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Consumer and Provider Costs

Discussion in 'Healthcare Reform Discussions' started by Brittney Johnson, Aug 26, 2019 at 11:22 PM.

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  1. Brittney Johnson
    MHA 516
    August 26, 2019
    Humberto Munoz

    Consumer and provider costs tend to grow annually at what seems to be an alarming rate. Healthcare seems to be unaffordable for most even with work-sponsored plans due to out-of-pocket costs. If things don’t change and we continue on this path we will no longer be able to afford to take care of ourselves. Federal polices can both help and hurt both the consumer and the provider when it comes to costs.

    Positive Impact of Federal Health Care Policies on Consumer Costs

    One of the biggest impacts on health consumerism is the Affordable Care Act. Though many may not be a fan of the act, for many it has impacted cost and spending in a positive way. “Barack Obama pledged on the campaign trail and as president that he would sign a health care bill that lowered family health insurance premiums by $2,500. Conservative politicians and pundits roundly mocked him. Yet the ACA has more than delivered on that promise, saving about $4,000 per family. And these lower health care premiums probably contribute to the recent rise in workers’ wages” (Emanuel, 2019)

    Also, by lowering the premiums it for many families the ACA did just what its name said made healthcare affordable for may who did not have access before. By these families and individuals having access to care, it eliminated the need for people to go to the emergency room which is also a driving factor behind health care due to the uninsured. The Affordable Care Act needs more work, but it has had its benefits.

    Negative Impact of Federal Health Care Policies on Consumer Costs

    The government typically plays a big role in healthcare reform and does not realize the effects of the policies it makes until later. Once the polices go into place and they see the damage caused then they have to repeal their decisions based on the damage that has been done. “The history of medical cost inflation and government interference in health care markets appears to support the hypothesis that prices were set by the laws of supply and demand before 1980 and perhaps 1990. Even the degree of monopolization and nationalization promoted by politicians before 1965 was not enough to cause significant cost inflation and spending increases (Figure 2) until demands created by Medicare and Medicaid outstripped the restricted supply of physicians and hospitals.” (Kanopiadmin, 2017).

    Overall all the impacts the government can have on consumerism and provider costs can be both negative and positive. You have increased savings due to the ACA and on the other hand, you have costs set by supply and demand that are essentially driven by the polices the government creates. “Health care organizations need to maintain their diligence in gauging, as well as following, emerging regulatory guidance and rules in addition to federal and state laws. This complexity of the health care regulatory environment is not likely to abate soon; therefore, it is expected that professionals who are responsible for health care administration will need to direct their attention to the legal environment as part of their duties.” (Larrat, Marcoux, & Vogenberg, 2012). Staying abreast to policies allows providers and consumers to be proactive and ultimately reduce costs.


    Emanuel, E. J. (2019, March 22). Name the much-criticized federal program that has saved the U.S. $2.3 trillion. Hint: it starts with Affordable. Retrieved from STAT website: The Affordable Care Act has saved billions in health care costs - STAT

    Kanopiadmin. (2017, May 9). How Government Regulations Made Healthcare So Expensive | Mike Holly. Retrieved August 27, 2019, from Mises Institute website: How Government Regulations Made Healthcare So Expensive | Mike Holly

    Larrat, E. P., Marcoux, R. M., & Vogenberg, F. R. (2012). Impact of federal and state legal trends on health care services. P & T : A Peer-Reviewed Journal for Formulary Management, 37(4), 218–226. Retrieved from Impact of Federal and State Legal Trends On Health Care Services