In the health care domain, the role of government is of paramount importance. It is mainly
responsible for shaping the health care financing aspects so that financial resources will be
available and the health care sector can function in an effective and efficient manner. In the case
of the health care system of the United States of America, the government serves as the largest
payer of health care services and solutions. At diverse levels, such as the federal level, state level
and local levels, the government influences the health domain as well as the quality of life of the
public (Tang et al., 2004). In the U.S., Medicare has been introduced and the federal government
purchases health care for millions of people who are old, and/or disabled.
The government impacts health care organizations by acting as a regulator, and buyer in the health
care domain. While serving as a regulator, it ensures that health care organizations carry out their
roles and responsibilities in a proper manner. Similarly, while acting as a buyer, it impacts the
financial performance and revenue of health care firms (Smith et al., 2003). e
Health insurance has a major impact on health care delivery. It serves as a primary tool that
ensures that people have necessary coverage relating to their health and they can have access to
proper care. According to the American Hospital Association (AHA), individuals need to enrol in
health coverage and attain health insurance so that their health and wellness can be improved. As
the health needs of people are diverse, the role of health insurance is critical since it can make
sure that people are able to make the optimum use of the available health care services that can
foster positive health outcomes. Moreover, health insurance can also reduce the financial burden
that individuals, families, and communities face in case of an emergency health-related situation.
The insurance can act as a safety net and support the streamlined and consistent flow of health
care delivery in the community setting (Report: The Importance of Health Coverage: AHA.
American Hospital Association, 2021). e
An appropriate measure that can be taken for the purpose of minimizing the number of uninsured
people while maximizing the quality and accessibility to care and minimizing its costs is to stabilize
the existing individual health insurance marketplace. According to the American Medical
Association (AMA), the actions relating to stabilizing the insurance market domain can help in
fostering a robust insurance ecosystem. It can basically encourage individuals from the low- as well
as middle-income groups to make use of health coverage. By adopting such a method, it will be
possible to encourage people from diverse communities and backgrounds to secure adequate as
well as affordable health insurance (Report: The Importance of Health Coverage: AHA. American
Hospital Association, 2021). In addition to focusing on the insurance market landscape, it is
necessary to emphasize the integration of innovation and digital technologies in the health
domain. By leveraging new kinds of technologies such as Artificial Intelligence (AI), robotics, etc., it
will be possible to automate existing processes and procedures in the health care setting and
improve the quality of service that is delivered to the patients.
The government in the United States is involved in healthcare by creating many laws and
regulations. Healthcare organizations are required to follow many of the regulations set forth by
the government. An example of this would be the HIPAA Privacy Rule. HIPAA is a federal law that
protects patient health information from being shared without the patient’s consent or knowledge
(Health Insurance Portability and Accountability Act of 1996 (HIPAA) | CDC, n.d.). Other examples
of government involvement with healthcare would be the Affordable Care Act, which increases
health coverage and improves quality of healthcare (Affordable Care Act (ACA) - Glossary, n.d.).
The HITECH Act, or the Health Information Technology for Economic and Clinical Health Act of
2009, provides financial incentives for organizations that prove meaningful use of healthcare
information technology (Office for Civil Rights (OCR), 2021). The American Recovery Reinvestment
Act of 2009 promotes the use of electronic health records and provided governance of EHR (Burke,
2010). Medicare/Medicaid provides health insurance to people with lower incomes (Medicaid |
Medicaid, n.d.). The Agency for Healthcare Research and Recovery has the goal of making
healthcare safer while increasing the quality and making healthcare more accessible and
inexpensive (Agency for Healthcare Research and Quality (AHRQ), n.d.). Almost all of these have
the intent to create higher quality healthcare and increasing the accessibility.
Health insurance can improve access to healthcare. Patients who have active health insurance tend
to have more positive health outcomes. Health insurance can also decrease financial strain and
there are also programs available within insurance plans that provide financial incentives for the
appropriate use of healthcare. An example of this would be an employer requiring yearly physical
exams to receive a financial discount on a healthcare premium. The insurance that I have through
my employer provides a discount if we meet certain health goals over the year. This encourages a
healthier lifestyle for employees while also providing a financial incentive.
Having health insurance can also improve medication compliance. This can occur when an
insurance program requires a person to use a mail order pharmacy or receive a 90-day supply of
maintenance medications. People who use medication for diabetes, cardiovascular disease,
asthma, birth control, or any other chronic illness that can be controlled through medication can
benefit from these services provided by health insurance. In my own personal experience, my
health insurance requires all maintenance medication to be prescribed on a 90-day supply and sent
through a mail order pharmacy. Although my employer has their own mail order pharmacy and
insurance company (Geisinger Health Plan and Geisinger Mail Order Pharmacy) and it is a self-
benefiting program that they make us use to save money on their end, I do find it convenient and
helpful to use a mail order pharmacy. e
Reducing the number of uninsured people would need to be done by increasing the availability of
Medicaid. Expanding public health services, like Medicaid, would allow for better health outcomes,
as mentioned above, for people with a lower income. e
References:
Affordable Care Act (ACA) - Glossary. (n.d.). HealthCare.Gov. Retrieved July 5, 2022, from
https://www.healthcare.gov/glossary/affordable-care-act/
Agency for Healthcare Research and Quality (AHRQ). (n.d.). AHRQ. Retrieved July 5, 2022, from
https://www.ahrq.gov/
Burke, T. (2010). The Health Information Technology Provisions in the American Recovery and
Reinvestment Act of 2009: Implications for Public Health Policy and Practice. Public Health Reports,
125(1), 141–145. https://doi.org/10.1177/003335491012500119
Health Insurance Portability and Accountability Act of 1996 (HIPAA) | CDC. (n.d.). CDC.Gov.
Retrieved July 5, 2022, from
https://www.cdc.gov/phlp/publications/topic/hipaa.html#:%7E:text=The%20Health%20Insurance%2
0Portability%20and,the%20patient’s%20consent%20or%20knowledge.
Medicaid | Medicaid. (n.d.). Medicaid.Gov. Retrieved July 5, 2022, from
https://www.medicaid.gov/medicaid/index.html
Office for Civil Rights (OCR). (2021, June 28). HITECH Act Enforcement Interim Final Rule. HHS.Gov.
Retrieved July 5, 2022, from https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-
enforcement-interim-final-rule/index.html
Report: The Importance of Health Coverage: AHA. American Hospital Association. (2021). Retrieved
July 9, 2022, from https://www.aha.org/guidesreports/report-importance-health-
coverage#:~:text=Impact%20of%20Coverage&text=Studies%20confirm%20that%20coverage%20imp
roves,on%20individuals%2C%20families%20and%20communities.
Smith, B. M., Eden, J., & Corrigan, J. M. (Eds.). (2003). Leadership by example: Coordinating
government roles in improving health care quality. National Academies Press.
Tang, N., Eisenberg, J. M., & Meyer, G. S. (2004). The roles of government in improving health care
quality and safety. The Joint Commission Journal on Quality and Safety, 30(1), 47-55.
