Health Policy and Reform: The Problem


The healthcare problem in the United States has been in existence for over two decades despite the joint efforts of the government and private partners to reverse this trend. While in the last ten years, the state of healthcare was deplorable but still fixable, currently, it is disorganized, expensive and inefficient (Longest, 2010). The existing state of the sector is characterized by over 40 million Americans lacking insurance cover, escalating premium rates and charges as well as increased bureaucracy in processing physician and patient demands (Daschle & Nather, 2010). It is predicted that these problems will escalate and create new challenges for the stakeholders if not addressed. However, gaining an understanding of the problems in the healthcare sector will avail several avenues to solving the issues.

Patient insurance is a major problem that affects a large part of the American population. The recent Obamacare reforms that targeted the rich in an effort to level the playing field also sought to provide universal coverage for all Americans (Davidson, 2013). This effort was praised as being creative and considerate of the minority communities within the United States that made up the bulk of citizens without insurance cover. However, this effort was also misplaced since its implementation overlooked one major aspect: the beneficiaries. Most of the minorities that would stand to benefit from the affordable insurance cover policy were not even aware of the bill in the first place. Poor sensitization on the part of the state was to blame even as insurance premium payers went up in arms over the possible impacts of the Obamacare bill. It is imperative to note that for a country’s health to be ascertained, universal coverage should be implemented in a thorough fashion (Davidson, 2013).

True to this statement, the 2010 health plan sought to ensure that all Americans were enrolled in an essential heath plan. However, the debate lies with the manner in which uninsured citizens would be handled. This section of the policy created problems for the involved parties since the Obamacare policy proposed that they would receive vouchers or payments to subsidize the enrollment costs for insurance plans. Other issues that arose from this section of the bill questioned the source of fund to run such an expensive healthcare reform. The idea to tax the rich to create funds to take care of the underprivileged seemed irrational to most economists and healthcare stakeholders and still triggers complex debates within political and economic circles (Davidson, 2013).

Poor Cooperation between Public and Private Sector Parties

            The nature of the relationship between the public and private sector in the United States has had numerous consequences on the provision of healthcare services to its citizens. Currently, the government plays a major role in healthcare when compared to the private sector. In the insurance field, the government administers Medicaid, the organization with the largest number of enrolled citizens. Medicaid is jointly funded by different states and the central government making it a formidable force (Daschle & Nather, 2010). The government also releases policy directives such as the patient protection and Affordable Care Act (Davidson, 2013). Conversely, the private actors in the health sector are mainly limited to the pharmaceutical industry where they engage in the research, development and marketing of drugs and other medical equipment. Since the public sector oversees the allocation of funds and the implementation of policies, the relationship between the two parties has been skewed in favor of the state (Kovner & Kinckman, 2011). The lack of a public-private mix that would ensure comprehensive proposals and resources are used to come up with a working healthcare system results in wastage of human resources and public funds while perpetrating incompetence in healthcare. If the government were to rely on the research, human resources and efforts of the private sector, the problems in the health sector would be solved.

Administrative Issues for Physicians and Patients

            The healthcare sector in the United States is a broad field characterized by numerous parties at different levels, many beneficiaries as well different entities that regulate the actions and decisions of these parties. With this magnitude of activity, the administrative burden placed on the physician and the patient is massive. These administrative burdens include insurance processes that require the establishment and patient to ratify and make payments, monitor premiums as well as checking in with the representatives regularly. Hospitals have many procurement needs for provisions, medical equipment and drugs that have to be performed. These establishments also have to deal with patient issues such as referrals, transfers, civil suits and other demands. Additionally, there are remuneration and union procedures for the hospital staff. With the advancement of the American healthcare sector into a multi-million industry, these processes have been magnified and complicated to an extent that they interfere with the delivery of swift and affordable healthcare (Davidson, 2013).


            The massive health reform proposed by President Obama may have the health of American citizens in mind but its success depends greatly on the implementation procedure adopted by the current government. Opinion polls conducted by the Kaiser Family Foundation revealed that a large section of the citizens held unfavorable opinions concerning the healthcare reform law. About 35% of the respondents pointed out biased insurance changes, inequality and increased taxation as the main flaws that plagued the reforms (Garson, 2013). Achieving a high public popularity for a policy proposal is an important step towards ensuring the success of that policy. Public support or the lack of it thereof is an indicator of the extent of failure of the healthcare sector in the United States. Effort should be made to restructure the sector and eliminate the drawbacks such as private sector monopoly, state bureaucracy and incomprehensive policies.


Daschle, Thomas, and David Nather. Getting It Done: How Obama and Congress Finally Broke the Stalemate to Make Way for Healthcare Reform. New York: Thomas Dunne Books/St. Martin’s Press, 2010.

Davidson, Stephen M. A New Era in U.S. Health Care: Critical Next Steps under the Affordable Care Act. 2013.

Garson, Arthur Jr. The US Healthcare System 2010: Problems, Principles, and Potential Solutions. American Heart Association. 2013.

Kovner, Anthony R. and James R. Knickman. Health care delivery in the United    States. 10th Ed. New York: Spring Publishing Co. 2011.

Longest, Beaufort B. Health Policymaking in the United States. Chicago, IL: Health Administration Press, 2010.

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