Unintended Consequences of the Affordable Care Act

2021-07-15 22:14:13
6 pages
1477 words
University/College: 
University of California, Santa Barbara
Type of paper: 
Case study
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Those who formulated the Affordable Care Act did not intend that the act would encourage the use of the Health Savings Accounts. The proponents of the act saw the Health Savings Accounts as tax breaks for those the wealthy. Nonetheless, there is a likely chance that they are trending up within the general population. The act led to a creation of over 16 million accounts in 2015 alone. These accounts are approximated to have over $30 billion assets, a figure that is also seen to likely double in the few years to come. The main item that is driving the action is the payment of the health costs involving the tax-advantaged dollars. Healthcare provision in the United States of America has been under extreme volatility for many years now. Like any other healthcare system, it is hard to ascertain the existence of effectiveness of the healthcare system. The implementation of the Affordable Care Act is seen as one of the provisions that have altered the healthcare system and healthcare provision in the United States of America. The Affordable Care Act was established during the President Obama's reign (Zamani-Gallaher, 2014).

Under this act, the out-of-pocket costs together with the health insurance deductibles are sky rocketed. This leaves many employees to increasingly take care of their health care costs. In a political environment, this would be termed as employee costs share increase. Employees are made to pick up large cost share involving before-tax dollars. These are with the Health Savings Accounts and the Flexible Spending Accounts (Zamani-Gallaher, 2014). The flexible accounts are effective. Nonetheless, such accounts require employees to predict with accuracy their costs of healthcare for the coming year. The contributions made to the flexible accounts attract insurance risk mechanism requirements that are often called use it or lose It. the employee is risking losing something that was not spent every year.

The existing care has brought about hospital monopolies. The planners did not intend this. The number of the hospital acquisitions and mergers has increased credibly over the past few years. These mergers and acquisitions have come in the form of large conglomerates of healthcare acquiring small community hospitals, resulting in regional monopolies. Some of the common examples are St. Lukes Health System, Enova Health System, and Partners Healthcare found in Massachusetts.

The emerging multi-hospital mergers led to slashing of the necessary competition in the healthcare market, hence commanding the market price. The emergence of the mergers has led to some imbalance in the healthcare market. it took the Massachusetts Superior Court to block the acquisition of smaller hospitals by Partners Healthcare, saying that the settlement that had been created by the partners had no strength to offer enough protection to enable partners to have a regulated check on the market power (Karaca-Mandic et al., 2013).

Two aspects specifically lead to these unintended consequences. The act encourages the creation of networks between healthcare providers. Under this act, institutions with high costs including specialists and hospitals are not included many insurance plans that are under the act. Because of this, the healthcare provider networks are made narrow. The act creates the idea of accountable care organizations. This is an integrated system of healthcare delivery that credits efficient use of the existing resources as a way of cutting down on the unnecessary spending by the people.

The Healthcare Act is lucrative to many state management of the system of health. Through this act, hospitals are given the power to use different systems of Medicare payment. The risk of high costs is spread. The risks are spread over larger populations, hence making the savings credible. The infrastructure and human resources are shared. The ideal reason that led to the adoption of this act was as a way of providing many dollars to the healthcare system besides bringing increased satisfaction to the people. Nonetheless, one specific and likely challenge with this act is that it results in a massive rise in the healthcare expenditure. Those organizations owned by hospitals are likely to experience 20% rise in spending by patients as compared to organizations owned by physicians (Zamani-Gallaher, 2014).

Such kinds of hospital monopolies are likely to damage the already volatile healthcare system in the United States of America. The monopolies are likely to result in increased costs of healthcare provision. The monopolies are dictating the prices of the different products in the market. The monopolies are also creating immense barriers to new partner entry, something that is likely to damage the competitiveness of the healthcare market. The elimination of the competitiveness in the market means that the innovative ways of dealing with present crises will be stifled.

The monopolies, which are unintended with the formulation and implementation of the act, will damage the complex system that is used to offer healthcare by the physicians. Such damage will further lead to the creation of untoward pathways where physicians use hospital standardizations to choose treatments instead of using recommended clinical protocols. The existing monopolies will lead to limitation of the options available for patients when seeking health care since the competitive market has been eliminated (Craft, 2015).

The decision to have this Affordable Care Act was to provide a uniform platform where healthcare provided to the people is affordable, accessible, and validated by its effectiveness. The people, affordable, efficient, and holistic to the people and the providers, arrived at the decision after considering many things including the need to make the healthcare provision accessible. The decision to undertake such an act in the national healthcare system was motivated by the ailing healthcare provision system, something that had crippled most of its provision to all the people coming from different economic capabilities (Craft, 2015).

The ethicality of the decision is seen with its fruition in providing what has initially intended apart from topping it up with the unplanned and unintended consequences. It was ethical for the act to be implemented since its deontological and utilitarian effects were all positive as they had been perceived and intended. The decision to protect human life using equitable healthcare system was ethical. The decision to have an accumulated way of managing financial requirements, and balancing them equitably for a better service provision was ethical. There were anticipated barriers but the mechanisms of managing them were ethical.

The costs of formulation, implementation, and evaluation of the act were all done within an ethical frame. The rightfulness of the act was foreseen as involving specific ways and methods that increased the chance for the individual participation of people in accessing healthcare. The act was created to ease health access and provide legibility in the management of healthcare systems. Financial constraints would still be felt within healthcare provision sector. The unintended consequences are seen to have been welcomed by the existing happenings within the healthcare market. Thus, it can be said that as planning for the act was taking place; the consequences were also likely but were not seen to have any intention. It is therefore imperative to see the unintended consequences of being part of the plan but not within the intentions of those involved in the formulation of the act and decision-making. The ethical standards that are in existence when formulating such protocols were all followed (Zamani-Gallaher, 2014). The standards were used as a framework that guided the formulators of the Affordable Care Act. The act, thus, was seen as to affect positively on the people. The act was to serve as a mechanism for increasing the chances for the healthcare system in the United States of America o act holistically.

The Affordable Care Act is one of the best systems that any nation can use to provide effective and affordable healthcare to its population. Nonetheless, as seen with the unintended consequences felt in the United States of America, the act might not seem effective holistically. It is important to consider providing countermeasures that ensure that the existing health care funding is managed. Healthcare is a vast body of any community or nation. The procedures that are taken to provide health care have to be subjected to equitable terms and conditions, most of which have to be ascertained by proper planning. To avoid further damage to the Affordable Care Act, the unintended consequences have to be managed within the framework of healthcare. Monopoly can be managed by an equitable balancing of the market. The healthcare market has to be balanced in terms of demand and supply together with financial balancing where there will not be loopholes in the financial structures in healthcare provision (Zamani-Gallaher, 2014).

 

References

Craft, M. C. (2015). Obamacare Has Unintended Consequences for Food Stamps. Bond Buyer, 1(34347), 1.

Karaca-Mandic, P., Abraham, J. M., Simon, K., & Feldman, R. (2013). Going into the Affordable Care Act: Measuring the Size, Structure, and Performance of the Individualand Small Group Markets for Health Insurance. Cambridge, Mass: National Bureau of Economic Research.

Zamani-Gallaher, E. M. (2014). Obama administration and educational reform. Bingley, UK: Emerald Group Publishing Limited.

 

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