Is Universal Healthcare right for America?
Even with the introduction of Medicare program in the United States, the debate for and against universal and comprehensive healthcare still rages on in the country. Against the backdrop of the many discussions in the globe, the right to access medical care regardless of one’s socio-economic status in the society became one of the most important issues. Many governments are charged with the facilitation of access to all citizens.
However, for a long time, many healthcare systems have been run on a capitalistic arrangement where an individual in need pays for the services provided according to market rates. This system has, however, been accused of locking out millions of households from middle and low income earning categories, who are not able to afford proper medical care for some medical procedures.
For governments, a healthy nation directly relates to a healthy economy where there is enough human resources and reduced expenditure on health infrastructure. In many cases, the rich have been able to access modern healthcare facilities while poor families continue to lose their loved ones because of affordability and accessibility issues.
As a result, the reactions for many governments have resorted to the formulation of policies and guidelines to facilitate fast, affordable and easy access for all (Pozgar, 2012). A universal healthcare framework is one such model that has been adopted globally.
However, for effective implementation, there have been challenges for healthcare organisations, professionals, administrators and for patients. This paper looks at the impacts of universal healthcare on the different stakeholders in the sector and provides recommendations for future improvement.
Universal Healthcare
Universal healthcare basically refers to the facilitation of basic healthcare services to residents of a particular region or country. Generally, this arrangement involves the provision of healthcare insurance and payment of healthcare costs by the government and other private institutions within an arrangement where the patients do not have to pay directly from their pockets.
Within a national establishment, universal healthcare may therefore involve the taxation of all citizens, combined with health insurance coverage that eventually caters for the costs of medical care when required. The government is also charged with the facilitation of universal care through policy formulation, regulation and providing mandate to all care providers.
In some forms of arrangement, popularly referred to as ‘single payer health insurance’, the government is only involved in financing of healthcare, while healthcare institutions are charged with service delivery.
Under the Affordable Care Act of 2010, the United States’ government has adopted the concept of universal healthcare that came into force in 2014 (Murray & Frenk, 2010). It is notable that by the time of adoption, the US was the only developed nation that did not have this kind of arrangement for its citizens.
However, the program did not come into the societal limelight recently as the legislation process may suggest. Calls for universal health coverage began in the early 1900’s, but legislation and adoption has seemingly dragged on, because the adoption of universal healthcare has its own challenges across the board that has led to intense debates.
Effective implementation of universal healthcare has numerous impacts on health professionals and organisations as outlined in the following section.
Impacts on Healthcare Professionals and Healthcare Organisations
The impact of universal healthcare on professionals and organisations in the sector are numerous. However, major impacts will be felt in the areas of financing, facility capacity building, personnel workload and regulatory requirements. First, funding is important for the success of any healthcare institution, be it for profit or not for profit.
Within the universal healthcare framework, there might be cash flow problems for hospitals that have to provide care and seek compensation from the insurance companies or the government depending on the arrangement. In most cases, the process of cost reimbursement may take some time.
Without proper management of finances within healthcare institutions, therefore, there might be many risks attached to insufficient supplies and late payment of health workers.
Secondly, capacity development plans for many healthcare organisations will remain highly effected. Universal healthcare improves access for the previously ‘locked out’ populations. As a result, there is a likelihood of increased numbers for the out and in-patient hospital sections. To be able to take care of this boom, hospitals will have to increase their capacity without compromising on the quality of care.
This may present a bigger challenge if financial management in the hospitals is not effectively enhanced. However, there are also opportunities for hospitals if the numbers are going to translate into improved financial performance hence increased expansion. The healthcare professionals like nurses may also expect improved pay structures.
On the other hand, increased number of patients is likely to result in issues of personnel workload. When the already overburdened healthcare professionals receive large number of patients in the wards and clinics, there is a need for increased personnel. Just like in the expansion of space and facilities, this is another area that is likely to negatively impact healthcare professionals and organisations if not effectively planned.
Lastly, regulatory requirements of the new healthcare act have new professions for access to quality care that may require change within healthcare organisations. The healthcare professionals will also need to acquaint themselves with the new requirements. For instance, every organisation must understand the procedures for claims and reimbursements for the different medical insurance plans.
Impacts on Patients and Families
Even though universal healthcare holds a big promise to patients and their families, the impact on the new system for this category must be noted. Generally, issues of access, quality, taxation and technical knowledge are most critical for this group of stakeholders. On a positive note, the impact of universal healthcare on access can be tremendous provided organisations effectively align to the required changes.
Patients from all forms of social and economic backgrounds will be provided with easy access to modern care facilities that they could not previously afford. This is a good step in the right direction for the US, since all citizens and particularly from the poor families will be assured of their right to live a healthy life.
For many families who have had to spend the little money they have on seeking treatment for chronic illnesses like heart disease, diabetes and cancer, this provides a lifeline for economic and social empowerment.
However, increased access raises an issue of quality of care within the participating healthcare organisations. In the event that poor management in such organisation results in overstretched capacity, the quality of care might be compromised at the expense of patients and their families. Any slight negative impact on quality of care may be against the main aim of universal healthcare in the country that many families have yearned for.
Another issue raised by the opponents of this program is that of taxation. The impact of facilitating this program on national economy may be damaging if not properly managed. Generally, when the government chooses to increase taxation to help in the funding of this program, families already living in tough economic times may be adversely affected.
Lastly, the issue of technical knowledge required for decision making is very important for the patients and the families. Many poor families may not have the literacy levels required to select the suitable medical plans for their households. Given that private and profit making institutions are involved in the program, the impact on choice of medical cover may be negative if proper guidance is not provided for families.
However, the mentioned impacts may not necessarily mean that universal healthcare may not be viable for the United States. There are numerous case examples that may be used to indicate the benefits of this program and how the many challenges associated to it may be overcome.
Critical Analysis
As stated earlier, many governments have strived to provide universal healthcare access to their citizens globally. The Netherlands, Germany and Singapore are examples of developed nations that have successful universal healthcare programs for their citizens (Hooe, Considine & Sethi, 2013).
The Asian nation can however be a better case for highlighting the importance of universal care programs. With a fast growing population, the economic powerhouse in the Asian continent still recorded higher rates of infant mortality and other deaths associated with venerable diseases like malaria. The rural populace in the country, mostly low-income earners, were the most affected.
However, the adoption of a single pay health insurance system for its population, the country has made enormous gains in the healthcare sector that may be a model for many countries.
As a result of the comprehensive medical care implemented by the government in collaboration with healthcare organisations and professionals, the life expectancy rates in the country have significantly improved similarly to the declining infant mortality rates. From this case, it is easy to connect the healthy population with the country’s booming economy.
Significance to the Practice of Healthcare Administration
Universal healthcare can only be achieved with proper management as already pointed out in the discussions. The implementation of universal healthcare programs provides challenges as well as opportunities for healthcare administrators. Universal healthcare has great implications for healthcare administration practice.
First, there is need for effective change management that should begin from administrative levels (Shi & Singh, 2012). For all departments and personnel to effectively implement universal care and take advantages of growth opportunities presented by it, administrators must be ready to initiate change.
Secondly, risk management is an essential part of health organisations’ success in the new universal care system. For administrators, the challenge for effective risk management is of great significance to performance, because the financial inflexibility that may be brought within the transitional period has far reaching implications for growth.
Third, quality assurance has been identified as another area of challenge for the universal healthcare program implementation. Administrators are also required to effectively co-ordinate departments and cross functional activities to ensure that success for all mentioned areas is attained. The benefits of universal healthcare present huge opportunities for administrators in the sector.
Most importantly, administrators are presented with the opportunity to attain the goal of providing healthcare to all individuals regardless of their cultural, social or economic backgrounds. In addition, administrators also have an opportunity to collaborate with their counterparts in other organisations to ensure that they comply with the requirements of the new system.
Recommendations
Having examined the benefits of universal healthcare, it is easy to conclude that the US needs the system. Given the success story noted from the selected case, the challenges identified may be eliminated in many ways. First, there is need for training of all administrators and personnel on the legal, economic and social implications of the newly implemented system.
Training will also help professionals provide guidance and advice to the illiterate individuals who may not be able to choose suitable healthcare plans for their families.
Secondly, the government and other sector stakeholders should engage in frequent policy restructuring to ensure smooth implementation, because universal healthcare relies on particular regional and institutional factors like geographical and demographic dynamics (Savedoff, de Ferranti, Smith & Fan, 2012).
The mode and nature of care for different individuals should also be clearly defined to avoid cases of congestion in hospitals. Next, it is important that healthcare organisations plan for financial risk protection through access to other sources of financing while reimbursements are forthcoming.
In this way, operations are likely to run without hitches pegged on capacity and resource availability. Lastly, community sensitisation programs should continue to be carried out to ensure that all citizens are aware of their rights of access and the available avenues for doing so.
References
Hooe, B. S., Considine, P. T., & Sethi, M. K. (2013). National healthcare systems: A worldview. New York: Springer.
Murray, C. J., & Frenk, J. (2010). Ranking 37th—measuring the performance of the US health care system. New England Journal of Medicine, 362(2), 98-99.
Pozgar, G. (2012). Legal aspects of health care administration. Sudbury, MA: Jones & Bartlett Publishers.
Savedoff, W. D., de Ferranti, D., Smith, A. L., & Fan, V. (2012). Political and economic aspects of the transition to universal health coverage. The Lancet, 380(9845), 924-932.
Shi, L., & Singh, D. A. (2012). Essentials of the US health care system. Sudbury, MA: Jones & Bartlett Publishers.