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Affordable Care Act and Double Patient Service Standards

Abstract

Based on insured and private patients, a double patient service standard has been a significant concern over the years. Private patients are given an advantage over the insured ones in many hospitals because the uninsured tend to pay independently and without delay. Hospitals and the government must place regulations that control standards offered by healthcare institutions. Patient services offered in different healthcare facilities generally vary in terms of whom they prioritize in the process of treatment. In 2010, the US President decided to sign an Act for Affordable Healthcare to ensure that all patients were treated equally.

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Introduction

Surveys that have been conducted concerning double standard in-hospital services have portrayed that they would instead attend to those private patients in most hospitals rather than patients who are under insurance coverage (Reddy et al., 2020). They prefer those who are paying from their pocket to those patients paying through the health insurance companies. Many hospitals that practice a double standard say that patients that pay themselves will do it on the spot. At the same time, those that pay through health insurance will have to go through a bureaucratic bottleneck. The above issue is most prevalent in countries with lax regulatory compliance policies in the healthcare sector. This study, therefore, seeks to determine the influence of double standards in hospitals in both developing and developed nations globally. The research will also touch upon the concept of how the US government has tried to regulate the situation by putting laws in place.

Problem

A double standard application has been a significant source of concern, especially in some states in the US. In most cases, private patients are well-off, with sufficient money to meet their medical needs without worry. Many insured people are often public employees who have a portion of their salaries withheld by the company directly and paid to the insurance organization before receiving their net pay (Reddy et al., 2020). Most of these workers are required to have health insurance. Until now, the unemployed must have purchased insurance that would cover the required expenses. The government encourages them to acknowledge the importance of insurance by mildly forcing them to purchase coverage and commit to trivial monthly payments. Those who are disadvantaged in society and end up with health complications tend not to have health insurance coverage. This situation, in turn, would cause them to have difficulties paying for their hospital bills.

Furthermore, most patients affected by the given hospital’s double standards are either middle-class or lower-class. They can hardly afford to cover their hospital bills with one payment. At the same time, most patients who pay out of pocket are well-off members of society. Some hospitals have enacted policies excluding people with health coverage from receiving specific care services at those facilities (Reddy et al., 2020). Conversely, other healthcare facilities could treat several diseases covered by health insurance. For example, certain hospitals refuse to perform any surgical procedures on patients that have insurance coverage. In some hospitals, patients with insurance must wait for lengthy periods for those who pay out of pocket to be treated before them. The US government under President Obama decided to counter the problem of such double standards by signing the Affordable Care Act.

Causes

After a long time of double standards plaguing the treatment process for US patients, President Obama signed the Patient Protection and Affordable Care Act into law in March 2011. It went forth being implemented in to countering the situation and became law in the United States. The majority of the provisions went into effect in January 2014, but several amendments were made before that date and would later continue for years to come. The Act demonstrates that everyone should have at least a minimum level of healthcare security. The Act generated decent insurance coverage for more than 30 million people who had previously been uninsured. Obama’s decision to pass the Affordable Care Act expressly expanded the Medicaid initiative and implemented government subsidies to assist both low- and middle-income Americans in obtaining private coverage.

Seriousness

The Affordable Care Act has had some positive effects as well as some drawbacks. Many more Americans now have access to health care and appropriate insurance. US citizens also gained access to a vast number of choices related to health benefits. Patients with preexisting conditions would not be refused coverage anymore, as there would be no time limits, with more screenings available. Simultaneously, high premiums for most US citizens and fines in the case where an individual does not have health coverage have caused a great deal of negative backlash for the Act. The rising taxes have led many employers to reducing the number of working hours to avoid paying for their coverage are all issues that have arisen due to the Act.

Solution

The government should establish regulations that any hospital must adhere to when providing services. The legislation should ensure that all individuals, as potential patients, have fair access to health care services. All kinds of healthcare facilities should ensure that there are no inequalities inherent in service provision and interactions with the stakeholders. If a hospital has decided to handle both private and insurance-covered patients, it can do so without discrimination (Reddy et al., 2020). A hospital should set a regulatory body to oversee the services being provided by medical care facilities and the hospitals unto their patients. The responsible agency will ensure that these hospitals’ services will contain no bias to any extent.

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Counterargument

Some claims have been made concerning the reason for hospitals providing double standards to their patients. None of the claims offers a substantial argument concerning double standards inherent in the patient services. Most organizations claim that patients who have insurance coverage tend to keep going to the hospitals for checkups, even without a significant adverse change to their condition. They only do so to ensure that they are exploiting their health coverage. According to Reimers-Hild (2018), this is a direct misuse of the hospital services.

Consultations without a primary concern should be inferior to the claims of patients with adverse conditions. Private patients are assumed to have more severe conditions than those with insurance coverage, as the latter visit the facility just for a health checkup (Sommers, 2020). According to the survey, uninsured patients arrive either during the night shifts or on the weekends. Instantaneously, the insured patients come primarily during the weekdays and regular daytime hours (Sommers, 2020). Demographic differences between these two groups seem to play a pivotal role in prioritizing healthcare service provision order. If an insured patient comes during the weekend or at night, they are given less attention than their uninsured counterparts.

Rebuttal to the Counterargument

The above argument does not have any concrete reason why hospitals should provide services affected by double standards. The claim that patients with insurance coverage tend to stay at the hospital all the time is not valid. Naturally, patients are encouraged to go for a checkup more often to avoid more complex health conditions that may arise in the future (Frerichs et al., 2019). Also, those who have health insurance are either middle-class or low-class people. In reality, these two groups do not go for medical checkups very often. They only visit the facility when they get exposed to adverse sicknesses, as in any other case, they would go and get medications directly from the pharmacist. The majority of those who have insurance coverage are either employed by the government or the private sector. Their work schedule makes hospitals unavailable from Monday to Friday and during the weekends, depending on the job requirements. These individuals will have to seek medical services either on weekends or at night after work. In reality, uninsured patients do not have any tangible competitive advantage over their insured counterparts.

Conclusion

In summary, a double standard in hospitals has been a significant concern over the years, especially in developing countries. Those with insurance coverage are treated as second-class patients. Concurrently, those paying directly from their pocket are given priority as the government encourages most people to acquire medical insurance covers. While the administration is looking forward to helping those who are less disadvantaged in society, hospitals tend to ignore the patients with insurance coverage before it is too late. To counter the mistreatment of patients in hospitals, the government and the hospitals should focus on deploying agendas that would bring equal treatment back in place. The most relevant solution for the problem could be establishing a regulatory body responsible for overseeing treatment, irrespective of the payment method. The Affordable Care Act should be expected to bring another iteration of positive influence as well.

References

Frerichs, L., Bell, R., Lich, K. H., Reuland, D., & Warne, D. K. (2019). Health insurance coverage among American Indians and Alaska Natives in the context of the Affordable Care Act. Ethnicity & Health, 1-16. Web.

Reddy, S., Allan, S., Coghlan, S., & Cooper, P. (2020). A governance model for the application of AI in health care. Journal of the American Medical Informatics Association, 27(3), 491-497. Web.

Reimers-Hild, C. (2018). Strategic foresight, leadership, and the future of rural healthcare staffing in the United States. JAAPA, 31(5), 44-49. Web.

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Sommers, B. D. (2020). Health insurance coverage: What comes after the ACA? An examination of the significant gaps in health insurance coverage and access to care remains ten years after the Affordable Care Act. Health Affairs, 39(3), 502-508. Web.

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