AffordableCare Act Stakeholders
Shareholdersin a health system are bodies fundamentally included in thehealthcare system, and reforms to the system will significantlyaffect them. The health care system` major shareholders are insurancecompanies, government, physicians, patients, pharmaceutical firms,and employers. This paper argues that although the Affordable CareAct has made it possible for everyone to obtain health insurance, thefinancial struggle is still prevalent, and conflict of interest amongstakeholders is on the rise.
Thesestakeholders are involved in the following ways patients acquiretheir health cover plans directly from insurance companies orindirectly from government intermediaries. Doctors then prescribemedication to patients having bought it from pharmaceutical firms.Many employers offer their employees` health insurance covers whichthey deduct from the employees pay. Simply put, physicians providemedical care patients receive it while the government deals withsubsidizing health care for the poor, disabled and elderly. The abovestakeholders all have obligations and responsibilities (Hall &Lord, 2014).
Besides,there are advocacy groups with the primary goal of reforming thehealthcare system in the U.S. These groups are, Medicare RightsCenter, National Physicians Alliance, National Immigration LawCenter, Disability Rights California and Center for Policy Analysis.The Physicians Foundation` managing director is representing theinterests of the physicians. The Insurance companies have theirrepresentatives as well the Chief Executive Officer of United HealthGroup, the Senior Vice President of Humana Group and the ExecutivePresident External Affairs of Well care Group. Some employers havetheir representatives the Director of Communication representing theADC Telecommunication, Chief Information Officer representingAmerican Water Works Association and Managing Director Bakers SquareRestaurants, to name a few (Hall & Lord, 2014).
Allstakeholders have their perspective regarding the cost of healthinsurance. The representatives from the Insurance companies claimthat the strict requirements to acquire health insurance and therising premiums are preventing countless people from procuring healthinsurance. As much as the insurance are profit driven, their natureof service must not be solely focused on profits. It is hard forpatients to acquire proper health care due to financial constraint.Sadly, the insurance companies focus on profits to meet the demandsof their stockholders. The insurers are not confident on how to ratetheir cover plans to the new people especially those thought to beuninsurable. The insurers are afraid of experiencing a financial lossonce they become lenient on their regulations. The insurers voice theabsorption of the newly insured clients has led to increasedexpenses. For this reason, they feel that the ACA is not working intheir favor, and hence they desire to leave (Hall & Lord, 2014).
Consequently,the physicians are not in support of insurance cover cost. Most ofthe physicians work for a profit-making facility they encouragetheir patients to have insurance since most of the insurancecompanies offer them something in return to look for clients. Mostare afraid that if the insurance cover rates reduce, they will notget enough commission.
Furtheron, patients are often afraid that they may fail to afford a medicalcover. Some patients do not go for medical checkup due to financialconstraints they face. Therefore, reducing the insurance rates anddoing away with the strict premiums favors the patients. However, thepatients feel that since the introduction of the health care reforms,their relationship with physicians has changed. Most of thephysicians no longer have time to talk in length they always rush toattend to the next patient to make more money. Ironically, thepatients say that they are experiencing increased premium rates. Asmuch as the ACA had helped them in the beginning, it is not helpingthem anymore since the premium rates have gone and the restriction isback (Hall & Lord, 2014).
Also,employers are expected to pay the insurance plans for theiremployees. The employers who fail to provide medical covers receivepenalties. The businesses are afraid of offering jobs to many peoplesince they feel they will pay more to the insurance companies. To theemployers, the reduction of insurance plans rates has not helped themin any way since the number of people they are required to insure hasgone up. The ACA may be trying to protect the people, but it isputting them under more problems since they can no longer get shortterm jobs because the employers do not want to pay more insurancecovers (Hall & Lord, 2014).
Theissue of insurance covers to all people is a priority to allstakeholders because all stakeholders are affected by the ACA. Theinsurance industry is afraid of failing or rather going out of themarket. Once people are guaranteed access to insurance at ratesindependent of health status, they will take advantage and remainuninsured until they get sick and then purchase insurance at averageprices and the insurers then charge high prices leading to a failedinsurance market. Additionally, physicians in public hospitalsreceive more patients while private doctors have seen the numberdecrease. Private physicians are experiencing a drop in the number oftheir patients, and this is exerting financial pressure on them. Mostdoctors claim that the ACA has not improved the patients` care in anyway. A large number of patients make it impossible for them to spendenough time with their patients. Some physicians are in a rush toleave to attend to their private clients who pay more than they getfrom the hospitals (Hall & Lord, 2014).
Furtheron, employers do not have it easy either they have had to cut wagesleading to the resignation of many workers. Some employers even havepart employees who do not require coverage to cut on the cost ofstaffing. Companies have also cut on the number of working hours, andthe employees react by leaving. On the other hand, patients areenjoying low-cost health coverage. Many people were unemployed, andothers did not work due to disabilities hence they could not affordan insurance cover. The ACA has ensured that all obtain an insurancecover and even reduced drug costs. However, people have been forcedto pay higher premiums resulting in financial pressure. Also, thetaxes have increased making life difficult for the average incomeearners (Hall & Lord, 2014).
Healthcarehas been one issue people never seem to be in agreement. TheRepublicans and Democrats have different opinions regarding healthreforms. While Democrats want all people to have insurance cover, theRepublicans do not want to pay more taxes emerging from the ACAregulations. The health care reforms have led to high premiums, andpeople are suffering financially. The health reforms have become apolitical liability, and it is hard for the law to correct itself. Ifanyone were to vie for a legislative seat offering a change in theACA requirements, most people would vote for the person (Hall &Lord, 2014).
Consideringthe sum of stakeholders and their different interests, what they wantis renegotiating. The stakeholders all want better health care ataffordable costs but without any rise in the cost of living. Thephysicians want better pay and better working environment where theybuild healthy relationships with their patients. The insurancecompanies want assurance that they will not undergo any loss, thepatients want affordable insurance plans and better healthcare whileemployers also fair premium rates for their employees to avoid layingoff or resignation and incurring a loss (Hall & Lord, 2014).
Itis important for the stakeholders to take part in finding a solution.However, they should be aware that nothing will be perfect and it isnot possible to meet all their demands. All stakeholders must bewilling to give up some of their self-interests to attain somethinggreat they can all work with. They must acknowledge that none of themhas all the answer and only their unity and understanding can helpthem out. The stakeholders must all agree to compromise to find asolution. However, no solution will meet the stakeholders` demands(Hall & Lord, 2014).
Inconclusion, it is important to have an insurance cover since it comesin handy during emergencies and when the hospital bill is very high.As much as the ACA desired to lower the insurance rates and providebetter healthcare, it did not put into account a number of things.For instance, the insurance companies are at a risk of falling out ofbusiness they have introduced high premiums to cover the losses theyincur, and this has only led to a decrease of clients. The patientsare not receiving adequate time from their physicians since thephysicians have many patients to deal while others hurry to attend totheir private clients. The employers are experiencing a loss sincethey have to pay large sums for their employees it has resulted insome companies going out of business. It goes without saying that asolution is urgently needed to prevent further challenges in thehealth care system (Hall & Lord, 2014).
Hall,M.A. & Lord, R. (2014). Obamacare:What the Affordable Care Act Means for Patients and Physicians.BMJ 2014 349:g5376 doi: 10.1136/bmj.g5376