Even though basic healthcare is a fundamental aspect of the performance of health systems across the United States, the government has always underestimated the population health and reduced investment in healthcare for many years. Consequently, many Americans failed to get treatment due to the absence of a fundamental law that regulates operations in medical centers between consumers and providers. However, in order to create more harmonized services, the government has ratified the Affordable Care Act (ACA) to help in achieving cost reduction in the health sector (Gruber, 2011).
Precisely, cost reduction has provided several ways through which consumer and provider incentives can operate together in facilitating cost reduction (Hicks, 2014). This paper seeks to synthesize the ways through which consumer and provider incentives are integrated in achieving cost reduction under the ACA. In addition, it aims at defending and/or criticizing major provisions of antitrust legislation in the United States.
Cost reduction measures by consumer and provider
According to Abrams, Nuzum, Mika, & Lawlor (2011), consumer and health provider incentives can work together in ensuring a decline in the cost of accessing health services in a number of ways. One of the ways through which the law can be applied is by using new customer protection requirements. Specifically, putting pieces of medical information on online platforms for customers can work a great deal in enabling consumers to compare different health insurance options and subscribe to policies that best fit their medical needs (Abrams, et al., 2011).
In addition, the ACA has a provision that forbids insurance companies from withdrawing coverage in case of any slight error. Under the law on insurance, customers and health practitioners have chances to initiate reforms in the entire health sector. It is important to underscore that the customers have an opportunity to reduce the cost of accessing key healthcare services from the health providers; an example of such synthesis is evident where the law has reduced cases where patients with some diseases such as breast cancer were dropping their health insurance coverage due to their health status (U.S. Department of Health & Human Services, 2014).
Under the ACA regulations, patients can appeal against any insurance company’s controversial decisions. Through external review processes, customers can determine how insurance firms handle their claims in promoting cost reduction strategies in the healthcare services they receive. In the context of provision, customers and healthcare providers can avoid various forms of exploitation (Kronenfeld, Parmet & Zezza, 2012).
Defending the antitrust legislation
In defending the key provisions of antitrust legislation, estimations reveal that over 30 million Americans can comfortably access affordable health and insurance services due to the ratification of ACA laws. However, the law has various negative impacts such as a rise in the number of individuals seeking subsidized insurance services. Besides, within the next five years, the American population might overwhelm the health centers, hence create inevitable shortages. An example of antitrust laws in action occurred when the United Regional Health Care System in Wichita Falls, Texas got sued for unlawful monopolization (Jones, 2013).
Conclusion
In conclusion, ACA regulations have greatly helped consumers and healthcare providers to reduce the cost of accessing health services. Conversely, insurance sector needs to follow the regulations to promote quality and affordability of healthcare services in the United States. However, the consumers should not use the laws to make unrealistic compensation demands of the insurance companies. Health providers should ensure they adopt proper regulatory measures that would help in reducing the cost of healthcare services on the platform of the ACA.
References
Gruber, J. (2011). Health care reform: What it is, why it’s necessary, how it works. Washington D.C: Macmillan Publications.
Hicks, L., (2014). Economics of health and medical care (6th Ed.). Burlington, MA: Jones & Bartlett Learning, LLC Publications.
Jones, D. A. (2013). The simple reader’s guide to understanding the Affordable Care Act (ACA) health care reform. Bloomington, IN: Abbott Press.
Kronenfeld, J. J., Parmet, W. E., & Zezza, M. A. (2012). Debates on U.S. Health Care. New York: Sage Publications.
Abrams, M., Nuzum, R., Mika, S., & Lawlor, G. (2011). Realizing the Health Reforms Potential. The Common Wealth Fund Journal 1 (1), 5-10.
U.S. Department of Health & Human Services, (2014), About ACA laws. Web.