[The effects of legislation on health care delivery]

By

Acknowledgement

This research would not have been possible without the supervision of my supervisor and my family and friends so I would like to thank them for their support throughout this research.

DECLARATION

I hereby take an oath that the content of this research is my own unaided work and it does not present the idea of my university or someone else. Moreover this report has not been submitted for any educational purpose to anyone.

Signed __________________ Date _________________

Abstract

In this study we try to explore the concept of “health care delivery” in a holistic context. The main focus of the research is on “legislation” and its relation with “health care delivery”. The research also analyzes many aspects of “health care reform” and tries to gauge its effect on “health care”. Finally the research describes various factors which are responsible for “health care delivery” and tries to describe the overall effect of “legislation” on “health care delivery”

Contents

DECLARATIONIII

ABSTRACTIV

CHAPTER 01: INTRODUCTION1

Introduction1

Significance of the Study4

Specific Research Sub Questions4

CHAPTER 02: LITERATURE REVIEW6

Health Care System6

Health Care Reform6

Types of Health Care Systems8

Government Intervention in the Health Care Market10

Entrepreneurial11

Welfare-Oriented11

Comprehensive11

Problems behind American Healthcare System12

Financial Structure13

Cost of care13

Acute Care14

What We (Americans) Have Failed To Do14

Social Policy Overview15

Barack Obama and Organizing for America: 2009-201016

Obama's health care17

Summary of the Bill18

Main points18

Health Care Structure19

Pros and Cons of the Health Care Reform20

Status of Health Care Reform in America22

Community and the society30

CHAPTER 03: METHODOLOGY32

Action Research32

Historical Development33

Characteristics34

Reflection34

Iterancy34

Collaboration35

Role of the Researcher36

A Case for and Against Action Research37

Making Judgment on Action Research39

CHAPTER 04: DISCUSSION41

Analysis of Q141

What are the factors that impede the implementation of a universal health system?41

Access to Health Care44

The importance of access to health care44

Improved access to health care services is now entrenched in provincial agendas.46

b)Measuring access to health care47

Public Opinion on the Health Care System48

Satisfaction with Health Care48

Current Definitions of Access and Barriers to Care49

Defining Access and Barriers to Care49

Barriers to Entry, Barriers in the Care Process, and Barriers from the Consumer's Perspective51

Barriers within Systems of Care or Treatment Episodes52

Analysis of Q254

What role should the federal government play in health care?54

The Need for Federal Intervention55

Analysis of Q356

What are some factors that can explain why the U.S. per capita spends more on health care?56

Health Care Spending: Large Differences, Unequal Results58

Money Alone Does Not Extend Lives59

What measures that can be implemented to constrain costs without restricting access?61

Utilization Review62

Utilization Review Defined62

Utilization Review Structure63

Strict Enforcement through Financial Risk Shifting64

Summary66

Analysis of Q4 and Q566

What are some of the possible effects of cost containment measures?66

Effects of Cost Containment Measures on Health Care66

Assuring Quality Care in the Managed Care Product67

Maintaining the Ethical Basis of Health Care70

Maintaining Access to Health Care71

CHAPTER 05: CONCLUSION AND RECOMMEDATIONS73

REFERENCES76

CHAPTER 01: INTRODUCTION

Introduction

Universal health care coverage has elicited much debate in recent times, particularly in the United States. Specifically, efforts to increase coverage have not addressed the inadequate reimbursement rates for physicians, which have sparked many contemptuous debates. The most controversial aspect of the health care bill seems to be the unprecedented mandate for all Americans to purchase health insurance. Within this mandate lies the “minimum essential coverage”, this coverage is either ...