lOMoARcPSD|61746433
Factors That Changed the U.S. Health Care System
PHCS 7000 - Introduction to the Health Care System
University of Cincinnati
lOMoARcPSD|61746433
First of all, the state of the current U.S. healthcare system was affected
by such demographic factor as population aging. The increase in life
expectancy in the United States affected not only older people, but
also the bulk of the workforce aged 20 to 65 years (Webster, 2020).
According to various estimates, life expectancy in the United States
will increase to 85 years by 2060 (Webster, 2020). From 2000 to
2060, the share of life spent in retirement will increase from 20 to
27% (Shrank et al., 2019). This demographic factor has changed the
U.S. health care system, contributing to the cost of medical care under
the Medicare program which increased significantly.
Due to the raise in life expectancy, significantly more funds are
required for the treatment of one old person. Changes in mortality
rates depending on income and education had an impact on the degree
of progressiveness of the social insurance and medical care system.
These trends have significantly affected the overall cost of
implementing the Medicare program, since the level of payments is
higher in absolute terms for individuals in the upper quarter of the
income scale than in the lower.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
lOMoARcPSD|61746433
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
lOMoARcPSD|61746433
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
lOMoARcPSD|61746433
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
lOMoARcPSD|61746433
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
lOMoARcPSD|61746433
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
lOMoARcPSD|61746433
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
lOMoARcPSD|61746433
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
lOMoARcPSD|61746433
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
lOMoARcPSD|61746433
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
lOMoARcPSD|61746433
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
lOMoARcPSD|61746433
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
lOMoARcPSD|61746433
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
lOMoARcPSD|61746433
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
lOMoARcPSD|61746433
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
lOMoARcPSD|61746433
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
lOMoARcPSD|61746433
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
lOMoARcPSD|61746433
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
lOMoARcPSD|61746433
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
lOMoARcPSD|61746433
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
lOMoARcPSD|61746433
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
lOMoARcPSD|61746433
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
lOMoARcPSD|61746433
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
lOMoARcPSD|61746433
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
lOMoARcPSD|61746433
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
lOMoARcPSD|61746433
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
lOMoARcPSD|61746433
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
lOMoARcPSD|61746433
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
lOMoARcPSD|61746433
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
lOMoARcPSD|61746433
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
lOMoARcPSD|61746433
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
lOMoARcPSD|61746433
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
lOMoARcPSD|61746433
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
lOMoARcPSD|61746433
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
lOMoARcPSD|61746433
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
lOMoARcPSD|61746433
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
lOMoARcPSD|61746433
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
lOMoARcPSD|61746433
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
lOMoARcPSD|61746433
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
lOMoARcPSD|61746433
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
lOMoARcPSD|61746433
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
lOMoARcPSD|61746433
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
lOMoARcPSD|61746433
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
lOMoARcPSD|61746433
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
lOMoARcPSD|61746433
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
lOMoARcPSD|61746433
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
lOMoARcPSD|61746433
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
lOMoARcPSD|61746433
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
lOMoARcPSD|61746433
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
lOMoARcPSD|61746433
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
lOMoARcPSD|61746433
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
lOMoARcPSD|61746433
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
lOMoARcPSD|61746433
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
lOMoARcPSD|61746433
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
lOMoARcPSD|61746433
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
lOMoARcPSD|61746433
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
lOMoARcPSD|61746433
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
lOMoARcPSD|61746433
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
lOMoARcPSD|61746433
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
lOMoARcPSD|61746433
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
lOMoARcPSD|61746433
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
lOMoARcPSD|61746433
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
lOMoARcPSD|61746433
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
lOMoARcPSD|61746433
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
lOMoARcPSD|61746433
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
lOMoARcPSD|61746433
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
lOMoARcPSD|61746433
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
lOMoARcPSD|61746433
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
lOMoARcPSD|61746433
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
lOMoARcPSD|61746433
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
lOMoARcPSD|61746433
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
lOMoARcPSD|61746433
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
lOMoARcPSD|61746433
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
lOMoARcPSD|61746433
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
lOMoARcPSD|61746433
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
lOMoARcPSD|61746433
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
lOMoARcPSD|61746433
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
lOMoARcPSD|61746433
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
lOMoARcPSD|61746433
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
lOMoARcPSD|61746433
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
lOMoARcPSD|61746433
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
lOMoARcPSD|61746433
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
lOMoARcPSD|61746433
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
lOMoARcPSD|61746433
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
lOMoARcPSD|61746433
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
lOMoARcPSD|61746433
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
lOMoARcPSD|61746433
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
lOMoARcPSD|61746433
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
lOMoARcPSD|61746433
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
lOMoARcPSD|61746433
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
lOMoARcPSD|61746433
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
lOMoARcPSD|61746433
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
lOMoARcPSD|61746433
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
lOMoARcPSD|61746433
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
lOMoARcPSD|61746433
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
lOMoARcPSD|61746433
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
lOMoARcPSD|61746433
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
lOMoARcPSD|61746433
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
lOMoARcPSD|61746433
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
lOMoARcPSD|61746433
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
lOMoARcPSD|61746433
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
lOMoARcPSD|61746433
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
lOMoARcPSD|61746433
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
lOMoARcPSD|61746433
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
lOMoARcPSD|61746433
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
lOMoARcPSD|61746433
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
lOMoARcPSD|61746433
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
lOMoARcPSD|61746433
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
lOMoARcPSD|61746433
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
lOMoARcPSD|61746433
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
lOMoARcPSD|61746433
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
lOMoARcPSD|61746433
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
lOMoARcPSD|61746433
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
lOMoARcPSD|61746433
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
lOMoARcPSD|61746433
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
lOMoARcPSD|61746433
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
lOMoARcPSD|61746433
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
lOMoARcPSD|61746433
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
lOMoARcPSD|61746433
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
lOMoARcPSD|61746433
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
lOMoARcPSD|61746433
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
lOMoARcPSD|61746433
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
lOMoARcPSD|61746433
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
lOMoARcPSD|61746433
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
lOMoARcPSD|61746433
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
lOMoARcPSD|61746433
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
lOMoARcPSD|61746433
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
lOMoARcPSD|61746433
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
lOMoARcPSD|61746433
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
lOMoARcPSD|61746433
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
lOMoARcPSD|61746433
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
lOMoARcPSD|61746433
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
lOMoARcPSD|61746433
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
lOMoARcPSD|61746433
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
lOMoARcPSD|61746433
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
lOMoARcPSD|61746433
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
lOMoARcPSD|61746433
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
lOMoARcPSD|61746433
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
lOMoARcPSD|61746433
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
lOMoARcPSD|61746433
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
lOMoARcPSD|61746433
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
lOMoARcPSD|61746433
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
lOMoARcPSD|61746433
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
lOMoARcPSD|61746433
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
lOMoARcPSD|61746433
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
lOMoARcPSD|61746433
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
lOMoARcPSD|61746433
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
lOMoARcPSD|61746433
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
lOMoARcPSD|61746433
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
lOMoARcPSD|61746433
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
lOMoARcPSD|61746433
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
lOMoARcPSD|61746433
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
lOMoARcPSD|61746433
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
lOMoARcPSD|61746433
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
lOMoARcPSD|61746433
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
lOMoARcPSD|61746433
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
lOMoARcPSD|61746433
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
lOMoARcPSD|61746433
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
lOMoARcPSD|61746433
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
lOMoARcPSD|61746433
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
lOMoARcPSD|61746433
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
lOMoARcPSD|61746433
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
lOMoARcPSD|61746433
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
lOMoARcPSD|61746433
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
lOMoARcPSD|61746433
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
lOMoARcPSD|61746433
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
lOMoARcPSD|61746433
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
lOMoARcPSD|61746433
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
lOMoARcPSD|61746433
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
lOMoARcPSD|61746433
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
The next significant factor was the legal one, namely the publication
of the law on patient protection and affordable care, which was one of
the main achievements of the Obama administration (Blumenthal et
al., 2020). Within its framework, registration of people within the
lOMoARcPSD|61746433
scope of a special state-regulated health insurance market has become
mandatory. This factor changed the U.S. healthcare system by making
it possible to purchase health insurance policies within a special state-
regulated market. 35% of the total number of people who took
advantage of the new initiative were under 40 years old (Shrank et al.,
2019). The point of this mechanism is that people who are not poor
enough for Medicaid and not old enough for Medicare can purchase
health insurance policies with the help of special state subsidies.
The next significant factor that has contributed to the state of the
current U.S. health care system is a political one. It is connected with
the coming to power of Donald Trump, one of whose main election
promises was to repeal Obamacare (Shrank et al., 2019). Trump’s plan
was not to completely eliminate the entire reform, but to repeal a
number of provisions and amend its paragraphs. This factor changed
the U.S. healthcare system through radical changes in the accepted
healthcare structure. Firstly, compulsory insurance by employers of
their employees and the personal obligation of citizens to buy
insurance was abolished. Secondly, since 2020, the federal support of
the states for the medical assistance program for low-income citizens
has been reduced (Shrank et al., 2019). Thirdly, the state authorities
were empowered at their discretion to exclude payment for pregnancy
and contraceptives from mandatory insurance plans.
Current Differences in Spending Patterns
Germany is the closest industrialized country to the US in terms of
GDP. In the USA, medical expenses of citizens increase by an average
of 6% per year (Shrank et al., 2019). At the same time, the average
annual GDP growth rate is about 5% (Blumenthal et al., 2020). In
lOMoARcPSD|61746433
2018, medical expenses in the country accounted for 18% of GDP,
and by 2020 the figure had increased to almost 19% (Blumenthal et
al., 2020). More than 400 billion euros are spent annually on
healthcare in Germany (Blumenthal et al., 2020). In fact, more than a
tenth of Germany’s GDP is accounted for by medicine, which is half
as much as in the United States.
In the USA, the infant mortality rate is quite high, in Germany this
indicator is much lower. Children in the United States are 70% more
likely to not live to their 20th birthday than children from other
industrialized democratic countries (Blumenthal et al., 2020). In
Germany, infant mortality has been steadily decreasing since 2000,
but in the United States, the indicator has not changed (Webster,
2020). At the same time, America spends more money on combating
child mortality per capita than Germany.
Change in Reimbursement Trends
Historically, in the late 1970s, private group health insurance covered
about 90% of employees in the private sector of the economy
(Blumenthal et al., 2020). Greater coverage was observed in industry
compared to agriculture and in large companies compared to small
ones. Private insurance in case of hospitalization was more
widespread than insurance in case of access to the services of doctors,
dentist, as well as the purchase of medicines, which is common at the
moment. Modern health insurance in the USA is organized in the
similar way. The insurance company collects the fund; from it, subject
to the occurrence of an insured event, payments are made to the client.
Coverage of medical services is carried out according to the terms of
lOMoARcPSD|61746433
the contract. If some manipulation is not included in the list, then it is
paid out of the patient’s pocket.
Historically, insurance provided payment for 80% of medical
expenses during the year, and 20% was paid by the patients
themselves (Shrank et al., 2019). If their expenses exceeded $ 1,200
per year, the insurance covered 100% of medical expenses until the
end of the year (Webster, 2020). Nowadays covering expenses is also
consistent with the contract. If the policy is concluded in the amount
of $ 15,000, and $20,000 is spent, then the difference is paid by the
patient (Webster, 2020).
Before Obama took office as president, the state participated in paying
for insurance for socially unprotected citizens very little. Mediation in
paying for the treatment of elderly people and patients with serious
illnesses was carried out by non-profit insurance companies, such as
Blue Cross (Webster, 2020). Nowadays, state aid in America is
provided for pensioners and poor categories of the population. To get
under the program, you need to fit certain conditions. It is offered to
people aged 65 and older, or citizens under 65 with a diagnosis of a
certain serious illness (Webster, 2020). However, no one is entitled to
regular maintenance, and the program pays for a specific illness. A
long stay in the clinic is paid for by the patients themselves.
There is also free insurance for the poor called Medicaid. The state
provides financial assistance to people with a small income. Medicaid
depends on the status of stay in America, pregnancy, disability. If the
birth took place under the Medicaid program, then up to 1 year old the
child automatically receives free medical insurance (Blumenthal et al.,
2020). Adoptive parents of children can also count on the help from
lOMoARcPSD|61746433
government. Therefore, reimbursement trends have changed from a
historical perspective. The changes mainly concern insurance for
socially vulnerable segments of the population, which almost did not
exist before Obama, the aging of the population, and the associated
tightening of insurance tariffs for the wealthy part of the population.
Impact of Health Care Reform Initiatives
The key reform initiative for US healthcare was the passage of
Affordable Care Act. This is the first large-scale reform in the
healthcare sector since 1965, involving universal health insurance
(Webster, 2020). One of the health care providers impacted by the
reform were physicians. In addition to the fact that Affordable Care
Act insurance is becoming more expensive, fewer doctors have started
accepting it (Webster, 2020). This insurance offers lower payments
for doctors in the treatment of patients than conventional health
insurance.
Operational planning in hospitals has undergone significant changes
since the adoption of the Patient Protection and Affordable Care Act.
Healthcare institutions had to seriously reconsider the allocation of the
budget for a set of measures for the organization of medical care,
including the salaries of physicians. Due to a decrease in the number
of cases of private insurance, doctors’ salaries were reduced. In this
regard, there has been a series of voluntary dismissals, and the
provision of the health care system with human resources has become
insufficient (Shrank et al., 2019). Thus, operational planning for
physicians after the adoption of the Patient Protection and Affordable
Care Act included adaptation to work in conditions of lower pay and
greater workload. This reform initiative impacted the decision making
lOMoARcPSD|61746433
of health care providers. Gradually, many doctors and clinics began to
refuse to accept insurance, as it is unprofitable (Webster, 2020). This
is due to the fact that Affordable Care Act is mainly beneficial to
those people who are sick a lot, but earn little, and for medical
institutions it is unprofitable.
Media Piece Review
In the situation proposed for consideration, I would choose the first
response. A multi-level approach would create a hierarchy of tasks to
increase the number of providers why participate in the Medicaid
Managed Care Programs. As a result of the hierarchical
decomposition, the relative independence of the levels of
administration of the Nokomis County Public Health Department will
be achieved, which means that their autonomous development and
modification will be possible to solve the problem from several
aspects simultaneously.
References
Blumenthal, D., Fowler, E. J., Abrams, M., & Collins, S. R. (2020).
COVID-19: Implications for the health care system.EThe New England
Journal of Medicine, 383(8), 1483–1488.
Shrank, W., Rogstad, T. L., & Parekh, N. (2019). Waste in the US
health care system: Estimated costs and potential for savings.EThe
Journal of the American Medical Association, 322(15), 1501–1509.
Webster, P. (2020). Virtual health care in the era of COVID-
19.ELancet, 395(10231), 1180–1181.
