The document summarizes key aspects of the current US healthcare system and policies. It outlines the various public and private entities involved in healthcare financing, including Medicare, Medicaid, private insurers, and programs for veterans and native Americans. It discusses how the majority of healthcare is financed through public/private insurers and employers. The Affordable Care Act aimed to provide coverage for the uninsured. Future healthcare models may focus on reducing costs through telemedicine, accountable care organizations, and addressing patients' long-term needs.

1. The Current State
of
Healthcare System
and
Healthcare PolicyJeong Lapitan

2. Healthcare System
 In today’s world of Healthcare, the System itself
is very complicated. Public and Private
Institutions, different agencies, organizations,
and the diverse in parties make it extremely
challenging to provide the proper healthcare
without financial burdens (Mason, Gardner,
Outlaw, and O’Grady, 2016).

3. Insurances to Healthcare
 Medicare & Medicaid
 Private & Third Party Payers
 Veterans Affair
 Indian Health Services

4. Insurances to Healthcare
 Medicare & Medicaid
Medicaid and Medicare are two (2) principle entitlement programs designed by the Federal
Government. Medicare has four (4) parts: A, B, C, and D.
Part A: This covers the inpatient services provided in the healthcare facility.
Part B: This covers physician appointments and outpatient services in a healthcare facility.
Part C: This gives beneficiaries’ options for participation in private-sector healthcare plans.
Part D: This covers for prescriptions that are not covered by Part A & B.
Medicaid provides access to healthcare for those who have physical or financial needs due to
poverty. This entitlement is financed by both Federal and State funding.

5. Insurances to Healthcare
 Private & Third Party Payers
Private and Third Party Payers pay for the majority of healthcare costs. Own Insurers
receive benefits from their employers which are deducted from their wages (Mason,
Gardner, Outlaw, and O’Grady, 2016). The employee then determines if he/she
prefers healthcare plans like HMO or PPO plans.
 Veterans Affair & Indian Health Services
Veteran Affair was designed for those actively serving in the Armed Forces along with
their dependents.
Indian Health Services was designed for tribal members in America.

6. How Healthcare is Financed
 Majority of Healthcare is funded by Public, Private, and Third Party Payers,
along with Medicare & Medicaid. Most Americans receive healthcare through
their employers which in part basically funds the Healthcare System. As for
those who are not employed, they may not have the opportunity to afford
healthcare. In part, Affordable Care Act was established in order to provide
healthcare for those who cannot afford the costs for healthcare in general.

7. No Insured Patients - How it may harm
the Population in general
Millions of uninsured Americans use health care services every year, despite not having health
insurance. Due to the fact that health care is very costly to most people and the vast majority of
uninsured have limited financial means, many uninsured often cannot pay their medical bills. Realizing
that most Americans who are not insured and are in need for healthcare, the federal government, states
and localities have long provided support. As mentioned due to rising costs, enactment of the Affordable
Care Act (ACA), millions of uninsured individuals will gain insurance coverage through either Medicaid or
private plans purchased through third party or public/private parties. On average, a person who is
uninsured has considerably lower annual health care expenses than a person who is insured. This
difference obviously reflects the uninsured population’s lower health services utilization rate and the
ability of having lower service use compared to the insured population. As people acquire coverage, the
costs for providers linked with caring for uninsured individuals will decline, as more people have a
supplement of payment for their care.

8. Future of Healthcare
The United States has a very unique way on how it manages its healthcare system.
However, in the US, healthcare is primarily run by the public and private sectors in a
free market, which creates difficult challenges on who dictates on policies. Health
insurance companies and other special interest groups have such a huge impact in
government in that they fund the majority of healthcare costs. This is one of many
main reasons why Affordable Care Act was set in place; to minimize healthcare costs
(Mason et al, 2016). In time, the cost of healthcare will rise and someone/something
will be responsible to pay this. New emerging models are being developed such as
telemonitoring to reduce 30-day readmissions (costing thousands to healthcare
facilities), acute care providers conducting screening accordance through Accountable
Care Organizations (ACO) along with National Quality Forum by addressing the full
assessment of the patients’ long-term needs beyond the emergent chief complaint
(Mason et al, 2016) and it can improve health habits to potentially reduce cost for
healthcare. There is a fine line between finance and ethics when involving
Healthcare(Mason et al, 2016).

9. References
 Mason, D., Gardner, D., Outlaw, F., and O’Grady, E. (2016). Policy and Politics
in Nursing and Health care (7th ed.) St Louis, MO: Elsevier
 Squires, D. & Anderson, C. (2015). U.S. Health Care from a Global
Perspective: Spending, Use of Services, Prices, and Health in 13 Countries.
The Commonwealth Fund. Retrieved from
http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-
health-care- from-a-global-perspective