As the health care sector continues to evolve, due to the implementation of innovative technology, an area that has lacked evolution is the health care delivery system. A lack of transparency within the health insurance market, has left consumers struggling to afford coverage, due to high deductibles, premiums, out-of-pocket costs, and narrow networks. Consumers feel bamboozled by insurance companies, since marketing ploys allude to a more affordable consumer-based approach to health care options, yet they fail to deliver on the promise. Instead, consumers find themselves paying catastrophic prices, just to receive health care services. Although there are many federal and state health care policies enacted to allegedly alleviate some of the financial strife, most have failed to lead to effective change, within the health care industry.
Federal and State Health Care Policies
Consumers are looking for affordable, patient-centered quality health care options, but are often on the receiving end of price gouging, due to a lack of transparency. According to NCSL (2020), “As spending on health care services continues to grow—particularly for hospital, physician and clinical services—state and federal policymakers are leveraging health care price transparency as a potential strategy to curb rising health care costs. Price transparency takes many forms, but the overall intent is to increase consumer knowledge of health care prices.” As most health care providers have shifted the paradigm to value-based payment options, lawmakers are having a difficult time, effectively mitigating costs. With health care programs such as Medicare, Medicaid, the Affordable Care Act, CHIP, private insurances, and pharmaceutical sectors all seeing an increase in demand, lawmakers on federal and state levels, must work together to provide a viable solution, to consumer pricing concerns.
Policy Effects on Consumer Costs
State and federal legislators, are now attempting to corral health care spending, by initiating newly developed health care laws. Implementing health care reform laws, transparency laws, payment reform and benefit design laws, laws encouraging provider competition, and laws governing oversight and regulation of costs, are all areas lawmakers are currently working to improve (Murray, 2019). The overall goal of legislators, health care providers, and organizations should be to overturn the imbalance of market power within the health care market and offer transparency to consumers, looking for improved health outcomes. If all work together to offer consumers relief for their wallets, the health care spectrum would rapidly see an increase in consumer engagement.
Positive and negative effects. Implementing policies that are in direct correlation to the insurance market, should be a top priority for all health care related sectors. According to BallotPedia (2020), “The economic health of a state can significantly affect its healthcare costs, insurance coverage, access to care, and citizens' physical and mental health. For instance, during economic downturns, employers may reduce insurance coverage for employees, while those who are laid off may lose coverage altogether. Individuals also tend to spend less on non-urgent care or postpone visits to the doctor when times are hard. These changes in turn may affect the decisions made by policymakers as they react to shifts in the industry. Additionally, a person's socioeconomic status has profound effects on their access to care and the quality of care received.” Although it seems like lowering prices would be a simple gesture, positive and negative effects, could arise. A positive effect would be that more consumers are able to afford health care, due to mitigated costs, but that could in turn, could lead to providers and organizations losing funds, due to reduced pricing. It will also cause more competitiveness within the health care sector, due to price wars that would be taking place, amongst providers and organizations.
Conclusion
In order for the health care industry to continue to thrive, they must adopt new concepts, that will appease consumers and providers. Pricing is the primary factor that needs to be addressed, to improve public opinion of the insurance market. The health care delivery system must be successfully overhauled, to provide consumers with pricing transparency, quality care, and improved health car eoutcomes.
References
BallotPedia. (2020). Healthcare policy in the United States. Healthcare policy in the United States - Ballotpedia
Murray, R. (2019). The State Of State Legislation Addressing Health Care Costs And Quality. https://www.healthaffairs.org/do/10.1377/hblog20190820.483741/full/
NCSL. (2020). Transparency of Health Costs: State Actions. State Actions Related to Transparency and Disclosure of Health and Hospital Charges
Federal and State Health Care Policies
Consumers are looking for affordable, patient-centered quality health care options, but are often on the receiving end of price gouging, due to a lack of transparency. According to NCSL (2020), “As spending on health care services continues to grow—particularly for hospital, physician and clinical services—state and federal policymakers are leveraging health care price transparency as a potential strategy to curb rising health care costs. Price transparency takes many forms, but the overall intent is to increase consumer knowledge of health care prices.” As most health care providers have shifted the paradigm to value-based payment options, lawmakers are having a difficult time, effectively mitigating costs. With health care programs such as Medicare, Medicaid, the Affordable Care Act, CHIP, private insurances, and pharmaceutical sectors all seeing an increase in demand, lawmakers on federal and state levels, must work together to provide a viable solution, to consumer pricing concerns.
Policy Effects on Consumer Costs
State and federal legislators, are now attempting to corral health care spending, by initiating newly developed health care laws. Implementing health care reform laws, transparency laws, payment reform and benefit design laws, laws encouraging provider competition, and laws governing oversight and regulation of costs, are all areas lawmakers are currently working to improve (Murray, 2019). The overall goal of legislators, health care providers, and organizations should be to overturn the imbalance of market power within the health care market and offer transparency to consumers, looking for improved health outcomes. If all work together to offer consumers relief for their wallets, the health care spectrum would rapidly see an increase in consumer engagement.
Positive and negative effects. Implementing policies that are in direct correlation to the insurance market, should be a top priority for all health care related sectors. According to BallotPedia (2020), “The economic health of a state can significantly affect its healthcare costs, insurance coverage, access to care, and citizens' physical and mental health. For instance, during economic downturns, employers may reduce insurance coverage for employees, while those who are laid off may lose coverage altogether. Individuals also tend to spend less on non-urgent care or postpone visits to the doctor when times are hard. These changes in turn may affect the decisions made by policymakers as they react to shifts in the industry. Additionally, a person's socioeconomic status has profound effects on their access to care and the quality of care received.” Although it seems like lowering prices would be a simple gesture, positive and negative effects, could arise. A positive effect would be that more consumers are able to afford health care, due to mitigated costs, but that could in turn, could lead to providers and organizations losing funds, due to reduced pricing. It will also cause more competitiveness within the health care sector, due to price wars that would be taking place, amongst providers and organizations.
Conclusion
In order for the health care industry to continue to thrive, they must adopt new concepts, that will appease consumers and providers. Pricing is the primary factor that needs to be addressed, to improve public opinion of the insurance market. The health care delivery system must be successfully overhauled, to provide consumers with pricing transparency, quality care, and improved health car eoutcomes.
References
BallotPedia. (2020). Healthcare policy in the United States. Healthcare policy in the United States - Ballotpedia
Murray, R. (2019). The State Of State Legislation Addressing Health Care Costs And Quality. https://www.healthaffairs.org/do/10.1377/hblog20190820.483741/full/
NCSL. (2020). Transparency of Health Costs: State Actions. State Actions Related to Transparency and Disclosure of Health and Hospital Charges