Care Plan Essays (Examples)

Care:

Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of…

References:

Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from http://rnjournal.com/journal-of-nursing/thryoid-storm-and-the-aacn-synergy-model

Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.

Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from  http://ccn.aacnjournals.org/content/23/1/73.full.pdf 

Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing

Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).

Prioritize the Nursing Care Needs of Margaret

The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…

References

Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.

Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.

Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.

Journal of Cardiovascular Nursing,25(3), 207-220.

Hourly nursing rounding is regarded as one of the most suitable means for enhancing patient satisfaction and clinical outcomes. This process can be described as a proactive, systematic nurse-centered evidence-based intervention to predict and deal with the various needs in hospitalized patients. There is sufficient evidence to demonstrate that effective hourly nursing rounding can enhance patient safety, promote team communication, and enhance the capability of staff to offer efficient patient care. Therefore, this approach would be a suitable method to help reduce falls, prevent ulcers, and call light use and result in enhanced patient satisfaction through evidence-based practices. The adoption of this method in the organization to improve patient satisfaction and clinical outcomes would require the development of a comprehensive implementation plan and participation from all key stakeholders.

Method of Obtaining Necessary Approval

The adoption of hourly nursing rounding in the healthcare facility to enhance patient satisfaction and clinical outcomes…

References

Brosey, L.A. & March, K.S. (2014, September 16). Effectiveness of Structured Hourly Nurse Rounding on Patient Satisfaction and Clinical Outcomes. Journal of Nursing Care Quality, 00(00), 1-7.

Forde, J.C. (2014, April 9). Intentional Rounding: A Review of Literature. Nursing Standard, 38(32), 37-42.

Negarandeh, R., Bahabadi, A.H. & Mamaghani, J.A. (2014, December). Impact of Regular Nursing Rounds on Patient Satisfaction with Nursing Care. Asian Nursing Research, 8(4), 282-285.

Timothy, H. (2015, June 2). Hourly Rounding is an Effective Patient Safety Strategy. Retrieved from American Sentinel University website:  http://www.americansentinel.edu/blog/2015/06/02/hourly-rounding-is-an-effective-patient-safety-strategy/

Planned change in the eldercare advocacy organization

In the coming years, many countries will experience a dramatic shift in healthcare infrastructure due to an expanding elderly population size. However, the changes may vary across countries depending on many factors such as the kind of social welfare available in each country, the political environment which determine policies, the level of healthcare available and individual expectations in each country. Due to this wide variance, the innovations within this space will also vary greatly. What this means to the healthcare manager is that managing innovations becomes very hard (Shlutz, Andre & Sjovold, 2015 p 42). This also impacts on performance management which is fast gaining popularity in the public sector as a means to improve on accountability. Unfortunately, it has been cumbered by a series of challenges in its implementation; this is in spite of the frameworks developed over the last couple of…

Care Coverage and Inequalities in the Education System

Traditional Care Coverage vs. Managed Care Coverage

Traditional care coverage is also known as Fee-for-service (FFS). Under this model, the patient pays for services that are itemized in the Invoice. The physicians gain an incentive to offer more treatments as payment depends on the quantity of care and not the quality of care. In the health insurance and healthcare sectors, traditional care coverage happens when physicians and other caregivers get a fee for each service like laboratory tests, office visit, procedure and other healthcare services. After providing services, the patient makes payments retrospectively. Traditional health coverage enables the patients to choose a healthcare provider, including a favorite hospital or doctor. The services rendered are paid for by the patient and then submits the bill to the insurance firm for reimbursement of the percentage it agreed to the insurer for the patient (Kongstvedt,…

References

Conchas, G. & Gottfried, M. (2015). Inequality, Power and School Success: Case Studies on Racial Disparity and Opportunity in Education. New York: Routledge

Duncan, G. J. & Murnane, R. J. (2014). Restoring Opportunity: The Crisis of Inequality and the Challenge for American Education. Boston, MA: Harvard Education Press

The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.

Conclusion

The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge…

In addition the effect of bill has changed the documentation awarded through the state as of a certificate toward a license and authorizes a doctor to pass on duties to a PA with the purpose of managing physician's scope of performance however Another effect of bill has enabled Indiana's doctor assistants to widen their area of the health care services and also provided an innovative average of patient care (Stephanie, Matlock (27 April, 2007). Health care bills gives right to patient to know what health care should be known by the plan as well as several limits on care, kinds of health care be not enclosed, any treatment diagram required to endorse in advance. Yearly planning about on disburse to physician and health providers, file a complaint regarding any, disagreement between patient and the plan, and also procedure to make complaint, allowance to access emergency room twenty four hours a…

Bibliography

American-Speech Language Hearing Association. (2007) Characteristics of Licensure Law. Retrieved on November 29, 2007 from www.asha.org

New York State. (April 2007) Managed Care Bill of Rights. Retrieved on November 29, 2007 from www.health.state.ny.us

Federal Trade Commission. (October 21, 2002) FTC staff opposes Ohio Bill to Allow Physician Collective Bargaining. Retrieved on November 29, 2007 at  http://www.ftc.gov/opa/2002/10/physicians.shtm 

Girardin, Pierre. Internet Health Services: A Case Study. Retrieved on November 29, 2007 from  https://www.isoc.org/inet96/proceedings/h5/h5_2.htm

Planned Change in a Department

Change within the Medical surgery department

There are various factors that occasion change within any organization, some may be due to change in the operations of an organization, some due to expansion, relocation, takeovers, mergers, external forces in economies, internal changes in operation modes or even unprecedented needs as unforeseen at the initial stages. This last one seems to be case within the medical surgery unit in our hospital.

The prevailing condition at the moment that needs a change approach that would improve the conditions within the medical surgery unit and the entire hospital in general is the imbalanced ration between the nurses and the surgery patients currently realized within the unit. The prevailing rate is one nurse within the medical surgery unit handling an average of 6-7 patients which has proven to be too high for a single nurse. The other pertinent problem within…

References

American Nurses Association, (2011). Effects of Nurses Shortage. Retrieved July 4, 2013 from http://ana.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/NurseShortageStaffing/NursingShortage/Effects.aspx

Honor Society of Nursing, (2013). Facts on the Nursing Shortage in North America. Retrieved July 4, 2013 from  http://www.nursingsociety.org/Media/Pages/shortage.aspx 

Nursing Theories, (2011). Change Theory by Kurt Lewin. Retrieved July 4, 2013 from  http://currentnursing.com/nursing_theory/change_theory.html 

National Foundation for American Policy (2007). Deadly Consequences: The Hidden Impact of America's Nursing Shortage by Stuart Anderson. Pp 4. Retrieved July 4, 2013 from  http://www.nfap.com/pdf/0709deadlyconsequences.pdf

health care to an indigent population.

As illustrated by the case, there were many unique problems associates with delivering health care to the indigent population. First, communication was an issue plaguing all parties involved. Difficulty in regards to understanding overall objectives and health care plans made operations inefficient and costly. Massive errors resulted from communication issues that ultimately hindered the access and quality of health care to the indigent population. Communication is the foundation of delivering health care. Everyone, from owners to employees must be able to effectively communicate in order to offer the quality of health care needed to support the indigent population. Without simple and comprehensive forms of communication, the overall health care program will falter as stakeholders are unaware of the overall vision and plan for the health care system.

Education also is a very profound problem in delivering health care to the indigent population. The community…

References:

1) "Cooper Green Hospital & The Community Care Plan" (2011, July 16) http://www.*****/Details/Cooper+Green+Hospital/43335

2) Swayne, L.E., Duncan, J., & Ginter, P.M. (2009). Strategic management of healthcare organizations (6th ed.). San Francisco: Jossey-Bass

3) Velasco, Anna (July 15, 2007) "Renovation transforming look of county hospital." Birmingham News

Obamacare, or formally known as the Affordable Care Act, is a recent healthcare law that will reach its implementation stage in 2014. Healthcare is certainly a fundamental necessity and indispensable to a growing human population. he United States is known for its adequate healthcare, servicing low income people through Medicaid, and the elderly through Medicare. However, recent events have led to a shift in what can possibly negatively impact the healthcare system for the United States.

Obamacare has good intentions in having its purpose be to supply affordable healthcare to everyone within the United States, but certain clauses and modifications have turned it into a dicey and uncertain situation. Not only are the costs piling up, and continue to increase, but the distribution of healthcare services is primarily execute through health insurance coverage. his means that there will be a change in how the healthcare system functions at the core…

The way that Affordable Care Act works, however, is that plans that would have failed to meet the standards of Bronze plan can no longer be offered. Such plans were often popular with either poor people who could not afford a better plan, or young people who are unlikely to have to make a claim. For such individuals, the increase in their health premiums might be significant, and political opponents of the Act are making every effort to collect anecdotes from such people to use as scare tactics (Radnofsky, 2013). The reality is that most young people were almost always going to have to pay more, which in part explains why it is older people who have signed up for plans on the exchanges (Mangan, 2013).

Are there Risks to the ACA?

There also risks with the Act that could jeopardize the way the system works. John (2013) notes that if not enough people sign up, then insurance companies will make smaller profits. He does note that the signups at higher rates

Lee is only the first step in the process of building a team that is able to cover all aspects of Mrs. Lee's care. The team approach involving a social worker, nurse, physician, pharmacist, and physical therapist affords Mrs. Lee a full range of professionals attending to her various needs.

Although Mrs. Lee has a number of problems that need to be addressed the one problem that must be addressed immediately is her elevated blood pressure. Hypertension is an important risk factor for the development and worsening of many complications of diabetes and an elevated blood pressure is like walking around with a detonated bomb. Within moments, and with little warning, a diabetic patient can suffer a stroke or heart attack as a result of an elevated blood pressure. Well over fifty percent of diabetics suffer from hypertension and proper treatment of hypertension can minimize most of the tangential problems…

References

Calle-Pascual, A.L. (2002). A preventive foot care programme for people with diabetes with different stages of neuropathy. Diabetes Research and Clinical Practice, 111-117.

Caminal, J. And Barbara Starfield, et. al.(2004). The role of primary care in preventing ambulatory care sensitive conditions. European Journal of Public Health, 246-251.

Deichmann, R.E. (1999). Improvements in Diabetic Care as Measured by HbA1c After a Physician Education Project. Diabetes Care, 1612-1616.

Epstein, M. (1997). Diabetes and hypertension: the bad companions. Journal of Hypertension, 55-62.

"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.,…

References

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.

Healthcare Delivery System Challenges

The American healthcare system has been criticized as favoring the middle and upper classes while ignoring the lower classes. Based on these speculations, the federal government has constantly tried to institute reforms in the healthcare sector though some of the proposals have failed to overhaul the industry. With rising insurance costs, the number of citizens barred from accessing quality healthcare has increased to more than 45 million uninsured Americans. On the same note, it is hypothesized that with time, the problems currently witnessed in the industry are likely to increase and finding solutions to them will be a tall order for the government (Stolberg & Pear, 2010). Despite the advent of new technology in the sector, which is likely to improve service delivery over the years, it is speculated that the cost of new tests and treatments will outweigh the savings. With the better technology, physicians…

References

Stolberg, S.G. & Pear, R. (March 24, 2010). Obama signs health care overhaul bill, with a flourish. The New York Times: p. A19. Retrieved March 1, 2013.

Woolhandler, S. & Himmelstein, D.U. (1997). Costs of care and administration at for-profit and other hospitals in the United States. The New England Journal of Medicine 336 (11): 769-774.

Swanson, E. (July 30, 2009). Health Care Plan: Favor / Oppose. Huffington Post.

Blumberg, L.J. & Holahan, J. (2009). The Individual Mandate: an Affordable and Fair Approach

ACA

The Affordable Care Act works on the premise that all Americans should have access to health care insurance. Because this is provided through insurance companies, the system is only enforceable under certain conditions. One of the key tenets of health care reform is the idea that those with pre-existing conditions cannot be denied insurance coverage. This group of people has long had problems getting insurance, and insurance companies spend tens of millions to invent pre-existing conditions that would then be used to deny coverage. Even insurance commissioners have been known to take offensive and absurd stances on pre-existing conditions, arguing that insurance companies should not have to take customers with such conditions because the person is to blame for their pre-existing condition (Ferguson, 2013). With attitudes like this from people connected to the insurance industry, the only way that the Obama Administration was going to achieve universal health care…

References

Ferguson, D. (2013). Georgia insurance commissioner: It's your fault if you have a pre-existing commission. Raw Story Retrieved December 6, 2013 from  http://www.rawstory.com/rs/2013/12/05/georgia-insurance-commissioner-its-your-fault-if-you-have-a-pre-existing-condition/ 

Klein, E. (2012). Unpopular mandate. The New Yorker. Retrieved December 6, 2013 from  http://www.newyorker.com/reporting/2012/06/25/120625fa_fact_klein 

Kliff, S. (2013). Washington State provides case study on effects of health care reform. Washington Post. Retrieved December 6, 2013 from http://articles.washingtonpost.com/2012-06-16/national/35461636_1_individual-mandate-health-insurance-insurance-reforms

AARP. (2013). For people 65+. American Association of Retired People. Retrieved December 6, 2013 from  http://www.aarp.org/content/dam/aarp/health/healthcare_reform/2013-07/aca-factsheet-for-65-aarp.pdf

History Of Health Care Mandate

The signing of the Affordable Care Act (ACA) by President Obama must be considered a landmark event in the history of the nation regardless of how one views the constitutionality of the legislation. Passage of the legislation marked the end of a long and acrimonious debate and brought the United States in line with the rest of the developed world in terms of providing universal health coverage to its citizens (Orszag, 2010). Unfortunately, the debate over the constitutionality of the ACA did not end with Obama's signing of the legislation as within days several different states filed suit against the law's requirement that most Americans purchase health; against the health care mandate.

The health care mandate was first offered as an option by the conservative think tank, the Heritage Foundation, as an option to the single-payer system that had been historically supported by Democrats and…

References

Block, S. (2010, April 29). IRS Lacks Clout to Enforce Mandatory Health Insurance. USA Today, pp. www.usatoday.com/money/perfi/insurance/2010-04-29 healthirs28_CV_N.htm?loc=interstitialskip.

Jost, T.S. (2010). Health Insurance Exchanges and the Affordable Care Act: Eight Difficult Issues. Lexington, VA: Washington and Lee University School of Law.

Orszag, P.R. (2010, August 12). Health Care Reform and Cost Control. New England Journal of Medicine, pp. 601-603.

Ponnuru, R. (2012, March 27). The History of the Individual Mandate. Retrieved from National Review Online:  http://www.nationalreview.com/corner/294585/history-individual-mandate-ramesh-ponnuru

U.S. Healthcare

The final legislation should have incorporated provisions to boost the IVD industry. On its entirety, the Patient Protection and Affordable Care Act must have benefited the IVD industry. This would have increased sales in a span of five years that it is otherwise seen in the absence of the law. Most significant IVD sales drivers will result from the legislation as an expansion of in the number of insured citizens and new coverage of prevention and wellness programs. If various key provisions are included in the PPACA, coupled with the population demographics, IVD product sales will be stimulated. This industry will die or live based on the number of the test procedures and hence increase in the number of persons with healthcare coverage will be appropriate for IVD. The Patient Protection and Affordable Care Act is a sophisticated legislature, virtually affecting all aspects of healthcare and the majority…

References

Law, J. (2009). Big pharma: How the world's biggest drug companies control illness. London: Constable.

Parks, D. (2012). Health care reform simplified: What professionals in medicine, government, insurance, and business need to know. United States: Apress.

Ross, B.M.C., & Ross, B.M.C. (2013). Beating Obamacare: Your handbook for surviving the new health care law. Washington, D.C: Regnery Pub.

Schweitzer, S.O. (2007). Pharmaceutical economics and policy. New York [u.a.: Oxford Univ. Press.

Healthcare Plan eview

The author of this report is to answer three general questions relating to healthcare program evaluation. The first question asks the author of this report to examine the overall purpose of healthcare program evaluation. The second question asks the author to identify at least five different types of common healthcare program evaluation techniques. Finally, one of those methods in particular will be selected and there will be a drilling down into more detail on that single type. While the purpose and method of operations is quite similar with all program evaluation types, there are some subtle to major differences from type to type.

At its core, the purpose of healthcare program evaluation is to analyze and improve the operations and performance of a healthcare program based on a systematic and full review of what is going right, what is going wrong and what needs to be changed.…

References

Fink, A. (1992, October 15). Formats:. National Center for Biotechnology Information.

Retrieved September 16, 2014, from  http://www.ncbi.nlm.nih.gov/pmc/articles/ 

PMC1336469/?page=1

MUSC. (2014, September 16). Program Evaluation 101. Program Evaluation 101. Retrieved

Improving Local Health Care:

Quality health care is an important aspect in the modern health care system because of the necessity for quality and safety improvement measures. This concept is described as the extent in which health care services for patients and populations enhance the possibility of desired health outcomes. These services also need to be consistent with the existing professional knowledge in the field. Consequently, quality and improved care services are determined through evaluating the impact of these services on desired outcomes and the extent they adhere to procedures based on scientific and professional knowledge. As part of improving health care services, health care systems should adopt several process-improvement strategies. These strategies should recognize ineffective care, inefficiencies, and avoidable errors and then effect changes on the system to result in improved care.

Incorporating Unapplied Telecommunications Concepts:

Based on the last visit to the local health care system in the…

References:

Angst, C.M., Devaraj, S. & D'Arcy, J. (2012). Dual Role of IT-Assisted Communication in Patient Care: A Validated Structure-Process-Outcome Framework. Journal of Management Information Systems, 29(2), 257-292.

Hughes, R.G. (2008). Tools and strategies for quality improvement and patient safety. In Patient safety and quality: an evidence-based handbook for nurses (chap. 44). Retrieved from  http://www.ncbi.nlm.nih.gov/books/NBK2682/

Business of Health Care

This study highlights essential facts about health care and health in the local, national, and international health care delivery. Healthcare in the U.S. stands at crossroads between opportunities and challenges. Both the local, national, and international health systems face common problems in the delivery of efficient, high quality and equal health services. All these are concurrently happening in times when the amount of care delivered exceeds the resource base. In the U.S., the demand for healthcare, just as in any industrialized country, is rising because of rising public expectation and the ageing population. The combination of technological developments and demographic changes increases the provision costs (Garman, oyer & Johnson, 2011).

Consequently, local, national, and international health care delivery systems are facing same issues of service rationing to cut costs due to a decreasing tax base for paying a rising demand and an increasing demand. Similarly, maintaining…

References

Garman, A.N., Royer, T.C., & Johnson, T.J. (2011). The future of healthcare: Global trends worth watching. Chicago, Ill: Health Administration Press.

Geisler, E., Krabbendam, K., & Schuring, R. (2013). Technology, health care, and management in the hospital of the future. Westport, CT: Praeger.

Gibson, R., & Singh, J.P. (2012). The battle over health care: What Obama's reform means for America's future. Lanham, Md: Rowman & Littlefield Publishers.

Kolker, A. (2011). Management engineering for effective healthcare delivery: Principles and application. Hershey: Medical Information Science Reference.

Contracts with doctors often contain a clause which doesn't allow the doctors to discuss

Health care 7 with their patients financial incentives to deny treatment or about treatments not covered by the plan (Glazer, 1996). This has caused many consumers, especially those with chronic illnesses, to form organizations with the American Medical Association and physician specialty groups to promote legislation forbidding "gag rules" (Glazer, 1996). One group, Citizen Action, has 3 million members and "has been lobbying in state legislatures for laws that would require plans to disclose how they pay their doctors; give patients the right to choose specialists outside the plan; and provide appeals for patients who get turned down for expensive treatments" (Glazer, 1996).

The doctor-patient relationship is also affected if a patient must switch to a new doctor under managed care. Having a longterm relationship with a primary doctor is important because he or she is…

Works Cited

Bennett Clark, Jane (1996, July). What you should ask your HMO.

Kiplinger's Personal Finance Magazine. pp. 92-93.

Glazer, Sarah (1996, April 12). Managed Care. CQ Researcher, 6,

Koop, C. Everett (1996, Fall). Manage with care. Time. pp. 69.

UK Healthcare

Within this section of Chapter One, a historical perspective of NHS will be provided. This discussion will identify problem areas that have emerged in relation to NHS with an attempt made to address the manner in which such problems have historically influenced reform efforts.

With the passage and associated provisions of the NHS Act of 1946, NHS was implemented in the UK in 1948. The NHS Act of 1946 served as the means by which a pattern of health service finance and provision was established in the UK following World War II (Baggot, 1998). According to Baggot, on the basis of the Act, the principle of collective responsibility by the state for the establishment of a comprehensive health service system was introduced, allowing for the planned use of services by the entire population at no cost. It was also intended that equality of access to services would be…

References

Baggott, R. (1998). Health and Health Care in Britain. London, Macmillan,

Barlow, M. (1998). The Fight of My Life. Toronto: Harper Collins

BMA Central Consultants and Specialists Committee (1990). Guidance on Clinical

Directorates London: BMA.

Expenditures on health care has been mounting faster than the economy for many years, representing a challenge not only for the government's health insurance programs, but also for the private sector. As health care expenditures consume a larger share of the nation's economic output, Virginians along with all Americans will be faced with progressively harder choices to make (the Long-Term Outlook for Health Care Spending, n.d.).

orks Cited

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14 February 2011, from < http://ifawebnews.com/2010/03/15/virginia-passes-budget-cutting-medicaid-other-health-services/>

"Monthly Premiums for Non-Medicare Eligible Retiree Group." 2010, viewed 14 February 2011,



Martin,…

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They offer the same flexibility and costs saving available to people at larger organizations. According an article published by Physicians Care,

"hen we set up a self-funded plan for a smaller employer, we help them select the appropriate level of stop-loss or excess-loss insurance, which provides reimbursement for large catastrophic claims. Stop-loss insurance allows smaller employers to consider this very economical approach to providing employee health benefits because it protects them from large claims ("Is Self-Funding or Fully Insured Right for Your Company?")."

Although self-funding can offer many organizations with the chance to reduce costs there are instances when this option is simply not appropriate. The inappropriateness of the option has a great deal to do with the demographics of the employees. If a company has a significant number of older workers or workers with chronic illnesses, such a plan would not be advantageous. The main reason for the lack…

Works cited

Advantages of Self-Funding. Retrieved September 30, 2009 from; http://www.physicianscare.com/content/public/default.aspx?id=327

Gammon, R.B. (2009) Self-funded health care could lower costs. The Business Journal of Milwaukee - by Retrieved September 30, 2009 from;  http://milwaukee.bizjournals.com/milwaukee/stories/2006/02/27/focus4.html 

Self-funded health insurance: It's about risk, vulnerability, cost savings

Schreck, Tom the Business Review (Albany) - by for the Business Review Retrieved September 30, 2009 from;  http://albany.bizjournals.com/albany/stories/2005/12/05/focus4.html

A recent article touted the 6.1% growth of spending on medical care in 2007.

The same article cautioned however that, "most experts know that no matter what the numbers say, there is still a great deal of work ahead to reform a healthcare system that is still fundamentally broken -- and is facing one of the worst economic recessions in decades" (Lubell, 2009, pg. 6).

Government and industry officials have been working to reform the industry for more than a decade yet the problem seems to be getting worse rather than better. More and more individuals are finding that insurance takes too much of their income and are forced therefore to forego that expense. Government is leery of committing to the cost of such expense, and industry is reluctant to offer expanded coverage without the backing of the federal government. As the interested parties do the two-step the problem becomes…

References

Bentley, C.S.; (2005) the new healthcare system, New American, Vol. 21, No. 18, pg. 44

Blizzard, R.; (2002) the haves and have nots of healthcare, Gallup Poll Tuesday Briefing, pp. 8-9

Brown, J.; (2009) Obama healthcare plan would shut down private sector, OneNewsNow,  http://www.onenewsnow.com/Politics/Default.aspx?id=414372 , Accessed February 10, 2009

Conn, J,; DerGurahian, J.; (2008) HIT budgets taking a hit: study, Modern Healthcare, Vol. 38, No. 50, pp. 10-11

President Clinton's And Obama's Health Care Policies

President Obama's Healthcare policies

The Affordable Care Act (ACA) has drawn some comparisons to elements of past efforts, including Mitt omney's health care plan in Massachusetts and the Clinton plan from the 1990s. This paper will mainly examine the context of the Clinton Plan vs. The ACA. After winning office, President Clinton followed up on a campaign promise to provide health care to the 37 million uninsured Americans. This plan had motivation citing a strong sense of social justice, especially in light of America's tremendous wealth. There was majority public approval for the plan at the time. However, a single payer plan idea faced opposition and Clinton needed to create an alternative (Pfiffner, 1994).

The Clinton government recognized that a major overhaul was not going to find favor, so he sought to implement a plan that would expand coverage rather than dramatically restructure…

References

Pfiffner, J. (1994). President Clinton's health care reform proposals of 1994. Executive-Legislative Relations. Retrieved April 30, 2013 from http://www.thepresidency.org/storage/documents/President_Clintons_Health_Care_Reform_Proposals.pdf

Mary, W. (2010). The Affordable Care Act. Journal of Vermont Nurse Connection, 13(4), 3.

Ha, J. (2012). "Health Care Reform" vs. "ObamaCare": Partisan Framing of FOX, MSNBC,

NYT, and WSJ. Journal of Communication, Culture & Technology (CCT), 8(1).

National health plan [...] how and why a national health plan should be introduced in the United States. Health care in the United States is a big business. As such, a national health plan threatens the bottom lines of gigantic health maintenance organizations, and they have fought national health care consistently. They fight a plan that could cause their demise, but ensure the increased health and well being of millions of Americans. It is time we stopped letting big business set the agenda for the health of the American people.

NATIONAL HEALTH PLAN

The Clinton administration's plan for national health care reform did not become a national health plan, but it opened the door for argument and debate about health care reform in the United States. Many experts and citizens still believe a national plan for health care should be instituted in America. How to institute a workable and viable…

Bibliography

Editors. "Health Care Information." Physicians for a National Health Program (PNHP). 2003. 26 April 2003.  http://www.pnhp.org/ 

Epstein, Richard A. Mortal Peril: Our Inalienable Right to Health Care? Cambridge, MA: Perseus Books, 1999.

Goold, Susan D. "Health Care Reform and the Battle for the Body Politic." Vol. 26, Contemporary Women's Issues Database. 3 Jan. 1997, pp 98+.

Palmisano, Donald J. "Health Care Labor Relations Issues: Donald J. Palmisano." Congressional Testimony. 29 July 1998.

Obama's health care reform will make health care more accessible and more affordable and make insurers more accountable, as well as expand health care coverage to every American and make the health care system sustainable by stabilizing family budgets, the economy and the Federal budget.

The cost of Obama's overall health care bill will cost approximately $940 billion over 10 years, according to the Congressional udget Office. The bill will include that by the year 2014 there will be significant health access reforms. Insurers will be prohibited from denying coverage to people with medical problems of charging them more money (CS 2010).

While these numbers do sound manageable, Congress has not responded kindly to Obama's health care reform ideas. When Obama has even mentioned the idea of health care for illegal immigrants, the president was rudely interrupted by a heckler yelling, "you lie" ( ). Under Obama's proposal of health…

Bibliography

CBS News. "What's in a health care bill? Take a dose." Retrieved on June 1, 2010, from the Web site:

 http://www.cbsnews.com/stories/2010/03/19/politics/main6314410.shtml 

CNN.com. (2010) "Obama calls for congress to face health care challenge." Retrieved on June 5, 2010, from the Web site:

 http://www.cnn.com/2009/POLITICS/09/09/obama.speech/index.html

nytimes.com/2010/05/24/health/policy/24health.html?scp=6&sq=congress%20health%20care%20may%202010&st=cse http://krugman.blogs.nytimes.com/2009/07/28/why-americans-hate-single-payer-insurance/?scp=7&sq=health%20care%20the%20single%20payer%20issue&st=cse

Peter Baker, "As Oil Slips Away, So Do Chances for Obama," New York Times, http://www.nytimes.com/2010/06/03/us/politics/03memo.html?scp=3&sq=obama health care plan&st=cse

Robert Pear, "Health Insurance Companies Try to Shape Rules," New York Times,  http://www.nytimes.com/2010/05/16/health/policy/16health.html 

Robert Pear, "Study Points to Health Law's Penalties," New York Times,  http://www.nytimes.com/2010/05/24/health/policy/24health.html?scp=6&sq=congress%20health%20care%20may%202010&st=cse   http://krugman.blogs.nytimes.com/2009/07/28/why-americans-hate-single-payer-insurance/?scp=7&sq=health%20care%20the%20single%20payer%20issue&st=cse 

Peter Baker, "As Oil Slips Away, So Do Chances for Obama," New York Times,  http://www.nytimes.com/2010/06/03/us/politics/03memo.html?scp=3&sq=obama  health care plan&st=cse

The ultimate House vote was two hundred and twenty to two hundred and seven. The senate vote was fifty three to forty three. The republicans were collectively opposed in both chambers (3 June 2010, 3).

The Future of the Health Care ill

Subsequent to disagreements as political enemies for more than a year, the Obama administration and the health insurance industry realized that they require one another.

oth have huge stakes in the success of the new health care law (14 May 2010, 1)

The political destiny of President Obama and Congressional Democrats rely on their capability to interpret it's assurance into realism for voters. This can be attained by restraining health expenses and making insurance accessible to everybody at reasonable price. Similarly, the fiscal future, in fact the continued existence, of the health insurance industry relies on the government. That is on set of laws being written by federal…

Bibliography

1. "Critics Question Study Cited in Health Debate, " New York Times, 2 June 2010, sec. a, p. 1.

2. "Health Reforms," New York Times, 26 March 2010, sec. a, p. 1.

3. "Two Health Care Adversaries Find a Need to Collaborate, " New York Times, 3 June 2010, sec. B, p.3.

4. "Companies Try to Shape Rules, " New York Times, 15 May 2010, sec. a, p.22

Health Plan Dev

Health Plan and Health Organization Development

Five Key Events

There are a multitude of different historical events that have occurred in the modern era in a manner that has drastically changed the way in which health and the relationships between society and healthcare has been viewed. In Germany in 1883, Chncellor Otto van Bismarck managed to implement a national insurance-like healthcare scheme that ensured certain basic access to healthcare for many working-class Germans that would otherwise go without medical care. A second highly similar event occurred in England in 1911 with the establishment of a national health insurance program, which eventually became the National Health ervice of the United Kingdom that still provides healthcare services to the nation's citizens today.

The ocial ecurity Act of 1935 represents a major shift in the direction of healthcare policy in the United tates, as this legislation laid the groundwork for…

Socioeconomic and Legislative Influences

In the latter part of the nineteenth century and the first half of the twentieth century, industrialization began to create ever more stark and extreme differences in the living standards of individuals and families living at different rungs on the socioeconomic ladder. Medical care had become hugely more effective, but could not be afforded by many of the working class, and thus government increasingly saw a need -- and felt certain pressures -- to intercede and provide at least a minimum of care for its citizens. There are directly pragmatic economic benefits of such intercession; improved healthcare leads to increased productivity and reduced costs in other social spending, even potentially reducing criminality as fewer families would find themselves in destitute situations without reliable wage earners due to illness or injury. All of these socioeconomic factors have led to an increased sense of social and civic responsibility for healthcare, yet the initial and direct expense of such a system on a national level with universal coverage has been a dissuasive factor.

Healthcare organizations in the United States have been hugely impacted by several key pieces of twentieth century legislation, including the Social Security Act of 1935, the adjustments to Medicare and Medicaid made in 1966 and in subsequent years throughout the following decades. Currently, the Affordable Care Act is set to go into full enforcement in 2014, and healthcare organizations and insurance providers are already beginning to make adjustments based on these anticipated changes.

Discharge Plan

Assessment of the Situation

As a case manager for patient in this case scenario there are at least four easily identifiable healthcare issues associated with the discharge of patient; 1. Patient safety related to second floor placement of apartment and navigation of two flights of stairs with walker while using pain medication and recovery time needed for hip replacement 2. Patient safety with regard to size and condition of apartment with limited room to navigate with walker, cluttered space and rug placement all of which are barriers to proper use of walker and ambulation an essential aspect of recovery, 3. The potential for patient non-compliance with new medication regimen for diabetes and dietary plan for weight and glucose control 4. Patient well being with regard to isolation and the inability to follow normal routines such as helping in bakery (two flights down) eating in bakery and interacting with…

References

Borg, C., Hallberg, I., & Blomqvist, K. (2006). Life satisfaction among older people (65+) with reduced self-care capacity: the relationship to social, health and financial aspects. Journal Of Clinical Nursing, 15(5), 607-618.

Byers-Lang, R.E., & McCall, R.A. (1993). Peer support groups: Rehabilitation in action. RE:View, 25(1), 32-36.

French, D.D., Bass, E., Bradham, D.D., Campbell, R.R., & Rubenstein, a. Z. (2008). Rehospitalization After Hip Fracture: Predictors and Prognosis from a National Veterans Study. Journal Of The American Geriatrics Society, 56(4), 705-710. doi:10.1111/j.1532-5415.2007.01479.x

Lin, P., Hung, S., Liao, M., Sheen, S., & Jong, S. (2006). Care needs and level of care difficulty related to hip fractures in geriatric populations during the post-discharge transition period. The Journal Of Nursing Research: JNR, 14(4), 251-260.

(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

The Foundation called specific attention to the prospect of institutional and policy-level strategies to increase the participation of under-represented minorities in the health professions. In response, the Institute Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Healthcare Workforce came out with a report, entitled "In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce." The Committee consisted mostly of academicians, two of whom represented the nursing profession.

In its report, the Committee recognized the importance of increasing racial diversity among health professionals in order to improve access to care, greater patient choice and satisfaction and better educational experiences for practitioners, among other benefits. It also recognized the lack of strategies in reducing institutional and policy-level barriers among health profession educational institutions or HPEIs. In response to the lack, the Committee recommended that health professions education make a clear stand and mission on the…

BIBLIOGRAPHY

AHRQ (2007). The national healthcare disparities report, 2006. Agency for Healthcare

Quality and Research, Medscape. Retrieved on June 18, 2009 from  http://www.medscape.com/viewarticle/552271 

www.medscape.com

Alabama Nurse (2004). ANA Review: Institute of Medicine report on workforce diversity,

Thus, Congress and whoever drafts the plan, really has to figure out how to show the health care interests the reform will help, rather than hinder, their profits, or it simply will not occur.

The health care plan must also be feasible and able to stand the test of Congress, who have vetoed all health care reform legislation offered up to them in history. Congress can find something wrong with just about any health care reform, from how much it will cost to how it is administered, and that means that the legislation has to be foolproof and have the support of a majority of the Congress or it will not pass. That is quite clear from the current mess with the auto industry and the lack of Senate support for a bailout.

eferences

Oberlander, J. (2007). Learning from failure in health care reform. N Engl J. Med, 357(17), 1677-1679.…

References

Oberlander, J. (2007). Learning from failure in health care reform. N Engl J. Med, 357(17), 1677-1679.

Oberlander, J. (2003). The politics of health reform: Why do bad things happen to good plans? Health affairs Suppl web Exclusives: W3-391-404.

..a commercial for Wal-Mart. When a Wal-Mart shows up within a television within a Wal-Mart, you have to question the existence of an outer world"(Ehrenreich, 179). The author is highly critical of places like Wal-Mart for she knows that these are the places where you do not get what you must as a citizen of the U.S. She writes: "When you enter the low-wage workplace -- and many of the medium- wage workplaces as well -- you check your civil liberties at the door, leave America and all it supposedly stands for behind, and learn to zip your lips for the duration of the shift." (p. 210)

Wal-Mart is described as an overpowering omnipresent entity that makes a worker feel like a prisoner. With most of the people coming from the most vulnerable section of the society like Holly who is " twenty-three, has been married for almost a year,…

References

UFCW report: "Wal-Martization of Health care." Retrieved online 22 Jan 2007:

 http://www.ufcw.org/take_action/walmart_workers_campaign_info/facts_and_figures/walmartonbenefits.cfm 

Is Wal-Mart Good for America?" Retrieved online 22 Jan 2007:

 http://www.pbs.org/wgbh/pages/frontline/shows/walmart/transform/protest.html

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…

Works Cited

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

Gingrich believes that there is a great need to repeal and substitute the huge government health bill with actual solutions that will lessen costs and enhance health outcomes. In addition to opposing the Obamacare because of its failure to accomplish universal coverage, he proposes the Patient Power Plan that will change the current system into a coordinated and innovative system rather than a broken and fragmented one.

I support Gingrich's proposal of the Patient Power Plan as the most suitable health care system that make health coverage more affordable, accessible, and portable. Since the plan gives patients an incentive to efficiently use medical care, it prevents excessive costs that are linked to overuse of medical care and excessive administrative burdens. One of the major advantages of such a plan is that it allows patients to self-insure for several likely medical bills through initiatives like medical savings accounts. Secondly, the plan…

References:

Paul, R. (2006, August 23). Lowering the Cost of Health Care. Retrieved March 20, 2012, from  http://www.lewrockwell.com/paul/paul339.html 

"Real Reform." (n.d.). PatientPowerNow.org -- Independent Institute. Retrieved March 20,

2012, from http://www.patientpowernow.org/free-market-health-care-summary/

In many cases, plans that have looked good on paper haven't worked out in real life. An example of this would be the "gatekeeper" practices, where the primary care physician decided if a patient needed to see a specialist, or have certain tests performed, or be hospitalized. The doctors had financial incentives to not refer, creating a potential conflict of interest, while patients resented their diminished ability to participate in their own healthcare decisions (Nichols, et. al., 2004).

In addition, employers are the real insurance providers for many people, and since employers are not a core part of health care systems, they make their decisions based on the bottom line: as host care costs rise, they pass at least some of this increase on to their employers by requiring higher co-pays on the insurance premium (Nichols, et. al., 2004).

Where consumer-driven health plans have been established, they have reduced costs…

Bibliography

Anderson, Gerard, and Hussey, Peter Sotir. 2001. "Comparing Health System Performance in OECD Countries: Cross-national comparisons can determine whether additional health care spending results in better outcomes. Health Affairs, 20:3.

Kaiser Family Foundation (KFF). 2004. "The Uninsured and Their Access to Health Care. Kaiser Commission on Key Facts, November.

Nichols, Len M.,; Ginsburg, Paul B.; Berenson, Robert a.; Christianson, Jon; and Hurley, Robert E. 2004. "Are Market Forces Strong Enough to Deliver Efficient Health Care Systems?" Health Reform, March-April.

Oddly, as a number of more objective critics have pointed out, Clinton's bill was "a compromise between market-oriented and government-centered reform ideas," (Carter 116). Although Clinton was concerned with creating a national healthcare system, he was also concerned with eliminating the federal budget crisis that he had inherited. The result was that Clinton offered a stepwise approach towards a socialistic healthcare system with an initial period, at least, of allowing the market to share some of the burden of insuring so many Americans. Doubtlessly, this is not to say that Clinton's plan would necessarily have been successful; merely that the reasons for which it was attacked and subsequently defeated were largely unfounded.

Overall, the true threat that the Clinton healthcare plan posed was to the Republicans. If Clinton had been successful in passing his bill, the legitimacy of the Democratic Party would have been restored; they could once again have…

Works Cited

Carter, Dan. "Rightward Currents: Bill Clinton and the Politics of the 1990s." From the Clinton Riddle edited by Todd G. Shields. Fayetteville: University of Arkansas Press, 2004. Pages 111-134.

Second Opinions for Tough & Smart Care

FLA, FECA, H2457

The federal government (under most current administrations) has tried to address the issue of the nation's need for better healthcare by focusing on improving what is already in place. Two of the regular efforts at this are the FLA (Family Leave Act) and the FECA, or Federal Employees' Compensation Act (DOL, b). The purpose of the first is to provide structured and economically efficient ways for people to be able to leave their positions, without risking their jobs, when they are dealing with either the birth of a child or a critically sick immediate relative. It is also seen as one effort to seek to protect men and women against the problems of gender injustice that can come about if women are challenged in keeping healthcare because of the choice to have children. FECA, on the other hand, seeks to…

REFERENCES

DOL.gov. The Family and Medical Leave Act. United States Department of Labor, Wage and Hour Division. Department of Labor. Web <  http://www.dol.gov./whd/regs/compliance/1421.htm >.

DOL.gov (b). The Federal Employees' Compensation Act. United States Department of Labor. Web. <  http://www.dol.gov/compliance/laws/comp-feca.htm >.

GovTrack.us. H.R. 2457 (111th): Right to a Second Medical Opinion Act of 2009. <  http://www.govtrack.us/congress/bills/111/hr2457 >.

R. Kuttner. Market-Based Failure -- A Second Opinion on U.S. Health Care Costs. New England Journal of Medicine, 2008; 358:549-551.

Healthcare in the United States: Where We Have Been, Where We Are Going

The current healthcare crisis in America is not one that happened over night. It is one that has been building for more than a quarter century. There was a time in America when healthcare was a stellar institution: research, cures, technological advances, and treatments. The focus of healthcare was maintaining and improving the quality of life. Then, during the early 1980s, managed care became an entity between the physician, the patient, and the healthcare provider of hospital services. It began subtly, but has, today, become one of the most aggressive and successful business ventures of our time; and it has been the unmaking of a once stellar and progressive American institution.

Managed care is a "distinctly American" product (Birenbaum, 1997). It was legislation introduced by the Nixon Administration with the intent to regulate healthcare and to maintain…

Reference List

Bernstein, A.B., Hing, E., Moss, A.J., Allen, K., Siller, A., and Tiggle, R. (2003). Health Care in America: Trends in Utilization. Hyattsville, MD: National Center for Health Statistics.

Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care. Westport, CT: Praeger.

Birenbaum, A. (1997). Managed Care: Made in America. Westport, CT: Praeger.

Committee on Health Care Access and Economics Task Force on Mental Health (2009). Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration. The Official Journal of the American Academy of Pediatrics, March, 30, 2009, pp. 1248-1251.