HCA 205 Week 5 Discussion PPACA and Your Take-Away

Sample Answer

According to the article” Neatly 20 Million Have Gained Health Insurance Since 2010″, Nicholas Bakalar, the author, says that the goal of the PPACA was to make health insurance coverage accessible for the U.S. Citizens and protect them from expensive or restricted care imposed by insurance companies.

Part I

The three keys elements of the act that I believe will be the most positive for the country are;

• More people have health insurance

Many people can agree with me that when you are sick, you feel like your world is stopping because it becomes difficult for you to do things that you usually do without even thinking, like for example, walking or talking. I remember when I first moved to America, I worked with a company that did not offer health insurance unless you were a salaried employee. I met a gentleman from that company that suffered from a toothache for several months.

I could tell his case was severe because he was not even enabled to eat regular food, and he had different types of over the counter medicines in his book bag, and also, his face gradually got deformed. I could tell that that gentleman was in constant pain because of the facial expression. None of the dentist offices that he contacted wanted to receive him because he had no insurance and those that accepted him requested at least two thousand dollars up front.

One day, he passed out in his apartment, and one of his roommates called the ambulance. He woke up at the hospital with no memory of how he got there and his nurse told him that he had mouth surgery. My point here is that if the man had easy access to health insurance ( Physical, dental, vision), his situation would not have escalated to the point where he almost died. So I strongly believe that more people need to access health insurance so that everybody can get the chance to get minor health issues checked before they get out of hands.

• People with pre-existing conditions can still get health insurance

According to the article “Don’t deny insurance to sick people. There are other ways to reduce health care costs.,” the authors say that before the ACA, about fifty million people had pre-existing health conditions that placed them at risk of losing health coverage. The authors use a cancer patient as an example of a person with a pre-existing condition and say that people in that situation were susceptible to get the payment of their medical expenses denied by their insurers before the ACA.

They also say that those that change jobs had difficulties getting another coverage. So, my view here is that insurance companies should provide health coverage to everyone without any complications because people are sick and they need medical attention and any other type of support that will help them get through their situations.

• Lower prescription drug costs

We did one simulation exercise where the patient, Trevor, could not refill his medication because he had no insurance and they were expensive. We can all agree that even though that was a simulation exercise, many people go through this every day. It is very frustrating and upsetting to know that someone got seen by his/her doctor, got a medical prescription, and cannot afford to buy his medicines.

At some point, it seems like not seeing a doctor due to lack of money or insurance is not different from seeing a doctor and not having money to buy your medicines. So, the reason why I believe that medications should be affordable for patients is that patients have already spent a lot of money at the doctor’s office and some have only little left to buy medications.

The three keys elements of the act that I believe will be the most negative for the country are;

• Constant changing

Even though the ACA is recently passed, it is going to change every year because some additional elements were delayed or suspended( Michael, Thomas, 2016). Getting additional elements or components very could mean anything from replacing a new regulation to an existing one or canceling a new regulation and replace it with nothing.

So, every time that the ACA gets modified, your health insurance contract with change too. I believe that changing the ACA components every year is negative because it will make people live with a constant fear of an unexpected loss or cost augmentation of their health coverage.

• You can get penalized if you do not have insurance

” If an individual goes without qualifying minimum essential coverage for more than a single period of up to three months in a year, he or she may owe a penalty under the Shared Responsibility payment.” (Michael, Thomas, 2016 ). The ACA is forcing people to get health insurance or making the situation look like not having health coverage is not different from breaking the law.

I believe penalizing people for not having insurance is negative for the country because I know that we normally get penalized most of the time only when we do something stupid like driving above the speed limit, for example. I believe that everyone should be free to do what they think is best for them, and getting health coverage should be optional.

• Many people are paying higher premiums

Because of the ACA, many people have been spending a lot of money out of pocket for medical expenses such as deductibles, copays, and coinsurance. Mr. Michael, Thomas says in his article that the out-of-pocket maximums coverage for an individual went from $6,600 in 2015 to $6,850 in 2016 and the family coverage went from $13,200 to $13,700 and this rate change were noticed in thirteen major cities in the U.S.

After reading this article, I understand once again that no one wants to lose money, I realize that every single time that the ACA is going to get any type of modification someone’s pocket is going to suffer for it. I believe that making pay higher premiums is negative because it makes us spend more money out of our pockets.

Part II

My definition of the U.S. healthcare system posted in week one.

I believe that the U.S. healthcare system is very capitalistic; money takes the first place, no matter what kind of disease the patient has. If someone gets “lucky” and gets treated first, he will be overwhelmed with medical bills later. About the medical care itself, I believe that the U.S. healthcare system is one of the best in the world. My new definition is not that different from the first, it is well known that the U.S. healthcare system is one of the best of the world, but the contrast is that many hospitals in this country practice patient dumping.

Many hospitals in the U.S. choose to get rid of patients that have no income, or insurance because they are not making any money off those people. Many of those patients are undocumented immigrants, homeless, or mentally ill patients and they are sometimes dumped on the streets, homeless shelters, or other hospitals ( Tony, Abraham, 2018). This shows that the healthcare system in this country is all about money and nobody in this business chain (Doctor, Pharmacists, etc.) is ready to lose a dime.

My first definition is broad, and I did not use an example to support my position. The second definition is more specific, and I used an example to show that the U.S. healthcare system is capitalistic and many of the people that run this system care more about the money than the people.

My vision of the U.S. healthcare system in the next 5 or 10 years.

There is no doubt that the technology is still going to be on point, but we will have more patients getting kicked out of hospitals because of the same reasons that I mentioned above. We can all agree that life is becoming much more expensive and many people are worrying more about feeding their families than getting them health coverage.

That means we are going to have more uninsured people in the next five to ten years, more patient dumping because many people cannot afford to pay their medical bills. So the situation that we are living now will get worse because the healthcare system is capitalistic; meaning that you are useless if they cannot make a profit from you.

Any potential reforms, research, suggestions for improvements.

One suggestion that I have for the improvement of the health care system is that the government should reduce the cost of healthcare. I know this is not easy, but I strongly believe that nothing is impossible for the government because if they can find billions of dollars to send astronauts to the moon, then they can also find money to finance our health care system and make it affordable for everyone.

Another suggestion I have is that this country needs to look around and study how countries like France, Canada, Australia and other developed countries manage their health care systems and come up with something that benefits everyone in this country.

References

• https //www.healthcaredive.com/news/patient-dumping-symptom-of-health-system-woes/516018/Links to an external site.
• https //www.nytimes.com/2017/05/22/health/obamacare-health-insurance-numbers-nchs.htmlLinks to an external site.
• https //www.usatoday.com/story/opinion/2018/07/12/cover-pre-existing-conditions-reduce-health-costs-other-ways-column/763590002/Links to an external site.
• https //www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.htmlLinks to an external site.