Consumer and Provider Costs

Discussion in 'Healthcare Reform Discussions' started by anonymous, Dec 16, 2017 at 3:49 AM.

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  1. anonymous

    anonymous Guest

    Consumer and Provider Costs​

    Over the past 50 years, it has been quite the challenge creating a health care system that keeps the cost of healthcare down, while increasing access to care. While some countries have figured out the magic formula to give universal health coverage, the U.S. still struggles to find that perfect system that will make everyone happy. With so many different factors involved in our health system, federal and state health policies are created to provide guidelines to improve our health system. These policies help to increase access, but it also comes at a price to some consumers. From a federal perspective, a policy such as the Affordable Care Act (ACA), is something that has negatively affected consumer cost. In its inception, the goals for the ACA is to increase access, promote quality, and improve the efficiency of our complex and fragmented patient-care effort (Larrat, Marcoux, & Vogenberg, 2012). However, although access has increased, so have consumers premium rates. From a state perspective, laws that expand coverage can lead to less cost to consumers if more people under one’s roof is afforded insurance.

    Positive and Negative Effect of Federal and State Health Policies​

    The ACA has had an impact on consumer cost as the costs to American taxpayers increase as the subsidies rise to keep premiums within reach. While there are subsidies that offset the rise in premiums, there is still nearly 9 million people who face the full market with no subsidy (Gonshorowski, 2016). Another reason why consumer cost rise is the law regarding age-specific pricing. With the ACA, premiums are restricted to a ratio of 3 to 1. Meaning, insurers cannot charge someone who is 64 more than three times what they charge an 18-year-old for the same coverage. This can be frustrating because statistics show that individuals older than 64 have medical costs five times the amount of young insureds (Gonshorowski, 2016). Lastly, the ACA drives up the cost for consumers because, in some instances, those that are insured are paying for services they do not use. By law, insurance will cover a list of preventative services with no co-pay, but to balance the cost, those services are built into their premiums.

    Contrary to what some people believe, federal and state policies are not all bad for consumers. At the state level, health mandate laws include required categories of up to 70 distinct benefits and health providers. The benefits include “persons covered” which now includes adopted children, handicapped dependents or even adult dependents ("National Conference of State Legislators,” 2017). An increase in coverage will certainly reduce the consumer cost for those individuals because they do not have to insure them separately.

    Conclusion​

    For the most part, federal and state health policies are created with good intentions. The ACA provides more access to care, but at an increase in subsidies to some individuals. State policies increased benefits to cover more dependents which reduces the cost for some consumers. Nevertheless, our health system still requires some and the hope is that we in the future, there is an increase in access to care, without raising consumer cost at all.








    References​

    Gonshorowski, D. (2016, October 31). Soaring Obamacare Premiums Hurt Consumers. The Heritage Foundation. Retrieved from http://www.heritage.org/health-care-reform/commentary/soaring-obamacare-premiums-hurt-consumers

    Larrat, E. P., Marcoux, R. M., & Vogenberg, F. R. (2012). Impact of Federal and State Legal Trends on Health Care Services. Pharmacy and Therapeutics, 37(4), 218–226.

    National Conference of State Legislators. (2017). Retrieved from http://www.ncsl.org/research/health/state-ins-mandates-and-aca-essential-benefits.aspx