprofit organizations (which included the Health Council of Canada, closed in 2014) aim to improve governance by monitoring and reporting on health system performance; disseminating best practice in patient safety (the Canadian Patient Safety Institute); providing information

Related Documents

  • Great Essays

    The Canadian health care system and related issues are hotly debated topics in Canada. The polarity of the debate is well represented in the somewhat divergent perspectives presented in the books: Health Care by Pat and Hugh Armstrong and The Canadian Regime by Patrick Malcolmson et al. Two aspects of the Canadian health care system are debated with vigor and vehemence, and will be the basis of the comparison between the two books, they are: federalism, and privatization. In Canada currently, the responsibilities of health care are split between federal and provincial governments, with the Federal government contributing about 20 percent of provincial health spending (225), 1 and while provinces provide the bulk of money, they adhere to federal…

    • 1720 Words
    • 7 Pages
    Great Essays
  • Great Essays

    Despite about nine percent of Americans being uninsured, around 50% of Americans receive private insurance via their employer. More than half of Americans have private insurance via their employer or the marketplace, with each insurance plan varying greatly in the coverage provided and the cost to the policyholder. For those living in the United States, understanding the complexities of coverage and healthcare financing is challenging, with many not entirely knowing the complete system (ISPOR, n.d.). The health care system is a polarizing topic in the United States, with new legislation often occurring on the state and federal levels. There is a need for Americans to understand the health care policies and legislation that can affect them, as just because an individual or family is insured does not guarantee they will receive certain services for a particular fee.…

    • 2530 Words
    • 11 Pages
    Great Essays
  • Improved Essays

    In doing so, the national and provincial/state governments as well as providers find themselves in conflict with each other and resolving it leads to significant increases in reimbursement. This then will put pressure on the other provincial/state governments to improve their contracts as well. Another issue that a federal system of health care face is the delivery of services. In such system, physicians can choose “where they will work and in the volume and mix of services they choose to deliver” (Vaughn, 2016, p. 762). Lastly, two opposing trends of allocation has been observed in provinces.…

    • 1257 Words
    • 6 Pages
    Improved Essays
  • Improved Essays

    Private Health Care System

    • 1447 Words
    • 6 Pages

    In order for a health care system to function efficiently it must be funded and set up properly (Angell 918). The Canadian system is not properly funded and this is why it is under attack for being inefficient and too costly (Steinbrook 1661). Health care should not be privatized…

    • 1447 Words
    • 6 Pages
    Improved Essays
  • Improved Essays

    That is, patient health information assimilated, analyzed, and programmed to identify what determines the price, quantity, and expenditures on health care. Closely linked is health insurance; thus, HIS technology tracks, and monitors utilization activity, and records insurance data, plus captures claim discrepancies according to reimbursement transactions between health care organizations and the insurer. Furthermore, the ACA contained initiatives, which have been instrumental in developing strategies, such as, the Accountable Care Organization (ACO) with measures to move the public health care insurance for seniors, i.e. Medicare from the fee-for-service systems to a somewhat similar capitation care model. Before the comparison, it is important to identify changes that affect the recipient of Medicare…

    • 1300 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    Managed Care Failure

    • 694 Words
    • 3 Pages

    Carmen et al. (2015) reports a 6.9 million enrolled in Medicaid during the period September 2013 and February 2015. With the trend of Medicaid plans using MCO's, the Medicaid Expansion component of the ACA will inevitably grow and take a much larger role in healthcare delivery. The ACA has undeniably expanded coverage but there are questions on whether or not it has provided better access and…

    • 694 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Affordable Care Act

    • 1007 Words
    • 5 Pages

    The Affordable Care Act, was built for renovation within the health care system, which is essential to encompass costs. The Patient Protection and Affordable Care Act covers several titles, which each address an essential element of reform. These are the quality, affordable health care for all Americans, the role of public programs, and to improve the quality and efficiency of health care. Also, for prevention of chronic disease, to improve public health, and the essential element is to reform the health care workforce. In addition, transparency and program integrity, and improving access to innovative medical therapies, community living assistance services and supports, and revenue provision.…

    • 1007 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    The article discusses how Obamacare is experiencing market failure. The textbook states, “We use the term market failure to refer to situations where the market generates imperfect (suboptimal) outcomes” (Schiller, 2016). Obamacare is a form of medical insurance offered through the federal government. “Obamacare also known as the Affordable Care Act, or the ACA is a law enacted to ensure that all Americans have access to affordable health insurance” (Neporent, 2013). The companies that are offering Obamacare, such as UnitedHealth Group Inc. and Aetna Inc., are experiencing great losses on individual plans.…

    • 297 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    Healthcare Vs Medicare

    • 722 Words
    • 3 Pages

    The Center for Medicare and Medicaid Services (CMS, 2012) a subsidiary of the Department of Health and Human Services which is a federal agency of the United States of America that operate and monitor the states Medicare and Medicaid programs which was establish in 1965. According to King (2011) the intension of the Affordable Care Act is to increase accessible to insurance, increase growth of the buyer securities, emphasize prevention and health improvements, expand quality and system performance, growth of the health workforce, and control increasing expense of health care. The Affordable Care Act was establish in 2010 as reported by King (2011). A comparison and contrast of the requirements, funding and prevention of the two programs will…

    • 722 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Doctors who take government health plans (Medicare, Medicaid) will have to accept 21 to 43 percent reduction on their payments, which is already 20 to 40 percent less than what private insurance pays (Matthews, 2015, para. 2 & 6). Consequently, the medical practice where I work at and others I known of has stopped accepting new patient covered under these plans. Medicaid insurers are having a hard time finding a primary doctor and if they do it’s still tough to find a specialist to their medical needs. Millions Americans are now insured under Medicaid, but who is going to treat…

    • 708 Words
    • 3 Pages
    Improved Essays
  • Great Essays

    Statistically, only twenty-eight percent of Americans are insured through government-funded programs such as Medicare and Medicaid, implemented in the middle 1960s. Medicare commonly insures older people with acute care needs. “Medicaid is the joint federal-state government-sponsored program that pays for health services for poor children, pregnant women, and mothers of young children as well as mentally and physically disabled and very poor elderly individuals” (Emanuel 36). The most recent attempt to maintain a current medical assistance problem was a new law widely known as Obamacare. President Obama signed the Affordable Care Act into law on the 23rd of March 2010, putting in place comprehensive reforms that are meant to improve access to affordable health coverage for everyone and protect consumers from unfair insurance company practices.…

    • 1634 Words
    • 7 Pages
    Great Essays
  • Decent Essays

    The Member of Parliament who raised the question has failed to grasp two important points. Firstly, although, from a theoretical vantage point, rights are universal, in practice rights are characterised by hierarchy. In Britain, the right to health care is of more practical value than the right to food. Secondly, because consumers are not sovereign, the health care market is susceptible to market failure. Although the existence of market failure and/or market inequalities is not in itself a reason for government intervention, the extent of the distortions and pervasive incentives that arise in health care renders government intervention in the funding and regulation of the health care market an economic…

    • 111 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    Service Delivery

    • 1244 Words
    • 5 Pages

    Health Governance and Service Delivery. Federal : Health Canada is an initiative of the federal government of Canada, which governs the overall functioning of the health sector of this vast nation. Health Canada supports the 10 provinces and 3 territories with funding to facilitate financial stability and provides for the needs of each province/territory.…

    • 1244 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    Healthcare Expensive Essay

    • 1122 Words
    • 5 Pages

    “An estimate done by the Census Bureau’s, said that thirty-three million Americans lacked health insurance in 2014 reflects a significant and welcome drop from the forty-two million it reported as uninsured in 2013,” said Dr. Robert Zarr, president of Physicians for a National Health Program, today (More Americans gain health coverage, but many can’t afford to use it: doctors group). In this time of rising health care costs, a great amount of Americans experience troubles or difficulties paying for needed health care services. With the costs that are expected to continue rising, changes happening to private insurance plans and public…

    • 1122 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    The system is publically funded, but doctors are still allowed to profit from certain services that are used in the NHS, such as “pay beds” and from some cosmetic services. Canada’s healthcare system is referred to as the “public” system. The structural actor of government had tried to gain support from the doctor colleges in Canada to create a public healthcare system that would try to exclude the private system. With the government being successful in gaining the support of the doctor’s colleges, they were able to monopolize the medical knowledge and then incorporate it into the Canadian healthcare system allowing them to create a public system. With Canada’s healthcare system trying to exclude the free market, it has not been fully successful in eliminating private mechanisms and profiteering from the…

    • 1587 Words
    • 6 Pages
    Improved Essays