Module 9 Final Project: Policy Memorandum

The Needs and Interests of the Key Stakeholders Identified

The key stakeholders identified in the issue include the government regulators, consumers and taxpayers, health care providers, as well as third-party payers. The General Assembly in the State of Albacore is the main government regulator mentioned in the case study. It is planning to pass a legislation that would require all health providers to have at least 30 percent of their workers to be of Spanish descent. Additionally, the third-party payers include Medicare and insurance agencies that reimburse payments to health care providers (Buff & Terell, 2014). Finally, the providers in the case are health care institutions such as hospitals and their professionals, who include physicians, nurses, and clinicians. These stakeholder groups are collectively referred to as the medical-industrial complex since they encompass a large and growing network of private corporations that engage in the provision and supply of health care services to patients for profit (Knickman & Elbel, 2019). At the base of such networks are the corporate ownership of hospitals and the interlocking ownership and production of technological and diagnostic machinery. Therefore, Hospital Bass is an example of health providers that are depicted in the case study.

Current Healthcare Laws, Policies, and Practices related to The Issue

The current healthcare laws that are relevant to the case include the Patient Protection and Affordable Care Act (ACA), the Medicare and Medicaid Act, and the Equal Employment Opportunity regulations. The ACA is part of the detailed law reform that promotes access to quality and affordable health care services (Fulton, 2017). It provides many rights that make health coverage fairer and easier to understand, along with subsidies to make it more affordable to many marginalized groups. The Medicare and Medicaid Act, on the other hand, is a law that resulted in the adoption of Medicare as a form of national health insurance. It provides health coverage for citizens aged above 65 or below it for those who are disabled irrespective of their levels of income. Medicaid also serves as a state and federal agency that provides health insurance cover for citizens who are socioeconomically disadvantaged groups. Further, the Equal Employment Opportunity laws advocate for the equitable distribution of employment opportunities.

Potential Conflicts Between the Stakeholder Groups

Each of the stakeholder groups may conflict due to differing interests. The health care providers such as Hospital Bass, for instance, seek to optimize profit by providing competent care to patients. However, they may conflict with third party payers such as Medicare and Medicaid, which aim at reducing the high costs of medical care. Additionally, the health providers may conflict with the proposals of the General Assembly in the State of Albacore because hospitals may find it challenging to comply with the law owing to shortage of health professionals from the Spanish community.

Legal Risks and Malpractice Issues

Hospitals’ lack of compliance with the proposed bill may potentially expose them to many liability risks. For instance, hiring health professionals who are not competent to address the distinct cultural needs of Hispanic patients may deter them from delivering high quality of care. Subsequently, they may be prone to malpractices associated with medication errors and misdiagnosis, which can potentially attract civil lawsuits. The General Assembly, on the other hand, may face opposition from activists who view Medicare and Medicaid Services as rights that should not be withheld irrespective of providers’ failure to comply with the bill.

References

Buff, M. J., & Terrell, T. D. (2014). The role of third-party payers in medical cost

increases. Journal of American Physicians and Surgeons, 19(2), 75-79.

Fulton, B. D. (2017). Health care market concentration trends in the United States: evidence and

policy responses. Health Affairs, 36(9), 1530-1538.

Knickman, J. R., & Elbel, B. (Eds.). (2019). Jonas and Kovner's health care delivery in the

United States. Springer Publishing Company.