HEALTH CARE REFORM

The Pros and Cons of Health Care Reform have on Consumers

The Pros and Cons of Health Care Reform have on Consumers

Outline

The outline for this particular paper is as follows: Firstly the thesis statement is covered, followed by an introductory paragraph that highlights the importance of healthcare reforms. The discussion section contains the major portion of this paper elaborating the history and facts covering the Medicaid Medicare Reforms. The paper ends with a brief conclusion that summarizes the topic.

Thesis Statement

Health care reform constitutes the process by which the social policies that regulate health care are created and modified. In essence, health care reform is driven, to a large extent, by regulatory reform.

Introduction

Health care reform, therefore, represents a subset of health care policy. However, it is important to recognize non-regulatory drivers of health care reform such as the impact of market forces on the level of quality of care, as with the Leapfrog group, and the recent report from the Institute of Medicine regarding medical errors (Schuster, 2008). Health care reform can lead to changes in the degree to which the government controls and manages access of the population to health care and the way in which health care is financed (Mechanic, 2006).

Disparate societal philosophies regarding the role and responsibility of the government in providing health care services, and the underwriting of such services, such as can be seen in the United States and Canada, do not preclude health care reform from having a profound impact on patients, the public, providers, and payers of these very different systems.

Discussion

The process of health care reform has led to diminished independence of the medical profession. This, in turn, has resulted in the current system by which health care providers are reimbursed for the services and resources that they provide. At one time, the medical profession controlled entry into the health care system and set the prices that would be charged for the delivery of their services (Geyman, 2006).

In addition, the medical profession determined which hospital a patient would be admitted to, which laboratory a patient would utilize, and where a patient would go for other radiological and ancillary services. Pricing was led by the costs incurred by the provider. To determine pricing, the provider determined its costs and the desired profit margin. Regulation of health care, at that time, was focused on the licensing and accreditation of health care providers (Guglielmo, 2007).

However, in the 1970s, driven by economic recession and inflation, health care reform became, in essence, a process focused on health care cost containment. Primacy was given to the development of reimbursement policies that would act to influence the behavior of providers such that utilization of health care services, and the attendant medical costs, would be reduced (Finger, 2008).

Medicare, which is underwritten by the U.S. federal government, provides health insurance for more Americans than does any other payer. Hence, changes in Medicare reimbursement policies constitute a significant component of health care reform (Schuster, ...