There are a number of contemporary issues in healthcare policy that are being debated across the county. These issues impact everything from personal health to public opinion to access to medical care.
State and federal policies regarding antitrust enforcement are notoriously weak and unenforced. As a result, hospitals and health care networks have too much market power to negotiate higher than competitive rates. That is, hospital consolidation results in higher consumer prices and potentially less access to medical care. When hospitals merge into consolidated markets of providers, health care costs will increase up to 20 percent. As hospitals acquire physician groups, prices will also increase because they won’t have to deal with laxer contractual relationship with practices. These price increases are usually passed on to the health consumers through higher insurance premiums.
Health Care Policy Control
There is still a debate going on as to whether the federal or state governments should control health care policies. Some feel that states should democratically develop their own policies, but others feel that the federal government should develop universal top to down solutions for all states. This is best illustrated through the health care exchange network situation. Almost half of all states have created through own Affordable Care Act exchanges, but the remaining states have selected a partnership model with the federally-facilitated marketplace. Generally speaking, state controlled exchanges tend to enroll a higher percent of people compared to the federal marketplace.
Health care policy makers are still debating about the necessary evils of high deductible plans and out-of-pocket costs. These two concepts have been historically promoted by conservative health care policy makers who promote choice and free-market ideals. Their liberal counterparts have not only failed to closely support the opposite policies, but the passing of the ACA has created marketplace plans that include even higher deductibles. High deductible health care plans are often associated with health savings accounts that do provide more flexibility and tax savings. Policy makers are still struggling to find the middle ground that protects individuals with limited income who have to deal with high deductibles.
Both political parties actually share certain concerns about health care issues and reform. For example, most policy makers support the limitation against age discrimination, lifetime caps and insurers’ discrimination against preexisting conditions. Most policy makers supported the ACA because they wanted to provide more health insurance options and make health care more accessible to more people. One of the most controversial concerns that still hasn’t been resolved is the issue of who is required, if any, to cover contraception. While the Supreme Court ruled in Burwell v. Hobby Lobby that a health plan offered by for-profit corporation doesn’t need to cover it, this issue is still being hotly debated.
Policy makers can’t agree if hospitals should get paid more than individual physicians for providing identical services. Ambulatory surgery centers (ASCs) are paid approximately half of what hospitals are paid for the same coded procedure. Hospitals continue to argue that the extra payment is necessary for the other services they offer, such as trauma and specialized care, but physicians correctly assert that these high prices are unfairly beneficial to hospitals. As mentioned above, consolidated hospital networks are very powerful and thus can force health care consumers to pay more for unexpected emergency services that they cannot control.
One of the technical contemporary issues in healthcare policy is whether or not individuals using the federal exchange should receive subsidies. The government currently subsidizes buying health care insurance on the federal and state exchanges, but the original ACA legislation does not specifically allow this to occur through federal exchanges.