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Health Policy and Law Basics
Health Policy and Law Basics
Name
Institution
Introduction
The paper seeks to identify the best model that is suitable for starting a healthcare centre from the three paradigms that were employed earlier in America. The three paradigms included professional autonomy, social contract, and free market perspectives. The paper also attempts to identify some laws the led to the three perspectives and how they influence the operations of an emerging healthcare today. The free market competition model has been an affirmative perspective to adapt since it leads to the creation of competent medical practitioners and improved quality of the healthcare.
Health Policy and Law Basics
The comprehensive health reform has been the main objective of the legislative system of the United States. As a result, the American Health Law continues to evolve largely by the influence of three major models. These models include the authority of the medical profession, egalitarian social contract and the market competition. Out of the three paradigms, the market completion model holds the legitimate interests and rights of the healthcare system in the 21st Century. The free market competition is suitable for developing a healthcare centre in my city since it gives the individual a choice to decide on the health insurance and health services they want. The model allows individuals to decide the best healthcare system they want based on their financial resources, provided the quality of the medical service is above minimum requirement specified by the board of the medical profession. The model gives the power to the consumers to maximize the efficiency of the healthcare services subject to their financial constraints, thus eliminating possible hidden cross-subsidies. In other words, people will tend to pay only for health coverage that benefit them and the healthcare providers will respond to the market pressure by economizing their resources to meet the satisfaction of the customers. The free market competition has been an attractive model to the modern society since as the market advocates argue, it sweeps through most of the political and legal instruments. For instance, the government is cognizant of the increasing need for a comprehensive array to provide primary healthcare for both low-income and diverse population. As a result, free market competition model has reduced the hierarchical barrier and centralized forms of providing healthcare to patients. The model has improved hospital science and public health science by taking the initiative to provide individual treatment. Such initiatives include informed sanitation, food inspection, public health education and accurate diagnosis of patients (Ameringe, 2008).
Advantage of free market competition model
The three paradigms have not reached reconciliation regarding ways of the society’s values in providing healthcare. Nevertheless, to some degree, the free market competition model facilitates collaboration between the public and the private health sectors. The degree of the increasing consumer preferences to the price signals in accessing healthcare service has raised the advantages of free market competition over other models. One of the advantages of the model is that both the social contract and the professional autonomy have been unable to meet the overall increasing health prices and expenditures. Since the expansion of pharmaceutical and the medical technologies in the modern era, there has been an increasing demand by consumers to achieve cost containment and equity on healthcare. As a result, the high forces of demand and supply of healthcare service tended to override the conservative practices of the other models which were restrictive and inequities. For example, the centralized model practiced earlier in the United States allocated health resources in one region and provided a limited supply in marginalized regions. Moreover, the autonomous model encourages market dominance leading to high costs of healthcare for the consumer. Nevertheless, the free market model gives the freedom for medical practitioners to open a centre at any place and give quality healthcare services. Another advantage is that the pragmatic feasibility of free market model provides a substantive solution to the rationing and centralization of healthcare resources through the principle of the consumer’s choice (Field, 2014).
My Perspective on Free Market Competition Model
In support of my choice of the paradigm of free market competition, I look at the legal responsibility of performing a surgery on a patient with his consent. The paradigm supports the hospital liability to include all the staffs involved in the operation, including the employer. The profit corporation ensures medical professionalism is carried out according to interest of the patients. Secondly, I view that self-regulation healthcare frameworks cannot produce competent physician; therefore, it will lead to low-quality healthcare. The mechanisms of market competition will facilitate strong professional culture of perfectionism in light of the modern defined standards of quality healthcare. However, the free market model has some disadvantages. For instance, low-income earners may not have enough money to access quality healthcare services. Secondly, it is difficult to control the prices; therefore, a free market model is dominated by price discrimination where different patients are charged different prices for the same health services (Mansell, 2013).
Source of Laws for the Three Paradigms
However, there are different sources of law that lead to the emergence of the three models. For instance, the model of the social contract originated from the article that considered the judicial doctrines to articulate both the social and political interests, in order to practice fairness and good policy. Secondly, the professional autonomy model became dominant in 1960, when the American Medical Association and hospital bylaws supported the autonomy of individual physicians. The autonomous model was further justified by the law of agency that allowed doctors to the knowledgeable agents for the wellbeing of the patients. Thirdly, the free market competition model was a product of the transforming social contract, whereby there were many problems that led to hospital liability. As a result, it placed healthcare institutions to be liable to damages when they treated without the duty of care for the patients and caused harm (Mansell, 2013).
Conclusion
As such, non-liability is out of tune in our healthcare objectives and social fabrics, and we have a duty to accountable for the healthcare being given to our patients. Changes in common law have paved way for market revolution and distribution of resources according to consumers’ preferences and choices. Therefore, the free market model has been a collaborative platform that has reconciled most of the conflicts of the other models.
References
Ameringe, C.F. (2008). The health care revolution: from medical monopoly to market
competition. California: University of California Press.
Field, R.I. (2014). Mother of invention: how the government created “free-market” health care.
New York, NY: Oxford University Press.
Mansell, S.F. (2013). Capitalism, corporations and the social contract: a critique of stakeholder
theory. Delhi: Cambridge University Press.
Health Policy Analysis
Health Policy Analysis
Ty Herring
Samford University
MHCA619.WB1
Dr. Haun
April 21, 2022
Health Policy Analysis
Research reveals that about 56% of Americans who seek mental health services cannot access them (Pabayo et al., 2021). The greatest barrier to access to mental health care is the increased cost of mental health services (Rowan et al., 2013). According to the author, individuals with mental illnesses have lesser chances of having health insurance compared to their counterparts without mental illnesses. On the same note, Coombs et al. (2021) urge that most Americans lack access to mental healthcare due to a lack of financial or physical resources to receive these services. People who have access to adequate healthcare are better positioned to take charge of their health, which has a positive long-term impact on their well-being. Therefore, this paper aims to provide an appropriate solution to the issue of lack of access to mental healthcare services.
Research reveals that health laws and policies strive to change the status quo by moving resources and enforcing particular behaviors to address the underlying health conditions (Heboyan et al., 2021). Mental health insurance laws are designed to enhance access to required treatment and avoid discrimination in insurance coverage by guaranteeing equitable coverage for mental health treatment and other medical disorders. Heboyan et al. (2021) further add that families with private health insurance but lack comprehensive mental health coverage face a heavy financial burden due to a lack of mental health parity. This issue has been dealt with in the past by adopting parity laws at state and federal levels. According to Heboyan et al. (2021), this legislation improves insurance coverage for mental health treatment.
There are various major laws, regulations, and policies in US healthcare. One of these is the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA aims to protect confidential patient healthcare data by explaining how healthcare providers can store, utilize, and disseminate patients’ healthcare information. Another regulation is the Health Information Technology for Economic and Clinical Health (HITECH) Act. HITECH Act requires that healthcare providers’ audits comply with HIPAA security and privacy requirements to promote patient information protection. Another law in the US healthcare policy environment is the Emergency Medical Treatment and Labor Act (EMTALA). This federal law mandates that healthcare organizations provide treatment and stabilization for all people who visit the emergency department, notwithstanding their capability to pay or their insurance status. One health policy in the US is Medicare. This is a federal health care program that covers people 65 and older or under 65 with a disability, regardless of their income (Huffman & Upchurch, 2018). Medicaid is another health policy in the US. Medicaid is a federal and state program that provides health coverage to low-income earners (Buchmueller et al., 2015). Among the beneficiaries of Medicaid include temporarily unemployed workers, expectant mothers, and people with disability. The children’s Health Insurance Program (CHIP) is another health policy in the US. CHIP is intended to provide health coverage to children from low-income households. Another health policy in the US is the Affordable Care Act. Preside Barack Obama sanctioned the ACA in 2010. The Act mandates US citizens to apply for health insurance coverage and levies a penalty for people who fail to while granting exceptions for certain protected groups. Since the selected policy issue in the United States is lack of access and coverage of mental healthcare, the proposed solution for this policy issue is an expansion of Medicaid. Increasing availability of insurance coverage could improve access to mental healthcare for low-income populations.
Medicaid is the main source of health coverage in the US and is by far the biggest single-payer for mental healthcare services in the US. In 2010, roughly 33% of the Medicaid-eligible individuals experienced a mental illness in the past year, and 11% had a significant mental illness (Rowan et al., 2013). As of January 2017, seventy-seven million people were covered by Medicaid (Mazurenko et al., 2018). ACA permitted American states to expand Medicaid eligibility for nonelderly people with earnings up to 138 percent of the federal poverty line. Even though the expansion was initially supposed to be implemented throughout the nation, the US Supreme Court in 2012 declared that states may opt-out of the expansion. A total of 32 states and the District of Columbia had opted to expand Medicaid eligibility as of 2017 (Mazurenko et al., 2018). The expansion of the Medicaid led to improved access of mental health care services. However, Medicaid coverage gap has been witnessed in the US. For instance, in 2019, 2.2M uninsured persons with earnings below the poverty line were left without a road to coverage since their states failed to expand Medicaid (Sullivan et al., 2021). Thus
According to Sullivan et al. (2021), one of the critical steps toward resolving the health crisis in the US is closing the Medicaid coverage gap. This is because Medicaid eligibility protects low-income persons and those with disabilities from financial barriers to health care. So far, research reveals that Medicaid expansion by ACA has led to an increment in treatment utilization among people with mental health issues (Novak et al., 2018). On the same note, Coombs et al. (2021) urge that Medicaid expansion led to remarkable improvements in healthcare access levels, with states that expanded their Medicaid reporting reduced out-of-pocket expenditure, higher rate of use of healthcare services, and fewer skipped medications. Rowan et al. (2013) reveal that insured people with mental health issues are more likely to utilize the health care sector, while those without insurance have higher chances of using human services or complementary medicine. Rowan et al. (2013) further add that the uninsured and those with public insurance had the lowest rates of mental health treatment for individuals with serious mental illness than those with private insurance. Therefore, based on these facts, it is evident that further expansion of Medicaid will serve as a suitable solution for the chosen policy issue, which is the lack of access and coverage of mental healthcare among Americans.
To ensure that the proposed solution is implemented, I will follow all the stages of the healthcare policy-making process. The process of healthcare policy-making comprises issue identification, policy formulation, selection, advocacy, adoption, implementation, evaluation, and reformulation. The first step in healthcare policy-making is agenda-setting. This stage entails the identification of the public problem. So far, this stage has already been completed where the public problem is the lack of mental healthcare access and coverage. The second step in the healthcare policy-making process is policy formulation. After the public problem is identified, a policy is formulated to help deal with the issue affecting the general population. This stage entails defining the policy objectives. So far, I have identified various barriers to mental health care access. Among the identified barriers are high mental health services costs, lack of insurance coverage, lack of awareness, limited options, long waits, and a sense of social shame. From this list, the high cost of mental healthcare services is the main barrier to access to mental healthcare among Americans. Thus, the main objective of my policy is to improve access to mental healthcare services by removing the financial barriers to access to mental healthcare services. The third stage in the healthcare policy-making process is policy adoption. This stage involves confirming the most appropriate policy to deal with the identified public problem. Expanding Medicaid has proven to increase access to healthcare services among people suffering from mental illnesses; thus, this is the most appropriate policy to be formulated. The third stage in the healthcare policy-making process is policy implementation. After identifying the best policy to address the chosen policy issue, the next step is to implement it. The implementation phase involves representing the conversion of new programs and laws into practice. During the implementation stage of my policy, I will involve various stakeholders, including consumer groups, mental health workers, government agencies, and academic institutions. The consumer group will comprise individuals who will speak on behalf of their own healthcare treatments. The mental health workers will be recruited from both general health and mental health facilities to share their knowledge about mental health and their services. Furthermore, government agencies will be engaged in the implementation stage to help with policy implementation. The academic institutions will be involved create awareness about the implemented policy. The fourth stage in the healthcare policy-making process is policy monitoring and evaluation. This phase entails measuring whether policy outcome to determine whether or not the intended goal has been achieved. This stage also entails an evaluation of the long-term effects of the policy leading to policy redesign or amendment. The policy-making cycle is summarized below.
Figure SEQ Figure * ARABIC 1: Policy-making cycle
Source: (Knill & Tosun, (2008).
References
Buchmueller, T., Ham, J. C., & Shore-Sheppard, L. D. (2015). The Medicaid program. Economics of Means-Tested Transfer Programs in the United States, Volume 1, 21-136.
Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among US adults with mental health challenges: A population-based study. SSM-Population Health, 15, 100847. https://dx.doi.org/10.1016%2Fj.ssmph.2021.100847Haddad, C. R., Nakić, V., Bergek, A., & Hellsmark, H. (2022). Transformative innovation policy: A systematic review. Environmental Innovation and Societal Transitions, 43, 14-40. https://doi.org/10.1016/j.eist.2022.03.002Heboyan, V., Douglas, M. D., McGregor, B., & Benevides, T. W. (2021). Impact of Mental Health Insurance Legislation on Mental Health Treatment in a Longitudinal Sample of Adolescents. Medical care, 59(10), 939. https://dx.doi.org/10.1097/MLR.0000000000001619Huffman, K. F., & Upchurch, G. (2018). The health of older Americans: a primer on Medicare and a local perspective. Journal of the American Geriatrics Society, 66(1), 25-32. https://doi.org/10.1111/jgs.15227Knill, C., & Tosun, J. (2008). Policymaking.
Mazurenko, O., Balio, C. P., Agarwal, R., Carroll, A. E., & Menachemi, N. (2018). The effects of Medicaid expansion under the ACA: a systematic review. Health Affairs, 37(6), 944-950. https://doi.org/10.1377/hlthaff.2017.1491Novak, P., Anderson, A. C., & Chen, J. (2018). Changes in health insurance coverage and barriers to health care access among individuals with serious psychological distress following the Affordable Care Act. Administration and Policy in Mental Health and Mental Health Services Research, 45(6), 924-932. https://dx.doi.org/10.1007%2Fs10488-018-0875-9Pabayo, R., Benny, C., Liu, S. Y., Grinshteyn, E., & Muennig, P. (2021). Financial Barriers to Mental Healthcare Services and Depressive Symptoms among Residents of Washington Heights, New York City. Hispanic Health Care International, 15404153211057563. https://doi.org/10.1177%2F15404153211057563Rowan, K., McAlpine, D. D., & Blewett, L. A. (2013). Access and cost barriers to mental health care, by insurance status, 1999–2010. Health Affairs, 32(10), 1723-1730. https://dx.doi.org/10.1377%2Fhlthaff.2013.0133Sullivan, J., Pearsall, M., & Bailey, A. (2021). To Improve Behavioral Health, Start by Closing the Medicaid Coverage Gap. Retrieved 21 April 2022, from https://www.cbpp.org/research/health/to-improve-behavioral-health-start-by-closing-the-medicaid-coverage-gap.
An essay on the effects of Lead on the Human population.
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An essay on the effects of Lead on the Human population.Lead poisoning occurs when human bodies get exposed to the metal. Lead poisoning is a common phenomenon that has been reported in many areas of the world and it usually occurs in two main ways, acute and chroming poisoning. Acute lead poisoning occurs when there are higher levels of exposure to the metal while chronic lead poisoning occurs if there is low but gradual exposure to the metal. Chronic lead poisoning’s effects take a lot of time to be felt after there is the accumulation of enough lead, altering the body functioning. Symptoms of acute lead poisoning may include severe headaches, digestive difficulties, convulsion, weak muscles, excessive fatigue, constipation, diarrhea, and vomiting. Chronic lead poisoning symptoms include neuro-behavioral effects in children, fatigue, muscle weakness and general malaise.
Exposure to lead occurs in different ways although it is mainly through exposure to lead in paint and petrol. Lead poisoning can also occur during its mining, processing or transportation. Lead can also be found in the soil as it is a persistent compound. Although health regulations have ensured that leaded paints and petrol are done away through, traces of the metal can be found in these products.
Lead poisoning affects the human IQ especially due to occupational exposure for adults. Lead poisoning can be transferred from pregnant mothers to their developing unborn children. This is because research has indicated that lead can cross from the mother to unborn children through the placental without being limited by the placenta barrier. Research on lead poisoning has linked it with behavioral changes such as individuals being anti-social and developing criminal habits. The effects on the IQ are generally high among children compared to adults because children can absorb up to 4 to 5 times more than adults under similar conditions of exposure.
Children are also vulnerable to lead poisoning because of their curiosity and their cravings to eat items that may not be necessarily food. In this process, children eat leaded paints on walls, furniture, soil and door frames increasing their exposure to lead poisoning. Children experiencing lead poisoning experience poor mental development and in excess poisoning, end up dying prematurely. Lead poisoning affects the nervous system of the fetus and in higher levels can lead to miscarriage, infertility in both men and women or stillbirths.
Prolonged exposure to lead can lead to kidney diseases including kidney failure. A research to determine if lead poisoning could lead to kidney diseases and eventually kidney failure made findings that indeed lead poisoning could lead to renal diseases. The research involved a research on 53 patients who had been diagnosed with lead poisoning with varying lengths of exposure. The researchers found out those patients who had been exposed to lead for lengthy periods exhibited permanent changes in what is known as chronic nephropathy. The scientists concluded that when there is lead intoxication in humans, it could lead to renal lesions.
Acute lead poisoning can lead to cardiovascular diseases, especially high blood pressure. Research has shown that lead in the human body affects the contraction and excitability of the human heat and this can lead to high blood pressure. This is because the presence of lead in the body hinders the normal functioning of the heart by altering how the smooth vascular muscles function. Since research has shown that lead poisoning also affects the body’s nervous system that controls the general body activities; it is likely to alter how the heart works. The Journal of the American Medical Association in the March 26, 2003, issue linked lead poisoning to the thinning of bones and high blood pressure in post-menopausal women. This was after a successful research that involved 2,165 women who were aged between 40 years and 59 years for a period of six years.
Scientific research shows that prolonged exposure to lead can lead to anemia (lead-induced anemia). Lead induced anemia has been attributed due to the reduced production of hemoglobin in the body and hemolysis. Hemoglobin is the compound that is found in the blood and allows for the packaging and transportation of oxygen from the lungs to other body parts and tissues. A person with acute lead poisoning could suffer from reduced hemoglobin levels as the metal gets its way into the blood. Hemolysis is a health condition where the red blood cells rupture and this allows for their contents to mix with blood plasma. This condition leads to insufficient amounts of hemoglobin in the red blood cells hence leading to lead-induced anemia.
Scientists and medics agree that there are no levels of lead exposure that can be termed as safe. This is because even small amounts of lead exposure could accumulate on the human body over time and lead to chronic lead poisoning. Avoiding any form of exposure to lead poisoning is the safest way to deal with lead poisoning.
References:
Goyer, R. A. (2016). Metal Toxicology: Approaches and Methods. Elsevier.Grandjean, P., & Landrigan, P. J. (2014). Neurobehavioural effects of developmental toxicity. The Lancet Neurology, 13(3), 330-338.
Jaishankar, M., Tseten, T., Anbalagan, N., Mathew, B. B., & Beeregowda, K. N. (2014). Toxicity, mechanism and health effects of some heavy metals. Interdisciplinary toxicology, 7(2), 60-72.