June 23, 2013
Professor Tirizia York
Health Care Reform
The health care reform in this country is in need of reform. Many initiatives have been made to protect the professionals that deliver health care services, and to protect the major corporations that have become stakeholders in the health system, but little has been done to protect the primary stakeholder, which is the consumer who accesses the health care system in search of treatment for a chronic condition or illness. There is transparency in the services consumers use on a daily basis. They know how much there mortgage payment is going to be, how much they have to pay for their cell phone bills, ...view middle of the document...
However, with the complex design of our health care system the opposite may in fact take effect. The larger Accountable care organizations power may allocate decision making power to fewer organizations and prevent their ability to compete in the health care process. The shutting out of the less powerful organizations may add to the problem that already exists which is providing more health care, absent of the quality of health care each American should be afforded the opportunity to have. In this case, providing better health care at a lower expense to the primary stakeholder is not likely to be the case (heritage.org, 2011).
Allowing Americans to be active participants in the decisions surrounding their health issues through education and full disclosure of the pricing involved in the diagnosis and treatment would help to lower the cost of medical services. It is believed that if a person is aware of how much services cost, they will be more discriminating in their health care purchases. The hospital emergency rooms and various trauma units are being flooded by people who cannot be treated any where else because of a lack of insurance. Four states are considering adopting a universal care program to avert the financial burden of the state. Health information technology, price transparency, and quality improvements are moves in the right direction to eliminate some of the problems this country faces in relation to health care, and health care reform (deloitte.com)
In addition to the problems with quality of care and transparency of pricing, is the new laws that are going into effect surrounding the new Obama Care Act. People are being faced with the task of selecting insurance providers, people who have little if any knowledge of what it is they should be looking for when doing so. Understanding the complex policies and the conditions they cover or the conditions they refuse to cover has baffled some of the most informed experts in the insurance field, and is sure to be overwhelming to the average consumer. Even with people assisting consumers in making the right insurance choices there still will be problems due to the purchaser being forced to make a purchase and do so with already limited finances. An informed decision is impossible to make without all the facts. Adding to the quandary is the fact that insurance companies are still being clandestine about the actual prices they negotiate with the providers, and the lack of disclosure of pricing imposes a barrier to the consumer being fully informed. Transparency is still not transparent enough to make the right decision for the average American. Hospitals present bills that are often overinflated because they are trying to negotiate with third party payers to get the most for a service they provide for a patient that cannot pay their bill, or otherwise has no insurance coverage. Due to over inflation of prices and prices inconsistent with the charge master documents...