Table of Contents
The American healthcare agency is a complex system comprising of various sectors that provide specialized services to the public. In essence, departments in the area of health give services in fields such as the environment, laboratory, family planning, and nutritional aspects that promote the welfare of the society. According to Sala-i-Martín et al. (2012), a country’s economic development can be enhanced by improving the health of the citizens and providing essential services to eradicate poverty from the society. Such actions tend to promote a healthy workforce that is crucial in determining the overall productivity of a nation. Healthcare providers in the United States are categorized into public, private, profit, and non-profit organizations. The federal government is responsible for providing various health services to the public, including poor Native Americans, war veterans, women, and children. In an attempt to fulfill this obligation, the government uses the two principal public healthcare programs in the country, which include Medicare and Medicaid. Notably, the health sector has undergone a series of changes from the past century to its current state. The factors influencing this evolution are also essential in predicting the future of healthcare in the U.S. The transformation of the United States health system is a process that involved historical issues, social factors, and government policies, thus necessitating for innovative changes to improve the sector.
History of Health Care
The American history of changes in health care dates back towards the end of the nineteenth century. According to Gereffi and Wyman (2014), the industrial revolution in the United States created steel mill jobs in most of the cities employing residents in those areas. However, the work increased the health risk to the employees as plants could occasionally explode molten steel that injured or in extreme cases killed workers. With the growing prevalence of these jobs, their unions grew in power with the aim of protecting members from financial losses as a result of illnesses or injuries acquired from the workplace. Subsequently, unions began offering different forms of health protections to the members to safeguard their welfare while at the workplace. However, their effectiveness was limited by an unorganized structure of the health system in the country.
Apart from the employee unions, the inability of people to live below the poverty threshold to afford their basic health care needs also spurred changes in the healthcare system of the United States. The government sought the most effective ways to ensure that everyone could afford meeting their health care needs and improve the life expectancy of its citizens as well. Moreover, the government also had considered minimizing the mortality rates in the country by promoting the affordability and quality of healthcare provided by medical institutions. Due to such reasons, major health acts and programs, such as the Affordable Care Act, Medicare, and Medicaid, were developed. Notably, these policies have contributed significantly to the transformation of the healthcare system of the United States. The cost of healthcare also increased rapidly as the government shifted its focus to the second Iraq war. The National Health Expenditure (NHE) recorded 17.9 percent allocation for the healthcare of the total Gross Domestic Product (GDP) by 2010 (Martin, Lassman, Washington, & Catlin, 2012). However, this era marked a new phase in the history of healthcare in the United States.
The Affordable Care Act
According to Beronio, Skopec, & Glied (2014), President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law in 2010. The PPACA, also the Affordable Care Act (ACA), was expected to transform the healthcare system of the United States and improve the quality of medical care provided in the country. However, due to complexity issues, the provisions of the law were to be implemented in phases to ease public and insurance companies through the transition process. The number of people enrolled for health insurance through the ACA program was 11.7 million by 2015 whereas approximation statistics demonstrate that the average enrollments per year were 11.4 million (Beronio, Skopec, & Glied, 2014).
The ACA program has faced challenges in its application for a variety of reasons. For example, employee and employer mandate to fulfill the healthcare obligations have been the most contentious issues regarding the law. The law requires employers to contribute towards healthcare coverage to their workers. However, employees also have to devote to this goal by a certain percentage of their income. Other provisions of the ACA have also been presented to the Supreme Court by constitutional violations.
Regardless of the controversies associated with the Affordable Care Act, the pre-existing condition clause has been the most helpful aspect of the program. Insurance companies had been denying coverage to people with pre-existing health conditions such as strokes, AIDS, asthma, and cardiovascular complications. However, with the introduction of ACA, the number of individuals covered by various health policies increased significantly. Besides, this effect was expected to improve the welfare of the society, especially the poor and the less fortunate community members.
Medicare covers most medical costs for individuals aged over 65 years as well as people on social security disability (Kongstvedt, 2012). Notably, this program is said to be one of the largest domestic programs in the United States. Medicare is provided regardless of the income levels of an individual. People who are eligible for Medicare include those with permanent disabilities, kidney diseases, federal and state government employees, social security recipients, and railroad retirees. According to Kongstvedt (2012), there are two parts of the Medicare program. The first part (Part A) includes basic hospital insurance that covers costs of hospitalization, post-hospital extended care, and home-based health services. The second part (Part B) is the optional supplementary medical insurance that assists in covering costs of diagnostic tests, prescription drugs, medical supplies, and physicians’ charges.
Medicaid is the second major health program in the United States. It is a federal grant to states with the aim of financing the healthcare needs of those who cannot afford or the poor (Kongstvedt, 2012). The services offered under the Medicaid program are primarily administered by states, including the decisions concerning the duration of coverage. Even so, the federal policies specify the essential health services that should be provided under Medicaid. Most beneficiaries of the Medicaid program include people with disabilities and older Americans in nursing homes.
Reasons for the Recent Changes in Healthcare
The health sector has experienced various changes in the scope of coverage as well as the type and quality of care provided in medical institutions. Furthermore, various factors have triggered these changes. For instance, a high population growth rate has increased the need for healthcare in medical facilities. This trend has also significantly increased the budget allocations for health, which has also adversely affected the country’s economy. The government sought ways to minimize the costs of healthcare, improve the quality of services, and increase health coverage across the country. Hence, this led to significant transformations in the health system of the United States.
The growing number of an aging population has also been another factor in the change of the health system. Due to an increase in the average life expectancy, the need to provide more specialized health services also has risen for conditions associated with aging. Therefore, this trend prompted for the development of medical programs such as Medicaid to serve the healthcare needs of older people.
Technological advancements have also promoted developments in the health sector leading to significant changes in the healthcare system of the United States. For example, the emergence of technical devices for scanning and detecting illnesses has improved the efficiency and quality of services offered by medical institutions (Laegreid & Christensen, 2013). Enhanced communication and database management systems have also enabled efficient record keeping and access to patient information by authorized agencies. Consequently, administering of new medical programs such as the Medicare and Medicaid has become more useful as well.
The effectiveness of health care can be assessed by the quality of services rather than quantity as offered by a medical institution. Furthermore, improving the quality of medical care necessitates a proper utilization of resources and employing the best medical practices. Specifically, this option involves using Evidence-based practices in nursing alongside the required facilities to provide adequate treatment and care for patients. The recommended change to improve the health sector is adopting technology in medical institutions for quality care services. For example, designing information systems that enhance interoperability between healthcare facilities might improve care services since each department can access the medical records of a patient to determine the most appropriate medication plan that professionals should adopt. Similarly, increasing the number of machines and devices used in the scanning, detecting, and treatment of certain conditions could significantly improve the quality of services offered by medical institutions. However, the use of technology would be an effective method of improving the health sector by enhancing interoperability between medical institutions to access crucial patient information and the use of modern methods of diagnosis and treatment. Consequently, this would increase the efficiency of medical facilities and the quality of services provided.
All in all, the history of the American healthcare system is dated back in the nineteenth century during the industrial revolution period. Furthermore, this time led to the emergence of employee protection policies and other medical coverage policies to safeguard the welfare of the society. In the recent years, the United States government has transformed its health sector through policies that aim at increasing the number of people under medical cover and improving the quality of services offered by medical institutions. Besides, these changes have been enforced through the implementation of the Affordable Care Act (ACA), Medicare, and Medicaid, which have been useful in the application. Additionally, the programs have also made health care services affordable for the poor and disabled individuals in the society. Based on the reasons that have promoted the growth in the health sector, it is necessary to adopt innovative changes in the context of healthcare to serve the needs of the community. Embracing the use of technology and information systems is one of the technology initiatives that ought to improve the services offered by medical institutions. Therefore, the government should provide financial support to the medical organizations to assist them in the acquisition of essential technological devices and machines.
- Beronio, K., Po, R., Skopec, L., & Glied, S. (2014). Affordable care act will expand mental health and substance use disorder benefits and parity protections for 62 million Americans. Mental Health, 2.
- Gereffi, G., & Wyman, D. L. (Eds.). (2014). Manufacturing miracles: Paths of industrialization in Latin America and East Asia. Princeton University Press.
- Kongstvedt, P. R. (2012). Essentials of managed health care. Jones & Bartlett Publishers.
- Laegreid, P., & Christensen, T. (Eds.). (2013). Transcending new public management: The transformation of public sector reforms. Ashgate Publishing, Ltd.
- Martin, A., Lassman, D., Washington, B., & Catlin, A. (2012). Growth in US health spending remained slow in 2010; health share of gross domestic product was unchanged from 2009. Health Affairs, 31(1), 208-219.
- Sala-i-Martín, X., Bilbao-Osorio, B., Blanke, J., Crotti, R., Hanouz, M. D., Geiger, T., & Ko, C. (2012). The global competitiveness index 2012–2013: Strengthening recovery by raising productivity. The Global Competitiveness Report 2012–2013, 49-68.