5 Most Important Regulations in the United States Healthcare System

Science and medicine are two concepts that are constantly evolving. We keep learning about health and safety and discover new connections between different diseases, actions, and consequences. As a result, the healthcare system needs to be regularly improved to stay up to date with the latest discoveries and standards. 

One of the ways in which this is done is through the regulations of the healthcare system. In the United States, these regulations are voted by the government and are often cause for a lot of public debate. 

Below, we’ve created a list of the five most important regulations in the United States healthcare system which have meant the most for the general health standards.

1. Healthcare Quality Improvement Act of 1986 (HCQIA)

The Healthcare Quality Improvement Act (HCQIA) was designed to protect medical professionals from lawsuits that could arise due to peer reviews. This act provides immunity for medical institutions and professionals during these assessments. This way, the healthcare system can be improved much more efficiently, as scientists have no reason to be afraid when they point out flaws in their colleagues’ work.

2. Medicare

Medicare is another very important health regulation in the United States, as it provides medical insurance for more than 50 million American citizens. This program was first established by President Truman in 1945 and then updated by President John F. Kennedy. Today, Medicare provides medical coverage for senior citizens in the United States. According to the Congressional Budget Office, there are no risks that the Medicare funding will be cut any time soon.

3. Medicaid

When it comes to public medical insurance, Medicaid is one of the most important regulations. It was established in 1975 by President Johnson who asked the healthcare system to provide free medical insurance for American low-income citizens. Today, more than 70 million low-income Americans enjoy full coverage thanks to this act. The success of this regulation can be seen in the fact that, in 2014, 50% of all medical expenses in hospitals were reimbursed by the government.

4. Children’s Health Insurance Program (CHIP)

When it comes to the health and well-being of children, the Children’s Health Insurance Program (CHIP) is the most important regulation in the United States. It governs the provision of full health coverage for children coming from low-income households. Thanks to this program, millions of children from low-income families enjoy professional medical care, many of which were disqualified by the health system before this regulation was established.

5. Hospital Readmissions Reduction Program (HRRP)

The Hospital Readmissions Reduction Program was created to encourage hospitals to be more efficient and provide better healthcare to citizens. However, its results are questionable. Namely, this regulation requires centers for Medicaid and Medicare to reduce their readmissions, unless they want their reimbursements to be decreased. According to HRRP, readmissions are defined as repeated visits by patients during a one-month period. However, this rule does not apply to certain chronic diseases, such as pneumonia and some heart conditions.