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英国代写--英国管理论文代写78分案例:The Reform of America’s Healthcare of 2010

英国代写--英国管理论文代写78分案例:The Reform of America’s Healthcare of 2010
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The Reform of America’s Healthcare of 2010

 

 

Table of Contents

1.0 Introduction............................................................................................................3

2.0 Current Literature Review...................................................................................3

3.0 The Needs of Reform.............................................................................................4

3.1 The Insurance Cost and Availability…………………………………………4

3.2 Quality………………………………………………………………………..6

3.3 The Cost of the Lack of Health Insurance…………………………………....6

4.0 The Obstacles...........................................................................................................7

5.0 The Benefits.............................................................................................................8

6.0 Conclusion...............................................................................................................10

7.0 Reference.................................................................................................................12

 

 

 

 

 

 

 

 

 

 

 

 

Introduction

     The president Obama signed the Patient Protection and Affordable Care Act (PPACA) on March 23, 2010, and the Health Care and Education Reconciliation Act of 2010 on March, 2010, to amend the PPACA. The healthcare system reform is thought to be the most significant reform of American social security in decades. The major expectation for this reform is to expand the Medicaid to those who have low-income and don’t have medical insurance. Also, the quality of insurance will be improved for those who already had medical insurance. However, the implementation process of this policy has faced with enormous obstructions as every innovation policy of health care has. Fortunately, it succeeded. This assignment mainly aims at analyze the policy, obstacles, and the solutions through the wholeimplementation process.

Current Literature Review

     Santa Barbara listed the history of presidents’ attempting to reform American health care system in her book The American Presidency Project. From the first introduction of Medicare by President Lyndon Johnson, 1965, to the State Children’s Health Insurance Program enacted by the U.S. government, the American health care system though has made huge progress, was still unsatisfactory. Leonard L. Berry stated in his article Confronting America’s healthcare crisis that healthcare in America is sick. It costs too much, wastes too much, errs too much, and discriminates too much. Though money is put into it, little of themreturn on the investment. The system is unsustainable.

     Americans are the only citizens who live in a developed country but without medical assurance for everyone. David Cecere, Harvard University, conducted a research and found that 45,000 deaths annually linked to lack of health coverage. When diseases arrive, people without health insurance try to manage the medical expenses at a minimal level by instinct, and a higher mortality is normally as the result.

Meanwhile the medical insurance company do far more better of chasing profits than providing services. Ezra Klein stated on the Washington Post that the medical insurance fee has grown more than 90 percent from 2000 to 2007. Insurance companies refuse to insure people with pre- existing conditions or charge for usually high fees. About 12.6 million adults under 65 have received discriminating treatment under these rules.

Clearly, the system’s reform is urgent. However, this problem has been there for a long time. Then what makes it delayed until 2010 and the process was still tough? What are the strategies to successfully put this policy through? This assignment will be mainly focused on exploring these questions. Moreover, the benefits of this system reform will be estimated by processing the data.

The Needs of Reform

The Insurance Cost and Availability

     From 2001 to 2007, wages increased 19 percent, while premiums for family coverage increased 78 percent, and price increased 17 percent, according to the Kaiser Family Foundation. A research conducted in February, 2009, showed that 52 percent interviewers had cut their medical expenses considering the fees, and 19 percent interviewers had been suffering serious financial difficulties due to medical fees. 15 percent of the U.S. population, about 41 million people lack coverage every year. The United States is the only developed country without medical insurance cover all citizens. Surprisingly, the U.S. spent no less money on healthcare than any other countries. In fact, America’s medical fees per capita exceed the Switzerland by 52 percent in the second place, according to the data in 2006. In 2009, the healthcare expenses possessed 21 percent of federal budget, which exceeded thedefense expenditure by 20 percent. In this situation, the government financial deficit reached 1.417 trillion dollar, according to the Budget Results for Fiscal Year 2009.

 

     Source: OECD Health Data 2010

Quality

     Ezra Klein stated on the Washington Post that the medical insurance fee has grown more than 90 percent from 2000 to 2007, and 10 most influential American insurance companies’pay-back rose 428 percent during this period. Moreover, Insurance companies refuse to insure people with pre- existing conditions or charge for unusually high fees. About 12.6 million adults under 65 have received discriminating treatment under these rules. And many patients’ contracts are terminated when they were diagnosed with cancers or other diseases with high costs of treatment. The quality issues also include the waste, the inequality, and the inefficiency, etc.

 

Source: Lane Kenworthy. America’s inefficient health-care system: another look

The Cost of the Lack of Health Insurance

     When disease occurs, people uninsured often try to keep the medical expenses at a minimal level, which usually are at the expense of health or even life. The other choice is depending on the social Medicare services, which certainly will burden the public expenses and occupy the medical resources. Eventually, this extra cost still comes from the taxers and the insurers.

     Money is only the directly visible costs, even more expenses are hidden. According toHidden Costs, Value Lost: Uninsurance in America, the IOM Committee on the Consequences of Uninsurance pointed out that: The uninsured lose their health and die prematurely; Families lose peace of mind because they live with the uncertainty and anxiety of the medical and financial consequences of a serious illness or injury; Communities are at risk of losing health care capacity because high rates of uninsurance result in hospitals reducing services, health providers moving out of the community, and cuts in public health programs like communicable disease surveillance; The economic vitality of the country is diminished by productivity lost as a result of the poorer health and premature death or disability of uninsured workers; Medicare, Social Security Disability, and the criminal justice system probably cost more than they would if everyone had health insurance up to age 65.

The Obstacles

The healthcare reform aimed at solving three major problems: Stop the too fast increasing trend of medical expenses and alleviate the financial burden of government, corporations and citizens; make medical insurance available to everyone and forbid the discriminating rules of insurance companies; improve the quality of medical services. The Democratic Party held that government functions should be expanded to create a public medical insurance plan, through which the insurance companies have to lower the fees in order to survive during the competition. In this way, more people will gain the access to medical insurance. Also, withguarantees of the government, citizens will not risk bankruptcy of suffering serious illness. The insurance companies are not allowed to turn down any patient with “expensive” illness.Essentials of this reform, Affordable Care Act (ACA) include: 1) a mandate for individuals and businesses requiring as a matter of law that nearly every American have an approved level of health insurance or pay a penalty; 2) a system of federal subsidies to completely or partially pay for the now required health insurance for about 34 million Americans who are currently uninsured – subsidized through Medicaid and exchanges; 3) extensive new requirements on the health insurance industry; and 4) numerous regulations on the practice of medicine.

However, the Republican Party opposed it. They regarded that the government’s participate will only create a high-cost, inefficiency bureaucracy, which will certainly cause the unfair competition environment and damage the customers’ option.

Moreover, though the reform will save much money in a long-run, the initial investment has to increase 188 billion dollar. The United States might suffer more damage in the global financial crisis with even more deficit.

Another obstruction comes from the clause of raising taxes from families with annual income more than 250 thousand dollar. Raising taxes has always been a sensitive issue in the United States. Not mention that in some upper-middle class’s perspectives, this reform is wasting the rich people’s money to support those vagrant, even illegal immigrants.

The Benefits

     The expansion of the medical insurance coverage will provide more qualified life for people who are currently uninsured. Three-fifths of uninsured people do not have regular doctor or medical home, making them much less likely to receive preventive medical care or to properly manage chronic medical conditions. Research from the Urban Institute estimates that 27,000 Americans may have died in 2006 because they lacked health insurance. The Institute of Medicine estimates that the aggregate, annual cost of uninsured people’s lost capital and income from illness and shorter life spans ranges between $65 billion and $130billion for each year without coverage.

     Actually, people uninsured received health care services valued at about 99 billion dollars in 2001 and increased by an estimated 34 to 69 billion dollar each year. But about 27 percent of Medicare’s budget goes to medical care for patients in their last years of life, which is too late, too painful and too inefficient. If the money is used in their early ages, in the form of insurance, situations will be much different.

     Projections suggest that with reform, total health care expenditures as a percentage of the gross domestic product will be 0.5% lower in 2030 than they would otherwise have been. In addition, although the Congressional Budget Office (CBO) expressed concern that health care costs will remain high even after reform, it also determined that the Affordable Care Act (ACA) will reduce the federal budget deficit by more than $100 billion over the first decade and by more than $1 trillion between 2020 and 2030. And the Commonwealth Fund recently projected that expenditures for the whole health care system will be reduced by nearly $600 billion in the first decade.

     It is certain that this reform is worthwhile. First, it without a doubt will save both money and health for people who currently are not insured. Second, it will alleviate the stress of fearing of losing the medical insurance, which is a nightmare for most Americans, foreveryone. Third, it will kill the discrimination of insuring industry that anyone deserves the same rights to be medical insured. Forth, the financial expenses on healthcare will be much more efficient for the greater financial stability of insurance-based financing. Fifth, it will reduce the federal expenses on healthcare and alleviate the government’s financial burden.

Conclusion

     The Affordable Care Act will save the health care spending: The CBO on March 20, 2010, estimated the legislation would reduce the deficit by $143 billion over the first decade and by $1.2 trillion in the second decade. The uninsured will be gradually insured: According to CBO estimates, the number of uninsured will be reduced by 32 million from current levels.The non-Medicare health insurance premiums will decrease: Administration officialsestimated a $2,500 reduction in premiums for each individual.

This is just the beginning. It represents the most significant transformation of theAmerican health care system since Medicare and Medicaid. It will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The focus on American health care system is gradually turning from cure to prevention, which not only costs less, but more important, the quality of life is much higher.

Though, three years has passed, the heat of the debate is still on. Concerns like the government intervention into the market, the even higher taxes, and the economic recession still may put the country in danger. However, the President Obama’s re-election and the achievements of the ACA might be a sign of the success of this revolutionary health care system reform.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reference

Joshua T. Cohen, Peter J. Neumann, and Milton C. Weinstein. Does Preventive Care Save Money? Health Economics and the Presidential Candidates. N Engl J Med 2008; 358:661-663.

Milton C. Weinstein, and Jonathan A. Skinner. Comparative Effectiveness and Health Care Spending — Implications for Reform. N Engl J Med 2010; 362:460-465.

Cutler DM, Davis K, and Stremikis K. The impact of health reform on health system spending, May 2010.

Peter R. Orszag, and Ezekiel J. Emanuel. Health Care Reform and Cost Control. N Engl J Med 2010; 363:601-603.

Kaiser Family Foundation, Health Care Costs: A Primer. March 2009.

The Kaiser Family Foundation. Medicare and the President’s Fiscal Year 2009 Budget Proposal. February 2008.

Maura Reynolds. A Matter of Mandates. CQ Weekly, Vol. 67, No. 41, November 2, 2009.

David Cecere. New Study Finds 45,000 Deaths Annually Linked to Lack of Health Coverage.Harvard Science. September 17, 2009.

Ezra Klein. Prescriptions for Reform Then and Now. The Washington Post, Outlook, Sunday.July 26, 2009.

Coverage Denied: How the Current Health Insurance System Leaves MILLIONS Behind.Available at: http://www.healthreform.gov/reports/.

Leonard L. Berry. Confronting America’s healthcare crisis. Business Horizons (2008) 51, 273—280.

Appleby, J. (2006b, October 19). Debate surrounds end-of-life expenses. USA Today.Passage page: 1B-2B.

Ayanian, J. Z., Weissman, J. S., Schneider, E. C., Ginsburg, J. A., and Zaslavsky, A. M.Unmet health needs of uninsured adults in the United States. Journal of the American Medical Association, 2000, 284(16), 2061—2069.

Davis, K. (2008, January 24). A prescription for our nation’s ailing health care system. TheCommonwealth Fund. Retrieved February 24, 2008, fromwww.commonwealthfund.org/publications/publications show.htm?doc_id=648305.

Hidden Costs, Value Lost Uninsurance In America. Institute of Medicine. June 2003.

Laxmaiah Manchikanti, David Caraway, Allan T. Parr, Bert Fellows, and Joshua A. Hirsch.Patient Protection and Affordable Care Act of 2010: Reforming the Health Care Reform for the New Decade. Pain Physician 2011; 14:E35-E67.

美国医疗改革2010
内容表
1引言............................................................................................................ 3
2目前的文献综述................................................................................... 3
3 ............................................................................................. 4改革的需要
3.1保险的成本和可用性................................................ 4
3.2质量................................................................................... 6
3.3医疗保险........................................... 6缺乏成本
4 ........................................................................................................... 7障碍
5的好处............................................................................................................. 8
6结论............................................................................................................... 10
7参考................................................................................................................. 12
景区简介
总统奥巴马签署的患者保护与平价医疗法案(PPACA)于2010年3月23日,与卫生保健和教育2010和解法案在3月,2010,修改PPACA。医疗体制改革被认为是美国几十年来最重要的社会保障改革。这项改革的主要期望是扩大医疗补助给那些有低收入者和没有医疗保险的人。此外,保险的质量也会提高那些已经有医疗保险的人。然而,这一政策的实施过程中,面临着巨大的障碍,因为卫生保健的每一个创新政策。幸运的是,它成功了。本文的主要目的是分析政策,障碍,和解决方案,通过整体的实现过程。
现行文献综述
圣诞老人巴巴拉列出了总统在她的书中试图改革美国医疗保健系统的历史。由美国总统约翰逊林顿,1965,对国家儿童健康保险计划的第一个介绍由美国政府制定,美国医疗保健系统,虽然取得了巨大的进展,仍然不能令人满意。伦纳德。他在他的文章中指出,美国的医疗保健危机,在美国的医疗保健是生病的。它的成本太高,浪费了太多的错误,太多太多,和辨析。虽然钱放进去,对themreturn对投资小。系统是不可持续的。
美国人是唯一一个生活在发达国家的公民,但是没有医疗保障的人。戴维的看法,哈佛大学,进行了一项研究发现,每年45000人的死亡与缺乏健康保险。当疾病到达时,没有健康保险的人会本能地管理医疗费用,并以较高的死亡率为结果。
同时,医疗保险公司的利润远远超过提供服务。以斯拉克莱因说,在华盛顿邮报,医疗保险费用的增长超过百分之90从2000到2007。保险公司拒绝为一般高费用的预先存在的条件或收取的费用投保人。在65岁以下的成年人中,约有12600000的成年人接受了这些规定的歧视待遇。
显然,制度的改革是刻不容缓的。然而,这个问题已经有很长一段时间了。那么什么让它推迟到2010,这个过程仍然是艰难的?什么是策略,成功地把这一政策通过?这项任务将主要集中在探索这些问题。此外,该系统的改革的好处,估计处理的数据。
改革的需要
保险费用和有效性
从2001到2007,工资增加了百分之19,而家庭保险保费增加百分之78,价格增加了百分之17,根据Kaiser家庭基金会。二月进行的一个调查显示,百分之52名面试官已经削减了医疗费用,百分之19名面试官因医疗费用而遭受严重的财政困难。百分之15的美国人口中,每年约有41000000人缺乏覆盖。美国是唯一没有医疗保险的发达国家。令人惊讶的是,美国在医疗保健方面的花费比其他国家都要少。事实上,美国的人均医疗费用超过了瑞士的百分之52,根据2006。2009,医疗费用具有联邦预算的百分之21,超过百分之20的国防支出。在这种情况

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