Abstract
The lack of health care facilities and the poor development and implementation of health reforms in the United States is adding difficulties in the lives of people. More than half of the population of the country is unable to have even the basis health care as there is no centralized health care system in the country and private organizations are providing health care and insurance services. These organizations are looting people by providing services at extremely high rates. This paper tends to focus the health budget by Obama administration and Trump administration. Likewise, it analyzes their efforts to develop and incorporate health reforms in the country in order to provide best quality health services to the citizens at reasonable costs. Moreover, the study focuses on the challenges and issues faced by both Obama administration and Trump administration in devising and incorporating these health reforms. The paper also investigates the root cause of these issues such as political influence in the public administration and the role of private service providers in the failure of federal policies.
Introduction
USA is facing serious issues related to health budget and lack of healthcare facilities for its citizens since last decade. It is one of the most developed nation on the planet since its sixty percent people lack even basic healthcare facilities and there is no centralized policy of the government neither the government is providing healthcare services to its citizens. Various private organizations and healthcare service providers are active in USA that are charging huge amounts from people in terms of health insurance and providing healthcare facilities. The major objective of this report is to compare the health budget of related issues in Obama and Trump administrations.
Likewise, the paper aims to determine the root cause of these issues to determine why a country like USA is unable to provide best quality healthcare facilities to its citizens in comparison to other developed nations of the world such as Canada and Australia. The paper would suggest certain solution and strategies to overcome these issues as well (Obama, 2016).
Obama is renowned for his health reforms and he is famous for his initiatives for improving healthcare services such as health insurance programs and especial health programs for adults and women in the USA. More than 20 million Americans are having access to healthcare facilities after hundred year due to health reforms of Obama administration.
Most of the people in the country were deprived of health insurance and the un-insurance percentage in the USA was more than thirty percent before his administration. The percentage of un-insurance is less than 10 by the virtue of Obama administration whose major target was to improve health services in the country.
Obama administration invested heavily in science and technology to incorporate innovative and advanced technologies in the health sector of the USA to provide best quality diagnostic and treatments to the citizens are reduced and affordable price. Obama administration devised various strategies and policies to overcome this issue and one of the best things in this regard was the specification of health choices for people and starting plans for small businesses. The major objective was to categorize the health services based on their cost to make them affordable for small businesses and people under 30 years of age (Marmor, 2009).
Likewise, the Obama administration gave special attention to children health and insurance and a special health insurance program was launched by the Obama administration in 2009 whose major objective was to ensure health insurance of low-income children. This program is was so successful that its policies were revised in 2015 and it is still operational in the USA.
In the same manner, the diagnostic services were improved in order to determine or to identify ailments at their start as it becomes easy to treat an ailment at the start of its malfunctioning, but this facility was highly expensive therefore, most of the people were unable to diagnose their ailments early. HIV screening was made free of cost and millions of people got benefit from this service (McKee, 2017).
Obama administration launched a special healthcare act that was known as Affordable Care Act and it was also known as Obamacare Act. The Act was incorporated in 2016 but it faced various issues that limited its performance, scope, and targeted missions and damaged the reputation of Obama administration as well. Some of the key issues faced by the Obama administration regarding this act and other healthcare services are briefly described in this paper however, their bird’s eye view includes the understandable taxes on people to get health insurance, increase in foreign debt and deficit, lack of IT infrastructure, and managerial issues.
Trump administration is struggling hard to overcome the issues faced in the Obamacare as the government has not suspended this program and this program is running with required changes by the Trump administration. The Trump administration is trying to expand the Affordable Act at the state level that means that the government is planning to start a program of block grants to every state of the USA to develop its own healthcare program to provide best quality health services to remote areas as well (Berwick, 2008).
This program will help more than 20 million people to get health insurance by 2026 and it will help the country to cut the federal spending on the health programs by $215 for ten years.
The Trump administration has increased the health budget of USA and it is now almost twice as in the other developed nations of the world and the major objective behind this increment to provide cost effective health services to the citizens of USA. The annual health budget of USA under Trump administration is $3.5 trillion, and it accounts for 18 percent of the GDP of the country. The federal government is financing more than $1.5 trillion of the total health budget of the country $3.5 trillion (McKee, 2017).
The state and the federal governments of the USA pay taxpayers more than fifty percent of the health budget yet, insurance companies are also paying in this context, and they are paying up to one-third of this budget.
However, like Obama administration, the Trump administration is also facing various issues like unemployment, homelessness, issue of refugees, and low capita income of people. They are unable to pay taxes, federal and state governments have to bear these expenses, and about half of the population of the country is still lacking facilities.
Research Purpose
The primary objective of this research is to determine the efforts done by the Obama and Trump administrations to improve healthcare facilities in the USA. Likewise, this research aims to highlight the healthcare budget in Obama and Trump administrations. Moreover, the study focuses on the issues faced by the Obama and Trump administrations in devising strategies and to implement them to improve the healthcare facilities and services in the USA.
The secondary objective or purpose of this report is to analyze the root cause of the issues that limit the performance of Obama and Trump administration that they were unable to achieve their targets and goals regarding the provision of best quality healthcare services to the citizens of the USA at optimal costs. Last but not the least, this research aims to recommend solutions for the future researchers to improve their research regarding this topic as it is a diverse topic and needs special attention to focus a certain aspect of the topic for research.
This study will surely help the future researchers in improving their research and it will serve as literature for these researchers.
Literature Review
Various researchers have discussed this topic previously as the lack of healthcare facilities and the high expenses of these facilities in the USA has emerged as the hot issue in the last few decades. Various studies are available in this context that compare the health budget of Obama administration with the Trump administration and these studies also focus the issue faced by both these administrations regarding fulfilling their promises and providing the best quality health services to the people of the USA at reduced costs.
Theodore Marmor and Jonathan Oberlander have discussed the options considered by the Obama administration to control the cost of health care in their study. This study reveals various options considered by the Obama administration to control the cost of health care along with the failed strategies of the Obama administration that were not practical due to various political and legal issues. This study also suggests the United States to learn valuable lessons from the other developed countries to offer best quality health services to its citizens at an affordable price (Marmor, 2009).
Obama devised various suitable heath care strategies, but his administration was unsuccessful to cultivate the best results from these strategies, as these strategies were not perused boldly. Obama administration was able to secure the Congressional majority at large scale regarding the expansion of insurance coverage in the country yet it failed to implement this strategy according to its merits, as it is a hard nut to crack to control the costs of medical care in America medical care system (Marmor, 2009).
The study is efficiently divided into four parts to cover the work done by the Obama administration to improve the health care services in the United States along with the challenges and limitations faced by this administration regarding the fulfilment of their targets and goals. The first part of the study discusses the challenges regarding the cost control along with the impacts of present recession in detail.
The second part of the study focuses the political challenges and barriers faced by any administration and especially the Obama administration to adopt the cost controls in the country. The third part of the study focuses the cost-control strategies and instrumentation used by the Obama administration to overcome these issues. It reveals that Obama administration was able to devise advanced and innovative cost-control instrumentation that helped it to achieve its goals and targets to the maximum level (Marmor, 2009).
The last part of the study discusses the issues in broader perspective, it includes international experience and practices used to control the medical expenditures, and it provides valuable lessons and recommendations for the future administrations in the USA.
In another study, Philip G. Joyce focuses the use of performance data by the Obama administration to improve the health budget and the overcome related challenges and limitations in this context. The study reveals that the Obama administration used the same method of using performance data like the one its ancestors did to devise better strategies for the provision of cost effective yet high quality health services in the country.
The Obama administration used the performance-informed budget to deal with the issue and this method is in practice since last five decades in the federal government. One of the best things done by the Obama administration was that it did nod discontinued the reforms of Bush’s administration however; the Obama administration modified those reforms and made them more useful and beneficial for the Americans (Joyce, 2011).
Some of the greatest reforms of the Obama administration were to understand and to determine the influence of the American Recovery, Reinvestment Act and eliminating those reforming practices that were useless, and whose performance was under-rated. These reforms were doing more harm than benefit and these were wasting resources in abundance.
Likewise, the Obama administration-initiated shot-term performance goals along with the initiation of funding programs to meet the financial needs of these limited programs to add value to the people of the United States in terms of health reforms. No doubt, the health reforms of Obama administration were much better than that of Bush administration but these were not as fruitful as they were expected as they were unable to use the performance data completely and their production was not according to the expectations owed to certain legal and political issues and challenges (Joyce, 2011).
The study also suggests the solutions for the Obama administration to improve its production by creating more chances or opportunities to use the performance data in decision-making. Likewise, there was a need to limit the spending and deficit according to the political changes by the Obama administration was unable to do that and it led towards its failure.
Likewise, evidence-based decision-making was another good option of the Obama administration to make bold decisions regarding the cost-control strategies by using the federal agencies to control these costs, but it was unable to handle pressure (Oberlander, 2010).
In another study, Jonathon Oberland explains the reasons behind the failure of health care reforms of 2009 devised by the Obama administration. One of the most common challenge faced by federal government and the Obama administration was the polarized political conditions of the country and strong criticism from the opposition. Likewise, the budget deficit is another common issue that is faced by almost every administration in the USA and so did the Obama administration (Oberlander, 2010).
However, the Obama administration and the democrats won the health reforms of 2009-2010 as they were well aware of the failure of Bush reforms and they learnt lessons from previous failures as well. One of the major strategies used by the Obama administration and the democrats to win this battle was to understand the significance of neutralizing the opposition of interest mafia in the country.
The table shows that the number of recipients were highest in 2009 from the last ten years.
Likewise, various studies are helping to understand the work of Trump administration regarding the improvement of health care facilities in the United States along with the issues faced by this administration to meet its targets and goals. John P. Geyman has explained the significance of the Affordable Care Act (ACA) and the role of Trump administration to enhance it. The Trump administration is trying hard to carry on this Act started in the Obama administration to facilitate the Americans with best health care facilities at a reduced cost (Geyman, 2015).
However, this is not the complete solution as the Trump administration is trying to fully implement the Affordable Care Act (ACA)by 2019 but it is anticipated in the study that still more than 37 million Americans would not able to have insurance policies. Trump administration needs to devise suitable strategies to meet certain challenges due to for-profit health care and insurance industry (Geyman, 2015).
Similarly, it is facing severe challenges diverse investor ownership and waste of bureaucracy that prevails in the market-based system. All these challenges combine to form barriers and hurdles in the way of health reforms.
In another study, Usman W. Chohan explains the role of budget offices along with the dichotomy of the political administration in creating and overcome issues and barriers in the way of health reforms. Health reforms fall under the public administration and the political influence in the public administration results into various issues and barriers in implementing health reforms. Likewise, the Legislative Budget Offices (LBOs) can play vital role in resolving these barriers and the study focuses on three primary roles or characters that can help to overcome these issues and they can work together to add value to the public (Chohan, 2018).
These characters include economists, legislators, and executives in the Trump administration. The Trump administration needs to review Legislative Budget Offices (LBOs) to revise the informative accounts that can surely help public administration to incorporate new and innovative health reforms in the country (Chohan, 2018).
Discussion and findings
The Unites States is facing serious issue of lack of health care and health insurance. More than half of the population of the country is deprived of availing these facilities despite of the fact that the health budget of the United States is almost double as any other developed nation in the world. The major behind this fact is the political involvement and the influence of pro-profit organizations in the public administration.
The bureaucracy is not supporting the public administration in fulfilling its mission and achieving its targets due to their stakes and people of the United States are suffering from this monopoly. This paper aims to determine the role of Obama administration and Trump administration in giving relief to public by providing them best health care services along with health insurance services at reduced cost (Béland, 2014).
However, the challenges faced by both these administrations are identical, these challenges are limiting their performance, and they are still unable to overcome these issues. More than thirty-seven million people in the United States are not insured and they cannot afford health services as most of the service providers in the country are private and they are charging high rates (Jones, 2014).
The economists, executives, and legislators have to play their roles to strengthen the public administration to overcome these challenges. Likewise, the country needs federal health care reforms, but it is not possible at once. Trump administration has authorized each state to devise its own health care reforms to ensure the provision of best health services to remote and distant areas of the country, yet it needs a lot more as USA is lagging behind in this segment as compared to other developed nations of the world.
Conclusion
To conclude, both the Obama administration and the Trump administration are facing identical issues in developing and implementing nations wide or federal health reforms in the country. Political pressure on the public administration is the root cause of their failure along with the private organizations who have created a strong mafia. They oppose to initiate federal reforms in the United States as it is their chief market and they are earning billions of dollars each year by selling their health care services and policies at an elevated rate.
Obama administration has struggled most in providing the best quality healthcare facilities to the citizens of USA at reduced cost. His administration also initiated Obama Care or Affordable Care Act that helped people to be insured and to avail high standard health care services at optimal cost. Yet this Act was unable to meet the increased demands of the population and due to various other reasons, such as weird tax policies of this Act.
Trump administration is also struggling hard to get maximum output from this ACT as it has not suspended the act and it is fully functional, yet 37 million people are not insured till date. Trump administration has doubled the budget for health care and it is double as compared to any developed nation.
Recommendations
This paper recommends the future researchers to focus on the mitigation strategies to overcome challenges faced by the Obama and Trump administrations to develop and incorporate health reforms in the country as the root cause and challenges are already focused in this report.
References
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