Health Care Reform and Equity

Health Care Reform and Equity
The author of the “Health Care Reform and Equity: Promise, Pitfalls, and Prescriptions” article delves into the subject of the US’s failure to make desired progress within the past ten years. The ACA (Affordable Care Act) attempts at expanding insurance coverage for the yet-to-be-insured 23 million individuals in the nation, though it requires additional laws for doing so. Two key challenges hampering progress are addressed in the article: alignment of the nation’s healthcare resources with the requirements of patients and primary care revitalization, mainly for the underserved population (Fiscella, 2011). Gaps in healthcare service provision have been impeding progress towards more equitable healthcare. This article puts forward the following six interconnected domains: insurance cost and coverage related access, doctor salary modifications, strengthening of primary care, health IT improvements, better accountability, and disparity monitoring, and national quality adoption (Fiscella, 2011).
This paper will deal with how the system’s prescriptions, promises, and pitfalls, as described by the article’s author, augment or weaken the biblical community and public health worldview concerning the following healthcare reform areas: health IT and primary care. According to Fiscella, primary care access has been linked to fewer outcome gaps. A sound primary patient care system forms the groundwork for greater equity in healthcare in the nation. Longitudinal, empathetic physician relationships with their patients help minimize stereotypes, besides promoting patient capacity and enablement, thus likely resulting in more equitable patient care (Fiscella, 2011). As more primary care practitioners don’t necessarily imply everybody in a given area can better receive or access primary care, studies that take into account patient-primary care doctor experiences or relationships prove valuable in determining the link between health outcome and primary care. Primary care’s positive influence on patient health is evidenced by a comparison of those who have, or lack, access to primary care practitioners as their routine care source (Starfield, Shi & Macinko, 2005). The article further discusses that the ACA attempts at transforming overall healthcare quality in the nation (which includes primary care) via several small, though possibly synergistic steps. Though the process is not easy, it will guarantee equitable primary care access to one and all.
The health IT arena highlights the fact that appropriate health IT, which includes EHR (electronic health record) availability, constitutes a mainstay in the transformation of primary care as well as improvement of healthcare equality and quality (Fiscella, 2011). The author’s provided details serve to dilute the extant knowledge on the subject, in that a value change among leaders, technology creators, and communities proves crucial to the equitable and sustainable implementation of technology. There are several examples of technologies undermining human rights, equity, and justice: for instance, sophisticated medical intervention adoption over simpler preventive techniques. But technological advancement is no guarantor of equitable health results. As technological advancements redefine how individuals, data, and systems interact, underprivileged population groups frequently find themselves overlooked. In places where technology solutions have been enforced for communities, the outcomes include weak policy, discarded equipment, and incompatible software.
The author of the article is right in claiming that robust incentives might be required for the promotion of effective information interchange between practitioners, patients, and systems. Without targeted interventions, the digital gap in technological access and knowledge could end up further widening gaps when practices start implementing e-scheduling, EHRs, and patient portals. Biases in decision making may be decreased with the use of features like patient registries, decision support, reminders, e-prescriptions, and automated digital order entry. Such features also offer the potential for equity improvement using better tracking, care standardization, and population management (Fiscella, 2011).
References
Fiscella, K. (2011). Health care reform and equity: Promise, pitfalls, and prescriptions. Ann Fam Med, 9(1), 78-84.
Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of primary care to health systems and health. Milbank Q, 83(3), 457-502. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690145/