Discussion Forum Question What are two possible policy options for a national health care plan? What are the possible short- and long-term consequences of each plan?

Students Answer

1.What are two possible policy options for a national health care plan?

    The purpose of a national healthcare plan is to make certain that everyone has access to needed health services. There are two different policy options possible for a national healthcare plan which are single-payer and multi-player (Tuohy, 2019). A single-payer plan provides comprehensive coverage that is covered by the government. It is usually financed through taxes or funding designated for healthcare. Currently, Medicaid would be an example of a single-payer plan. A multi-payer plan mandates comprehensive coverage which is offered by insurance companies that are regulated and the cost is subsidized by the government based on income, however, the insured still pays a premium for their own insurance. The healthcare marketplace programs would be an example of a multi-payer plan.

What are the possible short-term consequences of each plan?

    I feel the short-term consequences, in general, would be the same for both plans. The immediate (short-term) negative consequences for both plans would be the initial cost of developing, implementing, and administrating the nation wide plan (Blumberg & Holahan, 2019). There would be resistance from many healthcare providers, insurers, and politicians to establishing a budget and forcing a change. Providing a universal plan for healthcare would also increase the patient load, causing longer wait times, medical staff shortages, and the need for more facilities. Private healthcare workers could be put out of work or make less income due to regulated charges for services which could impact the quality of care provided. The freedom of choice for care would also be eliminated in the single-payer plan, however, a multi-payer plan would still allow choices for coverage and insurance companies.

    The positive short-term consequence for each plan would be better access for all to have their healthcare needs met (Blumberg & Holahan, 2019). There would be no loss in coverage due to change of employment. There wouldn’t be the concern of being in or out of network or within an allowable jurisdiction.

What are the possible long-term consequences of each plan?

    Again, in general, it seems the long-term consequences of each plan would be similar. It seems a negative consequence may be stricter regulations on the treatments patients can receive and the government would have control over the well-being of loved ones (Zieff et al., 2020). Administrative costs would remain high and, for multi-payer plans where people have more choice of where they go for care, there may still be unequal care for patients.

    An obvious positive possibility is that, as everyone has access to healthcare, the health of all individuals improves over time which should lead to less health services needed. If this happened there would be a financial savings in the future.

SIDE NOTE: I must admit that, as I learn and experience more about diversity and equality among my clients, I can see where a universal approach to healthcare could have a positive impact on many. However, I still have reservations on the quality of care that could be provided based on government regulations and control of the program. I guess I’m still “on the fence” on this idea and need to research it further.

2Second 

One possible policy option for a national health care plan is a single-payer system, in which the government would be the sole insurer for all citizens. Another option is a public option, in which the government would offer a public insurance plan alongside private insurance options. The short-term consequences of a single-payer system may include increased taxes for individuals and businesses to fund the program, while reducing overall health care costs for the population as a whole. However, long-term consequences may include potential rationing of health care services and a decrease in available medical technology and innovation. The public option may provide increased competition in the insurance marketplace, potentially reducing costs and increasing access to health care services in the short term. However, long-term consequences may include the potential for the public option to become the dominant insurer, leading to decreased competition and potentially higher costs for taxpayers. According to a study by the Congressional Budget Office, “A single-payer system could substantially reduce the cost of health care for the population as a whole, but its implementation would involve significant changes in the financing and delivery of health care” (Congressional Budget Office, 2019).

3. The Affordable Coverage Coalition is a large movement of people who serve in a health field that supports movements towards universal health care (American Academy of Family Physicians, 2021). One of the ideas that this coalition has is expanding the ACA’s premium tax credits to more people (American Academy of Family Physicians, 2021). The positive impact of this would be that the people who struggle to afford insurance would be more likely to afford it and therefore get the healthcare they need and deserve. The short-term consequence of this would be most likely political action against expanding the premium tax credits to others as it would make it more expensive for others. In the long run, a possible consequence is that people feel more inclined to try to qualify for the premium tax credit for their insurance instead of seeking another route for health care.

Another policy option for the encouragement of a national healthcare plan is one that would lower medical costs in hospitals and incentivize people to stay healthy (Council for Affordable Health Coverage, 2022). One way this could be done is through a point system where a certain percentage would be taken off the hospital bill for efforts made toward maintaining a healthy lifestyle. Some examples could be exercising regularly, attending yearly physical checkups, or reducing or eliminating drug and alcohol consumption. A short-term consequence of a policy like this is that there would be a reaction towards a healthier lifestyle in the public eye. A long-term consequence could be increased stigmatism towards those who don’t have a healthy lifestyle. Another consequence, in the long run, would be that people who aren’t as able (financially or physically) to achieve some of the goals to reduce healthcare costs would continue to fall through the healthcare gap.

4. The two possible policy options for a national health care plan include;

Medicare for all: The policy championed by Sen. Bernie Sanders (D-Vermont) during his runs for the Democratic presidential nomination in 2016 and 2020. is basically for insuring the healthcare of the seniors, but the reform will include the entire population. The merit of this reform would include; longer longevity, lower infant mortality, lower levels of obesity, and lower levels of specific diseases and healthier population (Jansson, 2020). This program could also enhances the community-based model of health care. If Medicare for all policy work out, every other insurance such as private insurance, employer-provided insurance, Medicaid, the current version of Medicare, including Obamacare would all be replaced (Fisher, 2023). The proposed policy would cover every medical bill with no burden on the patient, but long-term care may have out-of-pocket additional costs. Universal healthcare requires healthy people to pay for medical care for the sick, lowers healthcare cost, reduce administrative cost, and save companies money because companies don’t have to hire staff to deal with many different health insurance companies’ rules, instead, billing procedures and coverage rules would be standardized(Fisher, 2023).  However, in the long run, there would be an increase in medical usage because is free, and then people would be less about their health. On the government side of the divide, saving might not be as feasible as projected. With government limiting healthcare spending, there would be less incentives for doctors to provide quality care.

Medicare and Medicaid expansion: Incremental reforms that might eventually lead to universal healthcare. These include lowering eligibility for Medicare from age 65 to age 55 and raising eligibility levels of Medicaid to even higher levels than were achieved by the ACA (Jansson, 2020). Moreover, under the medical expansion policy advocated by lawmakers, the policy would automatically cover Medicare Part A (Hospital), Part B (physician), and Part D (prescription drugs), which would effectively create a new insurance option for those 50 and older (Fisher, 2023).

In the long run, the policy would increase insurance coverage, and improve access to care especially among low-income adults, Children’s insurance coverage would also increase once their parents gain coverage, and the expansion would also narrow coverage disparities, especially by giving access to many low-income people of color (The White House, 2021). The policy would also improve mental health among low-income adults with chronic conditions. On a final note, there would be no significant increase in the state budgets, while spending in other areas remains constant (The White House).