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sleeping under a rock the issue of health care in the United States has been on the minds of everyone. In a society where health costs have spiraled, employer sponsored health insurance is rapidly disappearing, and millions are going untreated the overall issue of health care has everyone concerned (Richmond, 2005). Virtually no one is untouched by its reaches.
Over the last several decades the federal government has become increasingly more active in the health care field and now it is being proposed that this involvement may become more extensive as federally funded health insurance is being proposed. This involvement by the national government began during the New Deal when Social Security was originally enacted and has increased gradually ever since (James G. Haughton, 1968). Some of this involvement is obvious such as Medicare and Medicaid but other forms of involvement are less obvious such as research funding and regulatory control (The Economist, 2010). Against this background the future of health care must be afforded broad consideration.
There are a variety of important things that must be considered relative to what the future might hold for health care. First, as has already been mentioned, the cost of health care has spiraled and some believe that these costs are out of control. The second thing that must be considered is that the United States population is an aging one (Chan, 2010). As a result, the demand for health care will increase as well. Any planning for the future must address both of these issues.
Planning for the future in any endeavor is difficult. There are always surprises and technological improvements tend to alter the accuracy of most planning but to move forward without a plan would be disastrous. Be aware, however, that if one asks fifty health care experts what to expect in the future you are likely to get fifty different approaches. This is the nature of future planning. For example, in the 1950s, infectious disease was the primary concern of the medical research community. Today, most infectious diseases in the United States have either been eradicated or placed under strict control. No one predicating the future of health care in the 1930s would have imagined how successful the medical profession would be relative to infectious disease. Similarly, cancer is the big health issue today and a majority of the dollars spent on health care research is dedicated toward treating and, hopefully, finding a cure. With any luck, the health care community will enjoy the same success in cancer care and treatment that the 1950s community did relative infectious diseases but this illustration demonstrates why health care planning is so difficult. Finding a cure for cancer would transform the landscape considerably but any planning must be done with the assumption that such cure will not be found.
One of the fast developing changes in health care has been how this care has been delivered. Historically, hospitals were the primary location for most treatments. If one needed surgery, x-rays, medication monitoring, etc. The only place to receive such treatments was in a hospital. Limiting such treatments to a hospital setting, however, became cost prohibitive and over the last two decades of the twentieth century and the first two decades of the twentieth-first century more and more services have been relegated to clinics, surgery centers, and home care. This transformation has reduced the costs of health care and made the need for treatment far less burdensome for the patients. This transformation has been extensive over the past fifty years but with technical advancements and continuing rising costs it can only be expected to continue.
The importance of the aging of the United States population cannot be emphasized enough. The baby boom generation born in the years following the end of the Second World War is reaching the minimum age for Social Security. The pressure that this development has on the United States' health care system, in general, and on the Social Security system, specifically, is almost disabling. In calendar year 2008 when the first wave of baby boomer persons reached 65 there were five working age individuals (persons between 18 to 64) for every recipient of Social Security benefits. By the year 2030 when most baby boomers will have retired, this ratio will be reduced to three workers for every recipient (Baranoff, 2009). This figure alone reflects how pressure will be increased on our health care system but when the other costs associated with an aging population are added in it is easy to understand the full extent of the problem. Experts associated with health care estimate that the spending on age related costs will increase from its present level of 7% of the gross domestic product to more than 15% of the nation's output by 2050.
How these costs will be absorbed by society is highly debated. Everyone wants to take care of the aging population but no one wants to be responsible for paying for it. Fewer workers mean less income tax revenue and the money must come from somewhere and, as governments have limited methods for raising revenue the likelihood is that a rise in taxing levels is on the horizon unless some other method is devised to generate governmental income.
Aging is not the only demographic figure that is affecting health care in America. The United States remains an attractive destination for immigrants seeking a new life. Whether through legal or illegal means, immigration remains at high levels and the population of the United States continues to grow at high levels. The United States population reached 300 million in late 2006 and is predicted to reach 400 million by 2050 (Congressional Budget Office, 2006). These figures will also impact health care as the demand is increased with many of these immigrants not being able to afford either health insurance or the cost of even basic health care.
An aspect of health care that is not often considered is the need for an educated workforce to administer the care. The technological advancements in the health care field have been exponential but the corresponding number of individuals proficient in the use of these advancements has not kept pace. The reasons for this discrepancy are varied. Among the reasons is the difficulty of attracting qualified candidates to the field of health care. The hours, working conditions, job pressures, and tough academic requirements make choosing a health care career a difficult one and the nation's colleges and universities have been the battle. Workforce shortages in health care exist today and are expected to increase as the demand for such services increases.
Another reason that workforce shortages exist is that government funded educational support has demonstrated a continued decline while correspondingly the cost of obtaining an education has increased (Callan, 2007). Political pressures and a struggling national economy have converted to mean less tax revenue and educational funding has been caught in the breach. It is no one's fault but it is a reality that must be addressed.
Remember how it was pointed out earlier how difficult predicting the future is? Well, there is no place where this is more obvious than in the area of medical research advances and technological improvements. Hot in the health care debates is the ethics of stem cell research. The present trend is toward expanding not only research into stem cell use and value but also toward its actual use in actual practice. The initial success in stem cell usage is phenomenal and how it will impact on health care will be interesting to observe. Stem cell technology has the promise of lowering health care costs in the future but the cost of development is considerable. Determining a balance between the cost and benefit is a serious policy consideration
Medical technology improvements and pharmaceutical breakthroughs occur daily. Such developments are expensive and the nature of business is such that these costs are passed on to the consumer. As a result, the use of these technologies and wonder drugs is expensive. In the days of near universal employer supplied health insurance, these increased costs went virtually unnoticed but now that more and more of the general public is expected to bear these costs they are being felt. Pressure is being brought upon the medical technology and pharmaceutical industry to attempt to keep their costs down but the reality is that they deserve to make a profit for their efforts. Like stem cell use and research, a balance is needed in order for the benefits to be realized by society while minimizing the costs as much as possible.
There is another segment of health care that is likely to increase the cost of health care in the near future but will ultimately lead to lower costs and increased levels of efficiency. Computers have changed nearly every aspect of life and they have nearly single-handily created a new industry in the form of information technology. In the health care field this means that the accumulation and storage of…[continue]
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