Healthcare Market Reforms. From the e-Activity, synthesize the primary ways in which consumer and provider incentives work together to achieve cost reduction under the Affordable Care Act (ACA). Provide at least one (1) example of such synthesis to support your response.
Healthcare Market Reforms. The Patient Protection and Affordable Care Act of 2010 provides many incentives to both health insurance companies and consumers to offer affordable and sustainable health care to United States citizens. Both of these incentives work together to achieve access to health care at affordable costs. One of the incentives provided to consumers by the act is that health care providers are prohibited by the law to deny health insurance or charge higher on the policies for patients with pre-existing conditions (Patient Protection and Affordable Care Act, 2010). On the flip side, the act provides an incentive to insurance companies where they are allowed a given range of policy plans that vary in the period (long and short-term) depending on the established pre-existing condition of the patient. This helps spread the risk of insuring patients with pre-existing conditions (Patient Protection and Affordable Care Act, 2010).
Therefore, using these two incentives that cover both the consumers and insurance providers, the act creates a balance between the patents and insurance providers since it covers both parties. These incentives provided by the act thus work together to lower costs on both the consumer and insurance providers. Another aspect of the act that reduces cost is that it empowers companies to increase their pool of clients since it empowers them to acquire insurance for patients with pre-existing conditions. This empowerment motivates more companies to invest in insurance leading to competition. From a business standpoint, competition leads to price wars leading to reduced rates for clients, thus reducing costs on the part of the consumer.
Healthcare Market Reforms. Defend or critique the critical provisions of the antitrust legislation in the United States. Analyze the significant ways in which quality issues in health care affect antitrust healthcare policy. Provide at least one (1) example of antitrust laws in action to support your response.
The antitrust legislation laws of the United States provide some provisions to ensure healthy competition and trade within the country (Janis, 2016). The most prominent of these provisions is that it prohibits contracts or conspiracies that aim at limiting or hindering trade (Janis, 2016). Since the beginning of time, the United States has heavily depended on trade. However, trade in the U.S is also characterized by cartels who conspire to limit various facets of trade to their advantage through crippling of trade for other parties thus making them the only beneficiaries of trade operations. If left unchecked, these cartels would cripple the entire economy. The antitrust legislation laws thus work to prevent and eliminate cartels, ensuring all citizens enjoy the right of free trade.
In the health sector, antitrust legislation touches on issues of quality of services offered by health caregivers through the formation of mergers. Over the years, research shows there exists a need for the formation of collaborative systems between hospitals and health care practitioners in a bid to work together to ensure patients get the best quality of health care. This shows the need for mergers in the health sector (Waller, 2016) where players of health sector such as hospitals, practitioners, researchers, and researchers come together to ensure patients get the best quality of services.
Healthcare Market Reforms. References
Janis, M. D., Hovenkamp, H., Lemley, M. A., Leslie, C., & Carrier, M. A. (2016). IP and antitrust: an analysis of antitrust principles applied to intellectual property law. Wolters Kluwer Law & Business.
Protection, P., & Act, A. C. (2010). Patient protection and affordable care act. Public law, 111(48), 759-762.
Waller, S. W. (2016). How Much of Health Care Antitrust Is Really Antitrust. Loy. U. Chi. LJ, 48, 643.