The Affordable Care Act (ACA) is in vigor since January 1, 2014, and hospitals and health care providers are not sure about how many people will knock at their door for health care. So far, according to Camp (2014) “More than two million people across the country have signed up for healthcare under the ACA and hospitals are bracing for a wave of newly insured patients”. How does that affect the uninsured people in North Carolina is an unanswered question. Seventeen percent of North Carolina’s residents are uninsured, according to Kaiser Foundation (2012).Health Care reform brings controversial and uneasy ethic issues to the population as well as to legislators. North Carolina can opt to expand Medicaid coverage to all individuals that have a household income less than 138% of the federal poverty level, but the question in the air is how NC will make it happen?. Financial Impact of ACA on North Carolina North Carolina has one of the highest index of the uninsured population when compared to States at the same size, 17% accruing to 1,604,300 residents.
Michigan has 12 percent; New Jersey has 15 percent; Virginia has 13 percent, according to Kaiser Foundation (2012). Milstead (2013) assures “Based on the Affordable Care Act, beginning in 2014 adults can qualify for Medicaid if their income is no greater than 138 percent of the Federal Poverty Level ($30,429 for a family of four in 2010)”. Besides of what the ACA says each State has its own policies for Medicaid eligibility, being it a joint initiative between State and Federal funds.
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According to American College of Physicians (2013) “ Unfortunately, the state has chosen not to expand its program at this time. The Urban Institute estimates that about 632,000 uninsured North Carolinians with incomes under 100% FPL would be denied coverage if North Carolina chooses not to expand its Medicaid program”.
Governor McCrory is committed to envigorate the Health Care program in his budget delivance for 2013-2015 in North Carolina (NC,) and assures that $575M will be added to Medicaid budget, $7.2M will be given for Drug Treatment Courts, and $30M to open a new psychiatric hospital, all to be delivered in two fiscal years period (Newsroom, 2013). Overall NC’s State economy seems to be picking up with an underemployment rate dropping from 17 percent in October 2011-2012, to 14. 9 percent from October 2012-2013 (Robesonian News, 2013). In addition, Murawsk (2013) assures “the economy is indisputably building up steam and moving in a direction we haven’t seen in years”.
With NC State biannual budget investing $612.2 M in three important areas of health care and the general economy steaming up it seems that more of NC uninsured community will be able to have an employer sponsored health care insurance, or be able to afford health insurance in the marketplace. It looks like a promising situation, that will surely help to banish the ghost of unfunded mandates, but if 100 percent of NC uninsured population will get what ACA proposes is something to be checked in the future. Ethics and Quality of Health Care
A citation of Frederick Douglass’ delivery for the Civil Rights in October 1883 comes in hand he said “Only base men and oppressors can rejoice in a triumph of injustice over the weak and defenceless, for weakness ought itself to protect from assaults of pride, prejudice and power”. As health care reform proceeds to its implementation around the country many issues come to our mind such, are there enough resources to attend everyone or we will have an incoming chaos? Will American society finally have an equally health care system distribution?
How are 32 million new health care system’s users fit into an already deficient system? Will there be enough nurses and doctors to deliver the quality of care that everyone is entitled? Is it a fair system for the society, is everyone getting what is deserved? Many people would like to speak up what they think about health care: What do Americans want from their health care system? Four fundamental goals have shaped our system. First, we want high quality health care that can provide the greatest benefits.
Second, we want freedom of choice so that we can decide the “who, when, and where” for our health care. Third, we expect our health care to be affordable so that we have resources for all of the other things we need or want. Fourth, we want our fellow citizens to share in the costs and also benefits of health care” (Sorrell, 2012). At one hand Franklin Roosevelt (1944) in the “Second Bill of Rights” mentions “the right to adequate medical care and the opportunity to achieve and enjoy good health”.
At the second hand who is paing for the good health care that everyone wants? Health care providers would they be nurses or doctors have their part to do in the delivery of quality health care, but a health care system that makes justice to everyone depends on the whole society. I believe adopting a modern system of nationwide assessment and intervention such “Population Health Model” (Kovner & Knickman, 2011,) would have a high impact on the financial and workforce redistribution, a great tool that can bring results using the integration model.
Summary ACA’s implementation has started and hospitals and health care providers are ready to receive new customers. North Carolina’s steaming up general economy and government’s budget can greatly help the population to get the health care they need. The right to health care comes to play when talking about health care reform, and we wonder if the new system will deliver the quality of care it proposes. Adopting Population Health Model for health assessment and intervention can be a solution for the health care issues in the U. S.
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