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Running Head: PUBLIC ADMINISTRATION 1

PUBLIC ADMINISTRATION 2

Public Administration

Student Name

Institution-Affiliated

Public Administration

One of the major policy issues facing both public administrators and non-profit organizations in the US today is ensuring the provision of safe, adequate, and quality medical or healthcare services to all citizens. With healthcare being recognized as a fundamental human right, policymakers have been forced to develop policies aimed at ensuring that influence not only the access to healthcare but also the quality and cost of healthcare that citizens receive and which impact on the overall health of the population. Despite this, the cost of care in the country is increasingly rising hence straining the incomes of healthcare consumers and even state budgets (Chandra, Finkelstein, Sacarny & Syverson, 2016). Moreover, there exist huge health disparities in the country which are not only caused by a historical interplay of norms, structures, and policies but also by other societal challenges such as unemployment, education, poverty, and inadequate housing among others. Given the foregoing background information, the purpose of this paper is to explore a public policy aimed at improving population health in the country while also providing recommendations regarding improvements.

Discussion

Healthcare policy constitutes the development and implementation of regulations, rules, and laws for effective or improved management of a country’s healthcare system. On the other hand, the healthcare system involves the services provided by healthcare professionals to patients. one of the major policy issues influencing access to healthcare is the insurance policy. In the US, the healthcare system is a combination of private and public insurance (Su, Asfaw, Tamers & Luckhaupt, 2019). When it comes to private insurance, healthcare consumers either buy insurance independently or receive coverage from their employers. However, the increase in healthcare costs has also led to an increase in insurance premiums forcing some employers to shift increased responsibility for contributions towards insurance premiums to their employees. This has strained the ability of employees to obtain the required safe and quality care (Su, Asfaw, Tamers & Luckhaupt, 2019). Besides, the country’s two major public insurance programs are Medicare which covers individuals above 65 years and younger individuals who have kidney diseases or certain disabilities and the Medicaid designed to cover people with disabilities and those of low income.

One of the major policy reforms regarding healthcare insurance if the Affordable Care Act, 2010 (ACA). The ACA, designed to reduce the huge health insurance costs for all people who qualify contains comprehensive reforms on health insurance and tax provisions that not only affect families, insurers, businesses and individuals but also government entities (Sommers, McMURTRY, Blendon, Benson & Sayde, 2017). Moreover, the ACA expanded the eligibility to Medicaid, prevented insurance companies from charging more for insurance or denying individuals coverage and created exchanges for health insurance while also allowing children to remain under the cover of their parents' health insurance until 26 years of age.

Given this, the ACA supports my selected policy issue of health insurance in several ways. To begin with, the ACA increased access to insurance coverage to millions of Americans who were previously uninsured. Moreover, the Act through cost-sharing reduction and premium tax credits enabled individuals of low income to qualify for increased saving on their healthcare insurance plans (Sommers, McMURTRY, Blendon, Benson & Sayde, 2017). This is essential in reducing the huge inequalities and disparities in the provision of healthcare that has prevailed in the country for ages.

Further, the Act, by requiring all insurance plans that are compliant to cover essential health services such as family planning, breastfeeding, ambulatory services, emergency services, certain preventive services, mental health and hospitalization services among others expanded the number of healthcare services that consumers can receive through their insurance plans (Sommers, McMURTRY, Blendon, Benson & Sayde, 2017). Finally, by requiring that all people in the country to have insurance cover, the ACA not only extended the provision of healthcare to previously uninsured Americans but also ensured that the country developed a broad pool of individuals with insurance which is important in supporting payouts to health insurance.

While the ACA has increased access to healthcare among American, certain policy modifications can impact its effectiveness either positively or negatively. These policy modifications are addressed in the preceding section. First is the removal of the individual mandate contained in the law. The individual mandate requires all adults to obtain insurance coverage or face penalties. The individual mandate has been controversial in that it is not only burdensome and intrusive but also that it is ineffective when used to spur insurance enrollment. However, the approach has also been considered effective in promoting private and market place insurance.

The second policy modification to the ACA that could affect it is the revision of the tax credit premium. For instance, the ACA requires insurance enrollees to contribute a set maximum amount as insurance premium which is calculated based on their incomes. In case the benchmark premium plan exceeds the set amount, then enrollees receive a tax credit on the difference. Subsequently, insurance enrollees are protected from sharp premium increases (Sommers, McMURTRY, Blendon, Benson & Sayde, 2017). However, the system is considered very expensive and not sustainable in the long run. This can be modified by developing an advanced premium support system through which the tax credits are set independently from the premium. Such a system can reduce the cost to government agencies but can also reduce the number of enrollees for insurance coverage.

The US constitution, while not explicitly recognizing the access to healthcare as a fundamental human right provides several powers to the congress that can be used to address the issue of health insurance in the context of providing or ensuring general welfare. To begin with, the congress has the mandate of enacting and reviewing laws under the constitution. This power has been used in the development of many healthcare reform laws and practices such as Medicare and Medicaid (Pozgar, 2018). Also, congress has two other powers from the constitution regarding healthcare management. These are taxation and spending powers. Under article 1 section 8 of the constitution, congress has the power for taxation and spending on healthcare. The section specifically states that“[t]he Congress shall have the Power to lay and collect Taxes, to ... provide for the ... general Welfare of the United States (Pozgar, 2018).”

Finally, the congress has the power to develop commerce and interstate regulations to not only guide but also promote private businesses (Pozgar, 2018). For instance, with many Americans receiving insurance coverage from private insurers, congress has the mandate of regulating the sector to protect individuals from high insurance charges while also ensuring that private insurers are profitable. On the other hand, private insurers complement the activities of the government in the provision of insurance cover.

Conclusion

As observed in this paper an effective healthcare system can improve the countries health by increasing the access of citizens to quality, safe, and affordable care. However, it requires the increased collaboration of a complex network of organizations and individuals both in the private and public healthcare sectors and proper policy alignment and practice among public agencies at both the local, state, and national levels. In the US, the different levels in collaboration with private agencies have a distinct and specific role to play in ensuring improved population care by creating conditions to enable access to care. However, for this to be achieved, policymakers in the country must provide both the required financial and political support which is crucial for the development of effective and strong public health institutions while also supporting private healthcare providers.

References

Su, C. P., Asfaw, A., Tamers, S. L., & Luckhaupt, S. E. (2019). Health Insurance Coverage Among US Workers: Differences by Work Arrangements in 2010 and 2015. American journal of preventive medicine56(5), 673-679.

Sommers, B. D., McMURTRY, C. L., Blendon, R. J., Benson, J. M., & Sayde, J. M. (2017). Beyond health insurance: remaining disparities in US health care in the post‐ACA era. The Milbank Quarterly95(1), 43-69.

Chandra, A., Finkelstein, A., Sacarny, A., & Syverson, C. (2016). Health care exceptionalism? Performance and allocation in the US health care sector. American Economic Review106(8), 2110-44.

Pozgar, G. D. (2018). Legal aspects of health care administration. Jones & Bartlett Learning.