Evaluating the Role of Insurance in the American Health Care System

This essay examines the significant role of the insurance industry within the American healthcare system, highlighting its influence on the development and implementation of the Affordable Care Act. It discusses the challenges posed by an aging population and explores the potential of a single-payer system as an alternative to the current multi-payer model. The analysis includes a comparison of cost, quality, and access under different systems, emphasizing the benefits of improved data exchange and e-prescription. Barriers to adopting a single-payer system, such as implementation costs and work culture, are also addressed. The essay concludes by advocating for rigorous research and collaboration between academia, industry, and government to standardize processes and improve healthcare quality through a single-payer system. Desklib provides a platform to explore more on this topic with access to past papers and solved assignments.

Significance of Insurance
Industry on the
American Health Care System
By:

Introduction
• Insurance industry is a major stakeholder in the American
healthcare system.
• It played a significant role in the development of the
Affordable Care Act between 2014 to 2018, contributing
an annual fees of $47.5billion to the federal government.
• Aging population challenges American healthcare system
in terms of long term and acute care
(Gaffne,Woolhandler, Angell & Himmelstein, 2016).

Single Payer System
• It is a an insurance system where a single
government plan provides insurance cover to all
the citizens.
• In a single payer system, new practices and
policies can be implemented, communicated and
evaluated with increased convenience compared to
the US soloed, multi formulary and multi payer
system (Chaufan, 2015).

Single Payer System: Cont.
• Single payer system provides high quality care to
Veteran Administrators at relatively reasonable
cost.
• It is more convenient medical system compared to
multi payer system.
• A single payer insurance plan provides high
quality medical care based on health plans and
reduces paperwork dramatically.

Single Payer System Overview:
Cost, Quality and Access
• Quality of medical care provided is high and the cost is
reasonably affordable.
• There is reduction in maintenance cost and
development of standard multiple data.
• Individual patient data can be accessed from master
patient index allowing easy movement of information to
a single payer system (Chaudhry, Wang & Wu, 2006).

Single Payer System Overview:
Cost, Quality and Access: Cont.
• There is easy exchange of patient information across
platforms.
• Access to medical information is easy by allowing e-
prescription which improves patient medical care
(Gabriel & Swain, 2014).

Health Information Exchange
Federated Model
Source: (Chaudhry, Wang & Wu, 2006)

Barriers To Adoption of a Single
Payer System
• There has been several negative and inconclusive
studies with regard to the installation of Computerized
Physician Order Entry (CPOE) showing their
relationship with patient harm .
• Design of patient health records requires a high level of
health literacy and technical expertise (Charles, Gabriel
& Searcy, 2014).

Barriers To Adoption of a Single
Payer System
• Lack of business model that supports long term
operation of PHRs.
• Work culture barriers .
• System cost, training issues and other matters
concerning single payer system.

Conclusion
• To reduce the cost of moving to single payer
system and improve healthcare quality, rigorous
research and implementation is required across
several arenas.
• Academic industry and government need to
reorganize interdependent roles that standardize
work culture and administrative processes to
achieve a single payer system that will improve the
quality of healthcare and HIT desired outcomes.

References
Charles D, Gabriel M & Searcy T (2014). Adoption of electronic
health record systems among U.S. nonfederal acute care
hospitals: 2008–2014, ONC data brief no. 23. Retrieved
March 9, 2016 from https://
www.healthit.gov/sites/default/files/data-brief/2014Hospit
alAdoptionDataBrief.pdf
Chaudhry, B., Wang, J & Wu, S. (2006). Systematic review:
Impact of health information technology on quality,
efficiency, and costs of medical care. Ann Intern Med. 2006;
144: 742-752.Retrieved from:
https://www.ncbi.nlm.nih.gov/pubmed/16702590

References
Chaufan, C. (2015). Why Do Americans still need Single-Payer health
care after major health reform?. International Journal of Health
Services, 45(1), 149-160. DOI: https://doi.org/10.2190/HS.45.1.l
Gabriel MH & Swain M (2014). E-prescribing trends in the United
States, ONC data brief no. 18. 2014. Retrieved March 9, 2016, from
https://
www.healthit.gov/sites/default/files/oncdatabriefe-prescribinginc
reases2014.pdf
Gaffne, A., Woolhandler, S., Angell, M., & Himmelstein, D. U. (2016).
Moving forward from the Affordable Care Act to a single-payer
system. Retrieved from:
https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.30315
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