In Search of a Cure: An Examination and Restructuring of Health Insurance and the Affordable Care Act in the United States

Abstract

The timeliness, quality, and innovation of health care in the United States are to be admired, but costs are high and accessibility to care for all is lacking. This thesis analyzes the current health insurance environment and the impact the Affordable Care Act (ACA) has had on health care. While the ACA has achieved its goal of providing more affordable insurance coverage to more Americans, the law falls short in several important ways. The six major reforms discussed in this thesis will improve the delivery of health care and reduce costs where the current structure fails. Specifically, the proposals include a recommendation to introduce the use of incentives for those who are eligible for public insurance to purchase private insurance – as such an approach is more beneficial to doctors and their patients. Furthermore, private insurance can be improved through the concept of continuous coverage to prevent coverage gaps when changing jobs and emphasizes High-Deductible Health Plans to provide affordable insurance options for healthy individuals. The continued existence of the private insurance sector is imperative due to resulting incentives for innovation in medical research and technology. Additionally, continued research and development for new leading-edge prescription drug cost control mechanisms is essential, as pricing and spending are currently unregulated and out of control. Through improved pricing techniques, government regulation, competition, and increased awareness and accountability among consumers, prescription drug expenditures can be contained while not stifling drug development. The medical malpractice structure must be improved as the current system results in unnecessarily high costs, due to the need for malpractice insurance and defensive medicine. The system needs to be rewritten to ensure access to a fair and knowledgeable panel of arbitrators and unbiased experts, while still protecting the safety of patients. New measures to improve transparency efforts will encourage more accountable pricing among providers and spending among consumers. Restructured price formulas for care and increased patient access to pricing practices will utilize both government regulation and competition to rein in medical costs. Finally, more emphasis on prevention through wellness programs will reduce the reliance of Americans on the health care system. Wellness programs provided through employers, insurance companies, and the government will effectively lower health care expenditures and dependence as a result of a healthier population. Although not all people will agree with these recommended reforms due to ideology, they are based on the research and analysis of reputable sources. They are motivated by the need to treat all Americans as equals and provide equal access to health care.