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What policy drivers could states and the federal government use to bring quality up and cost down? Are the current efforts effective?

Respond: There have been multiple failed attempts by the US government to bring the quality of care up and the cost to Americans for adequate services down. There has been The Health Information Technology for Economic and Clinical Health Act, The Affordable Care Act, The Medicare Access and CHIP Reauthorization Act of 2015, and many other forms of legislation. The latest endeavor seems to be moving from fee-for-service models to alternative payment models. I’ve seen this firsthand at the organization I work for when we learned about the SIP (Seriously Ill Population) program being rolled out. I’m pleased to see that the government is realizing there needs to be a continuum of care for its citizens, but in my opinion this change is simply not enough. Rewarding organizations for providing excellent care seems like a great idea. One hand washes the other. However, to me the real issue is that not everyone has access to care period. It’s great that we’re trying to make sure that if one is fortunate enough to have health care the government is trying to make sure it is quality based. But, what about those who fall in between the cracks? Those who make too much to qualify for federal aid, but can’t afford to take the cut from their paycheck? Why are we the only first world country who doesn’t provide free health care? Why do we not think every citizen’s health and well-being is important? Until we can ensure this basic human right, I’m not sure current efforts are effective or quite simply, enough.

Respond: With most things, there is always room for improvement, and healthcare is no exception to this. We should always be striving to improve the quality of care because we will never have it at 100%. In the last forty years, the definition of quality care has changed tremendously from being focused on supply chains to now more focused on the patient’s experience. Since the rebirth of the NCQA, the definition for healthcare quality “the degree to which health services for individuals and populations increase the likelihood of desired outcomes and are consistent with current professional knowledge (Nash, 2019, p. 390). Between 2009 and 2017 there was a great reform in healthcare and the focus changed to measuring performance based on patient care (Nash, 2019, p. 400). Many of the policies during that time attempted to provide better quality care to more Americans, but none were able to completely fix this country’s quality care deficit. One of the many problems that cannot be fixed by simply offering free healthcare to everyone. It’s not a simple fix but rather a gradual change that needs to be made. Someone will still be footing the bill for free healthcare to pay the hospitals, providers, etc. This will come from tax money and raise taxes. This will lower the amount of money providers and medical staff earn. I agree that the system is flawed but it’s complex as well and needs a strategized plan that will gradually change it over time and not flip the whole system in one day.