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Posted: December 31st, 2022

Reforms To The American Healthcare System

Reforms To The American Healthcare System
This assignment will be submitted to Turnitin®.
Instructions
The purpose of this assignment is to demonstrate knowledge of how the federal system of government works. Examine what the different branches and layers of government do to address a policy using a current issue to illustrate it. It is NOT to give your personal opinions on the issue.

Complete a research essay on how the federal government creates healthcare policy.

The U.S. healthcare system has been a controversial topic for decades. Here are the aspects and questions to address for this essay:

Identify a current policy problem for the American healthcare system, and then state a preferred policy solution to it and why it’s preferred (This is your thesis statement).
Briefly explain two competing solutions to this problem while addressing the responsibilities of each level of government (federal, state, and local) and the three branches of the federal government (executive, legislative, and judicial).
Build the argument for why your chosen solution is preferable, what critics say about the solution, and finally why the critics are wrong.
REQUIREMENTS:

750 word target length (about three pages), not including references listed at the end or footnotes if used.
Incorporation of concepts and terms from the required readings.
Inclusion of facts from a recent news article about the topic/solution.
Correct spelling, grammar, and formatting, whether it’s APA, MLA, or Chicago/Turabian.
See the essay rubric for further details on grading.
Writing tips:

1) Write concisely! More is not necessarily better if the required points from the rubric are missed.

2) Essays should be written in the third person perspective. (Avoid using “I, me, my, mine, we, us, our, you, your”).
High Expenditure Rates In The American healthcare System
One main challenge in the American healthcare system has been the ever-increasing healthcare expenditure. While the country has experienced an increase in the delivery of healthcare services since the passing of Patient Protection and Affordable Care Act (ACA) in 2010, the progress would come with an unintended consequence of rising costs (Fiedler & Young, 2020). Any policy solution implemented to reduce the overall healthcare spending should hence either lower the price or the utilization of healthcare. It would be preferred that the policy solution implemented does lower the price of operations rather than the use of healthcare due to the tradeoffs affiliated with the latter option. One of the recommended and preferred solutions would be intensifying advanced home based care through telehealth services (Shrank et al., 2021). Telehealth services have been found to be a cost-effective approach that will deliver quality patient care in a while increasing the healthcare access levels in the country.
Telehealth entails the provision of healthcare services through a wide range of technologies. This approach has specifically been effective when it replicates the in-patient care, speeds input from expert practitioners and avails information more regularly (Azar et al., 2017). Notably, after the outbreak of COVID-19, telehealth practically became a basic need for the general population, the health providers and the patients affected by the virus. The technologies were needed to allow patients to engage in real time with their healthcare providers on advice relating to their health challenges. This was not the trend prior to the pandemic considering only 2.4% of the population surveyed in the IBM MarketScan Commercial Claims and Encounters Database had acknowledged the use of at least one telehealth service in 2018 (Weigel et al., 2021). The use of telemedicine in the conventional Medicare and Medicaid and also among the beneficiaries enrolled in the managed care plans has been on a steady increasing rate but the levels remain low. The health pandemic would however indicate that it was time that the American health system was ready for such changes which come at the benefit of reduced health care expenses.
Various stakeholders need to make particular efforts that will facilitate the use of telehealth in the health system. The state and federal governments need to explore the legislative and administrative proposals seeking to modify the reimbursement policies which could impede the use of alternatives such as telehealth in providing in-person health services. The local government will need to carry out awareness initiatives among its communities where they are educated on how telehealth will provide quality healthcare services to them while eliminating the burden of travel seeking the services. Considering the branches of government, Congress representing the legislature will need to adopt the licensure compacts or model laws that improve the portability of licenses hence provisioning healthcare providers with opportunities for telehealth practice. The judicial branch is required to interpret the laws such as giving the professionals the liberty of determining whether and when it is safe and appropriate to provide the telehealth services with a consideration of professional standards. The executive is required to develop and harmonize the licensure standards and approaches in telehealth programs implemented in the country.
One competing solution to the reduction of health care costs has been to bring in more foreign trained doctors into the country. The American healthcare system is known for paying physicians considerably higher salaries than other developed countries. Notably, increasing the supply of these professionals should reduce the wages needed to be paid. The federal government will need to remove the barriers during immigrant processing for medical professionals and expedite their work authorization permits (Mathema, 2021). The State government needs to create an expedited pathway for the highly qualified foreign doctors wanting licenses to work in their regions. The local government needs to allow a streamlined integration of these doctors within the community for the delivery of streamlined healthcare services. The legislature will bring in more foreign doctors if they implement reforms such as eliminating the per-country green card caps and reforming the Reform the Conrad 30 J-1 Visa Waiver (Peak, 2019). The Executive through the Department of Health and Human Services and the Association Council need to identify the foreign medical residency programs that are comparable to the quality and rigor in American programs, the graduates from these equivalent programs need to be gvern residency waivers that allow them to forgo completing the American residency and rather make direct applications for state licensure. The judiciary will need to define the law reforms and inform the authorities and applicants on the quality of froeign doctors required in the American healthcare system.
While bringing in forein doctors will increase the supply of physicians and reduce the wage levels paid to the physicians, the use of telehealth services provides a better opportunity of reducing costs while providing quality healthcare. The current American society is digitally versed such that incorporation of telehealth will not be difficult especially for the patients. The system will only spend highl in setting up infrastructure with the maintenance taking up only a fraction of the costs. Ultimately, the country will provide quality healthcare at reduced costs while saving time and providing services in real-time.
Critiques of this approach have indicated that the care models and the contexts in which telehealth is implemented is typically heterogeneous leading to the concern of whether the technologies reduce the cost of healthcare services (Snoswell et al., 2020). Notably, the cost reduction effect of using telehealth services lies in the country’s measures while adopting the approach. For instance the state by state reimbursement under Medicaid would mean that the telehealth consultation is done at lower rates compared to the in-person consultations. In actual fact, both research and experience under the Medicare programs suggested that the concerns on increased spending in telehealth are overstated especially when they are weighed against the potential advantages in the quality patient experience and efficiency (American Hospital Association, 2016) When the proper service types are used at greater levels, the costs are considerably reduced. The modernization of the Medicare coverage of telehealth through innovative payment models and uses of additional resources will aid in making considerable cost benefits in healthcare. Telehealth increases the ability of accessing timely care while reducing the potential inconveniences that come from seeking in-person healthcare services.

References
American Hospital Association. (2016). Telehealth: helping hospitals deliver cost-effective care. Issue Brief, 30, 1-7.
Azar, M. A., Mnuchin, T. S. & Acosta, A. (2017). Reforming America’s Healthcare System Through Choice and Competition. Retrieved from https://www.hhs.gov/sites/default/files/Reforming-Americas-Healthcare-System-Through-Choice-and-Competition.pdf
Fiedler, M., & Young, C. L. (2020, October 1). Current debates in health care policy: A brief overview. Retrieved from https://www.brookings.edu/policy2020/votervital/current-debates-in-health-care-policy-a-brief-overview/
Mathema, S. (2021, November 7). Removing barriers for immigrant medical professionals is critical to help fight coronavirus. Retrieved from https://www.americanprogress.org/article/removing-barriers-immigrant-medical-professionals-critical-help-fight-coronavirus/
Peak, S. (2019, September 12). Foreign doctors will heal America—If Congress lets them. Retrieved from https://www.niskanencenter.org/foreign-doctors-will-heal-america-if-congress-lets-them/
Shrank, W. H., DeParle, N. A., Gottlieb, S., Jain, S. H., Orszag, P., Powers, B. W., & Wilensky, G. R. (2021). Health Costs And Financing: Challenges And Strategies For A New Administration: Commentary recommends health cost, financing, and other priorities for a new US administration. Health Affairs, 40(2), 235-242.
Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: scoping review. Journal of medical Internet research, 22(10), e17298.
Weigel, G., Ramawamy, A., Sobel, L., Salganicoff, A., & Cubanski, J. (2021, March 17). Opportunities and barriers for telemedicine in the U.S. during the COVID-19 emergency and beyond. Retrieved from https://www.kff.org/womens-health-policy/issue-brief/opportunities-and-barriers-for-telemedicine-in-the-u-s-during-the-covid-19-emergency-and-beyond/

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