Introduction
Access to healthcare services has long been a critical theme in the USA. However, despite numerous attempts to establish an effective and affordable system, it remains criticized due to its high spending and treatment costs. The Clinton administration’s healthcare reform plan and the Affordable Care Act, introduced by Obama, have not resolved tensions, and numerous issues remain unresolved today. Moreover, the rise of the health insurance industry and the corporatization of healthcare led to radical shifts in the practice. Nowadays, most barriers individuals face when trying to receive treatment are often associated with flaws in policy and the dominance of health insurance practices supported by large corporations that benefit from them.
State of Health Insurances in the US
The insurance industry and corporatization are the major factors responsible for the changes in care delivery and functioning of the sphere. The last one can be determined as the transformation of state-owned assets or organizations into corporations (Ferris, 2021). Thus, in the typical US city, care is delivered by three or four healthcare systems centered around large hospitals (Ferris, 2021). These entities have a central corporate governance and are fully accountable for their financial performance (Ferris, 2021; Hover, 2022).
Private practices are also corporatized, which leads to the establishment of a monopoly (Ferris, 2021). As a result, the cost of services grew significantly, and the inflation of healthcare prices deprives disparities of proper treatment (Ferris, 2021). It has become a significant concern for the nation’s health.
Meanwhile, the number of health insurance plans and their diversity continue to grow. Unfortunately, it does not lead to the increased utilization of healthcare services (Narita, 2023). Around one-third of adults in the US live without recommended treatment or do not see a doctor when sick (Nash et al., 2019).
Additionally, around 28.5 million citizens were uninsured in 2017 (Nash et al., 2019). At the same time, insurance coverage determines whether a person can get the required treatment, which alters the sector’s work radically. The increased cost, prices, and complicated access to care are the most problematic issues nowadays.
Legislative Efforts for Increasing Access to Healthcare
The Presidents and their administrations recognized the flaws in the healthcare policy and tried to address them. For instance, Clinton’s administration offered the idea of universal coverage with employers responsible for the costs of insurance premiums for workers (Oberlander, 2007). Using the regional purchasing tools, the government had to regulate insurance practices to guarantee cost control (Oberlander, 2007). However, the plan was too ambitious and opposed by the business because of the employer mandate (Oberlander, 2007).
Obama’s Affordable Care Act (ACA) focused on expanding Medicaid and establishing insurance marketplaces with subsidies, cost-sharing incentives, and rate restrictions (Campbell & Shore-Sheppard, 2020). Patient protection also included regulations to increase access to care (Campbell & Shore-Sheppard, 2020). In such a way, the plans focused on altering the approaches to insurance and business involvement.
The plans also implied specific mechanisms for paying to improve coverage. ACA relies on value-based payment models that reduce costs and increase affordability (Campbell & Shore-Sheppard, 2020). Employer-sponsored and marketplace plans function to ensure that individuals can access the necessary therapy. As for Clinton’s approach, the mechanism implied a higher level of government involvement in regulating the insurance industry and employers’ payments for packages (Oberlander, 2007). Thus, the approach became ineffective over time as the corporatization and dominance of big insurers required individuals to find the necessary sums to pay for their care. The issue is unresolved today as the prices are high, and many citizens cannot afford them.
Conclusion
Altogether, the modern healthcare sector remains highly corporatized and costly. The high insurance prices deprive minorities and disadvantaged groups of the chance to receive treatment. Clinton and Obama’s reforms attempted to alter the situation and promote positive change by altering the mechanism for paying and engaging other parties, such as employers or the government. However, regardless of these attempts, the problem remains topical, and many Americans cannot afford insurance plans for full coverage of their current health needs.
References
Campbell, L., & Shore-Sheppard, L. (2020). The social, political, and economic effects of Affordable Care Act: Introduction to the issue. The Russel Sage Foundation Journal of the Social Sciences, 6(2), 1-40.
Ferris, M. (2021). The corporatization of the healthcare system. Academic Festival Event, 147. 1-14.
Hover A. R. (2022). Observations on corporatization of healthcare systems in America. Missouri Medicine, 119(2), 93–97.
Narita, R. E. (2023). Consumption of healthcare services in the United States: The impact of health insurance. Journal of Risk and Financial Management, 16(5), 277.
Nash, D. B., Skoufalos, A., Fabius, R. J., & Oglesby, W. H. (2019). Population health: Creating a culture of wellness(3rd ed.). Jones & Bartlett Learning.
Oberlander, J. (2007). Learning from failure in health care reform. The New England Journal of Medicine, 357, 1677-1679.