Replacing Affordable Care Act With a Single-Payer Plan

Introduction

In the United States, efforts have been made for centuries to achieve Universal Healthcare, raising fears and hopes but yielding little beyond Medicaid and Medicare. In 2010, the Affordable Care Act (ACA) ushered in a new reform era. Despite the full implementation of the law, it is evident that most Americans will be uninsured in a decade. Nurses and doctors struggle with the ever-increasing demands for mind-numbing electronic documentation as the healthcare industry increasingly favors large hospital conglomerates and insurers that gain influence through consolidation.

The Affordable Care Act (ACA), which adds to the administrative system’s complexity, takes away time, morale, and money from doctors and patients. The Affordable Care Act focuses on three key goals: a) restructuring the commercial insurance market, b) expanding Medicaid to low-income people earning less than 133 percent of the federal poverty level (Blumenthal et al., 2015), and c) changing the way medical choices are made. However, all three objectives rely heavily on private-sector decisions rather than government laws. In comparison to the Affordable Care Act, the article below will present the Single Payer Plan as an alternative and the best strategy to follow (ACA). The paper’s arguments are based on three main agenda items: coverage, costs, and payment as critical indicators of pursuing a Single-Payer Plan.

Coverage

The Affordable Care Act (ACA) falls short in comprehensiveness and universality. Only a tiny percentage of the half-million uninsured Americans have obtained coverage, and underinsurance remains widespread. Since 2006, those firms seeking to reduce their healthcare expenditures have increased deductibles three times. Many of the estimated eleven million Americans who have already purchased policies under the Affordable Care Act’s (ACA) exchanges suffer exorbitant copayments and deductibles, which in Bronze plans average more than $5300 (Blumenthal et al., 2015). This type of underinsurance jeopardizes people’s financial well-being and access to care. Because of the high expenses, 36 percent of nonelderly adults in 2014 avoided getting the necessary healthcare (Blumenthal et al., 2015). With 41% in 2010, this decreased from 2010 (Blumenthal et al., 2015). Millions of individuals will be uninsured or underinsured by the end of 2022, putting them at risk of financial difficulty if they become seriously ill.

The Single-Payer Bill ensures that everyone is insured from the moment they are born. In contrast to the preceding statement on the Affordable Care Act (ACA), if implemented, the Single Payer Plan would give full coverage to everyone living in the United States without deductibles or copayments (Holahan et al., 2016). This would take the place of the current policy, which is a wasteful patchwork of coverage. Outpatient, dental, inpatient medical treatments, and prescription drugs would all be covered. It would cover long-term care, which only a tiny percentage of Americans presently have access to.

Costs

When thinking of the term “Affordable Care Act,” it is easy to think of the hope that it will finally put healthcare expenses under control. The recent experience seemed to back up the positivity: five years of pretty liberal growth expenditure corresponded with the passage and execution of regulations. However, the derailment began before the Affordable Care Act (ACA), implying that the deep recession was primarily to blame and that the economy’s full recovery would reignite medical inflation. According to the research, it is already taking place. The resurgence of healthcare inflation is unsurprising, given that most of the Affordable Care Act’s (ACA) cost-control provisions are based on shaky data. Many people believed that the Affordable Care Act (ACA)-supported the Accountable Care Organization (ACO) policy of substituting fee-for-service compensation with capitation-like reimbursement would encourage providers to enhance efficiency and coordination, resulting in cost savings. However, the Accountable Care Organization has yet to save Medicare money (ACO). Physician practices and hospitals have consolidated into enormous systems as a result of the ACO concept, which could use market power to demand high price, driving up privately insured costs (Sommers et al., 2015). By attaching payment to quality metrics, which were supposed to be important in preventing care denial in capitation, risk adjustment has provoked ubiquitous gaming and quality measures, which distort the data needed for actual quality improvement and equitable payment.

In support of the introduction of a Single-Payer Plan, it would reduce administrative costs and provide fewer incentives for corruption. In general, lowering administrative spending to that of Canadians would result in a 15% reduction in national health spending (Holahan et al., 2016). This will result in an annual savings of nearly $500 billion for improved and extended coverage (Holahan et al., 2016). Allowing the National Health Program (NHP) to bargain with pharmaceutical corporations over medical costs would save enormous amounts of money as it does in other countries across the world. The plan’s enhanced simplicity and efficiency would reduce healthcare inflation, allowing the savings to expand over time.

Payment

There have been many perceptions that the government can increase quality by just changing how physicians are compensated while lowering healthcare spending. Any payment method might generate an incentive that perverts a market-based system when commitment and professionalism are absent. As a result, we anticipate payment flexibility under the National Health Program. Healthcare providers are compensated either through wages at non-profit hospitals or a contractual, simplified fee-for-service schedule.

The National Health Program would pay providers of institutions like nursing homes and hospitals from operating expenditures paid through global budgets, similar to how cities finance fire departments. The administrative savings from eliminating the per-patient billing would be considerable. Profits, capital investments, or advertising could not be routed from operational money. Instead, the National Health Program (NHP) would fund expansion and modernization projects through separate; explicit capital grants focused on community needs rather than profit.

In a nutshell, a Single-Payer Plan would move healthcare funding from individual and company premiums to taxes. Actual universal coverage requires tax-based financing, as it ensures that everyone is immediately covered. Under the Single-Payer Plan, the total amount spent on healthcare may be reduced, even if some people pay less than others. In terms of choice and continuity, on the other hand, the National Health Program under the Single Payer Plan would eliminate limited networks in favor of a single extensive network that permits free clinician and hospital choice, preserving therapeutic ties and eliminating involuntary turnover (Holahan et al., 2016). This would be a progressive approach when opposed to the Affordable Care Act (ACA), where insurance corporations continue to limit and reject care while maintaining tight networks.

Conclusion

Despite the Affordable Care Act (ACA) passage, the American healthcare system is riddled with severe flaws. Underinsurance and lack of insurance persist, expenses are forced to rise, bureaucracy grows, and caring connections are pushed aside in favor of the prerogatives of financial health providers and insurers. Furthermore, a Single-Payer National Health Program is a beneficial alternative that would, in the long term, move healthcare from the domain of political hyperbole to the realm of reality. The Affordable Care Act (ACA) has begun the necessary transformation. It is past time for Americans to take more measures toward overhauling the healthcare finance system so that all citizens can enjoy their human right to complete coverage. The modern world has already completed laboratory testing for us, so now is the time to implement this well-proven, long-lasting answer.

References

Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The Affordable Care Act at 5 Years. New england journal of medicine, 372(25), 2451–2458. Web.

Holahan, J., Clemans-Cope, L., Buettgens, M., Favreault, M., Blumberg, L., & Ndwandwe, S. (2016). Research report: The effect on national health expenditures and federal and private spending. Web.

Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2015). Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. JAMA, 314(4), 366. Web.