Introduction
Health and its pursuit are greatly tied to the social and economic fabric of every country in the world. Out of the importance of the wellbeing of humans, many organizations that deal with public health have developed. Healthcare institutions, by and large, contribute to the wellbeing of the general citizenry and the communities that such organizations serve. Because of the growth of healthcare establishments as a collective industry, the government and other stakeholders have formulated policies that affect clinical services. Organizational health programs based on federal medical financings policies such as the US Medicaid, Medicare, and the Affordable Care Act (ACA) can impact the social determinants of health and curb the associated disparities.
Programs Based on Medicaid
A good example of a federal government healthcare financing policy is the Medicaid program which resulted from legislative amendments in the US Congress. In July of 1965, the US legislature passed some constitutional changes to social security laws that were dubbed the Social Security Amendments of 1965 (Longest, 2016). As a result of the legislative reforms, Medicaid was created as a public insurance regulation to provide health coverage to poor families and persons, including children, parents, expectant women, the aged, and people with disabilities (Matthew, 2018). From the structure of the program, the Medicaid policy can greatly impact the social factors of health to manage imbalances in the provision of medical services.
The Medicaid program can positively influence the health disparity that is existent in the US. For example, the policy is counter-cyclic as its enrolment expands to meet rising demands during economic downturns such as the Global Recession and the COVID-19 pandemic job losses. In times of economic Recession, many individuals plunge into poverty, and as such, few people can afford efficient medical services (Longest, 2016). The program allows for government funding to the most vulnerable, thereby expanding access to clinical services and eliminating health disparities (Matthew, 2018). Though subtly, the Medicaid policy affects the socioeconomic position of the poor by putting them in the same fiscal disposition as the rich class. Accordingly, the accessibility to disease treatment is increased as more people can effectively obtain medical services at the government’s expense.
Programs Based On Medicare
Another healthcare financing policy that is relevant to reducing health disparity is the Medicare program. Similar and overlapping to Medicaid, this medical financing scheme was created out of the Social Security Amendment of 1965 (Longest, 2016). Medicare is a national government health insurance scheme that protects individuals aged above 65, certain physically impaired youngsters, and people with indelible renal failures in dire need of hemofiltration or transplants (Longest, 2016). Unlike the Medicaid program, which focuses mainly on socioeconomic status, Medicare policy gravitates towards age as a social determinant of wellbeing.
From the structure of Medicare policy, the program can affect two important social determinants of health, such as age and socioeconomic position. The older generation, which comprises individuals nearing their seventies, are people who are most in need of specialized healthcare services (Longest, 2016). This is unlike those people who are below 65, who are still active and are not prone to diseases like the older generation. In addition, the income distribution for the entire population is always skewed toward people above 65 years old in the US (Longest, 2016). In these two scenarios, it is clear that older generations experience higher burdens of illness and health-related conditions than younger individuals. Therefore, Medicare policy bridges the gap between the junior and senior generations regarding access to medical services that would otherwise be hampered by age and lack of income.
Programs Based on ACA
Apart from the other aforementioned policies on healthcare financing, there is a policy known as ACA that can affect the social aspects of health. ACA is an exhaustive reform legislation ratified in 2010 by the Obama administration. Briefly, the law increases medical indemnity coverage for those who are insured in addition to reforming the health insurance market (James, 2016). More explicitly, the law was pegged on transforming the private assurance sector, expanding Medicaid to the working poor with certain minimum earnings, and changing the way medical decisions are made (James, 2016). In essence, the policy of ACA is mainly characterized by a subsidy of health insurance coverage which considers the income distribution of the citizenry.
As mentioned, healthcare accessibility with respect to income distribution for the US citizenry is greatly impacted by the ACA policy. This is an example of an allocative regulation in which millions of working poor are guaranteed access to healthcare services through health insurance coverage (Longest, 2016). Without a doubt, the government was seeking to alter the demand and supply of health insurance services to meet public objectives. In consequence, the social factor of access to healthcare is modified to include the majority of workers, whether poor or not. Indeed, this is a slight reprieve for the government in its bid to provide healthcare to its citizens.
Conclusion
In summary, organizational health regulations grounded on Medicaid, Medicare, and ACA can affect the social determinants of wellbeing and its associated inequalities. For instance, a Medicaid policy to include poor families, children, and the less privileged in a medical scheme eradicates the imbalance of healthcare accessibility between the rich and poor classes. Medicare works to encourage the older generation and the young who are disabled to access medical services at the expense of the federal government. On the other hand, ACA reformed the private insurance market, thereby desegregating the assurance sector with regard to the income distribution of the clients. Undoubtedly, the policies that emanate from the health financing programs of Medicaid, Medicare, and ACCA reduce the problem of disproportionate access to treatment by a specific group of people.
References
Longest, B. (2016). Health policymaking in the United States (6th ed.). Health Administration Press.
Matthew, D. (2018). Next steps in health reform: Hospitals, Medicaid expansion, and racial equity. Journal of Law, Medicine, & Ethics, 46(4), 906-912.
James, J. (2016). Health program guidelines: Charitable hospitals’ community benefit conditions. Under the Affordable Care Act, numerous philanthropic hospitals must satisfy fresh requirements to maintain their duty-free status. Health Affairs.