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Analysis of Healthcare Reforms: Scuka’s 1994 Study

Qualitative Article Analysis

Overview

Changing the realm of healthcare is an essential step towards improving the quality of life of the U.S. population (Romney, Brown & Fry, 2012). In their article, Scuka (1994) addresses the issue regarding the changes, which the healthcare area was supposed to undergo in the 1990s, as well as the implications of these changes.

Debating the complex economic situation that the United States was going through at the time, the author makes a very valid point concerning the issue of altering the healthcare system. Particularly, the strategies for managing the specified realm were reviewed in the article.

The assessment of the progress of the healthcare domain has always been a topical issue for the U.S. (Scuka, 1994).

Because of the need to embrace a variety of factors that affect the designated realm, as well as the need to consider the subject matter from social, economic, and financial standpoints, the actual process of identifying the implications of healthcare reforms is becoming increasingly complicated (Scuka, 1994). Hence, the need to identify the key parameters, according to which the process of healthcare system evaluation is going to occur, emerges.

Moreover, it is desirable to develop the model for addressing the specified issues. The sustainability of the model will define the viability of specific regulation in the realm of the global economy, therefore, enhancing the overall strength of the healthcare system and creating the environment, in which patients’ needs can be addressed in a manner as efficient and expeditious as possible.

Three Central Questions

Scuka’s research primarily revolves around three issues. Particularly, the researcher attempts at addressing the following problems in his article:

  1. What problems can be defined as essential and urgent ones in contemporary U.S. healthcare?
  2. What are the key criteria for the U.S. healthcare reform proposals should be assessed by?
  3. What benefits and disadvantages do the three proposals made by the U.S. Congress to change the healthcare system have, and what implications are to be expected of these proposals?

As far as the theoretical basis for the study is concerned, the research is grounded in a qualitative analysis of the existing studies regarding the subject matter, as well as the analysis of the regulations concerning the policies on adopting healthcare reforms or any other amendments in the designated area. Therefore, it can be concluded that the author uses general research as the key method of data acquisition and analysis in the study in question.

The specified method seems rather legitimate, seeing that the research is aimed at identifying the standards for adopting regulations in the realm of healthcare.

While one might consider the analysis of actual legal cases as a reasonable addition to the overall assessment of the situation, the overview of the laws that define the very existence of the healthcare system seems a rather legitimate approach to be taken. In addition, since there is no practical need to quantify the research outcomes, the adoption of a qualitative research design seems an adequate step.

Underlying Research Hypothesis

Since Scuka endeavors at locating the criteria for making changes in the U.S. healthcare system in his paper, most of the research questions concern the methods for designing the corresponding criteria. Particularly, Scuka maintains that the study should be focused on answering the following questions:

  1. Is the current U.S. healthcare system facing a crisis enhanced by the political and economic issues?
  2. How exactly should the process of evaluating the criteria for healthcare reforms occur so that sensible decisions could be made?
  3. Can the Universal Care Act, the Senate Bill 1227, and Pepper Commission Report be deemed as valid examples of the way in which the changes in the U.S. healthcare should occur, and what implications will the specified framework have on the target area and the stakeholders involved?

The study addresses the questions listed above in a rather elaborate and detailed manner. By considering the factors that shape the U.S. healthcare and especially the effects of the economic crisis on the subject matter, Scuka makes a valid statement regarding the connection between economy politics and healthcare, thus, making it obvious that the criteria for introducing a new regulation to the area in question have to incorporate economic and political factors as well.

Research Methods

As it has been stressed above, Scuka resorted to a qualitative study design so that the actual relations between the numerous factors, including the economic, political, and social ones, as well as the changes in the current healthcare rules and regulations, should be identified. Although the choice made by the author seems rather reasonable, it might be a good idea to incorporate several statistical pieces of evidence so that mixed research could be conducted and that the article could be based on a more solid set of data.

Whereas the study of the existing laws and regulations is clearly important for the further location of the avenues for altering the healthcare system, the analysis of several crucial cases could be viewed as an opportunity so that the effects of the application of the changes could be seen clearly.

As it has been stressed above, general research of the existing legal acts was chosen by Scuka as the basis for the paper’s methodology. It should be noted, though, that the specified approach has its problems, particularly, the fact that most of the data sources are going to be rather homogenous should be addressed.

Whereas the incorporation of actual case studies, focus groups and other methods for introducing actual live participants to the study helps create the experimental environment that represents the real-life scenario in a rather accurate manner, they still remain a model of the actual events, and a rather basic and vague model at that, since there are no actual calculations involved.

Model and Underlying Assumptions

Despite the efficacy of the experimental model used by Scuka, one must admit that it may lack objectivity. Although the experimental model does prove a specific point in a rather efficient manner by providing graphic evidence and sensible arguments, it may fail to represent the rest of the options available in an adequate way.

To be more exact, the specified tool does not allow representing the other side of the argument in an appropriate manner, therefore, restricting the people in charge to a comparatively small number of options, as well as suggesting that they should view the specified problem from a specific perspective, seems a rather biased way of reinforcing the law.

The experimental model, therefore, needs to be challenged and combined with, if not replaced by, an entirely new approach that would help introduce the people involved to a new way of looking at the problem. Particularly, it will be reasonable to out a stronger emphasis on the implications of the reforms to be adopted and incorporate strong ethical principles that the decision should be made on.

In other words, the experimental model incorporated into the study could have been combined with another research model that could serve as the support for the existing one. Thus, a more accurate result could have been attained, and a more detailed analysis of the issue could have been conducted.

The model, which the author uses as the key to conducting further analysis, can be considered rather basic. Being grounded in qualitative research, the specified model does not help obtain accurate results; however, it does allow proving the existence and the intensity of relationships between the key variables, i.e., the existing healthcare policies and the economic and political circumstances that the residents of the United States exist in.

Quantitative Article Analysis

Overview

The issue of health insurance has been brewing for quite long in American society. Numerous regulations suggested over the past few decades can be viewed as the means of addressing the situation, yet none of the changes to the existing healthcare system as it is viewed through the political prism have had any tangible effect on the provision of the corresponding services.

In their article, Kali, Quandagno, and Dixon (2009) consider the issue of healthcare reform and the possible improvements that can be made to provide the citizens of the United States with the health benefits that they are entitled to.

Particularly, the authors view the concept of the universal healthcare reform as the means of addressing the problem concerning the uninsured denizens of the U.S. population. Indeed, despite the acceptance of the Medicare reform, some of the healthcare issues, particularly the fact that certain tiers of the U.S. society could not have medical insurance on the conditions that they would find satisfactory deserve to be mentioned.

As Kali et al. (2009) explain, “The recent flurry of state innovations raises questions about its broader significance and implications for universal coverage” (Kali et al., 2009, p. 1342).

The authors make it very clear that the changes, which occur in the U.S. legislative system, are bound to reinvent the system of healthcare just as fast and radically as they changed the rest of the domains of the U.S. population’s lives. However, for the change to take place, certain efforts need to be made by Congress in terms of reconsidering the principles that the modern healthcare system is based on.

Three Central Questions

Kali et al. (2009) address a variety of issues that range from political to health-related ones in their article. However, a closer look at the research will show that the study revolves around a specific subject. Particularly, the authors discuss three principal issues that they believe in making the foundation of current problems in the realm of healthcare. To be more specific, the authors attempt at answering the following questions in their study:

  1. What broad implications for the concept of the universal coverage have for the U.S. healthcare system, and is it possible for state reforms to comply with the key tenets of the universal coverage principle, and what actions need to be taken to create the conditions required for this alignment?
  2. Is it possible to apply the concept of the universal coverage principles to the healthcare regulations system, in general, and not particular cases?
  3. Can the principle of universal coverage be adopted in the contemporary healthcare environment so that people without insurance could receive the healthcare services that they are entitled to by the U.S. Constitution?

The authors address the questions mentioned above in a very detailed manner, making it quite obvious that the concept of universal coverage can and should be applied to the contemporary healthcare environment.

The researchers, therefore, make it quite clear that the adoption of the universal coverage principle as the foundation for the U.S. healthcare system will allow addressing some of the most topical issues regarding health insurance in general and Medicare in particular. Particularly, the authors make an assumption that the integration of the universal coverage policy in the current U.S. healthcare realm will create better chances for the uninsured to receive the required medical services.

Underlying Research Hypothesis

As it has been stressed above, Kali et al. (2009) are obviously trying to prove that the principle of the universal coverage is bound to boost the present-day healthcare system, improving the quality of the services provided considerably and addressing the needs of the denizens of the U.S. population, who do not have insurance yet.

As Kali et al. (2009) state, by considering the consumer protection reforms that have been incorporated into the design of the U.S. legislation, the U.S. government may identify the universal reform design that will help meet the needs of all denizens of the U.S. population.

Particularly, Kali et al. (2009) insist that the incorporation of the consumer protection reform in the current healthcare reform design will help enhance the quality of services by allowing the people, who are not insured, to be provided with the necessary medical assistance and be checked by a doctor on a regular basis.

In other words, Kali et al. assume that the introduction of the consumer protection principle to the realm of healthcare and its further reinforcement in the designated area will help locate the existing problems in the specified area, as well as open access to the corresponding services to the members of the U.S. population, who have not yet been insured and, therefore, will be unable to access the corresponding healthcare services otherwise.

Although the idea suggested by Kali et al. (2009) is rather noble, its viability in the contemporary economic and political environment in the United States is hardly plausible. On the one hand, by revisiting the issue of providing assistance to those less fortunate, the U.S. legislation makes a leap forward; on the other hand, the specified goal may not align with the harsh realities of the current global economy and the increasingly high competition rates in the global market (Coadi, Clemens, & Gupta, 2014).

Research Methods

The author makes it quite clear that the study can be defined as quantitative. Indeed, the research design is clearly focused on quantifying the results as one of the means of analyzing the issue. Although Kali et al. (2009) view some of the qualitative aspects of the problem, such as the cause-and-effect relationship between the economic processes in the U.S. market and the healthcare issues, the study is still geared towards a statistical analysis, the use of mathematical models for making forecasts, and the analysis of statistical data.

Additionally, statistical data is used as a key source of information. The data collection tool in the specified research, which makes the quantitative method the basis for the specified study, is quite efficient. It should be noted, though, that, despite allowing for a very detailed analysis and helps provide graphic proof for the idea that the author of the study is trying to get across.

However, the specified approach has its problems. Particularly, the fact that the specified approach does not leave much room for establishing relations between the key variables, providing only their ratios deserves to be brought up. While the statistical analysis is essential for proving a specific point, it may not necessarily be as objective as the standards for academic research require it to be (Creswell, 2013).

To be more exact, the information retrieved from quantitative research comes from questionnaires and surveys, which traditionally provide rather subjective information based on the participants’ personal beliefs and convictions.

Although the specified information can admittedly be generalized, and, therefore, one may draw general conclusions from the information attained from a vast number of participants, it will still come from a rather subjective source. Therefore, the tool in question maybe not as reliable as it might seem. However, much to its credit, quantitative research helps provide a clear and all-embracive assessment of the issue under analysis.

Model and Underlying Assumptions

In order to analyze the data available in an adequate and appropriate manner, Kali et al. (2009) have adopted the fixed-effects model, which helps “automatically hold constant any unchanging unmeasured case attributes by effectively entering separate dummy variables for each state” (Kali et al., 2009, p. 1349). Indeed, the model in question allows for a rather exhaustive study of the variables and a rather accurate identification of the relationship between these variables.

Moreover, the model used in the study helps correlate the time-invariant specific of the state economy with the actual explanatory variables, therefore, allowing for a detailed analysis of the phenomenon in question. More importantly, the model used in the study can be deemed as appropriate for creating forecasts for the future development of the state economy due to the adoption of the serial correlation patterns as the basis for the data analysis.

In other words, the model that Kali et al. (2009) suggest as the tool for analyzing the current economic state of the healthcare environment, can be used as the foundation for the further forecasts in the designated area. Thus, avoiding possible issues in the evolution of the state economy, as well as predicting the essential stages of its further development, can be considered the key implications of adopting the suggested model.

Therefore, the quantitative approach used by Kali et al. (2009) can be considered justifiable. However, for an in-depth analysis of the problems that may occur in the realm of the U.S. healthcare, as well as the design and assessment of the further advances used to improve the corresponding services, the incorporation of qualitative methods should be viewed a possibility, as the specified tools help locate the practical outcomes of the measures adopted.

Reference List

Coadi, D., Clemens, B. J., & Gupta, S. (2014). The economics of public health care reform in advanced and emerging economies. Washington, DC: International Monetary Fund.

Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Thousand Oaks, California: SAGE Publications.

Kali, B. L., Quandagno, J., & Dixon, M. (2009). Can states lead the way to universal coverage? The effect of health-care reform on the uninsured. Social Science Quarterly, 90(5), 1341–1360.

Romney, D. M., Brown, R. Y., & Fry, P. S. (2012). Improving the quality of life: Recommendations for people with and without disabilities. Berlin: Springer Science & Business Media.

Scuka, R. F. (1994). Health care reform in the 1990s: An analysis of the problems and three proposals. Social Work, 39(5), 580–587.

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