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The administration and operating costs should be reduced to 20% of the premium earned. The 80% of the expenses should be spent on providing healthcare services to the holders of health insurance. The law further states that in case the insurance organizations fail to follow they are required to rebate the insurance premium to consumers. The unreasonable premium increase will not allow the companies to mint profits. They will be required to rebate $4 million in State of Kansas alone. The amount is $91 per family in the state having an insurance cover (HHS, 2013). The legal implications for not spending on health have enabled the insurance services providers to facilitate their consumers.
New Care Act support preventing illness:
The individuals of Kansas State are now enabled through the Act to seek insurance cover even after having pre-conditions for their health. The coverage plan for individuals with pre-conditions has enabled…
HHS.U.S. Department of Health & Human Services, (2013). How the health care law is making a difference for the people of kansas. Retrieved from website: http://www.hhs.gov/healthcare/facts/bystate/ks.html
Jacobs, L.R., & Skocpol, T. (2012). Health care reform and American politics: What everyone needs to know. USA: Oxford University Press.
Kingsdale, J., & Bertko, J. (2010). Insurance exchanges under health reform: six design issues for the states. Health Affairs, 29(6), 1158-1163.
Parks, D. (2012). Health Care Reform Simplified: What Professionals in Medicine, Government, Insurance, and Business Need to Know. USA: Apress.
Affordable Health Care Act
Impact of the affordable health care act
The affordable health care act, commonly referred to as Obamacare, brought a set of health care reforms aimed at making health consumers to be responsible for their health care. The act brought into law the patient's bill of rights, which gives Americans stability and flexibility in making informed health choices and decisions. Enacted by President Obama in 2010 as the Affordable Care Act, it aims in ensuring the insurance reforms in the country are comprehensive. This is achieved through providing discounts for seniors, protecting consumers against health care fraud, providing free preventive care, ensuring small businesses get tax credits, providing cover for pre-existing conditions, providing consumer assistance, and health insurance in the marketplace
The affordable care act also has other benefits for special groups such as women and youth. Women benefit from enjoying insurance options that provide them with…
Too many Americans are suffering unnecessarily at the hands of insurance companies that are simply out to make a profit. The healthcare system has been broken here in the United States for way too long. I think it was incredibly brave to stick up for the average Americans against big healthcare companies with millions of dollars to fight back. It is about time that someone in government recognize the problem for as bad as it is and actually take action to stop it, even if that meant loosing some support from your constituents. Americans need acceptable healthcare, and providing that necessary care is worth the small tax increases.
Still, in order to make sure that the legislation passes smoothly and is implemented properly, you must work on some sort of compromise to appease the epublican opposition. Without more support, some other politician may simply tear the Act apart the second…
Klein, Ezra. (2012). Unpopular mandate. The New Yorker. Web. http://www.newyorker.com/reporting/2012/06/25/120625fa_fact_klein
Health Care eform:
One of the major topics that have had a long history in the United States is health care reforms, which has been characterized by huge debates. Following decades of failed attempts by various Democratic presidents, a new law was enacted by President Obama to overhaul the country's health care system. The enactment of this legislation came after a year of harsh partisan combat with the purpose of ensuring access to health care insurance for millions of Americans. In addition to being the most controversial topic, health care reform law was the largest single legislative accomplishment of President Obama. Notably, this legislation will cost America's government approximately $940 billion over the next decade based on an analysis by the Congressional Budget Office. The office has also estimated that the law will lessen federal deficit by about $138 billion during the same period and a further reduction of the…
Cannon, M.F. (2010, March 1). The Best and Worst Health Care Reform Ideas. Retrieved December 15, 2011, from http://dailycaller.com/2010/03/01/the-best-and-worst-health-care-reform-ideas/
Cohn, J. (2011, January 20). About that Whole "Replace" Thing & #8230; Retrieved December 15,
2011, from http://www.tnr.com/blog/jonathan-cohn/81821/about-whole-replace-thing
"Health Care Reform.." (2011, November 15). The New York Times. Retrieved December 15,
Drug costs have gone from 26% of health care spending by private insurance companies in 1990 to 44% in 2006 (Kaiser Foundation, 2008). This issue has not been adequately addressed by health care reform. Instead, a deal appears to be made for $80 billion in concessions from the pharmaceutical industry in exchange for its support of health care reform (Kirkpatrick, 2009).
The underlying trend in each of these major issues in health care reform is controlling the rising cost. Malpractice reform seeks to control the cost of insurance to health care providers, so that they can pass those savings along to consumers. The public option provides a plan for affordable health care coverage for uninsured and underinsured Americans. This is deemed necessary because private insurers will not offer insurance to those it feels will demand too much in terms of health care costs going forward. Reducing the cost of health…
Carey, Nick. (2009). Uninsured Americans hope reform brings health coverage. Reuters. Retrieved October 7, 2009 from http://www.reuters.com/article/topNews/idUSTRE58F0NO20090916
The White House. (2009). The Obama Plan: Stability and Security for All Americans. Retrieved October 7, 2009 from http://www.whitehouse.gov/assets/documents/obama_plan_card.PDF
New York Times. (2009). Malpractice and Health Care Reform. New York Times. Retrieved October 7, 2009 from http://www.nytimes.com/2009/06/17/opinion/17wed2.html
Kaiser Family Foundation. (2008). Prescription Drug Trends. Kaiser Family Foundation. Retrieved October 7, 2009 fromhttp://www.kff.org/rxdrugs/upload/3057_07.pdf
Affordable Health Insurance
The Need for State Participation in Health Care Insurance Exchanges to Provide for Affordable Health Care for Millions of Americans in Need
In the United States, we have basic rights to life and liberty. Yet, many major health care companies are infringing on those rights because they are exploiting health care insurance rates, which has left millions of Americans either underinsured or not insured all together. This puts their lives directly at risk with limited access to essential care. In order to best provide for their uninsured or underinsured citizens, states need to work with the regulations of the Affordable Care Act and open up exchanges to provide for affordable health insurance to the millions of Americans who are currently in need under the ineffective system that is operating today.
In the current situation, there is a lack of affordable health insurance options.
Moreover, health insurance companies…
Health Care for America Now. (2009). Health Insurance Company Abuses: How the Relentless Drive for Profit Endangers Americans. Web. Retrieved November 26, 2012 from http://hcfan.3cdn.net/48b73f19dac6bc9fa7_vzm6iijoh.pdf
Paddock, Catherine. (2007). 47 million Americans without health insurance, census report. Medical News Today. Web. Retrieved November 26, 2012 from http://www.medicalnewstoday.com/articles/80897.php
State of California. (2012). Stakeholders. California Benefit Exchange. Web. Retrieved November 26, 2012 from http://www.healthexchange.ca.gov/StakeHolders/Pages/Default.aspx
The White House. (2012). Affordable Care Act: The New Health Care Law at Two Years. Care Act. Web. Retrieved November 26, 2012 from http://www.whitehouse.gov/sites/default/files/uploads/careact.pdf
Unless the physicians can succinctly argue their case for care and services, the managed care entity will, for reasons of medical necessity, deny access to care and services.
What Cost-Added atio Based on Illegal Immigrant Population?
The argument by opponents that loopholes exist that would allow illegal immigrants to access Obama's proposed legislation on healthcare services is rendered moot in lieu of the fact that those illegal immigrants are currently receiving healthcare services Medicaid and through Immigration and Naturalization Services (INS). The Federal eimbursement of Emergency Health Services Furnished to Undocumented Aliens states:
"Section 1011 of the (Medicare Prescription Drug, Improvement, and Modernization Act (MMA) (P.L. 108-173)) MMA appropriated $250 million dollars in FY 2005 through 2008 for payments to eligible providers for emergency health services provided to undocumented aliens and other non-specified citizens who are not eligible for Medicaid (Centers for Medicare and Medicaid Services, 2009, found online, p.…
Birenbaum, A. (1997). Managed Care: Made in America, Praeger Publishers, Westport,
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care, Praeger Publishers, Westport, CT.
Centers for Disease Control and Prevention (2009). Uninsured Americans: Newly
In addition, Senator Collins led the fight to restore critical f funding to Medicare for home health care so that elderly citizens and disabled can receive needed care in their own homes ("Biography")."
Obviously the senator encourages the funding of both Medicaid and Medicare as she has fought to ensure that both are funded correctly. Collins was also a supporter of the stimulus package that improves healthcare information technology.
As it pertains to abortions Susan Collins is also pro-choice and believes in stem cell research. She is adamant about the right of a woman to choose just as Senator Kennedy. She also voted no on prohibiting HHS grants to organization who perform abortions. She has also been a proponent of expanding stem cell research.
In both the present and the past Collins has worked to ensure that healthcare coverage is affordable. From the bill that she coauthored with Senator Kennedy…
Biography. Official Website of Senator Susan Collins. Retrieved June 20, 2009 from; http://collins.senate.gov/public/continue.cfm?FuseAction=AboutSenatorCollins.Biography&CFID=1388899&CFTOKEN=51070689
Fritze, J. Moderates in Congress feel health care push. Retrieved June 20, 2009 from; http://abcnews.go.com/Politics/story?id=7789528&page=1
Funding for Biomedical Research at Maine Medical Center. Retrieved June 20, 2009 from; http://senatorcollins.blogspot.com/2009/06/funding-for-biomedial-research-at-maine.html
Healthcare. Official Website of Edward Kennedy. Retrieved June 20, 2009 from; http://kennedy.senate.gov/issues_and_agenda/issue.cfm?id=dad5db98-20db-4e85-9b73-7a16c4eac15f
Healthcare Organization Case Study
Health Care Organization Case Study
Health Care Organization Case Study
Banner Healthcare represents a set of diverse healthcare related facilities that provide healthcare services to societies in USA and beyond. Banner seeks to establish a healthier life for communities through developing a healthy environment. Banner Healthcare is arguably the largest healthcare provider in the country. The organization spans seven states, including Arizona, California, Colorado, Nevada, Alaska, Nebraska and Wyoming. The organization operates 20 hospitals, including healthcare facilities. The organization offers such services as hospice care, home care and physician services. Banner Healthcare also provided $130 million as their contribution to charity. The organization is a healthcare leader in all the communities it offers its services. The agency has shown tremendous growth in the past years. They admit over 190 000 patients every year and have a workforce in excess of 29-000. The emergency departments…
Banner Health, (2008). Here Now: Making a Difference. Retrieved from http://www.bannerhealth.com/_communityupdate/Banner_Health_Community_Update.pdf on 18 May 2016
Harrington, C. & Estes, C. (2008). Health Policy: Crisis & Reform in the U.S. Health Care Delivery System, 5th Ed. Jones & Bartlett Publishers
Wolf, J., Hanson, H. & Moir, M. (Eds.) (2011). Organization Development in Health Care: High Impact Practices for a Complex and Changing Environment. IAP
educed costs for medical education would be the second to last alternative that would be likely to be effective. First, reducing the costs of medical eduction, through tax incentives and tuition caps, may make the medical field more attractive to some students; however, even with these in place, the costs would still be so significant that many potential future doctors would be still turned off from the profession. In contrast, free medical education would likely be very effective in recruiting students to pursue the medical profession. This would likely be especially attractive to good students who weren't good enough to receive significant scholarship money to help offset their education. However, this would be the most expensive alternative to implement for the United States. This cost could be offset by the service these doctors give, in exchange, for government-run medical facilities, but the infrastructure alone to this type of innovative plan…
Fox, R. & Abrahamson, K. (Oct-Dec 2009). "A critical examination of the U.S. nursing shortage: Contributing factors, public policy implications." Nursing Forum, 44(4). p. 235-244.
Ganley, B. & Sheets, I. (Jul 2009). "Educational innovations: A strategy to address the nursing faculty shortage." Journal of Nursing Education, 48(7). p. 401-405.
Medical student debt. (2011). Retrieved January 9, 2011, from http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy/medical-student-debt.shtml .
The Patient Protection and Affordable Care Act. (No date). Retrieved January 9, 2011, from http://dpc.senate.gov/healthreformbill/healthbill04.pdf .
American Health Care
After leading the world in the health of its citizens throughout most of the 20th century, the United States has fallen behind virtually all other wealthy nations in that regard, not to mention having fallen behind several nations that once relied substantially on U.S. aid (Dykman, 2008). While most of the developed world has already embraced the concept of universal government-funded national health care systems, the U.S. still relies on a for-profit model that has proven to be incapable of meeting the health care needs of society in any manner that is efficient, cost-effective, and equally available to all members of society. Even worse, the ongoing political influence of lobbyists for the for-profit health insurance industry continues to succeed in undermining meaningful health care reform (Kennedy, 2006), including by watering down the historic Affordable Care Act that eventually passed into law in 2009. Finally, the available evidence…
Dykman J. (2008). "Five truths about health care in America." Time, 172(22): 42-51.
Kennedy E. (2006). America: Back on Track. New York: Viking.
Reid T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin.
Tumulty K., Pickert K., and Park A. (2010). "America, the doctor will see you now."
The topic of this research is "PPACA- Patient Protection an Affordable Care Act." PPACA has created a great impact in the healthcare industry of United States of America. The study is based on the critical analysis of the act by reviewing the performance since its inception.
Arguably the most prominent recent healthcare reform has been PPACA (Patient Protection and Affordable Care Act). PPACA is also known as the Affordable care act and Obamacare. It was signed by the President Obama in the year 2010 in collaboration with the Healthcare econciliation Act. This act is considered to be one of the most major reforms passed in the healthcare system of United States; the last such major reform was passed in the year 1965 in the form of Medicaid.
When this provision Act was passed in 2010, there were 50 million…
Barr, Donald A. Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America. JHU Press. 2011
Blendon RJ, Benson."Public opinion at the time of the vote on health care reform." N. Engl. J. Med. 362 (16): e55. 2010
Elmendorf, Douglas. "CBO's Analysis of the Major Health Care Legislation Enacted in March 2010." Congressional Budget Office. 2011
Feldman, Arthur M. Understanding Health Care Reform: Bridging the Gap between Myth and Reality. CRC Press. 2011
Health and Legislative Issues
All Americans have the desire of having a healthcare system which is capable of delivering world-class security together with financial security. The system in place should always be accessible and one that impacts the economy positively. Successful healthcare reforms will lead to a maximization of the choices available for consumers put a restrain to the ever increasing medical care costs and make healthcare accessible to more and more Americans. There are a number of organizations that have consistently urged the president and congress on building on the existing systems which strengths in order to achieve health reform solutions that are workable in a bipartisan manner. However, there are some healthcare legislative issues that come up and have effects on various stakeholders such as legislators, consumers and other healthcare professionals. This paper will look at one of the current health legislative issues, who is affected most by…
Mears, B.(2012). Health care's big four issues: What the justices are tackling. Retrieved March 12, 2014 from http://www.cnn.com/2012/06/17/politics/health-care-issues/
ANA.(2010). Nursing Beyond Borders: Access to Health Care for Documented and Undocumented Immigrants Living in the U.S. Retrieved March 12, 2014 from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/Access-to-care-for-immigrants.pdf
Goodman, J., (2012). The Impact of the Patient Protection and Affordable Care Act on Job Creators and the Economy. Retrieved March 12, 2014 from http://www.independent.org/issues/article.asp?id=3385
American College of Emergency Physicians, (2013). The Ethics of Health Care Reform: Issues in Emergency - Medicine - An Information Paper. Retrieved March 12, 2014 from http://www.acep.org/Content.aspx?id=80871
Healthcare Data Compare Healthcare Grade of Maryland to Florida
Healthcare grades: The Commonwealth Fund
The Commonwealth Fund grades all states on access to healthcare, avoidable hospital use and costs, healthy lives, and prevention and treatment. For example, Pennsylvania ranks 12 on access: nearly
percent of nonelderly adult patients are insured and 92% of children. Florida has around 74% and Maryland around 83% of adults insured and 82 and 91% of children, approximately. In Pennsylvania, 86% of at-risk adults have had a checkup within two years versus 87 and 88% in Florida and Maryland respectively; 90% of patients in PA have not had to forego seeing a physician within the last two years because of cost versus 84% in Florida and 89% in Maryland (approximately). The low rates of insurance coverage in Florida reflect higher unemployment and poverty rates, combined with a higher percentage of workers who labor part-time and do…
State scorecard. (2011). Maps and Data. Retrieved September 26, 2011 at http://www.commonwealthfund.org/Maps-and-Data/State-Data-Center/State-Scorecard.aspx
All figures are rounded up or down, based upon the available data
Health Care -- PHI
A Primary Health Care Initiative (PHI) is a fundamental, affordable health care mode clearly illustrated the Declaration of Alma-Ata. Michelle Obama's "Let's Move!" adheres to the PHI format and uses the Health Belief Model as its guide. Unfortunately, several problems with both the Model and the initiative hamper its success. Several measures can be taken to significantly enhance the initiative's impact.
Identify PHI (20%)
A PHI is a fundamental and affordable mode of health care that is grounded in realistic, well-established and culturally agreeable science and practices, and is made accessible to all members of a community (HO, 1978, pp. 2-3). It relies on continuous financial and ideological support from the immediate and larger communities, as well as the wholehearted participation of community members, who are deemed partners in their own health care (HO, 1978, pp. 2-3). Though the initiative works with individuals in their local…
Clarke, V.A., Lovegrove, H., Williams, A., & Machperson, M. (2000). Unrealistic optimism and the health belief model. Journal of Behavioral Medicine, 23(4), 367-376.
Keating Simons, K. (2010, December 13). Let's Move: Looking at the flaws of a childhood obesity intervention. Retrieved November 8, 2013 from http://challengingdogma-fall2010.blogspot.com Web site:
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in…
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.
3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
Healthcare Financial Management
To quote Jonathan Clark at the beginning of his article, "Improving the revenue cycle can be a daunting task due to the scope and complexity of the interdepartmental process." Of the suggestions offered by the authors, which concept(s) give you the greatest insight into creating an improved evenue Cycle process in the organization where you work (or one in which you are familiar)? Be sure to identify which article or author you are referencing.
In his comprehensive advisory article to improve the medical industry's revenue capturing capabilities, entitled Strengthening the evenue Cycle: A 4-Step Method for Optimizing Payment, Jonathan Clark provides a series of sensible solutions to the ongoing dilemma of payment optimization. David Hammer also provides guidance to healthcare finance professional in his article The Next Generation of evenue Cycle Management, by reminding them that the key performance indicators (KPIs) which dictated policy in previous years…
Clark, J. (2008). Strengthening the revenue cycle: a 4-step method for optimizing payment. Healthcare Financial Management, 62(10), 44.
Hammer, D.C. (2007). The next generation of revenue cycle management. Healthcare Financial Management, 61(7), 49.
Seddon, J. (2008). Think system. Management Services, 52(2), 10.
Wilson, D.B. et al. (2004). 3 steps to profitable managed care contracts. Healthcare Financial Management, 58(5), 34.
All spending includes state and federal expenditures. Growth figures reflect increases in benefit payments and disproportionate share hospital payments; growth figures do not include administrative costs, accounting adjustments, or costs for the U.S. Territories.
Federal Fiscal Year: Unless otherwise noted, years preceded by "FY" on statehealthfacts.org refer to the Federal Fiscal Year, which runs from October 1 through September 30. for example, FY 2009 refers to the period from October 1, 2008 through September 30, 2009.
Urban Institute estimates based on data from CMS (Form 64) (as of 12/21/11).
From this entire chart, the entire increase in expenditure of…
Clark, Cheryl et al. "State Medicaid Eligibility and Care Delayed Because of Cost." New England Journal of Medicine, 368 (2013): 1263-1265. Print.
Ellwood, Marilyn Rymer et al. An Exploratory Analysis of the Medicaid Expenditures of Substance Exposed Children Under 2 Years of Age in California. U.S. Department of Health and Human Services, 1993. Print.
Goodnough, Abby. "October 25th." The New York Times. 25th October. 2012. Web. 29th March 2013. [ http://www.nytimes.com/2012/10/26/us/spending-on-medicaid-has-slowed-survey-finds.html?_r=0 ].
Grannemann, Thomas W. And Mark V Pauly. Controlling Medicaid Costs: Federalism, Competition, and Choice. Washington DC: American Enterprise Institute, 1983. Print.
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.
Prejudice and ethical/leadership issues with healthcare are nothing new but the fight to keep those standards and ethics on an even keel and prevent racism, bigotry and predudice of any sort including based on class, money, political ideology, nationalism, and so forth should be stomped out and eviscerated whenever it can be. People are people and should treated with dignity and respect regardless of their race, gender, beliefs and so forth. Even convicted murderers and rapists should not be treated disdain due to their actions because doing otherwise lowers the ethics and standards of the healthcare community that can and should still apply at all times.
Callahan, M. (2008). Healthcare providers constricted by financial, legislative, and regulatory issues. The Journal of Medical Practice Management: MPM, 24(3),
Cobaugh, D., Angner, E., Kiefe, C., ay, M., Lacivita, C., Weissman, N., & ... Allison, J.
(2008). Effect of racial differences…
Callahan, M. (2008). Healthcare providers constricted by financial, legislative, and regulatory issues. The Journal of Medical Practice Management: MPM, 24(3),
Cobaugh, D., Angner, E., Kiefe, C., Ray, M., Lacivita, C., Weissman, N., & ... Allison, J.
(2008). Effect of racial differences on ability to afford prescription medications.
The penalties for being out of compliance when OSHA comes knocking should be enough to motivate any healthcare facility to devise a plan to make sure that they are in compliance with OSHA's regulations. The startling thing is that it took an initiative like NEP to wake these facilities up and get them thinking about being compliant. Since they deal with people and their well being on an everyday basis, these are things that they should have been doing all along and not just because there is an increased probability of getting into trouble by OSHA.
Harris, S. (2012). OSHA in Health Care: Out of Sight & Out of Mind? etreived from http://ohsonline.com/articles/2012/04/01/osha-in-health-care.aspx
Healthcare workers. (2012). etrieved from http://www.cdc.gov/niosh/topics/healthcare/
New OSHA inspection initiative focuses on healthcare. (2011). etrieved from http://www.puresafety.com/public/workingwell/?p=1209#.UAa4aFJ6EM
Occupational Safety and Health Administration ("OSHA") Targets Nursing and esidential
Care Facilities. (2012). etrieved from http://www.hancocklaw.com/p/OSHA_Newsletter_212_May_H1768037.PDF
Prepare Your Facility…
Harris, S. (2012). OSHA in Health Care: Out of Sight & Out of Mind? Retreived from http://ohsonline.com/articles/2012/04/01/osha-in-health-care.aspx
Healthcare workers. (2012). Retrieved from http://www.cdc.gov/niosh/topics/healthcare/
New OSHA inspection initiative focuses on healthcare. (2011). Retrieved from http://www.puresafety.com/public/workingwell/?p=1209#.UAa4aFJ6REM
Occupational Safety and Health Administration ("OSHA") Targets Nursing and Residential
The idea with this part of the strategy is to be able to form some kind of a partnership with these individuals. This will help to push for a transformation inside the organization. As, these people will help to provide everyone with: a reason for adapting and pushing others to do so (indirectly). (Turner, 1999, pp. 162 -- 163)
Once this occurs, you could then have these individuals become a part of a committee. They will have the responsibility for making specific recommendations about how this can be implemented. This is important, because this will help everyone to realize that some kind of change is occurring inside the facility. Over the course of time, this will lead to shifts in the operating environment by giving people reason for embracing these changes. (Turner, 1999, pp. 162 -- 163)
The Effectiveness of the Plan
To determine the effectiveness of the plan the…
Nationwide Medical Errors Cost $19.5 Billion. (2010). The Society of Actuaries. Retrieved from: http://www.qualitydigest.com/inside/health-care-news/study-nationwide-medical-errors-cost-195-billion-annually.html
Kovnar, A. (2008). Jonas and Kovnar's Health Care Delivery in the United States. New York, NY: Springer Publishing.
Turner, S. (1999). Essential Readings in Managed Nursing Care. Gaithersburg, MD: Aspen Publishing.
The reason why, is because this is a sign that the quality of care that is being provided in declining. What normally happens is staff members, will often become frustrated with: health care environments that are inefficient and where management has an attitude of indifference. This is problematic, because it can spread through the organization like cancer by: eating away at the fundamentals that made the facility great.
Once this occurs, it will have an impact on: the costs, efficiency and profitability of the hospital. This is the point that this could undermine the reputation of facility and it could have an impact on the brand. When this takes place, it is a sign that many hospitals are falling into a downward spiral of: declining quality of care and increasing costs. At which point, it only becomes a matter of time until: some kind of major restructuring must occur or…
Ableson, R. (2010). Employers Push Costs for Health Care on Workers. New York Times. Retrieved from: http://www.nytimes.com/2010/09/03/business/03insure.html
Palfry, C. (2004). Effective Health Care Management. Malden, MA: Blackwell.
Shortell, S. (2006). Health Care Management. New York, NY: Thomason.
Realistically this compliance and assistance should be sought and used before, during and after negotiations with other health care organizations with which this organization might merge or enter a joint venture. Furthermore, the proposed contract itself should be passed by the FTC's Office of the General Counsel or its designee for approval before final ratification of the contract.
In order to merge and operate in a joint venture acceptable to the FTC, the organization must be mindful of Title 15 of the U.S. Code, specifically Section 7 of the Clayton Act, 15 U.S.C. § 18, Sections 1 and 2 of the Sherman Act, 15 U.S.C. § 1, 2, and Section 5 of the Federal Trade Commission Act. In addition, due to the FTC's recent special interest in the mergers/joint ventures of health care organizations, particularly but not solely in connection with price fixing, the organization should assume that…
Cornell University Law School. (n.d.). Legal Information Institute - 15 U.S.C. Section 1. Retrieved on March 19, 2013 from www.law.cornell.edu Web site: http://www.law.cornell.edu/uscode/text/15 /1' target='_blank' REL='NOFOLLOW'>
Health Care Reimbursement and Billing
Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the United States.
Discussion of Mrs. Zwick's coverage under Medicare Parts A, B and C
Medicare Part A (often called "hospital insurance") (U.S. Department of Health and Human Services, 2011, p. 15) assists in covering inpatient hospitalization and skilled nursing facilities, hospice and home health care (U.S. Department of Health and Human Services, 2011, p. 14). There is usually no monthly premium if you and/or your spouse paid Medicare taxes while employed (U.S. Department of Health and Human Services, 2011,…
Ethical implications of Mrs. Zwick's incurring costs related to her hospital-acquired condition are applicable despite the rehabilitation facility's exemption from POA/HAC Medicare laws. Having no first-hand knowledge of the cause of the urinary tract infection, no clear indication that I work at the rehabilitation facility and neither the privilege nor the duty of diagnosis, it would be unethical for me to tell Mrs. Zwick about my suspicions. Rather, a nurse is required to maintain his/her professional boundaries (American Nurses Association, 2001, p. 6). Simultaneously, a nurse is supposed to assure "responsible disclosure of errors" to patients and act to stop bad practices and promote best practices (American Nurses Association, 2001, p. 6). Consequently, a nurse in my position faces a dilemma: lack of personal knowledge and authority vs. my concern for the patient's well-being and constant improvement of the profession. In the face of this dilemma, I would: contact the rehabilitation facility's newly-hired nurse and advise/remind him/her of the duty to report to the appropriate supervisor and responsible disclosure to Mrs. Zwick; contact Mrs. Zwick's personal physician and explain the entire situation; direct Mrs. Zwick to discuss her health issues with her personal physician, who can review, diagnose and discuss the ramifications of her medical records, including but not limited to the urinary tract infection (American Nurses Association, 2001, p. 7). The desired outcomes would be: the rehabilitation center's absorption of Mrs. Zwick's costs related to her hospital-acquired infection through pressure exerted by its own nursing staff and Mrs. Zwick's personal physician; Mrs. Zwick's awareness of the true cause of her infection by health care providers who are directly responsible and capable.
Explain how the COBRA will allow Mr. Davis to continue his insurance coverage while he is out of work.
Due to Mr. Davis' termination from an employer of more than 20 employees, he can obtain coverage for himself, his spouse and his dependent children for up to 18 months (U.S. Department of Labor, 2012). In addition, due to his chronic cycle cell anemia, he may be entitled to an additional 11 months' extension for disability (U.S. Department of Labor, 2012). His employer is required to give a qualifying event notice to COBRA; then, COBRA sends a notice of the right to elect to continue coverage and an explanation of the steps that must be taken to continue coverage; Mr. Davis, his spouse and either or both of them in behalf of dependent children may elect for continuation of coverage
Health Care Reform Federal Deficit
The American Health Care Crisis and the Federal Deficit
The United States spends more than any other country on medical care. In 2006, U.S. health care spending was $2.1 trillion, or 16% of our gross domestic product. At the same time, more than 45 million Americans lack health insurance and our health outcomes (life expectancy, infant mortality, and mortality amenable to health care) are mediocre compared with other rich democracies. We spend too much for what we get.
Nothing is new about these sobering realities. The Nixon administration first declared a health care cost crisis in 1969. Four decades later, the United States still has not adopted systemwide cost controls because the politics of health care make it extraordinarily difficult to control costs. I explain below why this is so (Marmor, et al., 2009).
The starting point for understanding the politics of cost control is…
1. Eakin, Douglas and Michael Ramlet. (2010) "Health Care Reform is Likely to Widen Budget Deficits -- Not Reduce Them." Health Affairs, 29, no.6:1136-1141. Eakin and Ramlet examine the underpinnings of the Congressional Budget Office's projection that enacting the Patient Protection and Affordable Care Act will decrease deficits, and conclude that it is built on a shaky foundation of omitted costs, premiums shifted from other entitlements, and politically dubious spending cuts and revenue increases. A more comprehensive and realistic projection suggests that the new reform law will raise the deficit by more than $500 billion during the first ten years and by nearly $1.5 trillion in the following decade. This is an excellent article with regards to my article, written by two policy commentators at the forefront of their field. This article shows expertise in medical economics and offers compelling, clear arguments for the increase in the federal deficit due to the massive spending on entitlements as a result of passing the Patient Protection and Affordable Care Act. They project deficits, opposing the Congressional Budget Office, through their insightful analysis.
2. Marmor, Theodore, Jonathan Oberlander, and Joseph White. (2009) "The Obama Administration's Options for Health Care Cost Control: Hope vs. Reality." Ann Intern Med. 150:485-489. Controlling the costs of medical care has long been an elusive goal in U.S. health policy. This article examines the options for health care cost control under the Obama administration. The authors argue that the administration's approach to health reform offers some potential for cost control but also embraces many strategies that are not likely to be successful. Lessons the United States can learn from other countries' experiences in constraining medical care spending are then explored. This article offers evidence for the lack of cost containment in the Obama administrations' plans for health reform. It gives a good analysis of the international scene in health care as well.
3. Collins, Sara, Michelle M. Doty, Karen Davis, Cathy Schoen, Alyssa L. Holmgren, and Alice Ho. (2004) "The Affordability Crisis in Health Care." Commonwealth Fund Biennial Health Insurance Survey. Published in 2004, The Commonwealth Fund Biennial Health Insurance Survey, conducted from September 2003 -- January 2004, presents new and timely information on where the American public stands on solutions to reform the health care system. The survey finds widespread support for federal efforts to extend health insurance to more people, as well as a widely held belief that the financing of health care should continue to be a shared responsibility among individuals, employers, and the government. The survey also uncovered potential reasons for such strong support for health care reform. Among the insured and the uninsured alike, there is concern that health care security in the United States is eroding. People are experiencing reductions in insurance coverage that are threatening their financial security.
4. Etheridge, Lynn (1984) "An Aging Society and the Federal Deficit." The Milbank Memorial Fund Quarterly. Health and Society, 521-543. This article serves as early warning sign of the deficit battles to come. It argues that the conflict between the growing needs of an aging society and a federal budget which cannot afford its current commitments has become one of the nation's most difficult government policy dilemmas. Assistance for the elderly through Social Security, Medicare, and other programs-is already the federal government's largest fiscal responsibility. In 1985 these programs will require nearly half of all domestic program spending an estimated $256 billion. The future costs of these commitments will rise rapidly well into the next century, accounting-with national defense and interest costs-for virtually all of the spending increases in the projected $200 to $300 billion deficits. Etheridge asserts that the decisions about the nation's assistance to the elderly -- and about reaffirmation, reform, and/or retrenchment of these commitments-will thus be central to the coming budget debates.
Healthcare eform PPACA
Determine how this Federal law will affect market-driven and non-market driven decisions.
One of the industries that has felt the effects of the Patient Protection Affordable Care Act most immediately and intensely was the insurance industry in the United States. One of the chief reasons that the Patient Protection Affordable Care Act was introduced and passed into American legislation was the effect of rising health care costs attributed to arbitrary and non-competitive costs exacted from healthcare consumers from the insurance industry. There was a general lack of regulation within the industry, which had been demonstrated to have had a negative impact on healthcare outcomes and trends. The United States, while the largest economy and a dominant world superpower, has an underperforming healthcare industry compared to other developed, industrialized nations.
One of the central conflicts associated with the Patient Protection Affordable Care Act is related to philosophical differences…
Gitlin, Saul. (2002) "Demystifying the Asian-American Market" Retrieved from: http://www.mrcc-online.com/presentations/Asian_American_Market_11-12-02.pdf
Greenfield, Lazar. (2010). "National Health Care Expenditures: Addressing the Cost of Health Care in the United States" Annals of Surgery. 251: 2.
Weiss, Joshua A., Medical Marketing in the United States: A Prescription for Reform. George Washington Law Review, Vol. 79, p. 260, 2010. Available at SSRN: http://ssrn.com/abstract=1748902
Health Care eform:
In March 2010, after protracted public and political debate, the Patient Protection and Affordable Care Act (PPACA) was enacted into law by President Barack Obama. This legislation was one of the many health care reforms initiatives that have sought to rectify major features of the health care system in the United States such as service delivery, care coordination, and financing. Since its enactment, PPACA is considered as a milestone along the historical continuum of health care reform in America. Generally, health care reform in the United States is an issue that has continued to evolve based on the ever-growing health care needs of the population. However, this issue has been characterized with several challenges that are mainly influenced by the public's response to reform efforts.
Principal Features of U.S. Health Care System:
The Patient Protection and Affordable Care Act (PPACA), which is commonly known as the Affordable…
Bodenheimer, T., & Grumbach, K. (2012). Understanding health policy: a clinical approach (6th ed.). New York, NY: McGraw-Hill Medical.
"Key Features of the Affordable Care Act by Year." (n.d.). Features of the Health Law.
Retrieved from U.S. Department of Health & Human Services website: http://www.hhs.gov/healthcare/facts/timeline/timeline-text.html
Leflar, R.B. (2013, July 12). Reform of the United States Health Care System: An Overview.
Health Care Past, Current, And Future
The health of any nation should be a top priority for leaders and elected political representatives, but in the United States it took several centuries for the nation to begin to come to terms with providing health care for its citizens. This paper covers the gradual implementation of health care services and doctor training facilities in the U.S., and also covers the recent attempt by President Barack Obama to reform a chaotic, poor-functional and expensive health care system. Thesis: It is a scandal of massive proportions that a well-functioning, citizen-friendly universal health care system cannot be instituted in America, the world's most democratic superpower. Until the divisive and toxic political climate can be reformed, there is no chance of major reforms -- or for universal health care coverage -- in these United States.
Past Health Care Services -- Early America
Health care in colonial…
Daly, John. (2005). Professional Nursing: Concepts, Issues, and Challenges. New York:
Springer Publishing Company.
Gorsky, Martin. (2010). Good Health for America? History Today, 60(2), 1-6.
McCarthy, Robert L., and Schafermeyer, Kenneth W. (2007). Introduction to Health Care
Polls examining public support of the bill and specifically the public healthcare option vary significantly. ith regard to physicians, the New England Journal of Medicine surveyed over six thousand medical doctors and found there was a majority in favor of federally provided public healthcare insurance (Keyhani & Federman). Other polls have suggested an opposition to the public option (Marmor).
The public option would provide an affordable alternative to the current private health insurance options and would provide impetus for competition and positive change. hether "America's Affordable Health Choices Act of 2009" will be passed is currently uncertain. hat is certain is that the healthcare and health insurance system is currently not sufficient to provide healthcare support for nearly 48 million uninsured Americans. Alterations need to be made to increase access and affordability for those individuals who desire health insurance.
The healthcare and health insurance system in the United States…
Harrington, Charlene, Carroll L. Estes, and Cassandra Crawford. Health policy. Jones & Bartlett Publishers, 2004.
Keyhani, Salomeh, and Alex Federman. "Doctors on Coverage -- Physicians' Views on a New Public Insurance Option and Medicare Expansion." N. Engl J. Med 361.14 (2009): e24.
Kotlikoff, Laurence J. The healthcare fix. MIT Press, 2007.
Marmor, T. "The Obama Administration's Options for Health Care Cost Control: Hope vs. Reality." 7 Apr 2009. 1 Nov 2009 .
Health Care Blog:
"Alycia-Care: Peace of Mind…a Sick Child on't Be Denied Health Coverage"
hen Alycia Steinberg found out that her baby girl had cancer, of course as a mother Alycia was very upset and worried for the health and for the life of her daughter Avey. The kind of cancer that little Avey had was also a very serious kind of cancer, leukemia, and so Alycia and her husband worried about two main problems. One, a child that was only two years old, and two, would the insurance company that the family has cover a pre-existing condition?
But because the Obama Administration managed to get the Affordable Care Act through Congress in 2010 -- and now the United States Supreme Court has ruled that the Affordable Care Act is constitutional -- Alycia and her husband can feel safe as far as their daughter's health is concerned because their insurance…
Salcido, Dori. (2012). Alycia-Care: Peace of Mind in Knowing a Sick Child Won't Be Denied
Health Coverage. Healthcare.gov. Retrieved July 7, 2012, from http://www.healthcare.gov .
Technology is one of the main drivers of change in healthcare, and it is up to healthcare organizations to join the rest of the world in adopting new technologies to run their industry better. In most industries, something like electronic record keeping has been done for decades and nobody was wringing their hands about it. It is absurd that this is even an issue for healthcare companies. The best thing is to stop talking about this as if it is an "issue" or a "challenge," and just get it done. If you were to design the health care system from scratch, of course everything would be electronic. The development and adoption of these technologies will improve the quality of healthcare immensely, so the only real question is not how will this challenge affect healthcare, but how quickly can healthcare get its act together and join the 21st century.…
Kumbroch, D. (2014). Affordable Care Act creates big demand locally for healthcare workers. WHNT. Retrieved November 17, 2014 from http://whnt.com/2014/09/17/aca-creates-big-demand-for-healthcare-workers/
Wister, A. (2009). The aging of the baby boomer generation: Catastrophe or catalyst for improvement? Health Innovation Forum. Retrieved November 17, 2014 from http://www.healthinnovationforum.org/article/the-aging-of-the-baby-boomer-generation-catastrophe-or-catalyst/
The SG2 report (2010, p. 9) also mentions academic medical centers (AMCs), which will have enter into affiliation agreements in order to comply with the reformed care laws. This will furthermore mean more integrated physician networks and it integration, as mentioned above.
Two further important factors are mentioned by Moyers (2010). She notes that the inclusive nature of health care definitions for occupational therapists is a significant step forward in terms of recognizing the profession as a legitimate health care service. Occupational therapy, for example, is specifically included in the "Innovations in the Health Care Workforce" section of the new legislation. This is significant, because occupational therapists will now be eligible for state workforce grants, slots on the national commission on workforce, and other similar privileges enjoyed by other health care providers.
Other items, excluded from the bill, is the second item the author mentions. She notes that one of…
Davis, P.A., Hahn, J., Morgan, P.C., Stone, J., and Tilson, S. (2010, Apr. 23). Medicare Provisions in the Patient Protection. Retrieved from: http://www.nasuad.org/documentation/aca/CRS%20Reports/April%2023%20-%20Medicare.pdf
Moyers, P. (2010, Mar. 25). What Health Care Reform Means to Occupational Therapy.
Retrieved from: http://otconnections.aota.org/blogs/moyers/archive/2010/03/25/what-healthcare-reform-means-to-occupational-therapy.aspx
Sg2 Special Report: (2010, May). The Impact of Health Reform
The result is that a multilayered system which is inherently designed to maintain and improve our public health standards has instead become almost entirely designed by its profitability. The best opportunity we have for reversing this trend is the applying of pressure that only the federal government can bring to bear. Greater regulation of pricing, coverage and standards of care will shift the focus back to quality health outcomes rather than strict improvement of the bottom line at all costs.
- Is there a solution?
How can (or can't) public policy shape health care in the U.S. hat do you predict for the next year?
Public policy absolutely has the capacity to bring improvement to a highly dysfunctional system. The Affordable Care Act and many of its related sub-initiatives such as the Readmissions Reduction Program are indicative of this opportunity. Indeed, the continuing pressure upon hospitals to focus on producing…
Krueger, a. (2013). As ACA Implementation Continues, Consumer Health Care Cost Growth Has Slowed. Whitehouse.gov.
On the contrary, a comprehensive medical care solution that tackles the main issues driving up health care costs in America is possible. The main problem experienced by the average American is that health insurance premiums are cost prohibitive for the middle-class, but being uninsured can bankrupt a family forced to deal with even a minor catastrophic illness. Therefore, a national health insurance program has to be part of the solution. However, one cannot overlook the role that unpaid medical bills and exorbitant malpractice premiums also play in the modern healthcare crises. As a result, the solution must include a way to reduce malpractice premiums through tort reform, and a way to reduce the percentage of medical bills that go unpaid. The proposed three-prong approach would tackle all of those issues, without forcing any unwilling person to participate in a nationalized healthcare program.
American Tort Reform Association. "Medical Liability…
American Tort Reform Association. "Medical Liability Reform." ATRA Issues. 2007.
American Tort Reform Association. 6 Nov. 2008 http://www.atra.org/show/7338.
Kershaw-Staley, Tracy. "Miami Valley Hospital Files Lawsuit Over Unpaid Medical Bills."
Dayton Business Journal. 2008. Dayton Business Journal. 6 Nov. 2008 http://dayton.bizjournals.com/dayton/stories/2008/01/07/story5.html .
Why access to healthcare has become an issue in the U.S.
According to a 2010 Gallup Poll, Americans named access to services the "top issue" in health care ("Americans Name Healthcare Access Top U.S. Health Issue," 2010). Empirical research also reveals that access is the top problem in the American health care system at the moment, as "tens of millions of adults under age 65 -- both those with insurance and those without -- saw their access to health care worsen dramatically over the past decade," (Galewitz, 2012). The reasons for the problems related to access stem from social justice and cost barriers (Galewitz, 2012). Health care is simply too expensive for most Americans. As a result, many are delaying seeking treatment. The situation is as true for the insured as the uninsured, showing that health care access is a systemic problem (Young, 2012, p. 1). The 2010 Patient…
"Americans Name Healthcare Access Top U.S. Health Issue," (2010). Gallup. Retrieved online: http://www.gallup.com/video/144902/americans-say-healthcare-access-costs-top-health-issues.aspx
Galewitz, P. (2012). Access to health care in U.S. worsens, study finds. St. Louis Post-Dispatch. May 10, 2012. Retrieved online: http://www.stltoday.com/lifestyles/health-med-fit/fitness/access-to-health-care-in-u-s-worsens-study-finds/article_84fad081-8f9e-523a-a24f-0c19403430c0.html
Young, J. (2012). Health care access worsens. Huffington Post. May 7, 2012. Retrieved online: http://www.huffingtonpost.com/2012/05/07/health-care-access-urban-institute_n_1497658.html
(Menzel, 1990, p. 3) Fisher, Berwick, & Davis alude to the idea of integration in health care, with providers linking as well as creating networks of electronic medical records and other cost improvement tactics.
The United States and other nations over the last twenty or so years, have begun a sweeping change in health care delivery, regarding the manner in which health information is input, stored and accessed. Computer use in the medical industry has greatly increased over the last thirty years the culmination of this is fully networked electronic medical record keeping. (Berner, Detmer, & Simborg, 2005, p. 3) the electronic medical record trend began in the largest institutions first, as hospitals and large care organizations attempted to reduce waste and improve patient care, while the adoption has been much slower among physician's practices and smaller medical institutions. (Hillestad, et al., 2005, pp. 1103-1104) Prior to this time medical…
Resources, and Utilization
" (Arnold & Reeves, 2009). ith medical services price at the present time, illness or some kind of complicated to medical services may take people deprived of health insurance years to reimburse for bills that are medical. Furthermore, I believe that individuals who lost their jobs also are uninsured for the reason that their employer gave health insurance is no longer paying for them. I understand that based on the statistic; there are "way too many around 1 million workers that have lost their health reporting in the first three months of 2009. I think that helping people buy health insurance coverage with low-cost with offering the health plans options for the uninsured is the healthcare reform that is really needed now. In this way, individuals that are without health insurance will be able to afford paying their medical insurance to uphold their well-being.
In conclusion, with the increasing rapidly…
Arnold, P.J., & Reeves, T.C. (2009). International Trade and Health Policy: Implications of the GATS for U.S. Healthcare Reform. Journal of Business Ethics, 63(4), 34.
Belcon, M.C., Ahmed, N.U., Younis, M.Z., & Bongyu, M. (40-74.). ANALYSIS of NATIONAL HEALTHCARE SYSTEMS: SEARCHING for a MODEL for DEVELOPING COUNTRIES - TRINIDAD and TOBAGO as a TEST CASE. Public Administration and Management, 14(2), 10-14.
Bolduc, C.R. (2008). The impact of healthcare reform on HMO administrators. Hospital & Health Services Administration, 17(9), 23-45.
Reiboldt, M. (2010). The Industry Responds to the Passing of Healthcare Reform. The Journal of Medical Practice Management, 18(6), 327-328.
WHO rates France as having the best healthcare ("World Health," 2000). In addition to universal healthcare, France also has non-profit supplementary providers, which means that the government subsidizes 70% of regular expenses but pays 100% of more expensive or long-term treatment plans (Sandier, Paris, & Polton, 2004). Money for subsidies comes from mandatory earnings contributions such as 5.25% salary, capital income, and gambling winnings (Sandier, 2004).
An argument that often arises is that people say they don't want the government deciding what medical procedures they can have. However, decisions regarding what procedures are covered by a particular health plan are made by the healthcare insurance companies, which are for-profit ("Insurance Verification," n.d.). Many people are denied treatment regardless of the illness. As already mentioned, some of the other nations with universal healthcare have supplementary plans in addition to the government plans that allow the patient more choice.
There are many…
Carrasquillo, O., Himmelstein, DU.,Woodhandler, S., Bor, DH. (1999). A Reappraisal of Private Employers' Role in Providing Health Insurance. NEJM, 340(1), 109-114.
"Insurance Verification & Eligibility Services." (n.d.). Retrieved from http://www.globaledgeusa.com/insurance_verification_eligibility_services/
Mahon, Mary. (2010, June 23). U.S. ranks last among 7 countries on health system performance. EurkAlert. Retrieved from http://www.eurekalert.org/pub_releases/2010-06/cf-url062210.php
Reid, T.R. (Producer). (2008, April 15). Frontline: Sick around the world [Television broadcast]. New York: Central Broadcasting Service.
People still die because they cannot afford health care, and that simply is not right in the most powerful nation on earth. People should not have to go bankrupt or lose their home because they cannot afford health insurance, and health care should be more affordable for everyone. An Indiana Congress member notes, "Expenditures on health-care lobbying last year rose to $325 million, as health-care providers, insurers, drug makers, medical professionals and others all worked to make sure their interests were served as Congress took up their issues" (Hamilton). Americans need to stop listening to lobbyists and start taking health care reform into their own hands for real health care reform to occur in this country.
Hamilton, Lee. "Who Lobbies for the est of Us?" Indiana University. 2004. 22 Jan. 2008. http://congress.indiana.edu/radio_commentaries/who_lobbies_for_the_rest_of_us.php
Montanaro, Domenico. "Kucinich Details Health-Care Policy." Firstead.MSNBC.com. 2007. 22 Jan. 2008. http://firstread.msnbc.msn.com/archive/2007/10/25/430486.aspx
Hamilton, Lee. "Who Lobbies for the Rest of Us?" Indiana University. 2004. 22 Jan. 2008. http://congress.indiana.edu/radio_commentaries/who_lobbies_for_the_rest_of_us.php
Montanaro, Domenico. "Kucinich Details Health-Care Policy." FirstRead.MSNBC.com. 2007. 22 Jan. 2008. http://firstread.msnbc.msn.com/archive/2007/10/25/430486.aspx
Health Care: The Next Twelve Months
Over the next twelve months, there will be many changes to health care in the United States. The largest and most ambitious goal is to provide the majority of Americans with health insurance (Blendon & Benson, 2010). However, there will be a presidential election and a Supreme Court ruling, which means that 2012 could be the year that determines whether the health care law moves forward or whether it is shut down. It could also go forward in part, after having large pieces of it removed, and it could go forward with some fundamental changes. How the elections go will greatly affect the law - unless, of course, the Supreme Court strikes the law down before the elections arrive. It seems like that the Supreme Court will rule on the individual mandate from a constitutional standpoint, and that could lead to some of the…
Blendon R.J., Benson J.M. (2010). Public opinion at the time of the vote on health care reform. New England Journal of Medicine, 362 (16): e55.
Elmendorf, D.W. (2010). Additional information on the effect of the Patient Protection and Affordable Care Act on the Hospital Insurance Trust Fund. Congressional Budget Office.
Peterson, C.L. & Chaikind, H. (2010), Summary of small business health insurance tax credit under PPACA. Congressional Research Service.
Health care reform has the objective of getting more people insured, and leveraging government bargaining power to lower the cost of health care. Our organization needs to be ready for this. We have the baby boomers joining Medicare, and Medicare is seeking to lower health care costs; so are private insurers. As an organization, we need to bring our costs down in order to remain profitable. This need not be hard -- every other country in the world does it. In this context, streamlining operations, eliminating waste, bargaining with suppliers and finding ways to streamline services to increase customer turnover are all measures that I would undertake in order to ready the organization for the full implementation of health care reform. Eliminating waste is a critical component of maintaining profitability within the health care system (Berwick & Hackbarth, 2012).
Something I would do differently with respect to health care planning…
Berwick, D. & Hackbarth, A. (2012). Eliminating waste in U.S. health care. JAMA. Vol. 207 (15) 1513-1516.
Farmer, J. & Nimegeer, A. (2014). Community participation to design rural primary healthcare services. BMC Health Services. Vol. 14 (130) [HIDDEN]
Olsen, E. (2008). SWOT Analysis: How To Perform One For Your Organization (Webcast). Virtual Strategist.
Each of these was included in the initial Senate bill, but was struck from the final Senate version. Despite the victories, the group isn't ready to pledge support for health reform bills. The AMA will not endorse any legislation unless Congress gets rid of the mandated payment cuts of more than $200 billion over 10 years in the government's Medicare program for the elderly. The cuts are part of Congressional action that was passed in 1997 in order to cut costs in the Medicare program, but have never gone into effect. There are also several hospitals, insurers, pharmaceutical manufacturers and advocacy groups that are withholding final support. Most of these groups have pledged support to health care reform in principle while working privately through lobbyists to protect their industries (Eaton and Pell, 2010).
Healthcare lobbyists range from very large companies and corporations to very small groups who are all looking…
BREAKING: Health care lobby invests in reform summit. (2010). Retrieved March 1, 2010, from Citizens for Responsibility and Ethics in Washington Web site:
Eaton, Joe and Pell, M.B. (2010). Lobbyists Swarm Capitol to Influence Health Reform.
Retrieved March 1, 2010, from the Center for Public Integrity Web site:
At which point, the overall costs of care will be passed on to the tax payer in the form of higher taxes. This leads to a decrease in the overall quality of care and it will not slow the price increases, as the government seeks to restrict access to these services. Then, when the program becomes broken (such as: what is happening to Social Security) removing or reforming the bureaucracy is nearly impossible. (Messerili, 2010)
A second argument that many critics make about universal health care is: it will stifle innovation. Whenever, the government is running any kind of program, they will place a large number of restrictions and regulations on the industry. When this takes place, you are causing some of the best and brightest minds to seek careers in other fields, as the restrictions from the government are too cumbersome. A good example of this would be: the…
Trends in Health Care Costs and Spending. (2006). Retrieved March 13, 2010 from Kaiser Foundation website:
Andersen, R. (2007). Changing the U.S. Health Care System. Washington D.C: National Academy Press.
Gratzer, D. (2002). Better Medicine. Toronto, on: ECW Press.
Not only is there cost competition, but the real cost of a lot of services have actually gone down over the past fifteen years despite a tremendous increase in demand and enormous technological change. For example, the cost of conventional LASIK vision correction surgery has dropped radically, even as the procedure has become more technically superior (Herrick and Goodman, 2007).
Many experts have suggested that the solution to the health care system's troubles is to have a more market-based approach. Consumer-directed health plans are at the heart of this idea. If people are made to spend more of their own money, they'll be more practical users of care and look for better value at lower prices. This is how other industries work, and people don't complain much about them. It has been asked why health care should be any different. People think that the government should get out of the…
Frakt, Austin. (2010). Health care is different (from other industries). Retrieved February 20,
2011, from Web site: http://theincidentaleconomist.com/wordpress/health-care-is-different-from-other-industries/
Herrick, Devon M. And Goodman, John C. (2007). The Market for Medical Care: Why You
Don't Know the Price; Why You Don't Know about Quality; and What Can Be Done
However, they contradict themselves trough supporting one's right to commit physician-assisted suicide, since this would virtually mean that the individual who is no longer willing to live is not provided with health care meant to prevent him or her from dying (Epstein, 1999, p. 1).
Among those opposed to the fact that health care is becoming increasingly better are those who are in their twenties and are obliged to work hard in order to pay for their own medical insurance and for that of the underprivileged (Bonner, 2010).
Contemporary health care is basically provided by groups forced to pay taxes in order for others to benefit out of the process. The fact that health care is a privilege and not a right was made obvious ever since the 1954 foundation of the Department of Health, Education, and elfare. The name contained the term welfare with the intention of highlighting how…
Bloche, M.G. ed., The Privatization of Health Care Reform: Legal and Regulatory Perspectives (New York: Oxford University Press, 2003)
Epstein, R.A. Mortal Peril: Our Inalienable Right to Health Care? (Cambridge, MA: Perseus Books, 1999)
Heirich, M. Rethinking Health Care: Innovation and Change in America (Boulder, CO: Westview Press, 1998)
Sanders, B. (2009). Retrieved from the Huffington Post Website: http://www.huffingtonpost.com/rep-bernie-sanders/health-care-is-a-right-no_b_212770.html
S. Department of Health and Human Services, 2011). Furthermore, subpart C explains the privileges and the protections of confidentiality that is attached to the patient's record along with much exception (U.S. Department of Health and Human Services, 2011).
The penalty for anyone who breaks confidentiality is imperative. In "November, 23, 2009" was increased to $11,000 (U.S. Department of Health and Human Services, 2011). This goes for anyone in the medical field or has access to this information. A person has to follow HIPAA precisely or face a huge fine. If one thought of this ahead of time, whether or not they own a business, then no issues would arise legally. However, sometimes this does occur, especially for those who want to harm another person, yet in the medical field the goal is not to do this to any individual, regardless, otherwise he or she could face losing their license in…
U.S. Department of Health and Human Services Civil Rights. (2011). Your health information privacy rights. Retrieved May 3, 2011, from U.S. Department of Health and Human
Services Civil Rights:
U.S. Department of Health and Human Services. (2011). Health information privacy. Retrieved May 3, 2011, from U.S. Department of Health and Human Services:
In their move from a completely government-paid and -- operated healthcare system to a fees-based approach, the Chinese have greatly improved the efficiency, availability, and efficacy of their healthcare system (Wan & Wan 2010). This suggests that a combination of perspectives, rather than the market or single-payer perspectives that form so many healthcare systems, is most effective.
There are also, of course, healthcare systems that have developed in the same period as those mentioned above, but with far more negative results. The South African healthcare system, though effective in combating certain specific conditions, has many of the same failings as the United States' system, only on to a far more apparent degree. A lack of organization and responsiveness, exacerbated by an attempt to exert highly politicized and highly centralized control over healthcare provision, has plagued South African efforts to combat AIDS and many other problems the country -- and the…
Offredy, M. (2008). "The health of a nation: perspectives from Cuba's national health system." Quality in primary care 16(4), pp. 269-77
Sewankambo, N. & Katamba, A. (2009). "Health systems in Africa: learning from South Africa." The lancet 374(9694), pp. 957-9.
Squires, A. (2009). "U.S. Healthcare reform: A comparative book review." Nursing ethics 16(5), pp. 673-5.
Wan, Y. & Wan, Y. (2010). "Achievement of equity and universal access in China's health service: A commentary on the historical reform perspective from the UK National Health Service." Global public health 5(1), pp. 15-27.
ecause unions retain the exclusive right to negotiate on behalf of its members, the individual worker may have little recourse to easily address incompetent leadership.
The Disadvantages of Unionized Labor for Healthcare Employers:
The primary disadvantages of unionized labor for healthcare employers correspond to the relative loss of control over issues and workplace elements commonly transferred to workers (through their unions), which accounts for the traditional resistance with which many employers responded to unionization attempts. On the one hand, unionized workforces are able to secure better pay and benefits from employers than would have been available to workers without union representation; likewise, employers must cede control over many aspects of operational and personnel decisions traditionally within administrative control.
On the other hand, particularly in light of the beneficial effect that unionized nursing has had on the quality of patient care and reduction in patient mortality, it is difficult to conceive…
Daft, R. (2005) Management (7th ed.) Mason: Thomson South Western.
Nevins, J., Commager, H. (1992) a Pocket History of the United States.
New York: Pocket Books
Seago, J., Ash, M. (2002)
In fact Congress should pass a bill that gives that prescription drug benefit to Medicare patients.
QUESTION NINE: In the United States, healthcare is so expensive that over 45 million people are without health insurance. It is a broken system, leaving out many people, especially children. Recently the executive branch vetoed a bill that would have provided health insurance to millions of middle and low-income children, indicating a lack of government concern for the well being of the population. Bush said it was too expensive, yet it's not too expensive to continue spending billions on an unpopular war in Iraq. Meanwhile, for the past 45 years, Canada has had a "government-funded, national healthcare system..." based on these five principles, according to www.medhunters.com.One, it is universally available to permanent residents; two, it is comprehensive; three, it is available regardless of income; four, it is "portable within and outside" Canada; and five,…
American Association of Colleges of Nursing. (2007). Fact Sheet: Nursing Shortages.
Retrieved Feb. 7, 2008, at http://www.aacn.nche.edu/media/factsheets/nursingshortage.htm .
Duke, Elizabeth. (2004). Report to Congress. The Critical Care Workforce: A Study of the Supply and Demand for Critical Care Physicians. U.S. Department of Health & Human
Services / Health Resources & Services Administration. Retrieved Feb. 6, 2008, at http://bhpr.hrsa.gov/healthworkforce/reports/criticalcare/cc1.htm.
(ennie; Fontanarosa, 2006)
Apart from financial reasons, millions are not bale to access healthcare due to a lot of barriers inclusive of geography, racial differences and immigrant status. The people who do not have access to required care, that might comprise incapability to get primary care chronic care, specialist care, or emergency care stand at risk for severe health consequences. As per a recent report, absence of health insurance was linked with considerably lowered application of recommended healthcare services for cancer prevention, cardiovascular disease threat reduction, and diabetes management within the lower-income as also higher-income adults. Apart from the concerns, trouble, and stress directly associated to their illness, patients those who lack insurance or are underinsured also encounter increased levels of debt, threatening calls from collection agencies, anxiety, and possible insolvency. (ennie; Fontanarosa, 2006)
Impact of reform measures on the nursing profession:
The U.S. healthcare system is considered among the…
Granger, David; Young, Audrey. (1999) "Healthcare and the Underserved: America's Poor and Managed Care." Project of the Standing Committee on Health Policy: American Medical Student Association. Retrieved 10 September, 2007 at http://www.amsa.org/pdf/hlthcareunderserved.pdf
N.A. (2002, Jun 1) "Collective bargaining in the nursing profession: salient issues and recent developments in healthcare reform" Hospital Topics. Retrieved 10 September, 2007 at http://goliath.ecnext.com/coms2/summary_0198-95081_ITM
N.A. (n. d.) "Nursing's Agenda for Healthcare Reform." The American Nurses Association
Inc. Retrieved 10 September, 2007 at http://www.needlestick.org/readroom/rnagenda.htm
Healthcare Case Study Schuylkill County, PA
County Overview - Schuylkill County, Pennsylvania is located in the heart of the anthracite Coal region of Pennsylvania where the Schuylkill iver originates. Pottsville is the county seat, and the county showed a population of just under 150,000 as of 2010 with a density of 190 persons per square mile. The total area of the county is 782 square miles, almost all land, less than 1/2 a per cent water. The county's history, likely due to large coal deposits, focused on the railroad and industrialization (Schuylkill Chamber of Commerce, 2011).
The county experienced the high point of its population during the 1920s and 1930s, and has been losing people ever since, most between 1950 and 1970, with about a 1-2% population loss since the turn of the century. This is likely due to the lack of appropriate jobs and opportunities within the county. Schuylkill…
County Health Statistics - Healthcare 2010. (2009, March). Retrieved from Pennsylvania Department of Health: http://www.portal.state.pa.us/portal/server.pt-in_hi_groupoperator_1=or&in_hi_req_objtype=18&in_hi_req_objtype=17&in_hi_req_objtype=512&in_hi_req_objtype=514&in_hi_req_objtype=43&in_hi_req_objtype=1&in_hi_req_apps=7&in_hi_req_page=10&in_ra_topoperator=or&
Comprehensive Plan. (2010, March). Retrieved from City of Pottsville, PA: http://www.city.pottsville.pa.us/html/cp1.htm
Election Statistics. (2010, June). Retrieved from Pennsylvania Department of State: http://www.dos.state.pa.us/portal/server.pt/community/running_for_office/12704
Schuylkill County. (2010, June). Retrieved from Sperling's Best Places USA: http://www.bestplaces.net/economy/county/pennsylvania/schuylkill
S. healthcare structure do not include the unobserved disparities. This may sound very rudimentary, even silly to point out, but in by understanding that the numbers are actually worse than they appear, and that the rising costs of healthcare services re associated with both what we see and can't see, it is easier to understand how costs rise so quickly.
It is also a sobering fact that what we cannot observe is still out there, existing beyond the scope of the government and social programs designed to help people overcome obstacles to access to healthcare and health insurance. The ethnic group that is most unobserved within the bounds of many of the studies and statistics related to the disparities in the U.S. healthcare industry is non-Mexican Latinos (Bustamante, et. al., 2009). This group represents a major portion of the U.S. population that currently lacks access to healthcare. In understanding this…
Bodenheimer, T., Chen, E., and Bennett, H.D. (2009). "Reorganizing Care:
Confronting The Growing Burden Of Chronic Disease: Can The U.S. Health Care Workforce Do The Job?" Health Affairs. Vol. 28, No. 1. Pp. 164-174.
Braveman, P.A., Cubbin, C., Egerter, S., Williams, D.R., and Pamuk, E. (2010).
"Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us." American Journal of Public Health. Vol. 100, No. 1. Pp. 186-196.
It means they have an equal opportunity to receive contraception, prenatal counseling and services, post-natal services for mother and child, preventative healthcare services, vaccinations, and dentistry services, from earliest childhood and through their lives into their elderly years when they require more medical services to remain healthy and active. To the extent everyone in a given community or society has the same relative access to healthcare services and to the extent those services received are of comparable quality, healthcare access could be described as being equitable. On the other hand, to the extent everyone in a given community or society does not have the same relative access to healthcare services and to the extent those services received are not of comparable quality, healthcare access could be describes as being inequitable (Kennedy, 2006; eid, 2009).
Healthcare Equity in the Contemporary United States
Unfortunately healthcare access in the U.S. is not equitable…
Kennedy, E. (2006). America: Back on Track. Viking Press: New York.
Reid T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer
Health Care. New York: Penguin Books.
Health Care oles in Communication
Communication is a fundamental piece of health care education and has been shown to improve health outcomes, patient compliance, and patient satisfaction. Quality health care emphasizes knowledge and utilization of communication skills. Health care professionals often express anxiety and lack of confidence and are deficient in a creating a situations that are conducive to open and candid communication with patients (Kameg et. al., 2009).
Effective communication involves gathering information, establishing a relationship or connection with a patient, and supporting the person through words and other non-verbal forms of interactions. Effective communication involves not only the interactions between the staff and the patient but also the interactions between staff and the interactions between the staff in front of the patient. Many times the high demand for services in a health care facility cause the staff to overlook the importance of good communication skills and enables situations…
Beer, J.E. (2003). Nonverbal Communication: Communicating across cultures. Cultures at work. Retrieved May 29, 2011 from http://www.culture-at-work.com/nonverbal.html
Coiera, E. (2006, May). Communication systems in healthcarre. Clinical Biochemist Reviews. nursing.Vol. 27, Issue 2, 89-98. Retrieved May 28, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1579411/
Gamble, T.K. & Gamble, M. (2006). Communication works. Burr Ridge, IL: McGraw-Hill.
Health Communication. (2010). Health communication. Healthy people 2010: Objectives for improving reproductive health. Office of Disease Prevention and Health Promotion. Retrieved May 29, 2011 from http://www.hhs.gov/opa/pubs/hp2010/hp2010rh_sec2_healthcomm.pdf
Health Care Finance
Financial analyst Eric Feigenbaum (2009) notes that while we like to think of hospitals in terms of compassion, patient care and dedication to altruistic aims, they are businesses concerned with revenues and expenses like any other business (Feigenbaum 2009, p.2). In today's hectic world of economic downturn and financial struggles felt from individuals of every demographic and social status, revenue and expense accounting are issues that must be addressed carefully by nearly every business in every market. The same holds true for the health care industry and health care providers. With financial uncertainty come threats for health care providers in managing revenue and expenses during the upcoming years. However, with these threats remain certain opportunities for health care providers to take on in order to combat the uncertainty that comes with managing revenue and expenses when the amount of each is not ideal.
With the appropriate management…
Bristow, W. (2009). How to thrive during a recession. Doctor's Digest. 81(1): p.16.
Retrieved from: LexisNexis Database.
Feigenbaum, E. (2009). Categories of expenses and revenues in the hospital business setting. Demand Media, 2(1), pp. 2-5. Retrieved from: ProQuest Database.
Johnson, N., McNichol, E. And Oliff, P. (2011). Feeling the recession's impact on health care. Handbook of Health Economics 3(2), pp. 54. Retrieved from: ProQuest Database.
Health Care Market
In discussing the market for a health care good or service, one must first understand that in speaking of "health care," one is actually speaking of the entire health care industry, along with each of the goods and services that are produced and exchanged within this market. From organ transplant operations and blood donation to therapeutic massages and nursing home activity programs, the span of health care goods and services is both vast and varied. Further, in viewing today's uncertain economy, the market for health care goods and services is one that brings with it many different questions that must be addressed in order for a stakeholder to fully comprehend what decisions need to made in order to turn a profit.
Scarcity of esources
Scarcity of resources within this market significantly influences the decisions that stakeholders are forced to make. With scarcity of resources comes limited action…
Case, K. And Fair, R. (2007). Principles of economics. Upper Saddle River, NJ: Pearson
Fullerton, D. (2008). How economists see the environment. Nature, 385(6701), p. 433.
Retrieved from: LexisNexis Database.
Healthcare Legal Issues
Discuss the impact Federalism has on the regulation of health care delivery; how do the different sources of law as they related to the federal and state governments matter, if at all?
In general, federal regulation of health care delivery would be much more appropriate and efficient than state or local law, at least in so far as major aspects of health care delivery are concerned. That is because state laws vary considerably; that makes it impossible to establish a consistent or uniform standard of health care delivery across state lines. Certainly, there are aspects of health care that are appropriate to regulate at the state or even the local level, but there are others that would be much better to regulate on a national or federal level.
One of the best examples of an aspect of health care delivery that should be regulated federally are elements…
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
Here second question that is raised for the author is that till now and for the future, many healthcare architectures have been designed that increase the availability of the patient records, not only on the national but on an international scale as well. The author in the study has only focused on the national or local availability of the patient records.
Content of the article is strong and there are a number of important facts given in the article in relation to the importance of healthcare indexing systems. The healthcare indexing systems being used in U.S., UK and Australia have been mentioned as an example. The two models of the indexing architecture given by the author in the beginning have been linked by the author with the examples. The loopholes that can be noticed in these cases are the absence of any privacy and security concerns that may be an…
Liu, V., Caelli, W., Smith, J., May, L., Lee, H.M., Ng, H.Z., Foo, H.J., and Li, W. (2010). A Secure Architecture for Australia's Index-Based E-health Environment. Proc. 4th Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2010), Brisbane, Australia, p. 7-16.
A patchwork of laws provided narrow privacy protections for selected health data and certain keepers of that data." (Administrative Simplification in the Health Care Industry) Therefore, new technologies such as relational databases have simplified the data gathering and maintenance processes of all types of healthcare related data like the physician information process. It is not unheard of today for healthcare and insurance providers matching or 'sinking data' on a monthly or quarterly basis because of the availability of better communication capabilities as well as compatible database comparison processes.
Even the doctors themselves have access to providers' systems and databases today. Through automatic telephone systems, business to business Internet portals, and tape or disk delivery processes, all of a physician's personal, office and patient information can be updated easily. In many cases, the entire process including security and confirmation is a completely hands free operation. In other words, without human intervention,…
Administrative Simplification in the Health Care Industry. Ed. HIPAA. Health and Human Services. 23 Oct. 2004 http://www.hipaa.com/.
HMO Patients Can Contact Their Doctors Electronically as Blue Shield of California Expands Online Communication Services. Ed. Unknown. October 29, 2003. Relay Health. 23 Oct. 2004 http://www.relayhealth.com/rh/general/news/newsRecent/news49.aspx .
Hoffer, Prescott, and McFadden. Modern Database Management. 7th ed. Add City: Add Publisher, Add Year.