Management Action Plan – Term Paper

Healthcare Reform


Without a doubt, health care reform has a long history in most jurisdictions. Although legislators have often envisaged health care reforms by enacting federal statutes, the enforcement has always been in shambles. For instance, in 2010, the American Congress passed two landmark reforms that sought to redefine the healthcare landscape in the country (the Healthcare and reconciliation act of 2010; the Patient Protection and Affordable Care Act). It is imperative to note that different regimes have often honed various reforms as every leader bears a different perspective. Although the countrys health care system is yet to deliver equitable services to all its citizens, the reforms have played a focal part in alleviating service delivery (Gibson and Janardan 24). To date, health care plays a vital role in increasing the average life expectancy, tackling maternal mortality issues, and addressing numerous emerging health concerns. According to a World Bank report, most economies have a higher health cost compared to their economys GDP. The premise implies that most health care systems are inefficient resulting in resource wastage.

Hire a custom writer who has experience.
It's time for you to order amazing papers!

order now

Problem or Opportunity for Improvement

Underinsurance is an inherent challenge that continues to plague most countries and regions around the world. In this age of modernity characterized by rapid development, life has become unbearable due to many economic downturns that often threaten the livelihood of many citizens. For instance, in 2008, the world experienced a fatal financial meltdown that resulted in heightened unemployment, innumerable foreclosures, and an economic halt. At the time, most of the working population could not access healthcare, since their respective companies had experienced financial difficulties. Similarly, a large population of the countrys citizenry lacked basic health insurance, a factor that complicated the health care metric in the country. While addressing a public gathering in 2010, Warren Buffet noted that the exorbitant costs that American-based companies incur as health insurance for their employees disadvantage numerous corporations in the country (Jacobs 118). Over time, the number of employer-paid insurance packages has declined significantly. Notably, a significant number of baby boomers is hitting retirement age and coupled with the increased annual health care cost is continually straining different governmental sectors. In 2014, the uninsured population in America accounted for more than 14% down from 17% in the previous fiscal year. Although the economy recorded a decline in the uninsured populace, the government spread headed tailor-made solutions targeting specific grouping that recorded a high rate of underinsurance.

Evidently, health care without insurance is barely affordable. Only the affluent in any society would afford the soaring healthcare prices without the variety of insurance packages. Therefore, the lack of insurance predisposes the destitute in any society to a myriad of complications in case a disease strike. The premise affirms that health care is an imperative social amenity that guarantees a population of a high living standard. Without this guarantee, such a society leads an impoverished life characterized by the inability to access quality care that would address any emerging concerns. Statistics affirm that lifestyle diseases have become the primary health challenge for most in the society. For instance, cancer, diabetes, and heart conditions among other complications have become a common phenomenon in most households. Therefore, the lack of insurance often predisposes the ill patients to premature deaths.

In the instance, the government and those concerned with the health insurance fail to intervene and address the plight of millions around the world; preventable deaths will always strike. In the less developed countries, maternal mortality is still a scathing healthcare issue that continues to plague many households (Gibson and Janardan 49). Although America and other developed nations have cubed such deaths, more than 10% of the population is uninsured. Therefore, the massive investment in technological advancements in the healthcare sector does not suffice if it does not help in spreading wellness. In a recent report, the World Health Organization (WHO) affirmed that lack of insurance cover decapitates economic progress as it robs the society of numerous individuals at their prime years of operation.

Measurable Goal

The management action plan intends to spearhead a campaign to create awareness and sensitizes government officials to take action. In essence, healthcare is a government-borne responsibility to ensure that its citizenry has access to affordable and quality care at all times. The plan intends to put the government on notice regarding healthcare affordability. Since most of the resources in the healthcare docket end up in wastage or embezzlement schemes, the plan seeks to sensitize the masses about their rights visa via the comprehensive governmental packages. It is crucial to highlight that a significant portion of the uninsured population is unaware of affordable health insurance that would absolve all the underlying risks. Therefore, the sensitization program will highlight the massive disparities between private and public insurance policies while instigating the government officials to take responsibility. A successful management action plan will bring legislators on board to fast-track the enactment of affordable health care statutes that safeguard the needs of the impoverished in society. By sensitizing the masses on the need to uptake health insurance and putting the government in check, the management action plan will ensure that the uninsured rate reduces significantly. At the time, resources, and a revamped team of dedicated individuals to this cause pose as the primary challenges.

A List of Possible Actions

Statistical data assert that the life expectancy rate in America has been increasing gradually. The Tenet acknowledges that the healthcare sector has been undergoing constant improvements. However, the underinsurance menace threatens the attained progress as a given population of the countrys population fails to enjoy the health care privilege. The core problem plaguing the health care sector is wastage. For instance, the American government spends more per capita income on health compared to any other developed nation. However, the country is yet to achieve a desirable health care metric, as most of the resources do not reach the intended target. According to Donald Berwick, the outgoing administrator of the Center for Medicare and Medicaid services, a significant portion of healthcare spending estimated at 30% goes to waste. Donald reiterated that wastage takes five variant formations including patient overtreatment, administrative bureaucracies, ill-coordinated care, fraud, and burdensome rules. In 2011 alone, Medicare and Medicaid lost more than 65 billion meant to alleviate health to fraud through improper payments. Although some scholars pose health insurance costs and availability as the core problem, fraud and wastage have played a central role in escalating the underinsurance menace.

Analyze and Prioritize Key Action Steps

Control Fraud and Embezzlement of Funds

First, the federal government ought to impose strong measures against fund embezzlement schemes. Although the Medicaid has proposed punitive fines and imprisonment charges, the measures have not curbed fraud in the health care docket. Since the government has dedicated a high per-capita towards healthcare, it should also envisage salient prohibitive bylaws that hinder corruption. It would be prudent to hasten ongoing court cases on corrupt practices and ensure that the criminal offenders face the wrath of the law. Such a measure would act as a deterrent to any fraudulent individual who endeavors to perpetrate such heinous activities.

Impose Price Ceilings on Private Insurance Companies

According to Starr (2011), the federal government should desist from taking a back seat in the implementation of health insurance. As such, the government ought to implement ceilings on private companies that offer insurance services. Since time immemorial, there has been a considerable gap between private and public service providers. While the government tries to subsidize insurance covers that target low-income individuals, most private companies exploit the middle-income earners through exorbitant prices. The government ought to impose strict pricing charges for all private insurance companies seeking to envisage consumer protectionism. In essence, the private insurance companies have been racking massive profits while their customers continue to languish through poor services. In attempting to negate further consumer exploitation, the government ought to intercede and take strict measures against any corporation that inculcates extra charges over and above the provided legal limit.

Encourage the Business Community to offer Insurance Packages to Employees

Ever since the 2008 financial crisis, companies have been trying to mitigate losses by reducing expenses. As such, most of the companies within and without America stopped incurring insurance costs on behalf of their employees. In the yesteryears, corporations often catered for the needs of their employees, as they perceived their personnel as irreplaceable assets. In this modernized age, unprecedented population growth coupled with high literacy levels has created a highly employable society. Therefore, the supply for employees far surpasses the demand implying that employees are highly replaceable. In such a scenario, employees lack the basic bargaining power for better pay as well as benefits commensurate to their respective efforts. In light of these assertions, the government ought to intervene and encourage the employers to insure their employees through various schemes. For instance, the federal government could issue tax subsidies for a company that uptake insurance plans seeking to give such institutions a competitive advantage over rivals.

Organize the Key Action Steps into a Management Action Plan

Undoubtedly, the success of the management action plan lies in the legislative process. Healthcare reforms require aggressive sensitization for the public to offer their input before congressional deliberations commence. The first step would encompass informing key stakeholders in the health sector regarding the underinsurance menace and inviting their input towards suggested resolution mechanisms. It would be momentous to encourage the business stakeholders to discuss insurance price ceilings, incentives to employers, as well as subsidized packages that target the low-income grouping. Following the deliberations, the legislative process will commence and finally sensitize the populace to take required measures towards insuring their individual households.


The Public Accounts Committee should oversee the Control Fraud and Embezzlement of Funds. Within a month, the committee ought to provide a legal framework that endeavors to seal all underlying loopholes in the system. The business committee in Congress should Impose Price Ceilings on Private Insurance Companies and Encourage the Business Community to offer Insurance Packages to Employees. The board should table a complete summation of its findings within three months. Therefore, the implementation of the plan ought to take three months followed by an evaluation phase to underscore the attained progress.

Measurement and Monitoring

The success of the program will be evident through a considerable uptake of health insurance policies. Performance monitoring will envisage reports from government institutions regarding new insurance policies offered the corporate bodies as well as individuals. After six months, it will be prudent to undertake a survey on new insurance policies and their impact on the healthcare sector in the country.

Works Cited

Gibson, Rosemary, and Janardan P. Singh. The Battle over Health Care: What Obama’s Reform Means for America’s Future. Lanham: Rowman & Littlefield Publishers, 2011. Print.

Jacobs, Lawrence R, and Theda Skocpol. Health Care Reform and American Politics: What Everyone Needs to Know? New York: Oxford University Press, 2012. Print.

Starr, Paul. Remedy and Reaction: The Peculiar American Struggle over Health Care Reform. New Haven: Yale University Press, 2011. Print.