Financial Management Criticisms of Medical Essay

Excerpt from Essay :

To demonize the concept of universal healthcare with the word 'rationing' "buys into the myth that we don't have rationing of medical services now. But we do. It takes many different forms. It is commonplace for health insurance companies and HMOs to deny patients beneficial treatment. They find a variety of excuses for doing so, and may not openly admit it, but we all know that it happens. Medicare rations drugs by requiring co-payments that many patients can't afford. Emergency rooms ration care by making people wait so long in line that some just give up and go away" (Singer 2011).

Question 3

The recent decimation of many retirement funds means that more and more members of the elderly are eligible for both Medicare and Medicaid. The elderly on fixed incomes often struggle to afford medications not currently covered within the provisions of Medicare because of the "doughnut hole" in prescription drug coverage in the Medicare Prescription Drug, Improvement and Modernization Act of 2003. The most logical solution is one which is currently experiencing tremendous political resistance, however, namely to add new individuals to the insurance who are not chronically ill or elderly. One of the advantages of national healthcare, or at very least a healthcare system where everyone is required to have some type of insurance is that the 'risk pool' is much larger. "Adding young healthy Americans to the insurance rolls means a: society doesn't pick up the exorbitant tab when they get injured and end up at the emergency room and b: Because the under 26 crowd tends not to get sick, adding them to the insurance pools helps bring the very balance that was intended by the new law. The more healthy people available to pay for those in the pool who are ill (translation -- the older people), the better the system works and the lower our premium charges should go. The individual mandate [in the 2011 healthcare legislation] that requires everyone to get insurance would obviously have the same effect, on an even larger scale" (Leonard 2011).

Additional Discussion Question

The advantage of having different professional disciplines of care is that various specialties can offer different skills and paradigms to provide more comprehensive care to patients. Nurses adopt a more holistic social approach that places patient's social and emotional needs in the context of the patient's physical state of wellness which can inform doctor's more technical perspective. The shorter educational demands in terms of years for nurses and the different types of nurses also allows for more people within the field to provide care, which is particularly relevant given the shortage of healthcare professionals.

Perhaps the most obvious inequity is not in regards to education but in regards to access to care. Patients in rural areas frequently lack access to medical professionals of any kind. Additionally, there is a critical shortage of nurses and general practitioners nationwide, because of the higher fees that can be commanded by specialists. However, this would suggest that offering financial incentives (such as government scholarships and loan forgiveness) to general practitioners and doctors who practice in rural areas (after they have practiced for a certain length of time) to address this inequity might be superior to 'blending' the educations of doctors, nurses, and other health providers.

References

Kane, Robert, Rosalie Kane, Neva Kaye, Robert Mollica, Trish Riley, Paul Saucier, Kimberly

Irvin Snow & Louise Starr. (1996). Managed care.

Retrieved August 12, 2011 at http://aspe.hhs.gov/Progsys/Forum/basics.htm

Leonard. Sean. (2011). How to fix Medicare. Salon. Retrieved August 12, 2011 at http://www.salon.com/technology/how_the_world_works/2011/05/25/the_long_march_to_healthcare_reform/index.html

Singer, Peter. (2011). Issue clash: Health care reform. PBS. Retrieved August 12, 2011 at http://www.pbs.org/now/shows/health-care-reform/issue-clash.html

Sources Used in Document:

References

Kane, Robert, Rosalie Kane, Neva Kaye, Robert Mollica, Trish Riley, Paul Saucier, Kimberly

Irvin Snow & Louise Starr. (1996). Managed care.

Retrieved August 12, 2011 at http://aspe.hhs.gov/Progsys/Forum/basics.htm

Leonard. Sean. (2011). How to fix Medicare. Salon. Retrieved August 12, 2011 at http://www.salon.com/technology/how_the_world_works/2011/05/25/the_long_march_to_healthcare_reform/index.html

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