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Health Care Costs and Health Care Quality
he Robert Wood Johnson Foundation, dedicated to improving the health and health care of Americans, focuses on research, publication and funding. wo of its articles, "What is the National Quality Strategy?" And "What's the price of health care?" focus on several important issues of national health care. By simplifying the explanation of our National Quality Strategy and examining several states' attempts at health care cost transparency, the articles can assist developers of health care policy in their efforts to reduce health care costs while improving health care quality.
he articles chosen are "What is the National Quality Strategy?" (Robert Wood Johnson Foundation, 2012) and "What's the price of health care?" (Robert Wood Johnson Foundation, 2012).
Issues Discussed in the Articles
"What is the National Quality Strategy?" discusses the National Strategy for Quality Improvement in Health Care, also known as the National…
The authors' Perspectives Compared with Personal Perspective
Both "What is the National Quality Strategy" and "What's the price of health care?" are authored by the Robert Wood Johnson Foundation, a philanthropic organization founded by Robert Wood Johnson II of Johnson & Johnson, a global leader in health care products manufacturing and dedicated to improving the health and health care of Americans through research, publications and grants (Robert Wood Johnson Foundation, 2012). The American Beverage Institute (Doyle, 2003) and the Center for Consumer Freedom (Center for Consumer Freedom, 2007) both criticize the Foundation for being anti-alcohol. However, from the perspective of a health care provider, the perspective of a major health care products manufacturer that is anti-alcohol -- even if the accusation is true - is not particularly troubling, for two reasons: neither article addresses only alcohol per se; alcohol consumption is, in fact, a significant contributor to health care problems in the United States (National Institutes of Health, 2012), so a foundation addressing health care concerns would tend to include alcohol in its discussions.
"What is the National Quality Strategy?" mirrors the basic elements disseminated by governmental publications (U.S. Department of Health and Human Services, 2012) while simplifying the explanations for general
As the increased costs that they are paying, will more than likely mean that they cannot afford to receive routine physicals and checkups. When you begin to reduce the number of visits, the odds increase that various conditions and ailments may be discovered once it is too late. This is when the condition has become so bad, that it will require an individual have to visit a specialist. Once this take place, it means that the cost of treatment to increase. Evidence of this can be found with a Milliman Study, which found that cost shifting represents 15% of the total costs at a health care facility. As various business and government programs are often seeking out ways to reduce their overall financial burden. ("2010 Medical Cost Trends")
At the same time, the rising health care burden on the individual could mean that they might not be able to afford…
2010 Medical Cost Trends. Blue Cross. 2010.
"Census Bureau." NY Daily News. 2009. Web. 30 Aug. 2010.
Medication Errors Injure 1.5 Million People. National Academies. 2006. Web. 30 Aug 2010.
At present, we spend nearly 15% of GDP, or $7,000 per man, woman and child in the United States on healthcare. The next highest nations, Germany and France, spend only about 10% of their GDP on healthcare. The additional 50% we spend does not reward us in longer lives or a better quality of life.
Those in the healthcare community would argue that Americans receive the best healthcare in the world, and we therefore pay more. I would argue that the best measure of healthcare is longevity, and Americans do not live longer than those in other developed countries. While we may lead the world in high-tech solutions to healthcare problems, the results are no better than elsewhere -- just more expensive.
We as consumers bear the primary responsibility to control costs
Our current experience in the healthcare system is that we make few choices, and do little to scrutinize…
Health Care Cost for Average Families Is Increasing
Health care costs are increasing at their lowest rate in 20 years, according to recent studies (AON, 2015), but at 4.1%, these costs are still increasing faster than the rate of inflation (Patton, 2015). For the average American family, the reality that health care cost increases have been sustained over two decades, at rates faster than either wage increases or the inflation rate, is cause for concern. Families already having a tough time making ends meet ultimately find themselves devoting increasingly large portions of their earnings to health care, to the detriment of other expenditures. There are a number of different factors that have contributed to this trend.
One of the reasons why health care costs have increased so much is that there are a number of different causes, and these causes are all working in the same direction of increasing costs.…
AON (2015). U.S. health care cost increases at lowest rate in nearly 20 years: AON. Insurance Journal. Retrieved June 26, 2016 from http://www.insurancejournal.com/news/national/2015/11/12/388800.htm
Khazan, O. (2014). Why Americans are drowning in medical care debt. The Atlantic. Retrieved June 26, 2016 from http://www.theatlantic.com/health/archive/2014/10/why-americans-are-drowning-in-medical-debt/381163/
Patton, M. (2015). U.S. health care costs rising faster than inflation. Forbes. Retrieved June 26, 2016 from http://www.forbes.com/sites/mikepatton/2015/06/29/u-s-health-care-costs-rise-faster-than-inflation/#5cacbed56ad2
PWC (2016) Medical cost trend. Price Waterhouse Coopers. Retrieved June 26, 2016 from http://www.pwc.com/us/en/health-industries/health-research-institute/behind-the-numbers.html
Health Care Costs in the United States on the Access to Care
Total U.S. Spending on Health Care vs. Overall Health in America
The United States spends an extraordinary amount of money on health care. n 2009, health spending was $2.47 trillion dollars and accounted for 17.3% of the U.S. economy in 2009 (Pickert, 2010). This was a significant increase over the 2008 figure of $2.34 trillion and "was the largest one-year jump since 1960" (Pickert, 2010). This has led to predictions that by 2019, U.S. health spending will be $4.5 trillion (Pickert, 2010). Much of this spending is government spending. Approximately one-fifth of the federal budget in 2009 went to health-care spending. That year, the "federal government spent about $500 billion on Medicare; the federal government and states spent some $380 billion on Medicaid" (Pickert). However, while U.S. health care spending has risen, the quality of health care in…
Increased medical costs mean that medical facilities may need to reduce their budgets. Oftentimes, this results in decreasing staff numbers and not replacing medical equipment and supplies when necessary. This is particularly troublesome for large-scale care providers, like hospitals, where supplies form a significant part of their budgets. "Many -- but not all -- of the price hikes are driven by the continually-rising price of oil, but others are not" (Zieger, 2008). The relationship between medical supply costs and oil prices is not simply about transportation, some medical supplies, like latex gloves, require oil to manufacture them. However, they also happen to be critical in helping curb the spread of disease in a hospital environment. "All told, it's an ugly picture that shows no signs of getting better over the near-term. And with many hospitals at the break-even point or even losing money, supply costs could be the straw that breaks the camel's back for some" (Zieger, 2008).
Zieger, A. (2008, July 22). Rising medical supply costs squeeze hospitals. Retrieved December
5, 2011 from Fierce Health Finance website: http://www.fiercehealthfinance.com/story/rising-medical-supply-costs-pinch-hospitals/2008-07-22
healthcare costs which are causing hospital a great deal of financial pain while also hurting patients in terms of higher bills. We need to understand that if an industry knows that its maintenance costs a lot, it will obviously pass on some of those expenses to its customers. The same is being done in healthcare industry and this is primarily because the cost of running and maintaining operations in a healthcare industry is very high in the U.S. The article talks about a research that is being carried out by a university and that seeks to find out if cost reduction methods used by other industries can be replicated in hospitals and other medical facilities as well. This is an important issue and the article is written to highlight the problem of higher maintenance costs in this industry and the fact that much of these costs can be avoided with…
Health Care Costs
ays to Cut Them Right Now
In the face of high health care costs, the health care industry is striving to reduce costs by addressing chronic, expensive drains on health care dollars. Researchers have offered numerous steps that can be taken to significantly reduce costs. Furthermore, while some cost-cutting programs are considered ineffective window-dressing, major health care providers have systematically and pointedly taken successful steps to reduce costs while rewarding compliance with those steps.
Three of the Ten ays to Cut Health Care Costs Right Now, Described by Arnst
hile Catherine Arnst describes 10 ways to cut health care costs right now and Kaiser Permanente addresses all 10 of those ways, 3 of the ways Kaiser Permanente cuts health care costs leap to mind: cracking down on fraud and abuse; developing a healthy workforce; and stopping infections in hospitals. "Fraud and abuse" in health care includes but…
Arnst, C. (2009, November 12). 10 ways to cut health-care costs right now. Retrieved on July 23, 2012 from www.businessweek.com Web site: http://www.businessweek.com/magazine/content/09_47/b4156034717852.htm
Coalition of Kaiser Permanente Unions. (2012). Healthy Workforce | Labor Management Partnership. Retrieved on July 23, 2012 from www.lmpartnership.org Web site: http://www.lmpartnership.org/healthy-workforce
Kaiser Permanente. (2008). Healthy workforce gateway. Retrieved on July 23, 2012 from epf.kp.org Web site: https://epf.kp.org/wps/portal/healthyworkforce/selectregion-WCM_GLOBAL_CONTEXT=
Kaiser Permanente. (2011, March 9). New research unveils high support for programs to reduce infections in hospitals. Retrieved on July 23, 2012 from xnet.kp.org Web site: http://xnet.kp.org/newscenter/pressreleases/nat/2011/030911sepsis.html
The healthcare industry is in turmoil. Ironically, there are many sides and perspectives to the argument because healthcare in this country is and always was a major part of all aspects of life. We cannot just say 'let's fix the doctors' and all the problems go away. Every single man, woman and child as well as every single private and business decision in one way or another is affected by the existing healthcare cost situation. Most people do not consider that even the price of milk in their grocer's store or the overall cost of their automobile has in some way been affected by the crisis in healthcare. Consider a simple business decision like hiring a new employee in any business sector. This relatively mandatory decision comes with all types of hidden healthcare related concerns. In the private sector, consider a family member deciding to go…
healthcare costs for smokers are significantly higher than their non-smoking counterparts, and this paper reviews the relevant literature to measure the degree, if any, to which smokers are currently paying their own health care costs. An analysis of the costs that are associated with the second-hand smoke generated by smokers to identify additional costs is followed by a summary of the research and important findings are presented in the conclusion.
Smokers Should Pay for Their Own Health Care Costs Incurred from Smoking-elated Diseases
Despite a growing number of aggressive campaigns to completely eradicate the habit in recent years, many Americans continue to smoke tobacco and incur a number of smoking-related healthcare problems as a result. In fact, the costs that are associated with caring for smokers' healthcare needs far exceed those of their nonsmoking counterparts, but some analysts argue that smokers are already paying their own share of health care…
Cox, S. & Foster, J. (2011). A smoking dilemma. Journal of the International Academy for Case
Studies, 17(1), 125-127. [PRINT]
Daynard, R.A. & Barr, B. (1999, November 8). Is Janet Reno's RICO lawsuit against big tobacco legally justified? Insight on the News, 15(41), 40. [PRINT]
Limbaugh, D. (2001, May 7). Federals' tobacco suit should go up in smoke. Human Events,
Higher Health Care Costs on usinesses
Without doubt, America faces some heavy challenges in the forthcoming years. First, still reeling from the terrorist attacks of September 11, 2001, the United States struggles to find the medium ground between protecting its border and sacrificing its people's civil liberties and stepping on other countries' sovereignty and freedom. Most recently, we've faced a large budget crisis, with huge line items such as Social Security and the social welfare net being threatened like never before.
Of course, we face our usual income disparity issues, with the rich getting wealthier, and the poor being evicted from the job market altogether, and with a sense of finality. Then there are the scores of environmental issues, crime issues and the large divide between the "blue" states and the "red" states.
ut none of these problems may be as galvanizing and as critical to solve as the nation's…
http://www.fff.org/freedom/1201e.asp http://www.ncsl.org/programs/health/healthcostsrpt.htm#dir http://www.ftc.gov/opa/2004/07/healthcarerpt.htm
Canadian Medical Association Journal: Oct. 1, 2002: 167 (The link between publicly funded health care and compulsory licensing.)
Buffett Taylor & Associates: Employee Wellness Initiatives Study.
Technology and Cost Containment:
The ongoing increase in the costs of health care has become one of the major impediments towards increasing the accessibility and affordability of care services and enhancing patient outcomes.
Policymakers and various stakeholders in the health care industry have taken various measures to help lessen the costs of these services. One of the major initiatives undertaken by these stakeholders is the adoption of technology to address health care issues related to cost. Health information technology incorporates a wide range of technologies that are used to manage and share patient information electronically instead of the use of paper records (Takvorian, n.d.). Health information technology has been adopted because of its potential to enhance patient safety, improve the quality and efficiency of health care, and assist in restraining the rising costs.
Even though technology is considered as a major measure for lessening the escalating costs of health care,…
Jessup, A, (2012, May). Health Care Cost Containment and Medical Innovation. Retrieved from U.S. Department of Health & Human Services website: http://aspe.hhs.gov/sp/reports/2012/costandinnovation/ib.shtml
"Snapshots: How Changes in Medical Technology Affect Health Care Costs." (2007, March 2).
The Henry J. Kaiser Family Foundation. Retrieved June 30, 2014, from http://kff.org/health-costs/issue-brief/snapshots-how-changes-in-medical-technology-affect/
"Summing Up HITECH Goals." (n.d.). Success EHS -- A Part of Greenway. Retrieved June 30,
Influences towards the U.S. healthcare costs
Influence on U. S Healthcare
Influences on U.S. Healthcare costs
Throughout the years, the United States level of healthcare has been adversely affected by various emerging trends concerning Medicare. Some of these factors are the increasing health insurance industry, advancement in technologies used in medicine, demography changes and the improvement of customer support for healthcare. This has implicated towards the expenditures that continue to pile up towards the citizen and the U.S. government.
Increment in the rapid changes, in health insurance, has put health policies on the limelight. This is due to the cost containment towards the community (Kaiser, 2007). The issue of affordability of the insurance towards the citizens has advocated the re-address of this issue. Similarly, inconsistencies and different explanations from health policymakers has affected levels of health services from insurance providers and eventually implicating to division of costs from…
Karen, D. (2008). Slowing the Growth of Health Care -- Learning from International Experience. The New England Journal of Medicine. Vol 359. Pg 1751-1755.
Orszag, P. (2009). Demographics is a bigger problem than health care costs. Keith Hennessey: Guide to American Economic Policy.
Siegel, J.S. (2011). The Demography and Epidemiology of Human Health and Aging. New York: Springer.
Cost of Hypertension
The economics of health care depends on a progressive decision process that allocates scarce resources, in a manner that achieves the best overall outcomes (Alcocer & Cueto, 2008, p. 147-149). This process is necessarily complicated and imperfect, and the desired result can be influenced by a number of social and political forces, including geographic boundaries, racial and economic disparities, and competing funding needs. To provide the best health care possible for a given funding level, policy makers will need to increasingly rely on evidence-based approaches to help them grasp the cost-effectiveness of specific treatments.
This cost-effectiveness calculation is complicated by conditions or diseases that contribute to the morbidity and mortality of other conditions. For example, hypertension is often recognized as a direct-contributing factor to diabetes, ischemic heart disease, and cerebrovascular disease and aggressive hypertension treatment can't always be assumed to be cost-effective (Author, 2012). The…
Alcocer, L. & Cueto, L. (2008). Hypertension, a health economics perspective. Therapeutic Advances in Cardiovascular Disease, 2, 147-155. doi: 10.1177/1753944708090572.
Athanasakis, K., Souliotis, K., Tountas, Y., Kyriopoulos, J. & Hatzakis, A. (2011). A cost-utility analysis of hypertension treatment in Greece: Assessing the impact of age, sex and smoking status on outcomes. Journal of Hypertension, 30, 227-234. doi: 10.1097/HJH.0b013e32834d9f18.
Author, J.B. (2012). The cost of hypertension.
Barton, P., Andronis, L., Briggs, A., McPherson, K. & Capewell, S. (2011). Effectiveness and cost effectiveness of cardiovascular disease prevention in whole populations: Modeling study. British Medical Journal, 343, 1-10. doi: 10.1136/bmj.d4044.
"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.
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 .
Healthcare spending by the New York State persistently surpasses its earnings. That difference continues to be expanding and is also anticipated to broaden unless of course there happen to be severe, continuous modifications in spending budget actions. Lieutenant Governor ichard avitch, in "A 5-Year Strategy to Deal with the State of New York's Spending budget Deficit" released during March 2010, approximated this structural disproportion within the state's spending budget to become no less than $13 billion. The structural inequality isn't simply the consequence of the economic downturn that started during 2007, and a commonly strengthening economic climate is not going to get rid of it.
To help the State of New York in providing the solutions and dedication to quality that its residents rely on, structural modifications are needed. The aim of this paper is actually to summarize one particular realignment - solving an outright inequity involving the state as…
California Public Employees' Retirement System, "Facts at a Glance: Health," September 2010, http://www.calpers.ca.gov/eip-docs/about/facts/health.pdf .
Citizens Budget Commission, Out of Balance: A Comparison of Public and Private Employee Health Benefits in New York City, December 2009, http://www.cbcny.org/sites/default/files/REPORT_Survey_12162009.pdf .
City of New York Office of Labor Relations, "New York City Summary Program Description, Health Benefit Program," 2010, http://www.nyc.gov/html/olr/downloads/pdf/healthb/full_spd.pdf.
Government Finance Officers Association, "Recommended Practices, Health Care Cost Containment 2004," http://www.gfoa.org/downloads/corbaHealthCareCostContainment.pdf .
Second, poor health in the individual probably detracts from his or her capacity to contribute to society more directly than the harm to productive society represented by the cost of the individual's healthcare.
Furthermore, the vast majority of American healthcare dollars are spent on individuals in their later years, after their productive lives are already over, rather than on working-age people. Finally, while reducing healthcare costs is necessary for the optimal health of the American economy, it probably relates more directly to private economic matters rather than to consuming national resources that could otherwise be dedicated to technological development in a general sense.
Response to Statement #3: As suggested in Response #2, optimum public health is not necessarily a prerequisite for global competitiveness unless by "health" one means healthy enough to reach productive adulthood. On the other hand, the American population is undoubtedly on the verge of an obesity crisis,…
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.
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.
(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
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.
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.
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.
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 .
Healthcare spending and GDP
With the renewed comprehensive healthcare system, the obvious challenge that came with it is how to finance it. The huge projections of the financial inputs needed to efficiently run the program portends a challenge to the government and is likely to spin out of control and be unaffordable in the long run after a few decades from now. This is informed by accompanying supplies and services increasing in cost like the essential original drugs that have been noted to have increased in prices among other services within the healthcare. In many countries people are expected to pay for their own health care. Therefore the ability of people to pay for their health care or the affordability of the healthcare has become a policy issue in many countries and especially an issue of urgency. The issue of healthcare spending has been a topic for debate over the…
Rise in healthcare spending can also be attributed to the use of improved technology, vaccine improvement, antibiotics, introduction of disease care as well as advances in surgery. There have also been improved medical devices like CT scanners, MRI, ultrasounds and defibrillators that can be implanted. At the same time there are developments in pharmaceuticals and administration costs have also contributed to the rise in costs of healthcare. Mostly the heath care costs are due to medical technology which is approximately over 200 billion per year (Wayne, 2012).
The Americans lifestyles also impact the health care industry in significant measures, almost sixty percent of the population is overweight and childhood obesity is rampant. Other factors that have an impact on the healthcare spending are; poor diets, high blood pressure, smoking, lack of exercise, drugs and drinking. It is the people themselves who have pushed the costs of health care up. The high healthcare spending ahs effects not only to families but also to businesses and public budgets. Expenditure on healthcare is seen to rise at a rate that is fast even faster than the state of the economy entirely and the wages of the working people.
In 2011 spending on medications, hospital visits as well as other medical care went up with an estimated percentage of 3.9 this consumed about 17.9% of the GDP. This is more than three times the deficit. Much of the money is considered to be spent appropriately which is keeping people alive and healthy but of
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.
Surgeons in Canada report that, for heart patients, the danger of dying on the waiting list now exceeds the danger of dying on the operating table. Emergency rooms there are so overcrowded that patients awaiting treatment frequently line the corridors. Not only is there a long wait for care, but care is frequently denied to patients who prognosis is poor. In ritain kidney dialysis is generally denied patients over the age of 55. At least 1,500 ritons die each year because of lack of dialysis.
Countries with national health care systems also lag far behind the U.S. In the availability of modern medical technology. In Canada, high-technology medicine is virtually unavailable. In addition to being biased against new medical technologies, national health care systems generally discriminate against nontraditional practitioners, such as naturopaths and chiropractors.
It is true that Canada spends only about nine percent of its GDP on health care,…
Financing National Health Insurance." (2003, February 4). Available:
http://www.pnhp.org/nhibill/nhi_financing.html (Accessed 9 Feb. 2005).
Health Care Policy Issues. Sept. 2004. Available:
http://www.newsbatch.com/healthcare.htm (Accessed 9 Feb. 2005).
(Wolf, 2008) When you put all of these different elements together, it means that denying health care services to undocumented workers and their families will cause their underlying levels of health to slowly deteriorate. If something serious does occur, these people will more than likely be forced to fend for themselves.
Conducting research in these two areas would be beneficial in influencing health care policy / outcome by: highlighting the overall human cost of the problem on the industry and society. Where, the act of denying them access to health care and the lingering effects could be considered a human rights issue. As a result, the research that would be conducted would be beneficial, in highlighting the overall harsh conditions that these families are forced to endure. Once you present the situation in this light, this will shift the debate from one of a cost issue to being about: basic…
Health Care for Undocumented Immigrants. (2008). Medical News Today. Retrieved from: http://www.medicalnewstoday.com/articles/56809.php
Aparico, A. (2004). Costs of Care and Lack of Health Insurance. Immigrants, Welfare Reform and Poverty Policy. (pp. 73 -- 77). Westport, CT: Praeger.
Wolf, R. (2008). Rising Health Care Costs. USA Today. Retrieved from: http://www.usatoday.com/news/washington/2008-01-21-immigrant-healthcare_N.htm
On the other hand, the industry will most likely insist on the service quality segment rather than on the price transparency. A constant improvement of the services provided within the healthcare facility will not only produce the appropriate competition on the market, but it will also provide the incentives for the other healthcare organizations, thus rising overall quality levels in the market. This will rather change the way hospitals price their services rather than price transparency.
Nevertheless, price transparency will change ridiculous situations in which the client is charged $35,000 to change a battery in a pacemaker. It will drive such prices lower, encouraging price competition.
1. A Call for Transparency in Healthcare Cost and Quality. On the Internet at http://blogs.msdn.com/healthblog/archive/2006/05/16/599064.aspx.Last retrieved on June 30, 2007
2. Feld, Stanley. What Is Real Price Transparency? Medicine: Healthcare System. May 2007. On the Internet at http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2007/05/what_is_real_pr.html.Last retrieved on June 30, 2007…
1. A Call for Transparency in Healthcare Cost and Quality. On the Internet at http://blogs.msdn.com/healthblog/archive/2006/05/16/599064.aspx.Last retrieved on June 30, 2007
2. Feld, Stanley. What Is Real Price Transparency? Medicine: Healthcare System. May 2007. On the Internet at http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/2007/05/what_is_real_pr.html.Last retrieved on June 30, 2007
Call for Transparency in Healthcare Cost and Quality. On the Internet at
Changes to Healthcare Practice and Delivery: A Study of Two Detroit, MI Healthcare Facilities Separated by Twenty Years
Changes to technology and to the political and regulatory landscape have led to many changes in the ways that businesses in all manner of industries operate. Increased communications capabilities, the shrinking size and cost for advanced technologies, and a variety of other changes have provided many businesses with an opportunity to operate more efficiently, and in so doing have also made many industries and markets more competitive. An examination of some typical businesses operating in these industries today as compared to their counterparts that were in operation twenty years ago provides ample evidence of the changes that have occurred and the ways in which businesses have adapted.
The healthcare industry has by no means been immune from these changes, but in fact has changed more than many other industries due…
Anderson, J. & Aydin, C. (2005). Evaluating the organizational impact of health care information systems. New York: Springer.
Armoni, A. (2000). Healthcare information systems: challenges of the new millennium. Hershey, PA: Idea Group.
Wager, K., Lee, F. & Glaser, J. (2009). Health care information systems: a practical approach for health care management. New York: Wiley.
When considering the ever-changing and highly competitive economic landscape of the modern world; governments, businesses and institutions must remain diligent in their care and compassion for their citizens and staff members. With the current exponential growth and advancement of technology and the computerization of business and learning, voters, workers and consumers have become much more connected to the organizations they patronize (Kurzweil). Accordingly, these important groups are faced with the continuous task of finding new ways to understand and subsequently accommodate the needs of their followers, while simultaneously securing lucrative business models and job environments. One of the most important needs presented in all demographics is reliable healthcare. Thus, with the inelasticity in the demand for healthcare, countries need to determine an applicable system, whereby citizens can have access to the medical services they will inevitably need. Collective access to healthcare represents the main problem in field of…
Blumenschein, K. And M. Johannesson. "Economic Evaluation in Healthcare. A Brief History and Future Directions." Journal of Pharmacoeconomics 10.2 (1996): 114-122.
Cox, Malcolm, et al. "Health Care Economics, Financing, Organization and Delivery." Family Medicine January 2004: 20-30.
Hamburger, Tom and Kim Geiger. "Healthcare Insurers Get Upper Hand." The Los Angeles Times 24 August 2009.
Jeremiah Hurley. "An Overview of the Normative Economics of the Health Sector." Journal of Health Economics 1.1 (2000): 55-118.
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…
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
Meanwhile, without any competition, such as n the form of a public healthcare insurance system, the private healthcare insurance industry also continually increases premium fees virtually at will (Kennedy, 2006; eid, 2009). Furthermore, by refusing policies to high-risk patients, private health insurers essentially "cherry pick" the lowest risk patients while leaving the most expensive medical services to be furnished at the public's expense by public funds available to provide healthcare for low-income individuals (Kennedy, 2006; eid, 2009). That is why, at the very least. The future of American healthcare insurance must include a public option (Kennedy, 2006).
The Issue of Government Healthcare Insurance Lobbying
The principal way that the private healthcare insurance industry maintains its control over American healthcare is through political lobbying of government representatives (Kennedy, 2006). In fact, there are approximately six healthcare industry lobbyists in Washington for every publicly elected representative. Throughout the 2009 negotiations in Washington…
Kennedy, E. (2006). America: Back on Track. Viking: New York.
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
As a result, millions of Americans remain unable to bear the heavy financial toll of medical expenses. Indeed, the problem of a lack of insurance for many is related to the problem of the cost of healthcare. So confirms the article by Consumer Reports (CR) (2008), which finds that "health-insurance premiums have grown faster than inflation or workers' earnings over the past decade, in parallel with the equally rapid rise in overall health costs. Industry spending on administrative and marketing costs, plus profits, consumes 12% of private-insurance premiums." (CR, 1) This reiterates the case that the undue imposition of costs by the healthcare industry -- a reflection of a free-market industry with little to no regulatory oversight -- has negatively impacted the accessibility and quality of healthcare for many of the poorest users.
Moreover, these users are most vulnerable to the long-term economic damages provoked by unexpected healthcare costs. So…
Bureau of Labor Education (BLE). (2001). The U.S. Health Care System: Best in the World, or Just the Most Expensive? The University of Maine.
Childress, M. (2010). Poverty is on the Upswing, but Metric is Out of Date. The Washington Independent.
Cockerham, W.C. (2004). Medical Sociology and Sociological Theory. The Backwell Companion to Medical Sociology.
Consumer Reports (CR). (2008). High Health Care Costs. Consumer Reports Health.org.
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
Health Policies Medicare
hen everyone in our country finally starts to reach the age of 65 years of age or older, then every person will become eligible for Medicare. It is clear that there are some elderly that are having minimum health concerns while others recurrently are dealing with medical issues for which they will have to seek out treatment by the doctor. However, research is starting to display that there are at least five top conditions that are enhancing on medical and drug spending. It is obvious that Heart disease circumstances are the number one medical issue that the those that are considered elderly are facing and that is becoming very costly to them. Most are unaware that the second one is the disease cancer and it could be internal or external for various elderly patients. Other issues such as joint ailments a lot of the times can cost…
Wenzlow, Audra T., et al. "Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness." Psychiatric Services 62.1 (2011): 73-8.
Sommers, Benjamin D. "Loss of Health Insurance among Non-Elderly Adults in Medicaid." Journal of General Internal Medicine 24.1 (2009): 1-7.
Verdier, James, and Allison Barrett. "How Medicaid Agencies Administer Mental Health Services: Results from a 50-State Survey." Psychiatric Services 59.10 (2008): 1203-6.
Harman, Jeffrey S., Allyson G. Hall, and Jianyi Zhang. "Changes in Health Care use and Costs After a Break in Medicaid Coverage among Persons with Depression." Psychiatric Services 58.1 (2007): 49-54.
Others believed that cost control would become a matter for distant and impersonal government boards, with a direct effect on care, and that the reduced competition brought about by the federal government's entrance into the insurance market in any form would simply lead to rising healthcare costs without any real control or oversight. These two pictures of dire futures brought about by the healthcare bill seem to be mutually exclusive, with one predicting uncontrolled expenses and the other control so tight that care is potentially denied for expense reasons alone, but both were a part of the argument against the national healthcare bill.
There has also been considerable debate regarding exactly who will be overseeing the program. There was considerable talk of "death panels," a deliberately fear-invoking image of a bunch of suit-wearing individuals determining when it was time for a person to die rather than continue to receive…
Another hugely contentious issue in the healthcare debate that raged in the summer of 2009 was the control of the expenses of the program, and how that would be related to the care received and the cost of that care (and the insurance to begin with) to the average taxpayer. On one side, many politicians and advocates stressed that even a single-payer system wouldn't mean that a government bureaucrat would decide care based on a need to control expenses; the programs overseers would assess the costs of providing healthcare and adjust spending and rates accordingly, just as occurs in the private insurance and medical services industries. Others believed that cost control would become a matter for distant and impersonal government boards, with a direct effect on care, and that the reduced competition brought about by the federal government's entrance into the insurance market in any form would simply lead to rising healthcare costs without any real control or oversight. These two pictures of dire futures brought about by the healthcare bill seem to be mutually exclusive, with one predicting uncontrolled expenses and the other control so tight that care is potentially denied for expense reasons alone, but both were a part of the argument against the national healthcare bill.
There has also been considerable debate regarding exactly who will be overseeing the program. There was considerable talk of "death panels," a deliberately fear-invoking image of a bunch of suit-wearing individuals determining when it was time for a person to die rather than continue to receive expensive medical care. The thought of panels of government bureaucrats overseeing every aspect of care, including end-of-life care, was horrific to many people, and a major source of anger and opposition to the bill. Proponents of the bill, however, insisted that the doctor and patient would still determine health care plans, and that the government's role would purely be in ensuring adequate funding in order to cover the vast majority of currently uninsured Americans. The reconciliation of these two views is still long in coming.
In the current era of managed care in medicine, physicians and other healthcare providers and institutions have been under tremendous pressure to reduce costs. In that regard, avoiding unnecessary hospitalization is one of the most important goals of lowering the costs of healthcare delivery (Stanhope & Lancaster, 2004). Toward that end, diverse strategies have evolved to provide as many healthcare services as possible on an ambulatory basis.
Hospitals and insurance companies now encourage patients to participate in preventative medicine and routine testing intended to lower the costs associated with hospitalization over the long-term. The strategy is simply to reduce the incidence of serious illnesses, particularly those that typically develop over many years and which are capable of prevention through behavior modification and early detection through diagnostic testing (Stanhope & Lancaster, 2004).
Because state and federal governments must absorb much of the costs of uncompensated medical services, the many administrative agencies…
References Stanhope, M., Lancaster, J. (2004) Community and Public Health Nursing (6th ed.) St. Louis: Mosby.
(Findlay, 2001, 90 -- 119) (McLeod, 2003, pp. 895 -- 908)
What is the possibility of bias entering the study? If the study is susceptible to bias, state and explain the type of bias that may enter the study and what steps can be incorporated to minimize the entry of bias.
The possibility for bias in the study is low. The reason why, is because researchers will have limited access to the patients they are seeing (through: the use of anonymous surveys). This will dramatically reduce the possibilities of bias existing. (Findlay, 2001, 90 -- 119) (McLeod, 2003, pp. 895 -- 908)
ased on your hypothesis/proposal, how will the proposed generated results help to develop an effective health policy for the target population of your chosen topic?
The proposal will help to develop an effective health policy. This is accomplished by: providing specific insights about how the increasing utilization of…
Findlay, S. (2001). Direct to Consumer Promotion. Pharmaco Economics, 19 (2), 109 -- 119.
Kryst, M. (2005). A Population-Based Survey. Headache, 34 (6), 341- 350.
McLeod, P. (2003). Physicians and Practice Characteristics. Medical Care, 41 (8), 895 -- 908.
Nursing homes, residential care facilities, and home health care will be core issues on the agenda for representatives in that area. In areas with substantial populations of non-native English speakers, a nurse might need to lobby for a greater wealth of bilingual health care services.
Community nurses are also becoming increasingly aware of the issues related to health care access including the growing number of underinsured or underinsured citizens. When communicating with lawmakers who have little first-hand knowledge of what health care costs are like or how health care integrates with the community, nurses need to focus on the issues that legislators understand. Policies related to access to health care can be framed in ways that achieve direct and immediate results. For example, a nurse might propose a strong network of community health and outreach centers that provide information on preventative care in multiple languages. Similarly, a nurse might work…
At the same time, 25% of Americans do not have any kind of health insurance coverage or not enough to pay for all of their expenses. (Amadeo) This can have an impact upon their financial well being, as a person must spend money that they do not have, to treat different conditions that could be life threatening. Once this begins to occur, is when the total number of bankruptcies will begin to rise sharply. As nearly half of all the filings that are made are: medical related, due to the overwhelming costs and the inability to pay them. (Amadeo) These different challenges are creating sudden shift in the economy that are: having short- and long-term impacts upon economic growth.
What is happening is rising health care costs are beginning to become a hidden tax on: businesses and consumers. As they are slowly eating away at any kind of added investments…
"The Boomer Stats." BBHQ, 2011. Web. 10 Mar. 2011
"The Economic Effects of Health Care Reform." The White House, 2010. Web. 10 Mar. 2011
Amadeo, Kimberly. "Health Care Reform." About.com, 2011. Web. 10 Mar. 2011.
Francis, Diane. "Health Care Reform is Smart." Huffington Post, 2010. Web. 10 Mar. 2011.
The government should provide health care, because the economic characteristics of health care make it ripe for abuse in a market environment. Government should provide as a service to its population those goods that, for one reason or another, are open for abuse in a normal market economy. Normally, the main condition is natural monopoly, which makes the case for government involvement in commodities like electricity, water, or policing. Health care is not a natural monopoly in that there can reasonably be a number of different providers, but it has other characteristics that make it a strong candidate for government intervention.
In even the freest capitalist economies, there are public goods that the government provides. The government provision of certain services is accepted by populations because the alternative -- total anarchy -- results is a severely degraded quality of life. No government services at all is a failed…
Besley and Gouveia write about different modes of health care provision. They discuss in particular some of the cost drivers in the American system, and evaluate some other systems in order to come to some conclusions about what other options exist. They note that insurance is a key issue for a private health care system, and because of this most countries opt for public health care systems, typically with mandatory insurance.
Gupta and Davoodi seek to understand how corruption affects the provision of government services, including health care. Unfortunately, their analysis has significant bias, as they begin with the assumption that government-run programs are inherently corrupt.
Transparency International is an organization that measures the level of government corruption in all the countries of the world. This source was required to examine the claims of Gupta and Davoodi. It was found that in the West there is very little government corruption. While the U.S. has more than most Western nations, it remains a spurious claim on the part of Gupta and Davoodi that corruption is inherent in government programs. Further, the line between corruption (accepting payment in return for favors) and capitalism (accepting payment to provide a service) is not explored.
Lloyd and Sreedhar wrote about Hobbes' moral and political philosophy. Hobbes' seminal discussion about the state of nature is relevant because societies have evolved different forms of governance specifically to avoid the state of nature; an argument that government should not be involved in health care must consider the implications of having such a weak government -- these range from the state of nature to poor health outcomes and quality of life measures.
In 2004, a Ten-Year Plan to Strengthen Health Care was announced, primarily intended to improve access to medical services, decrease wait times, and update medical equipment and ensure accurate reporting and enhance public health promotion and prevention programs. Shortly thereafter, the Canadian Supreme Court affirmed the nation's health care philosophy and the immediate need to implement further improvements envisioned by the ambitious 2004 plan in striking down a Quebec law that had prohibited private medical insurance for covered services:
The evidence in this case shows that delays in the public health care system are widespread and that in some serious cases, patients die as a result of waiting lists for public health care...In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services."
According to legal experts, the decision could "open the door to a wave of lawsuits challenging the…
Canadian Medical Association Journal.
1939 September; 41(3):
Chaoulli v. Quebec: Judgments of the Supreme Court of Canada Accessed, September 2, 2007, at http://scc.lexum.umontreal.ca/en/index.html
Kraus, C. (2005) Canada's Supreme Court Chips Away at National Health Care.
Health Care Finance
Greenwald engages in a discussion comparing the U.S. health care system to, well, other health care systems. An interesting methodological fault is that Greenwald cherry-picks his examples. In one paragraph, he compares the U.S. with Canada, in other the UK, and in another Spain. he problem, methodologically, is that he can cherry-pick data from whatever country best suits his argument. What this means, in terms of interpretation, is that Greenwald's findings need to be taken with a grain of salt. As an example, Greenwald notes higher wait times in three countries for urgent coronary artery bypass. Nobody likes high wait times, but Greenwald's U.S. figure doesn't factor in the uninsured, whose wait time is infinity. hey just die. he issue many have with the U.S. system is not that performance is poor; it is that performance is only good when you can afford it.
his cuts to…
This cuts to the heart of the difference between the U.S. And other industrialized countries. The trade-off between quality of care and universal care exists in any nation. The trade-off that other countries have made is that they have chosen universal care, even when there are times when service standards are lower. In the U.S., there has never been a strong collective motivation to make that trade-off. There are reasons for this, and they are more social that medical. While some have argued that lobbyists are the issue, I disagree with that assessment, because most other nations adopted universal health care long before lobbyists took over the U.S. government. The lack of universal health care in the U.S., therefore, is more related to social factors. The erosion of the manufacturing base has in turn eroded the sort of jobs where working class Americans can get health insurance; replace such jobs with part-time retail and the number of insured will decrease. Further, at-risk groups such as the poor, African-Americans, Native Americans and the disabled are disproportionally uninsured (Link & Phelan, 1996). There is a certain lack of concern with the well-being of these groups that has resulted in a lack of desire to provide insurance for them. It's kind of the elephant in the room -- while Canada and Europe were developing universal health care, a lot of parts of the United States were having trouble wrapping their head around desegregation in schools. We should not be so naive as to think this mentality does not play a role in public opposition to universal health care. As well, health care costs were manageable and for most, the system has worked reasonably well. This means there was no impetus for change -- only recently with the explosion of health care costs has there been concern about paying for health insurance even from the middle class.
There are a number of reasons why health care costs are lower in other nations. Greenwald notes that American health care facilities are more likely to invest in the most modern equipment. I wish he did not cherry-pick his supporting evidence ("seniors in Miami in the last six months of their lives receive the best care anywhere in the world") because this is a fairly demonstrable reality. At the top end, the U.S. health care system is usually better than in other countries. The fault Greenwald has is not following through and asking why this is. He is correct in pointing out that the best care can and should cost more. But facilities invest so heavily for two key
Health Care +
Greenwald identifies several factors that are resulting in escalating health care costs in the U.S. One of these is the values and expectations of the American people. The consumer (patients) have an expectation that they will receive a very high standard of care, and there is reason to believe that these expectations are increasing over time. This results in a demand driver for health care companies to constantly invest in research and development. There are other factors as well. Greenwald cites consumption by the disadvantaged and immigrants -- I'm not sure I agree with that. His argument is that the government is a payer, and many are using emergency care because they lack insurance, but this is logical fallacy. A lack of insurance is the reason these users are expensive -- it is not their existence that is the problem. Greenwald also notes that the rise in…
Greenwald, H. (2010). Health care in the United States: Organization, Management and Policy. John Wiley & Sons: San Francisco.
ef: The Health Care bill signed by Andrew M. Cuomo -- Governor for Treatment of Autism Spectrum Disorder
I wish to state that the legislation must have come in earlier than this. Autism is a condition that requires medication and care for children and the legislation passed by the Governor Albany, NY on November 1, 2011 requires that the treatment of Autism Spectrum Disorder be brought under the health care coverage. This is a laudable step in New York and it will be a blessing to such families with autistic children to afford the expensive health care costs. The law now makes it mandatory for the health insurance companies to provide coverage for treatment of autism spectrum disorders, and the companies however may resort to 'deductibles, co-pays, and coinsurance consistent with those imposed on other benefits.' (Cuomo, 2011)
Discussing the law Governor Andrew M. Cuomo said that the…
Cuomo, Andrew M. (2011) "Governor Cuomo Signs Law to Expand Health Care
Coverage for Treatment of Autism Spectrum Disorder"
Retrieved 12 November 2011 from http://www.governor.ny.gov/press/1112011Spectrum%20Disorder
National Conference of State Legislatures. (2011) "Insurance coverage for Autism"
Figure 1 portrays the state of Maryland, the location for the focus of this DR.
Figure 1: Map of Maryland, the State (Google Maps, 2009)
1.3 Study Structure
Organization of the Study
The following five chapters constitute the body of Chapter I: Introduction
Chapter II: Review of the Literature
Chapter III: Methods and Results
Chapter IV: Chapter V: Conclusions, Recommendations, and Implications
Chapter I: Introduction
During Chapter I, the researcher presents this study's focus, as it relates to the background of the study's focus, the area of study, the four research questions, the significance of the study, and the research methodology the researcher utilized to complete this study.
Chapter II: Review of the Literature in Chapter II, the researcher explores information accessed from researched Web sites; articles; books; newspaper excerpts; etc., relevant to considerations of the disparity in access to health care services between rural and urban residence in Maryland…
Potter, S. (2002) Doing Postgraduate Research. London: Sage.
Qualitative research: Approaches, methods, and rigour, (2008, Nov. 7). Microsoft PowerPoint Qualitative Research AdvC08 RS.PPT. Retrieved March 10, 2009 from www.unimaas.nl/bestand.asp?id=11629
Wolvovsky, Jay. (2008). Health disparities: Impact on Business and Economics Summit. Maryland's healthcare at a glance. The Heart of Community Health Baltimore Medical Syste. Retrieved March 10, 2009 at http://dhmh.maryland.gov/hd/pdf/2008/oct08/Jay_Wolvovsky.pdf
Access and Availability
The biggest problem in terms of access to healthcare is in rural areas. Our investigation found that there are very few if any rural clinics or healthcare facilities.
Access to healthcare is also limited to those that can afford insurance or qualify for Medicare or Medicaid. The unemployed and the poor are at a major disadvantage when it comes to gaining access to healthcare. The location of healthcare facilities is limited to the larger municipalities.
The entity that is responsible for the healthcare system is the United States Government. In addition, Puerto ico has a governor and a cabinet in place to ensure that the appropriate laws are carried out. The entity that makes laws concerning healthcare is outside of the country but the entity that enforces these laws is inside the country. Services are evaluated by state run entities and agencies of the United States…
The World Factbook -- Puerto Rico. Retrieved November 8, 2004 from; http://www.cia.gov/cia/publications/factbook/geos/rq.html#People
Puerto Rico: Estimated Number of Persons Living with AIDS at the End of 2002. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=HIV%2fAIDS&subcategory=Persons+Living+with+AIDS&topic=All+Ages
HIV / AIDS Among Hispanics. Retrieved November 8, 2004 from; http://www.cdc.gov/hiv/PUBS/Facts/hispanic.pdf
Puerto Rico: Total Number of Adults with Diagnosed Diabetes, 2002. Retrieved November 8, 2004 from;
The article states, "The enormous human and economic costs associated with occupational stress suggest that initiatives designed to prevent and/or reduce employee stress should be high on the agenda of workplace health promotion (HP) programs" (Noblet, LaMontagne, 2006, p. 346).
Along with the article's assertion that reducing employee stress should be beneficial to both the individual and the company, the article also documents the many problems that can occur due to stress in the workplace. The article espouses, "For employees, chronic exposure to stressful situations such as work overload, poor supervisory support and low input into decision-making have been cross-sectionally and prospectively linked to a range of debilitating health outcomes, including depression, anxiety, emotional exhaustion, immune deficiency disorders and cardiovascular disease" (Noblet, p. 347). Many of these illnesses are debilitating and can be long-term which adds to the company's cost due to employee absence(s) directly affecting the company's bottom line.…
Aldana, S.G., Merrill, R.M., Price, K., Hardy, a. And Hager, R. (2005) Financial impact of a comprehensive multisite workplace health promotion program, Preventive Medicine, 40, 131-137.
Downey, a.M., Sharp, D.J., (2007) Why do managers allocate resources to workplace health promotion programmes in countries with national health coverage?, Health Promotion International, Vol. 22, No. 2, pp. 102-111
Musich, S.A., Adams, L. And Edington, D.W. (2000) Effectiveness of health promotion programs in moderating medical costs in the U.S.A., Health Promotion International, 15, 5-15
Ozminkowski, R., Ling, D., Goetzel, R., Bruno, J., Rutter, K., Isaac, F. et al. (2002) Long-term impact of Johnson & Johnson's health & wellness program on health care utilization and expenditures. Journal of Occupational and Environmental Medicine, 44, 21-29.
Starbucks has committed to provide healthcare coverage to employees who work at least 20 hours a week. This year, the cost will add up to over 200 million dollars for coverage of its over 80,000 employees. Schultz's perspective, differing from G is that the company's healthcare accounts for its very low employee turnover and high productivity. However, their generosity is even now bringing down their bottom line, Starbucks is attracting older workers who no doubt join the company for its healthcare benefits. As a result, Shultz notes that Starbuck's future healthcare costs will dramatically increase. Starbucks has seen that their insurance costs have had double digit increases in each of the past four years, and that this growth is completely "non-sustainable." Part of the reason that Starbucks is able to maintain its current healthcare policy is the relative newness of the company and its current lack of retirement healthcare costs.…
Moroni, R. (2005, August 29). Foreign Competition May Push U.S. Health Reform.
Grand Rapids Business Journal. 23 (36), p4-4, 1/3p. Retrieved September 21, 2006, from the EBSCO HOST Regional Business News database. (an 18097323).
Yip, P. (2005, October 18). General Motors health-care deal an example of changes over time. Dallas Morning News, the (TX). Retrieved September 21, 2006, from the EBSCO HOST Newspaper Source database. (an 2W62009610037).
They have a strong balance sheet that enables them to acquire capital easily and cheaply, but they are shifting their staff to physician ratio from 6.11 to 7.5, indicating that their administrative cost structure is going to increase dramatically as a result of their current expansion strategy. Whether or not this represents a weakness that can be exploited by MCMPC remains to be seen, but it may materialize as a weakness in the future. There is the threat, however, that given the declining morale at MCMPC some of the clinic's physicians may defect to Innovative in order to advance their careers and improve the professionalism of their working environment.
The external environment provides a number of challenges for MCMPC. The unfortunate reality is that the company is ill-equipped to address many of these challenges. They have proven unable to build the key resources in specialists and referrals, and they have…
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 Financing and Nursing
Healthcare is one of the most contentious subjects in the United States today, with the financing of the healthcare system the specific issue of concern in legal, ethical, and pragmatic spheres. The debate surrounding this industry has impacted all areas of the healthcare industry, including the nursing profession, in a variety of complex ways that are both direct and indirect. ising healthcare costs without a rising ability to pay has created a strain on many medical institutions, and a rising demand for are with the rapidly aging population of the United States (that is, with a much larger older generation(s) in the country, the overall demographic of the nation is shifting quickly towards more elderly and care-intensive individuals) has not been adequately met with a rising provision of services (Kovner et al. 2011). The following paragraphs will explore several implications of this situation on…
Cleverley, W., Cleverley, J. & Song, P. (2011). Essential of Healthcare Finance. Sudbury, MA: Jones & Bartlett.
Kovner, A., Knickman, J., Weisfield, G. & Jones, S. (2011). Jonas & Kovner's Health Care Delivery in the United States. New York: Springer.
Mason, D., Leavitt, J. & Chaffe, M. (2007). Policy & Politics in Nursing & Healthcare. New York: Elsevier.
Healthcare for Mentally Impaired Patients
Probing what information is available about the current status of placement or accommodation and level of personal healthcare available to mentally impaired and emotionally disturbed individuals, it is clear that the analysis is as diverse as there are different mental illnesses. While statistics on managed care treatment for people with severe and disabling mental illnesses are sparse, it is evident that the financial responsibility to care for and house these patients is enormous.
According to Dr. David Satcher, the Surgeon General (1999), approximately 20% of the U.S. adult population has a mental illness. He says, "These illnesses include anxiety disorders, mood disorders, anorexia nervosa, and severe cognitive impairment. More serious mental illnesses include ipolar disorder and schizophrenia. Mental illness accounts for 15% of overall burden of disease -- more than malignant cancer and respiratory diseases -- and as far back as 1996 the direct cost…
Boulard, G. (2000, April). Forgotten Patients the Mentally Ill. State Legislatures, 26, 12. Retrieved February 13, 2004, from Questia database, http://www.questia.com .
Callahan, D. (1993, October) Minds and hearts: priorities in mental health services.
The Hastings Center Report.
Fox, M. & Kim, K. (2004, January) Evaluating a Medicaid Home and Community-based Physical Disability Waiver. Family and Community Health. Vol 27: 37.
In order to be successful in the present complex and frequently unfavorable business settings, a healthcare organization's strategic direction should be estimated, focused, and financially sustainable. Strategic business planning is an indispensable instrument to aid organizations focus strategic choices within the financial actualities of their environment. An efficient strategic business planning cycle includes making an evaluation, identification of business objectives, making strategies, performing an impact analysis and developing an execution plan. The important steps in strategic business planning comprises of conducting an assessment, identifying business objectives, making a strategy, carrying out an impact analysis, and developing an implementation plan. This procedure could include a one-to-three-year sequence and can be applied at the clinical service line or at the level of business unit level for a greater focused planning. The only certainty in the present healthcare environment is a constantly changing set of hypothesis regarding the future. (Bachrodt; Symth,…
'A New Look Into Strategic Financial Planning." Retrieved from http://www.hospitalconnect.com/aha/fsi/monitor / Accessed on 4 May, 2005
Bachrodt, Andrew. K; Symth, Patrick. J. (November, 2004) "Strategic business planning linking strategy with financial reality" Health Care Financial Management. Retrieved from http://www.findarticles.com/p/articles/mi_m3257/is_11_58/ai_n6359509 Accessed on 4 May, 2005
Brown, Judith. (2005) "Ten Strategies to Manage Employee-Healthcare Costs." Career
Journal. Retrieved from http://www.careerjournal.com/hrcenter/ipma/20041207-ipma.html Accessed on 4 May, 2005
Discuss the Challenges of eference Pricing-describe it, is it currently feasible, what are the pitfalls if it was part of your job assignment to build and manage such a program to control cost. What are the advantages and pitfalls if you are an individual using this "reference pricing" as an element of your personal health insurance program?
eference pricing has enormous potential to curb rising healthcare costs. In this situation, the insurance company or other stakeholder sets a target price that reflects what is considered a fair market value. Then if the consumer selects a healthcare service that is less than that amount, they are obligated to pay nothing. However, if the consumer selects a service that is greater than the reference price, then they are obligated to pay the difference. This system gives the consumer an incentive to participate in controlling costs whereas they might not otherwise…
Lechner, A., Gourevitch, R., & Ginsburg, P. (2013). The Potential of Reference Pricing to Generate Health Care Savings: Lessons from a California Pioneer. National Institute for Healthcare Reform, Brief No. 30.
Political Calculations. (2015, May 8). Did Obamacare Bend the Health Care Cost Curve? Retrieved from Townhall Finance: http://finance.townhall.com/columnists/politicalcalculations/2015/05/08/did-obamacare-bend-the-health-care-cost-curve-n1995787/page/full
The White House. (N.d.). The Affordable Care Act and Trends in Health Care Spending. Retrieved from The White House: https://www.whitehouse.gov/sites/default/files/docs/fact_sheet_implementing_the_affordable_care_act_from_the_erp_2013_final1.pdf
There are a number of innovations that can lower the cost of health care. The first category of innovation is prevention. esearchers are studying the issue of prevention more intently, as the cost benefits of avoiding illness, or of early detection, are evident. Exploration of the human genome is particularly important in helping the health care industry in early detection, and prevention. Gene therapy and other innovations can help keep people from getting certain conditions in the first place, and when such innovations are focused on chronic conditions, they can dramatically lower the total cost of health care.
Another type of innovation that can lower the cost of health care is anything that reduces the length of stay or the invasiveness of procedures. Many such innovations, such as arthroscopic surgery, have already contributed to lowering the costs associated with certain procedures. obotics is a major player here, having…
Aamodt, M (2013). Industrial/Organizational Psychology. Wadsworth Cengage: Boston
Chaffee, J. (2012). Thinking Critically. Wadsworth Cengage: Boston.
Domoff, S., Hinman, N., Koball, A., Carhart, V., Baik, K. & Carels, R. (2012) . The effects of reality television on weight bias: An examination of The Biggest Loser. Obesity. Vol. 20 (5) 993-998.
Greenwald, H. (2010) Health Care in the United States:: Organization, Management and Policy. John Wiley & Sons: San Francisco.
Despite of the receipt of federal funding to assist in the set-up of an insurance exchange program, the Minnesota legislature is not cooperating with the Governor Drayton's plans to design a program. Instead, in a classic example of partisan politics, the legislature is going forward with its own plans to design an exchange program. In doing so, the legislature is placing the State of Minnesota in a position of possibly losing the grant provided by the federal government. According to the grant provisions, the state must show it can operate an effective exchange program by the end of calendar year 2012 or the federal government under the terms of ACA will impose a one size fits all exchange on the state. Even the state's most conservative political groups oppose this happening and advocate that the state's executive and legislative branches cooperate in formulating an acceptable state exchange program.
Berkel, Jessica Van. "HCMC fights back against Pawlenty's GAMC Cuts." 3 December 2009. Minnesota Daily . http://www.mndaily.com/2009/12/03/hcmc-fights-back-against-pawlenty%E2%80%99s-gmac-cuts . 7 April 2012.
Gray, Virginia. "Incrementing Toward Nowhere: Universal Health Care Coveragein the States." Publius (2010): 82-113.
Harrington, Scott E. "The Health Insurance Reform Debate." The Journal of Risk and Insurance (2010): 5-38.
Minnesota Department of Human Services. "General Assistance Medical Care." 11 September 2011. http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&Redirected=true&dDocName=id_006257 . 7 April 2012.
health care profession is undergoing fundamental change due in part to new laws and regulations. These laws and regulations, although well intended may result in unintended consequences for the nursing profession overall. In the future, the role of a nurse will be fundamentally altered. For one, regulation such as the Affordable Care Act will result in an entire population of insured patients needing care. As such, the role of a nurse will ultimately be predicated on a more individualized basis with specialization in certain aspects. Caring for diabetes is no different in this regard. The public is particularly prone to diabetes primarily due to dietary and lifestyle considerations. As such, the topic of proper care and prevention of this issue is paramount to community health. The population at risk, due in part to regulation, is now society as a whole. This presents interesting challenges and opportunities for the overall health…
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2) Polonsky, K.S. (2012). "The Past 200 Years in Diabetes." New England Journal of Medicine 367 (14): 1332 -- 1340
3) Stewart WF, Ricci JA, Chee E, Hirsch AG, Brandenburg NA (June 2007). "Lost productive time and costs due to diabetes and diabetic neuropathic pain in the U.S. workforce." J. Occup. Environ. Med. 49 (6): 672 -- 9
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…
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