Public Health

Public Health

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Public Health

• Briefly describe the public health problem and the policy that addresses the problem.

The public health problem of interest is limited accessibility of quality and affordable health care due to a rising cost of health care services. This is a major issue which has affected millions of Americans especially those who cannot afford to pay for their health care insurance or pay directly for health care services. The rising cost of health care services includes the rising prices of prescription charge, primary care, and specialized care which have limited the accessibility of quality health care. Some of the effects of rising health care cost include; i) rising insurance premiums, ii) limited access to specialized care such as breast cancer screening and maternal care for women, and iii) limited access to specialized care for different vulnerable groups such as persons who have chronic health conditions or those who are at a high risk of getting chronic illnesses.

To address this public health problem, the federal government introduced the Patient Protection and Affordable Care Act which famously known as Obama Care. This policy was signed by President Barack Obama in March 2010 with the goal of bringing key reforms in the health care sector to address the problem of health care cost, quality, and access. The primary objectives of the Affordable Care Act (ACA) were to; prevent the increase in the cost of prescription drugs and health care services, ensure that all citizens could have access to affordable health insurance coverage, promote patient protection, and deliver better services (Amadeo, 2019).

• Examine the nature and magnitude of the problem and the people who are affected.

Generally, the issue of increasing health care cost affected all Americans, especially those who could not afford health insurance coverage and the vulnerable population groups. Persons who could not afford health insurance could not access quality health care services since they were very expensive and they would not afford to cater for out-of-pocket payments. Vulnerable population groups included the aging population who are the most vulnerable group to be affected by chronic illnesses. The high cost of medication limited the ability of the affected group to access quality health care thus leading to a high mortality rate. The magnitude and nature of the high cost of health care can be analyzed as follows.

Rising insurance premiums

As of 2004, the cost of health care services had increased by 4 percent. Quality health care services and prescription drugs were getting expensive forcing the healthcare insurance providers to increase their premiums. Premiums were rapidly increasing between 2000 and 2010 at a rate of 8 percent for family premiums covered by employers (Amadeo, 2018). Due to this, hundreds of thousands of employees were afraid to change their jobs fearing they would not access affordable premiums. Health care became very expensive for ordinary citizens especially those who did not have a stable income or were low-income earners.

Limited access to specialized care for women

Healthcare became very expensive for most women who had regular and different health care needs. The ones who suffered the most were the young women who did not have insurance to cover for their maternal care. The cost of hospitalization was increasing and most young women could afford to cater for out-of-pocket payments. Besides this, preventive and wellness care for women became very expensive. This is because most patients could not afford insurance that would cover clinical visits and treatment. As a result, only a few women could access preventive care.

Limited access to specialized care for persons with chronic illnesses

People suffering or at risk of suffering from chronic were not covered by most health care plans due to the high cost of health care. This is because chronic conditions and other conditions such as disability were very expensive since the patient needed close monitoring and more personalized treatment. Besides this, most of the drugs which are used in the treatment of chronic illnesses are very expensive (Fox, & Shaw, 2015). Medicaid and Medicare health plans had limited options to assist patients who needed more personalized treatment. Patients using these options were forced to use out-of-pocket payment for prescription drugs since some plans did not cater for drug expenses.

Patient protection issues

The problem of patient protection affected all patients who interacted with health care providers and insurance companies. Insurance companies had very harsh policies which did not favor the interests and concerns of the patients. For example, insurance companies could charge high premiums for certain serious illnesses which made it very expensive for a citizen to be covered for chronic illnesses. Besides this, there were cases of malpractice among insurance providers who could not cater for a patient’s medical expenses due to various reasons.

When it comes to the roles of health care providers, there were more mistakes which were committed by hospitals as they offered care (The Observer Editorial Board, 2017). Patients who could not afford quality health care due to high cost were forced to use other cheaper options which would cause more harm than good. For example, there were repeated cases of hospitals readmissions and increased use of prescription drugs which did not improve the quality of health of the patients. The fact that quality health care services were only accessible to those who could pay higher premiums and care plans left out the poor and low-income earners.

• Explain in detail the scope of the public health policy. Be sure to provide specifics about the problem that was addressed.

The provisions of ACA include to enhance prevention and wellness, improve quality and expand access to insurance, improve consumer protections, and limit the rising cost of health care. Each of these provisions aims at addressing health care concerns related to the access, quality, and cost of care. The goal of the ACA was to expand the access to insurance coverage (both private and public) to about 32 million uninsured citizens. Under this policy, both the private and public insurers are expected to increase their coverage of care by enrolling more people to the health plan.

According to Fox and Shaw (2015), the ACA has managed to improve the accessibility of medical health plans with over 11 million people being enrolled in the program. This plan has helped people with limited financial capabilities and in need of expensive health care services. This is because they are able to pay very cheap premiums after which they are entitled to a variety of benefits provided by the ACA. This objective resonates with the goal to control the rising cost of prescription drugs and health care services. This is because one of the factors which have prevented citizens from accessing health care insurance is the high cost of premiums and strict conditions set by insurance companies.

In order to improve the consumer protections, the ACA has implemented different strategies which aim at ensuring that patients received the best quality of care. These strategies address issues such as patient readmission and prescription of different drugs. In patient readmissions, hospitals are required to ensure that patients receive optimum care which will reduce patient’s hospital visits. If a patient is readmitted into the same hospital within a specific time period due to a medical error or a persistent health issue the hospital is not supposed to charge the patient extra costs for health care. Lastly, the ACA has improved the quality of health care by incorporating ten different categories of benefits which are provided under this policy. These categories include preventive and wellness visits, prescription drugs, maternity, and newborn care, pediatric care, outpatient care, mental and behavior treatments, services and equipment to help persons with disabilities and chronic conditions, lab tests, hospitalization, and emergency room services (Amadeo, 2018).

References

Fox, J. B., & Shaw, F. E. (2015). Clinical preventive services coverage and the Affordable Care Act. American journal of public health, 105(1), e7-e10.

Kimberly Amadeo, (2018). The 10 Essential Health Benefits of the ACA. Retrieved from https://www.thebalance.com/the-10-essential-health-benefits-of-obamacare-3306051

Kimberly Amadeo, (2019). 10 Obamacare Pros and Cons. Retrieved from https://www.thebalance.com/obamacare-pros-and-cons-3306059

The Observer Editorial Board, (2017). Some reminders of life before Obamacare. Retrieved from https://www.charlotteobserver.com/opinion/editorials/article127783904.html