Healthcare Politics
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Health Maintenance Act Organization are groups of medical insurance that provide health insurance services at an annual fixed fee. HMO Act is a federal law of the USA, which was enacted during President’s Richard Nixon’s era in 1973. The act is in bill S.14 Public law 93-222. It defines HMO’s qualifications, and it enhances and promotes HMO’s development and sets standards for their operations. Since then, several amendments have been made, which brought clarification and changes in its articles and made adjustments that suit the modern world. The act intended to deliver a comprehensive, cost-effective healthcare system and of high quality to the Americans (Hodgin, 2018).
California Medicaid Reform (1982) was selecting contracting legislation where only hospitals that contracted with the state government to provide health services at a particular cost were allowed to be participants of the Medi-Cal program (Rubenstein, 2016). The California beneficiaries were allowed to be attended at any of the approved hospitals for emergency services. The program also allowed the transfer of stable patients to the contracted hospital after the management of the emergency. The California state opted for this reform to reduce healthcare costs that the hospitals charged the citizens. This is through the negotiation of prices and making the hospitals cut unnecessary costs. This reform has helped reduce the state’s medical expenses and increase the rate of competitiveness among the hospitals in California.
The American Health Security Act (1993) was introduced in the Senate by Senator Wellstone proposed cost reduction by adopting a publicly accountable single-payer system. This program would provide comprehensive health care services for all American citizens regardless of their working or health conditions. The act would allow for equitable financing and ensure the consumers and the service providers make clinical decisions rather the insurance companies. According to Wellstone and Shaffer (2010), the act proposed elements such as a fixed annual budget, consumers having the liberty to choose their health care service providers, having a publicly and streamlined administration that’s accountable to its subjects, the coverage would be universal and based on the residency rather than employment state, the benefits should be comprehensive and inclusive of primary and preventive health care services, and quality assurance.
The Patient Protection and Affordable Care Act (2010), also known as Obamacare, was signed into law on March 3, 2010, and since then, it has significantly changed the American healthcare system. The act provides various patient protections and rights that have made the healthcare coverage to become more easy, fair, and understandable. Subsidies by reducing cost-sharing and premium tax credits have also helped make healthcare coverage affordable to the consumers (USA.gov, 2013).
In conjunction with the above, the Patient Protection and Affordable Care Act intended to improve health insurance accessibility to the citizens, enhance wellness and disease prevention, quality and system performance improvement, and expansion of the healthcare workforce to meet the population demands. More than 95% of legal Americans could access health insurance, recording an upsurge from 30 to 50 million people (Amadeo, 2011). The act also allowed individuals to choose means of coverage they could access through their employer, Medicare, Medicaid, or through the private providers. There is an option of purchasing health insurance from health insurance exchange for those who could not get insurance. This group is considered legible under the expanded Medicare guidelines and can be subsidized.
References
Amadeo, K. (2011, May 18). How the Affordable Health Care Act affects you. The Balance. https://www.thebalance.com/2010-patient-protection-affordable-care-act-3306063
Hodgin, S. (2018, April 23). Health Maintenance Organization Act: History & summary. Study.com. https://study.com/academy/lesson/health-maintenance-organization-act-history-summary.html
Rubenstein, E. (2016, January 26). Emergency surgery for Medicaid. City Journal. https://www.city-journal.org/html/emergency-surgery-medicaid-12759.html
USA. gov. (2013). Patient Protection and Affordable Care Act. HealthCare.gov. https://www.healthcare.gov/glossary/patient-protection-and-affordable-care-act/
Wellstone, P. D., & Shaffer, E. R. (2010, January 15). The American health security act — A Single-Payer proposal | NEJM. New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJM199305203282013