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Health Law and egulations
In America, the health care industry is highly regulated. This is because there are certain aspects of the law which are designed to improve quality and offer everyone with a variety of treatment options. To fully understand this relationship requires carefully examining a specific government agency, the laws impacting the industry, the effects on a health care provider and how this is affecting communities. Together, these elements will highlight the way they are influencing how health care services are delivered across the country.
Explain the role of one specific governmental regulatory agency that has a significant effect on the health care industry.
One government agency which is responsible for the regulation of health care is the Centers for Medicare and Medicaid Services (CMS). Their responsibility is to ensure quality and the efficient delivery of health care services for older adults, the disabled, children and low income…
A Summary of Fees and Taxes. (2013). Coventry Healthcare. Retrieved from: http://altius.coventryhealthcare.com/web/groups/public/@cvty_regional_chcut/documents/newsletter/c082316.pdf
Better Care. (2013). CMS. Retrieved from: http://www.cms.gov/
Health Care Law / Legislation. (2004). Coventry Healthcare. Retrieved from: http://healthamerica.coventryhealthcare.com/web/groups/public/@cvty_regional_chcpa/documents/webcontent/c041879.pdf
Standardization of the Claims Process. (2009). AMA. Retrieved from: http://www.ama-assn.org/resources/doc/psa/admin-simp-wp.pdf
Health Law and Ethics
In this case, there are a number of ethical issue that are raised therein. The first ethical issue is the fact that the physician tries to convince the mother not to report this particular negligence to the authorities on the strength that it was not child abuse. This is a misconception that it is only child abuse cases that should be reported and not other matters like negligence should be reported even though they led to serious injuries like the bilateral femur fractures that this child suffered. The other issue is that the physician went ahead to treat the child without necessarily calling the day care what could be the likely cause of the injury. This enquiry could have maybe let the day care take extra precaution about the injury and avoid further incidences as such.
The best ethical principle that can be used to address…
Ascension Health, (2012). Principle of Distributive Justice. Retrieved January 30, 2012 from http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=80:principle-of-distributive-justice&Itemid=171
Ascension Health, (2012). Principle of Informed Consent . Retrieved January 30, 2012 from http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=84:principle-of-informed-consent&Itemid=171
Demand Media Inc. (2012). Ethical & Cultural Issues in Medical & Surgical Nursing. Retrieved January 30, 2012 from http://www.ehow.com/facts_5864774_ethical-issues-medical-surgical-nursing.html
Food and Drug Administration, a United States federal agency, with regards to its major effects in the health care industry. Two examples of healthcare laws that are enforced by the Food and Drug Administration are also given. This paper will also discuss the effects of these healthcare laws on several specific healthcare providers.
The Food and Drug Administration (FDA)
The FDA is an agency of the United States federal government that is mandated by law to protect public health. Its tasks comprise ensuring that human and veterinary drugs, medical instruments, food supplies, cosmetics, radioactive substances, and biological products in the United States are not only effective, but are also safe for human and animal use. The agency is tasked with enabling advances in public health by providing assistance to speed up innovations that help make pharmaceutical medicines more affordable, safer, and more effective. The agency is responsible for ensuring that…
Gibbs, J. (2012). FDASIA's Impact on Novel IVDs. Genetic Engineering and Biotechnology Rules, 32(17). Retrieved, from http://www.genengnews.com/gen-articles/fdasia-s-impact-on-novel-ivds/4531/
Kramer, D., & Kesselheim, A. (2012). User Fees and Beyond -- The FDA Safety and Innovation Act of 2012. The New England Journal of Medicine, 367, 1277-1279. Retrieved, from http://www.nejm.org/doi/full/10.1056/NEJMp1207800
(2010, December 7). U.S. Department of Justice. Pharmaceutical Manufacturers to Pay $421.2 Million to Settle False Claims Act Cases | OPA | Department of Justice. Retrieved July 4, 2015, from http://www.justice.gov/opa/pr/pharmaceutical-manufacturers-pay-4212-million-settle-false-claims-act-cases
What We Do (n.d.). US Food and Drug Administration Home Page. What We Do. Retrieved July 4, 2015, from http://www.fda.gov/AboutFDA/WhatWeDo/default.htm
1996 passed Health Insurance Portability and Accountability Act has on healthcare organizational policies. This will be done through answering several review questions.
Law and Organizational Health Care Policy
There are several ways that health law can be conceptualized. Health law can be viewed as entailing not just the law on financing and delivery of healthcare but also all other related areas of study that are associated with the link between health and law. Simply put, healthcare law focuses on judicial, executive, and legislative rules and guidelines that regulate the healthcare industry. The said industry includes healthcare facilities, systems, health care practitioners, medical device manufacturers, pharmaceutical companies, private and public insurers. Each of these stakeholders functions within several different and interrelated legislations (WCL.edu, 2016).
Health policies are the strategies, actions, plans or decisions taken to attain specific healthcare goals in a certain population. A well-drafted health policy is the one which:…
Abood, S. (2007). Influencing Health Care in the Legislative Arena. The Online Journal of Issues in Nursing.
Bianca, A. (2016, January 23). Purpose of Organizational Policies and Procedures in Health Care Settings. Retrieved from Chron: http://smallbusiness.chron.com/purpose-organizational-policies-procedures-health-care-settings-81742.html
Cherry, B., & Trotter Betts, V. (2005). Health policy and politics: Get involved! In B. Cherry, & S. Jacobs (Eds.), Contemporary nursing: Issues, trends & management (pp. 211-233). St. Louis, MO: Elsevier Inc.
healthpolicyjrnl. (2015). About. Retrieved from Health Policy Journal: http://www.healthpolicyjrnl.com/content/aims
Health care Law: Medical Use of Marijuana in Florida - Senate Bill 8A (2017A)
Using marijuana for medical purposes was allowed under The Medical Use of Marijuana Senate Bill enacted on 23rd June 2017. Marijuana and Marijuana delivery devices are exempted from tax by the bill, if they are sold, handled, used or delivered for medical purposes. The bill outlines the conditions that a patient must meet to qualify to use marijuana or related delivery device. The bill gives the basis for establishing marijuana testing laboratories. It sets up the Coalition for Medical Marijuana Research and Education. The latter is set to be established at the H. Lee Moffit Cancer Center and Research Institute, Inc (Florida Health, 2017).
Patients with recommendation from a physician can obtain medical cannabis from dispensaries that have been licensed by the state; thanks to The Senate Bill 8A (2017A). Medical practitioners are restrained from…
Dills, A., Goffard, S., & Miron, J. (2016). Dose of reality: The effect of state marijuana legalizations.
Florida Department Health Updated Fiscal Analysis, (2013).Financial Impact Estimating Conference: Use of Marijuana for Certain Medical Conditions Serial Number 13?02. Retrieved from http://edr.state.fl.us/Content/constitutional-amendments/2014Ballot/UseofMarijuanaforCertainMedicalConditions/NotebookUpdates_11-4-13.pdf on 19 February 2018
Florida Health, (2017). 2017 Legislation. Retrieved from http://www.floridahealth.gov/licensing-and-regulation/newest-legislation/2017-legislation.html on 19 February 2018
Mason, D. J., Gardener, D. B., Outlaw, F. H., O\\\\'Grady, E. T. (2016). Policy & Politics in Nursing and Health Care, 7th Edition. ISBN 978-0-323-24144-1, St. louis, Missouri, Elsevier.
Public health core function that is principally addressed by the author is law. As pointed out by the author, public health law infrastructure that is sound is imperative for the reason that it institutes the powers and duties of government to safeguard injury and disease and promote the health of the population (Gostin, 2008). There are examples of how law is used in public health. To begin with, at a personal and individual level, this core function can educate, generate inducements, deter as well as punish. A good illustration is in the sense that health communication promotions provide education and encourage people to make much healthier choices and decision (Gostin, 2000). Secondly, in public health, law as a core function mandates agents of change behavior to have product designs that are much safer and also the use of property. A good example is in the sense that the government undertakes…
Health Care eform:
In March 2010, after protracted public and political debate, the Patient Protection and Affordable Care Act (PPACA) was enacted into law by President Barack Obama. This legislation was one of the many health care reforms initiatives that have sought to rectify major features of the health care system in the United States such as service delivery, care coordination, and financing. Since its enactment, PPACA is considered as a milestone along the historical continuum of health care reform in America. Generally, health care reform in the United States is an issue that has continued to evolve based on the ever-growing health care needs of the population. However, this issue has been characterized with several challenges that are mainly influenced by the public's response to reform efforts.
Principal Features of U.S. Health Care System:
The Patient Protection and Affordable Care Act (PPACA), which is commonly known as the Affordable…
Bodenheimer, T., & Grumbach, K. (2012). Understanding health policy: a clinical approach (6th ed.). New York, NY: McGraw-Hill Medical.
"Key Features of the Affordable Care Act by Year." (n.d.). Features of the Health Law.
Retrieved from U.S. Department of Health & Human Services website: http://www.hhs.gov /healthcare/facts/timeline/timeline-text.html
Leflar, R.B. (2013, July 12). Reform of the United States Health Care System: An Overview.
Healthcare in Sweden
The healthcare system in Sweden is used as one of the model systems in the world. hen Johan Hjertoqvist from the Timbro Policy Group spoke before the Montreal Economic Institute in 2002, he said, "...you refuse to accept the consumer as an equal partner, you still look upon the client, the patient, as an inferior partner in the relation" and "you deny the need for good working condition when it comes to the staff, etc." (http://www.iedm.org/conference5_en.html).Moreover, he stressed the need to move interests and priorities away from the processes and production organization to "the quality of the outcome for the consumer" (http://www.iedm.org/conference5_en.html).Quality seems to be synonymous with healthcare in Sweden.
Two important characteristics of the Swedish healthcare system are that it is "decentralized and it is run on democratic principles" (http://www.si.se/docs/infosweden/engelska/fs76.pdf).All residents of Sweden are covered by the national health insurance system which covers medical care, pharmaceuticals,…
Fact Sheets on Sweden: The Health Care System in Sweden. Swedish Institute. May 1999. http://www.si.se/docs/infosweden/engelska/fs76.pdf .(accessed 06-27-2003).
Gennser, Margit. "Sweden's Health Care System." http://oldfraser.lexi.net/publications/books/health_reform/sweden.html.
A accessed 06-27-2003).
Hadenius, Stig; Lindgren, Ann. "Sweden: On Sweden Health care." Countries of the World. January 01, 1991.
Not only do these practices discourage preventative care and monitoring, they also diminish the quality of the good that insured individuals are buying from the health insurance companies. Insured individuals are paying for insurance and paying for most of their healthcare costs in addition because of the exorbitant deductibles. PPACA's prohibition of these practices ultimately forces health care companies to raise the bar and give health insurance customers more value for money.
Public-Private Partnerships Prevent ureaucratization of Health Care
There are widespread misconceptions that the PPACA will provide health insurance through some government-run bureaucracy. Actually, PPACA is built on close cooperation between health insurance companies and the government. Under PPACA, the government does not operate hospitals nor does it provide medical insurance to individuals. Actually, it requires individuals to carry some form of private health insurance or suffer a penalty. The only time the government becomes involved is when an…
Patient Protection and Affordable Care Act. Public Law 111 -- 148. Available at http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf
Patient Protection and Affordable Care Act - Summary. http://thomas.loc.gov/cgi-bin/bdquery/z-d111:HR03590:@@@L&summ2=m&summary
"An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act,
Letter to the Honorable Evan Bayh." Congressional Budget Office. Douglas W. Elmendorf. November 18, 2009. Available at http://cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf .
Diversity of Aging Population -- Innovative Healthcare
Over the past several decades there has been an avalanche of research and scholarly narratives focusing on the aging of millions of Americans -- among them the "baby boomers" that were born between 1946 and 1964 -- including their numbers and their health vis-a-vis the impact on the sometimes struggling healthcare system. But there has been a dearth of research on how American healthcare services will respond -- and is currently responding -- to an increasingly diverse older population when it comes to racial, cultural and ethnic identities. This paper points to the numerous issues and challenges that not only face an increasingly diverse older American population when it comes to healthcare, but also the challenges that the healthcare system itself faces as these Americans move into the twilight of their lives.
hat should be the Vision and Mission of Healthcare Professionals in…
Administration on Aging. (2010). A Statistical Profile of Black Older Americans Aged 65+.
Retrieved April 2, 2014, from http://www.aoa.gov .
Bookman, A. (2008). Innovative models of aging in place: Transforming our communities for an aging population. Community, Work & Family, 11(4), 419-438.
Centers for Disease Control and Prevention. (2007). The State of Aging and Health in America
Health Care Practices in Honduras
In order to understand healthcare in Honduras, it is important to understand that Honduras is one of the poorest countries in the Western hemisphere (ennert & Koop, 2009).
"The economic situation is accompanied by a shortage of health professionals throughout the country. There are 57 physicians and 129 nurses per 100,000 people. In the United States, the corresponding ratios are 256 and 937 per 100,000 respectively" (ennert & Koop, 2009). This scenario means that many people in Honduras lack access to formal healthcare and must rely upon home or folk remedies for diagnosis and treatment of disease. The dire economic conditions in Honduras help create an atmosphere of chronic disease and health conditions that promote disease. Some of these problems include: diarrheal diseases, respiratory infections, lack of access to clean drinking water, waste disposal issues, muscle pain, and tuberculosis (ennert & Koop, 2009). In fact,…
Marson, M., Prohaska, A., Burris, S., Richardson, C. Crigger, N. (2006). Rural Hodurans perceptions about health and healthcare practices. Retrieved September 30, 2012 from Journal of Undergraduate Nursing Scholarship website: http://www.juns.nursing.arizona.edu/articles/Fall%202006/marson.htm
Massachusetts General Hospital. (2012). Honduras: Bits of culture. Retrieved September 30,
2012 from http://www2.massgeneral.org/interpreters/b_hon.asp
Rennert, W., & Koop, E. (2009). Primary health care for remote village communities in Honduras: A model for training and support of community health workers. Family Medicine, 41(9), 646-51.
Health of Indigenous Australian Using Ecological and Holistic Health Paradigm
Patterns of health and illness
Impact of Broader Environments
Health is a basic component of human life that comprises of multiple facets. The description of health has witnessed dramatic change during past few years, as it has become a holistic phenomenon. Previously, it was considered that a healthy person is the one who does not suffer from any ailment or illness. However in recent times, the physical, psychological and communal aspects of human life have been amalgamated to give a broader perspective to human health which is identical to the concept of indigenous communities (Hjelm, 2010).
Numerous organizations are working extensively for providing adequate health care to the world population since many decades. However, it is appalling to notice that discrimination on social, economic and…
Australian Institute of Health and Welfare 2012, Australia's health 2012, AIHW, Australia.
Biddle, N & Yap, M 2010, Demographic and Socioeconomic Outcomes Across the Indigenous Australian Lifecourse: Evidence from the 2006 Census, ANU E. Press, Australia.
Caltabiano, ML & Ricciardelli, L 2012, Applied Topics in Health Psychology, John Wiley & Sons, Great Britain.
Carson, B, Dunbar, T & Chenhall, RD 2007, Social Determinants of Indigenous Health, Allen & Unwin, Singapore.
Health Management (Discussion questions)
The Emergency Medical Treatment and Labor Act (EMTALA) is a law governing how and when patients may be denied treatment or moved from one hospital to another in cases of extreme medical conditions. EMTALA was legalized as a component of the 1986 consolidated budget reconciliation (ichards & athbun, 2009). Sometimes, it is known as the CONA law. This generalized name has generated other laws. A common provision under the COBA name is the statute that governs continuation of benefits derived from medical insurance after job termination. The principal provision of this statute is as follows:
Patients visiting the emergency unit seeking treatment or examination for medical conditions must be given the required medical screening diagnosis. This will be helpful in identifying if they are suffering from emergency medical conditions. In case they are, then hospitals are obliged to either furnish them with appropriate treatment…
Davis, N.A., & Cleverley, W.O. (2010). Essentials of health care finance: A workbook for health information managers. Chicago, Ill: American Health Information Management Association.
Ferenc, D.P. (2013). Understanding hospital billing and coding. St. Louis, Mo: Elsevier.
Richards, E.P., & Rathbun, K.C. (2009). Medical care law. Gaithersburg, Md: Aspen Publishers.
Institute of Medicine (2013). Emergency medical services at the crossroads. Washington, D.C: National Academies Press.
Health and Legislative Issues
All Americans have the desire of having a healthcare system which is capable of delivering world-class security together with financial security. The system in place should always be accessible and one that impacts the economy positively. Successful healthcare reforms will lead to a maximization of the choices available for consumers put a restrain to the ever increasing medical care costs and make healthcare accessible to more and more Americans. There are a number of organizations that have consistently urged the president and congress on building on the existing systems which strengths in order to achieve health reform solutions that are workable in a bipartisan manner. However, there are some healthcare legislative issues that come up and have effects on various stakeholders such as legislators, consumers and other healthcare professionals. This paper will look at one of the current health legislative issues, who is affected most by…
Mears, B.(2012). Health care's big four issues: What the justices are tackling. Retrieved March 12, 2014 from http://www.cnn.com/2012/06/17/politics/health-care-issues/
ANA.(2010). Nursing Beyond Borders: Access to Health Care for Documented and Undocumented Immigrants Living in the U.S. Retrieved March 12, 2014 from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/Access-to-care-for-immigrants.pdf
Goodman, J., (2012). The Impact of the Patient Protection and Affordable Care Act on Job Creators and the Economy. Retrieved March 12, 2014 from http://www.independent.org/issues/article.asp?id=3385
American College of Emergency Physicians, (2013). The Ethics of Health Care Reform: Issues in Emergency - Medicine - An Information Paper. Retrieved March 12, 2014 from http://www.acep.org/Content.aspx?id=80871
For a long time, the Health Care concern has been a centre of discussion in the society as well as among the representatives in a bid to find out which would be the best way to cushion Americans from the ever increasing burden of having to take care of themselves medically. Efforts have been made but still there is no single solution to the issue hence a combined effort between the citizens and the government is very essential in ensuring that the ultimate goal is achieved and each American has adequate Health care assurance. This is the aim of the Health eforms that was passed into law at the behest of the current president, Obama.
Provisions of the Health eform
There are several benefits that the Health eforms are expected to bring to the American population in general. One of the central changes is the fact…
Ben LaBolt, (2010). Senator Obama Introduces Bill to Strengthen Emergency Medical Care
Systems. Retrieved November 13, 2011 from http://www.emsvillage.com/articles/article.cfm?id=2185
Bill Atkinson, (2010). What Obama's health care bill means for EMS. Retrieved November 13,
2011 from http://www.ems1.com/ems-advocacy/articles/779154-What-Obamas-health-care-bill-means-for-EMS/
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in…
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.
3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
Realistically this compliance and assistance should be sought and used before, during and after negotiations with other health care organizations with which this organization might merge or enter a joint venture. Furthermore, the proposed contract itself should be passed by the FTC's Office of the General Counsel or its designee for approval before final ratification of the contract.
In order to merge and operate in a joint venture acceptable to the FTC, the organization must be mindful of Title 15 of the U.S. Code, specifically Section 7 of the Clayton Act, 15 U.S.C. § 18, Sections 1 and 2 of the Sherman Act, 15 U.S.C. § 1, 2, and Section 5 of the Federal Trade Commission Act. In addition, due to the FTC's recent special interest in the mergers/joint ventures of health care organizations, particularly but not solely in connection with price fixing, the organization should assume that…
Cornell University Law School. (n.d.). Legal Information Institute - 15 U.S.C. Section 1. Retrieved on March 19, 2013 from www.law.cornell.edu Web site: http://www.law.cornell.edu/uscode/text/15 /1' target='_blank' REL='NOFOLLOW'>
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.
Health Care Reimbursement and Billing
Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the United States.
Discussion of Mrs. Zwick's coverage under Medicare Parts A, B and C
Medicare Part A (often called "hospital insurance") (U.S. Department of Health and Human Services, 2011, p. 15) assists in covering inpatient hospitalization and skilled nursing facilities, hospice and home health care (U.S. Department of Health and Human Services, 2011, p. 14). There is usually no monthly premium if you and/or your spouse paid Medicare taxes while employed (U.S. Department of Health and Human Services, 2011,…
Ethical implications of Mrs. Zwick's incurring costs related to her hospital-acquired condition are applicable despite the rehabilitation facility's exemption from POA/HAC Medicare laws. Having no first-hand knowledge of the cause of the urinary tract infection, no clear indication that I work at the rehabilitation facility and neither the privilege nor the duty of diagnosis, it would be unethical for me to tell Mrs. Zwick about my suspicions. Rather, a nurse is required to maintain his/her professional boundaries (American Nurses Association, 2001, p. 6). Simultaneously, a nurse is supposed to assure "responsible disclosure of errors" to patients and act to stop bad practices and promote best practices (American Nurses Association, 2001, p. 6). Consequently, a nurse in my position faces a dilemma: lack of personal knowledge and authority vs. my concern for the patient's well-being and constant improvement of the profession. In the face of this dilemma, I would: contact the rehabilitation facility's newly-hired nurse and advise/remind him/her of the duty to report to the appropriate supervisor and responsible disclosure to Mrs. Zwick; contact Mrs. Zwick's personal physician and explain the entire situation; direct Mrs. Zwick to discuss her health issues with her personal physician, who can review, diagnose and discuss the ramifications of her medical records, including but not limited to the urinary tract infection (American Nurses Association, 2001, p. 7). The desired outcomes would be: the rehabilitation center's absorption of Mrs. Zwick's costs related to her hospital-acquired infection through pressure exerted by its own nursing staff and Mrs. Zwick's personal physician; Mrs. Zwick's awareness of the true cause of her infection by health care providers who are directly responsible and capable.
Explain how the COBRA will allow Mr. Davis to continue his insurance coverage while he is out of work.
Due to Mr. Davis' termination from an employer of more than 20 employees, he can obtain coverage for himself, his spouse and his dependent children for up to 18 months (U.S. Department of Labor, 2012). In addition, due to his chronic cycle cell anemia, he may be entitled to an additional 11 months' extension for disability (U.S. Department of Labor, 2012). His employer is required to give a qualifying event notice to COBRA; then, COBRA sends a notice of the right to elect to continue coverage and an explanation of the steps that must be taken to continue coverage; Mr. Davis, his spouse and either or both of them in behalf of dependent children may elect for continuation of coverage
S. Department of Health and Human Services, 2011). Furthermore, subpart C explains the privileges and the protections of confidentiality that is attached to the patient's record along with much exception (U.S. Department of Health and Human Services, 2011).
The penalty for anyone who breaks confidentiality is imperative. In "November, 23, 2009" was increased to $11,000 (U.S. Department of Health and Human Services, 2011). This goes for anyone in the medical field or has access to this information. A person has to follow HIPAA precisely or face a huge fine. If one thought of this ahead of time, whether or not they own a business, then no issues would arise legally. However, sometimes this does occur, especially for those who want to harm another person, yet in the medical field the goal is not to do this to any individual, regardless, otherwise he or she could face losing their license in…
U.S. Department of Health and Human Services Civil Rights. (2011). Your health information privacy rights. Retrieved May 3, 2011, from U.S. Department of Health and Human
Services Civil Rights:
U.S. Department of Health and Human Services. (2011). Health information privacy. Retrieved May 3, 2011, from U.S. Department of Health and Human Services:
Health eform Act
The work of Flanagan, Miller, Pagano, and Wood (2010) entitled "Employee Benefit Plan eview -- Meyerowitz, Health care eform Is Here -- Now What?" states that health care reform laws are expected to have an impact that is significant in nature and this is on the health insurance industry as well as on employee benefit issues as well. The Patient Protection and Affordable Care Act (PPACA), which was then supplemented and modified, less than one week later, by the Health Care and Education Tax Credit econciliation Act (HCEA)." (Flanagan, Miller, Pagano, and Wood, 2010) Those two laws are referred to as "Health Care eform" or "Health eform Laws." (Flanagan, Miller, Pagano, and Wood, 2010) The Health eform Laws are reported, while being extremely lengthy and in depth and very detailed to "leave open a host of issues that will have to be resolved either through agency regulations…
Current Internal Revenue Code (Standard Federal version), SEC. 45R. EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL EMPLOYERS (2010) WK_ Current Internal Revenue Code SEC 45R EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL EMPLOYERS.pdf
Part III - Administrative, Procedural, and Miscellaneous Section 45R -- Tax Credit for Employee Health Insurance Expenses of Small Employers Notice 2010-44
National Tax Advisory (2010) What you need to know now about the tax aspects of health reform litigation. 6 Apr 2010.
IRS Rulings & Other Documents (2002-Current), Rev. Rul. 2010-13, Internal Revenue Service, (May 3, 2010) WK_ IRS Rulings Other Documents 2002-Current Rev Rul 2010-13 May 3, 2010.pdf ©2010 Wolters Kluwer.
Health Care eform:
One of the major topics that have had a long history in the United States is health care reforms, which has been characterized by huge debates. Following decades of failed attempts by various Democratic presidents, a new law was enacted by President Obama to overhaul the country's health care system. The enactment of this legislation came after a year of harsh partisan combat with the purpose of ensuring access to health care insurance for millions of Americans. In addition to being the most controversial topic, health care reform law was the largest single legislative accomplishment of President Obama. Notably, this legislation will cost America's government approximately $940 billion over the next decade based on an analysis by the Congressional Budget Office. The office has also estimated that the law will lessen federal deficit by about $138 billion during the same period and a further reduction of the…
Cannon, M.F. (2010, March 1). The Best and Worst Health Care Reform Ideas. Retrieved December 15, 2011, from http://dailycaller.com/2010/03/01/the-best-and-worst-health-care-reform-ideas/
Cohn, J. (2011, January 20). About that Whole "Replace" Thing & #8230; Retrieved December 15,
2011, from http://www.tnr.com/blog/jonathan-cohn/81821/about-whole-replace-thing
"Health Care Reform.." (2011, November 15). The New York Times. Retrieved December 15,
The experiences of seniors within the healthcare delivery system will alter how all Americans view healthcare. The healthcare delivery systems and overall organizational structure in the United States has been slow to adjust but that rest of the world is currently in flux that will migrate into our system. Technological advances in communication have made telehealth and telemedicine vialbel solutions to our outdated healthcare industry orgainzational structre. While these types of advances are only in their infancy, "...there seemed to be broad acceptance that telehealth and telemedicine had provided positive benefits to the worlds healthcare delivery system." (Telehealth Applications) Our technoloically challenged seniors have actually discovered the trend within the healthcare system and telehealth and telemedicine seems to be an advance that will find worldwide support so we as a nation will be reqquired to jump on the bandwagon.
In conclusion, this article review focused on new Healthcare Delivery Systems…
Farnsworth, Chris. "The Truth About Fraud" Washington Monthly 01 May 1997.
Joshua-Amadi, Mabel. "Recommendations: A Study in Motivation: Recruitment and Retention in the NHS" Nursing Management. February (2003).
Soloye, Daniel J. "Privacy and Power: Computer Databases and Metaphors for Information Privacy" Stanford Law Review July (2001).
Telehealth Applications. (2004) "Current Telehealth Applications" Retrieved October 26, 2004, at http://www.startegis.com/epic/internet/inict-tic.nsf/PrintableE/it07545e.html
Integrity is a major issue for healthcare organizations because there are many avenues for fraud, and for people to demonstrate a lack of ethics. The problem is that the temptation is sometimes too great and despite the fact that there are laws in place to guard against these practices unethical behavior takes place anyway. The government, which supplies a lot of the money which goes for treatments through Medicare and Medicaid, has structured certain laws to make sure that the practices of healthcare organizations are ethical, but billions of dollars in fines are still doled out every year. The big drug companies complain of arcane and hard to decipher legalese, but the fact is that although they realize the issue and the penalty they continue to subvert the law. This paper looks at qui tam statutes and cases, Medicare and Medicaid admissions criteria, installing a corporate integrity program, and…
American Speech-Language-Hearing Association (ASLHA). (2010). Summary of self- referral and anti-kickback regulations. Retrieved from http://www.asha.org/practice/reimbursement/medicare/regulations_sum.htm
Hanford, J.T. (2001). Regulation of the healthcare professions. Ethics & Medicine, 17(3), 188-190.
Louthian Law Firm. (2012). Healthcare fraud qui tam whistleblower protection lawsuits.
Mattie, A. & Ben-Chitrit, R. (2009) The federal False Claims Act and qui tam actions: What every healthcare manager should know. Journal of Legal, Ethical and Regulatory Issues, 12(2), 49-65.
Healthcare eform PPACA
Determine how this Federal law will affect market-driven and non-market driven decisions.
One of the industries that has felt the effects of the Patient Protection Affordable Care Act most immediately and intensely was the insurance industry in the United States. One of the chief reasons that the Patient Protection Affordable Care Act was introduced and passed into American legislation was the effect of rising health care costs attributed to arbitrary and non-competitive costs exacted from healthcare consumers from the insurance industry. There was a general lack of regulation within the industry, which had been demonstrated to have had a negative impact on healthcare outcomes and trends. The United States, while the largest economy and a dominant world superpower, has an underperforming healthcare industry compared to other developed, industrialized nations.
One of the central conflicts associated with the Patient Protection Affordable Care Act is related to philosophical differences…
Gitlin, Saul. (2002) "Demystifying the Asian-American Market" Retrieved from: http://www.mrcc-online.com/presentations/Asian_American_Market_11-12-02.pdf
Greenfield, Lazar. (2010). "National Health Care Expenditures: Addressing the Cost of Health Care in the United States" Annals of Surgery. 251: 2.
Weiss, Joshua A., Medical Marketing in the United States: A Prescription for Reform. George Washington Law Review, Vol. 79, p. 260, 2010. Available at SSRN: http://ssrn.com/abstract=1748902
Health Care: The Next Twelve Months
Over the next twelve months, there will be many changes to health care in the United States. The largest and most ambitious goal is to provide the majority of Americans with health insurance (Blendon & Benson, 2010). However, there will be a presidential election and a Supreme Court ruling, which means that 2012 could be the year that determines whether the health care law moves forward or whether it is shut down. It could also go forward in part, after having large pieces of it removed, and it could go forward with some fundamental changes. How the elections go will greatly affect the law - unless, of course, the Supreme Court strikes the law down before the elections arrive. It seems like that the Supreme Court will rule on the individual mandate from a constitutional standpoint, and that could lead to some of the…
Blendon R.J., Benson J.M. (2010). Public opinion at the time of the vote on health care reform. New England Journal of Medicine, 362 (16): e55.
Elmendorf, D.W. (2010). Additional information on the effect of the Patient Protection and Affordable Care Act on the Hospital Insurance Trust Fund. Congressional Budget Office.
Peterson, C.L. & Chaikind, H. (2010), Summary of small business health insurance tax credit under PPACA. Congressional Research Service.
Healthcare Legal Issues
Discuss the impact Federalism has on the regulation of health care delivery; how do the different sources of law as they related to the federal and state governments matter, if at all?
In general, federal regulation of health care delivery would be much more appropriate and efficient than state or local law, at least in so far as major aspects of health care delivery are concerned. That is because state laws vary considerably; that makes it impossible to establish a consistent or uniform standard of health care delivery across state lines. Certainly, there are aspects of health care that are appropriate to regulate at the state or even the local level, but there are others that would be much better to regulate on a national or federal level.
One of the best examples of an aspect of health care delivery that should be regulated federally are elements…
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
Health Care Reform Federal Deficit
The American Health Care Crisis and the Federal Deficit
The United States spends more than any other country on medical care. In 2006, U.S. health care spending was $2.1 trillion, or 16% of our gross domestic product. At the same time, more than 45 million Americans lack health insurance and our health outcomes (life expectancy, infant mortality, and mortality amenable to health care) are mediocre compared with other rich democracies. We spend too much for what we get.
Nothing is new about these sobering realities. The Nixon administration first declared a health care cost crisis in 1969. Four decades later, the United States still has not adopted systemwide cost controls because the politics of health care make it extraordinarily difficult to control costs. I explain below why this is so (Marmor, et al., 2009).
The starting point for understanding the politics of cost control is…
1. Eakin, Douglas and Michael Ramlet. (2010) "Health Care Reform is Likely to Widen Budget Deficits -- Not Reduce Them." Health Affairs, 29, no.6:1136-1141. Eakin and Ramlet examine the underpinnings of the Congressional Budget Office's projection that enacting the Patient Protection and Affordable Care Act will decrease deficits, and conclude that it is built on a shaky foundation of omitted costs, premiums shifted from other entitlements, and politically dubious spending cuts and revenue increases. A more comprehensive and realistic projection suggests that the new reform law will raise the deficit by more than $500 billion during the first ten years and by nearly $1.5 trillion in the following decade. This is an excellent article with regards to my article, written by two policy commentators at the forefront of their field. This article shows expertise in medical economics and offers compelling, clear arguments for the increase in the federal deficit due to the massive spending on entitlements as a result of passing the Patient Protection and Affordable Care Act. They project deficits, opposing the Congressional Budget Office, through their insightful analysis.
2. Marmor, Theodore, Jonathan Oberlander, and Joseph White. (2009) "The Obama Administration's Options for Health Care Cost Control: Hope vs. Reality." Ann Intern Med. 150:485-489. Controlling the costs of medical care has long been an elusive goal in U.S. health policy. This article examines the options for health care cost control under the Obama administration. The authors argue that the administration's approach to health reform offers some potential for cost control but also embraces many strategies that are not likely to be successful. Lessons the United States can learn from other countries' experiences in constraining medical care spending are then explored. This article offers evidence for the lack of cost containment in the Obama administrations' plans for health reform. It gives a good analysis of the international scene in health care as well.
3. Collins, Sara, Michelle M. Doty, Karen Davis, Cathy Schoen, Alyssa L. Holmgren, and Alice Ho. (2004) "The Affordability Crisis in Health Care." Commonwealth Fund Biennial Health Insurance Survey. Published in 2004, The Commonwealth Fund Biennial Health Insurance Survey, conducted from September 2003 -- January 2004, presents new and timely information on where the American public stands on solutions to reform the health care system. The survey finds widespread support for federal efforts to extend health insurance to more people, as well as a widely held belief that the financing of health care should continue to be a shared responsibility among individuals, employers, and the government. The survey also uncovered potential reasons for such strong support for health care reform. Among the insured and the uninsured alike, there is concern that health care security in the United States is eroding. People are experiencing reductions in insurance coverage that are threatening their financial security.
4. Etheridge, Lynn (1984) "An Aging Society and the Federal Deficit." The Milbank Memorial Fund Quarterly. Health and Society, 521-543. This article serves as early warning sign of the deficit battles to come. It argues that the conflict between the growing needs of an aging society and a federal budget which cannot afford its current commitments has become one of the nation's most difficult government policy dilemmas. Assistance for the elderly through Social Security, Medicare, and other programs-is already the federal government's largest fiscal responsibility. In 1985 these programs will require nearly half of all domestic program spending an estimated $256 billion. The future costs of these commitments will rise rapidly well into the next century, accounting-with national defense and interest costs-for virtually all of the spending increases in the projected $200 to $300 billion deficits. Etheridge asserts that the decisions about the nation's assistance to the elderly -- and about reaffirmation, reform, and/or retrenchment of these commitments-will thus be central to the coming budget debates.
(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
While it may not be just to hold an organization liable, absolutely, for every instance of employee negligence, there is a rationale for imposing such liability in many cases. For example, many types of industries entail potential danger to others that are inherent to the industry.
Individual workers are not likely to be capable of compensating victims of their negligence, but the employer benefits and profits financially by engaging in the particular industry. Therefore, the employer should not necessarily escape liability for compensating all harm caused by their activities, regardless of fault in particular instances.
10.A nurse is responsible for making an inquiry if there is uncertainty about the accuracy of a physician's medication order in a patient's record. Explain the process a nurse should use to evaluate whether or not to make an inquiry into the accuracy of the physician's medication order.
Like other highly trained professionals, experienced nurses…
Abrams, N., Buckner, M.D. (1989) Medical Ethics: A Clinical Textbook and Reference for the Health Care Professionals. Cambridge, MA: MIT Press
Caplan, a.L., Engelhardt, H.T., McCartney, J.J. Eds. (1981) Concepts of Health and Disease: Interdisciplinary Perspectives. Reading, MA: Addison-Wesley
Starr, P. (1984) the Social Transformation of American Medicine.
New York: Basic Books
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…
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.
Health Care Past, Current, And Future
The health of any nation should be a top priority for leaders and elected political representatives, but in the United States it took several centuries for the nation to begin to come to terms with providing health care for its citizens. This paper covers the gradual implementation of health care services and doctor training facilities in the U.S., and also covers the recent attempt by President Barack Obama to reform a chaotic, poor-functional and expensive health care system. Thesis: It is a scandal of massive proportions that a well-functioning, citizen-friendly universal health care system cannot be instituted in America, the world's most democratic superpower. Until the divisive and toxic political climate can be reformed, there is no chance of major reforms -- or for universal health care coverage -- in these United States.
Past Health Care Services -- Early America
Health care in colonial…
Daly, John. (2005). Professional Nursing: Concepts, Issues, and Challenges. New York:
Springer Publishing Company.
Gorsky, Martin. (2010). Good Health for America? History Today, 60(2), 1-6.
McCarthy, Robert L., and Schafermeyer, Kenneth W. (2007). Introduction to Health Care
The Joint Commission on Accreditation of Healthcare Organizations -JCAHO is among the leading health-care benchmarks setting and accrediting bodies in the world today. To provide for continuous improvement to the safety and quality of health care provided to the general public through the provision of health care accreditation and the related services, which enable performance improvement in organizations that provide healthcare is the mission of JCAHO. The Joint Commission assesses and accredits almost 20,000 health care organizations and programs in the United States. It is an independent and non-profit organization. JCAHO has developed modern and professionally-based benchmarks. The Joint Commission assesses the compliance healthcare organizations using these standards. JCAHO services are provided to the full range of organizations involved or assisting in healthcare in any form. An organization accredited by the Joint Commission is acknowledged all around the country as meeting the performance standards of JCAHO, which…
"Health Facility Quality Assurance" Retrieved from http://184.108.40.206/search?q=cache:slYBAH_cu48J:www.doh.wa.gov/HWS/doc/HS/HS_FSL.doc+DOH+regulates+hospitals& hl=hi& ie=UTF-8 Accessed on 18 November, 2004
"HHS: What We Do" Retrieved from http://www.hhs.gov /about/whatwedo.html/
Accessed on 18 November, 2004
"JCAHO: Joint Commission on Accreditation of Healthcare Organizations" Retrieved from http://www.qmsonline.com/jcaho.htm. Accessed on 18 November, 2004
Information technology and computers have also begun to affect, in ways that are both bad and good, family life, community life, education, freedom, human relationships, democracy, and many other issues. By looking into the broadest sense of the word it can be seen that cyber ethics should actually be understood as a branch of applied ethics, and ethics should be something that is believed in by all that provide medical information, whether via the Internet or in some other way, since providing false or fraudulent information could be damaging and potentially deadly for many people.
This particular branch of ethics analyzes and studies information technology and what type of ethical and social impacts it has. Within recent years this new field has led to countless courses, workshops, articles, journals, and many other ways of expression. With the World Wide Web becoming so popular when it comes to health care information,…
Bynum, T.W. (1999) the Foundation of Computer Ethics. A keynote address at the AICEC99 Conference, Melbourne, Australia, July 1999. Published in the June 2000 issue of Computers and Society.
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.
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 .
Here second question that is raised for the author is that till now and for the future, many healthcare architectures have been designed that increase the availability of the patient records, not only on the national but on an international scale as well. The author in the study has only focused on the national or local availability of the patient records.
Content of the article is strong and there are a number of important facts given in the article in relation to the importance of healthcare indexing systems. The healthcare indexing systems being used in U.S., UK and Australia have been mentioned as an example. The two models of the indexing architecture given by the author in the beginning have been linked by the author with the examples. The loopholes that can be noticed in these cases are the absence of any privacy and security concerns that may be an…
Liu, V., Caelli, W., Smith, J., May, L., Lee, H.M., Ng, H.Z., Foo, H.J., and Li, W. (2010). A Secure Architecture for Australia's Index-Based E-health Environment. Proc. 4th Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2010), Brisbane, Australia, p. 7-16.
A patchwork of laws provided narrow privacy protections for selected health data and certain keepers of that data." (Administrative Simplification in the Health Care Industry) Therefore, new technologies such as relational databases have simplified the data gathering and maintenance processes of all types of healthcare related data like the physician information process. It is not unheard of today for healthcare and insurance providers matching or 'sinking data' on a monthly or quarterly basis because of the availability of better communication capabilities as well as compatible database comparison processes.
Even the doctors themselves have access to providers' systems and databases today. Through automatic telephone systems, business to business Internet portals, and tape or disk delivery processes, all of a physician's personal, office and patient information can be updated easily. In many cases, the entire process including security and confirmation is a completely hands free operation. In other words, without human intervention,…
Administrative Simplification in the Health Care Industry. Ed. HIPAA. Health and Human Services. 23 Oct. 2004 http://www.hipaa.com/.
HMO Patients Can Contact Their Doctors Electronically as Blue Shield of California Expands Online Communication Services. Ed. Unknown. October 29, 2003. Relay Health. 23 Oct. 2004 http://www.relayhealth.com/rh/general/news/newsRecent/news49.aspx .
Hoffer, Prescott, and McFadden. Modern Database Management. 7th ed. Add City: Add Publisher, Add Year.
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.
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.
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 .
The SG2 report (2010, p. 9) also mentions academic medical centers (AMCs), which will have enter into affiliation agreements in order to comply with the reformed care laws. This will furthermore mean more integrated physician networks and it integration, as mentioned above.
Two further important factors are mentioned by Moyers (2010). She notes that the inclusive nature of health care definitions for occupational therapists is a significant step forward in terms of recognizing the profession as a legitimate health care service. Occupational therapy, for example, is specifically included in the "Innovations in the Health Care Workforce" section of the new legislation. This is significant, because occupational therapists will now be eligible for state workforce grants, slots on the national commission on workforce, and other similar privileges enjoyed by other health care providers.
Other items, excluded from the bill, is the second item the author mentions. She notes that one of…
Davis, P.A., Hahn, J., Morgan, P.C., Stone, J., and Tilson, S. (2010, Apr. 23). Medicare Provisions in the Patient Protection. Retrieved from: http://www.nasuad.org/documentation/aca/CRS%20Reports/April%2023%20-%20Medicare.pdf
Moyers, P. (2010, Mar. 25). What Health Care Reform Means to Occupational Therapy.
Retrieved from: http://otconnections.aota.org/blogs/moyers/archive/2010/03/25/what-healthcare-reform-means-to-occupational-therapy.aspx
Sg2 Special Report: (2010, May). The Impact of Health Reform
ecause unions retain the exclusive right to negotiate on behalf of its members, the individual worker may have little recourse to easily address incompetent leadership.
The Disadvantages of Unionized Labor for Healthcare Employers:
The primary disadvantages of unionized labor for healthcare employers correspond to the relative loss of control over issues and workplace elements commonly transferred to workers (through their unions), which accounts for the traditional resistance with which many employers responded to unionization attempts. On the one hand, unionized workforces are able to secure better pay and benefits from employers than would have been available to workers without union representation; likewise, employers must cede control over many aspects of operational and personnel decisions traditionally within administrative control.
On the other hand, particularly in light of the beneficial effect that unionized nursing has had on the quality of patient care and reduction in patient mortality, it is difficult to conceive…
Daft, R. (2005) Management (7th ed.) Mason: Thomson South Western.
Nevins, J., Commager, H. (1992) a Pocket History of the United States.
New York: Pocket Books
Seago, J., Ash, M. (2002)
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
Massachusetts Cost Limiting Proposal
One of the major problems of the current healthcare system implemented by the State of Massachusetts is the cost of maintaining the program and providing the necessary healthcare to Massachusetts' citizens dependent on the state insurance program. Ideally, of course, the program would be paid for via the revenues generated form business contributions, premium payments into the state system, and general tax funding. Revenue can only make up half of the solution for paying for the system, however; costs must also be effectively managed and strictly limited if the program is to be successful in the long-term. One proposal for limiting these costs is switching from a reimbursement-for-services model of physician payment to the creation of performance-based salaries or regular payments.
There are several features of moving to a pay-for-performance rather than a pay-for-service model that have the potential to yield significant savings. As…
Health Care ight or Privilege
Health Care ight Privilege
Whether health care is a right or a privilege is one of the most intensely debated social questions of the modern era, but phrasing it in this binary way of one or the other masks a deeper problem that is far more complex. The specific issue at hand is the rationing of scarce medical resources. If there were unlimited resources where everyone could achieve the maximum health all the time, we would not have to ask the question, but this is clearly not the case. Glannon argues this requires a theory of "distributive justice" (2005, p. 144), and outlines the four main theories that have emerged from the modern discussion, which are Utilitarian / consequentialist, Libertarian, Communitarian and Egalitarian.
Utilitarian, consequentialist theory is often invoked toward a solution of who deserves health care when there is not enough for everyone, and…
Brownstein, B. (1980). Pareto optimality, external benefits and public goods: a subjectivist approach. The Journal of Libertarian Studies, IV (1), 93-106. Retrieved from mises.org/journals/jls/4_1/4_1_6.pdf
Gensler, H. (1998). Ethics: a contemporary introduction. New York: Routledge.
Glannon, W. (2005). Biomedical ethics. New York: Oxford University Press.
Hare, R. (1963). Freedom and reason. London: Oxford University Press.
Health Care Situation: Medical Error Due to Doctors' Bad Handwriting
Identify a health care news situation that affects a health care organization such as a hospital, clinic or insurance company.
I have identified the following health care news situation as the topic of my paper: "Poor Handwriting of Doctors and its implied risks for the Patient, Hospital and Medical Malpractice Insurance." Poor handwriting of physicians resulting in poor legibility of entries into patients' medical records carries very dramatic risks for all above-mentioned interest bearers. It can result in severe health danger for the patient and - in extreme situations - even cause a patient's death. Doctors' bad penmanship has long been seen a problem within organized medicine and the patient safety movement. Three American Medical Association (AMA) policies dating back to 1992, urge doctors to "improve the legibility of handwritten orders for medications" and review all orders for accuracy and…
Berwick, Donald M. & Winickoff, David E. (1996). The truth about doctors' handwriting: a prospective study. BMJ Vol. 313 (21-28 December 1996). 1657-1658. www.bmj.com/content/313/7072/1657.full, accessed 21 August 2011.
Bruner, Anne & Kasdan, Morton.L. Handwriting Errors: Harmful, Wasteful and Preventable.
1-4. www.kyma.org/uploads/file/.../Harmful_wasteful_and_preventable.pdfSimilar, accessed 22 August 2011.
Gallant, Al. (22 November 2009). For a secure electronic health record implementation, user authentication is key. 1-2). searchhealthit.techtarget.com/.../User-authentication-is-critical-for-pl.., accessed 24 August 2011.
The Obama administrate had just announced that they would be revoking federal funding for the Medicaid Women's Health Program amid a fight over several clinics that were affiliated to providers of abortion amshaw & Belluck, 2012()
Gov. Perry issues a letter to Thomas Suehs who is the head of the Texas Health and Human Services Commission directing him to work with the legislative leaders to identify potential sources of funds to keep the program afloat amshaw & Belluck, 2012()
The program itself costs around $40 million which is 90% covered by the federal government. Therefore this cut in budget would mean that the Texas state would need to find about $36 million to fund the program amshaw & Belluck, 2012()
Since the program provides care to about 130,000 low-income women all over the state, Gov. Perry felt that the program was extremely beneficial to the state and that is why…
http://billingsgazette.com/news/state-and-regional/wyoming/mead-state-must-keep-trying-health-care-reform-projects/article_5cd2a264-f221-509e-97fe-f0ecc5d91ef7.htmlBarron, J. (2012). Mead: State must keep trying health care reform projects Retrieved March 10th, 2012, from Ramshaw, E., & Belluck, P. (2012). Perry Pledges to Finance Texas Women's Health Program Retrieved March 10th, 2012, from www.nytimes.com/2012/03/09/us/perry-pledges-to-finance-texas-medicaid-womens-health-program.html?_r=1&emc=tnt&tntemail0=y
The American Public Health Association (APHA) is founded. This organization is concerned with the social and economic aspects of health problems.
The National Quarantine Act is signed into law. This legislation is designed to prevent entry into the country of persons with communicable diseases.
1899 the National Hospital Superintendent's Association is created. It later becomes the American Hospital Association.
Patel & ushefsky, 1995, p. xvii)
The seeds of health care legislation and centralization began before 1875 but began to take hold as the most accepted manner in which to ensure safe and scientifically founded health care for many and to begin to ensure that diseases that commonly plagued a newly urbanized and highly stressful environment of mass immigration could be dealt with, in a more centralized and practical manner. Founded earlier in 1847, the American Medical Association began to have a concrete and centralized role in the health care decisions…
http://www.questia.com /PM.qst?a=o&d=5001282891' target='_blank' REL='NOFOLLOW'>
Discuss barriers to health and safety benchmarking
Barriers to carrying out a safety health bench marking exercise
"Health and safety benchmarking is a planned process by which an organization compares its health and safety processes and performance with others to learn how to: reduce accidents and ill-health; improve compliance with health and safety law; and/or cut compliance costs" (Health and safety benchmarking: Improving together, 1999, HSE: 1). Just like assessing one's competitors is an important component of improving productivity and quality standards, it is also important that the company gain a sense of 'where it is' in relation to the industry as a whole in terms of safety compliance.
However, there is often organizational resistance to carrying out such exercises. First and foremost, it must be understood that "benchmarking is not just about comparing data or copying your competitors. Benchmarking is more about continuously learning from others, learning…
Health and safety benchmarking: Improving together. (1999). HSE. Retrieved:
the Allied health care staffing agency is a staffing agency that focuses on the niche of the nursing jobs within the healthcare industry in Chicago
The Allied healthcare staffing agency works to recruit registered nurses belonging to all medical Specialties, Practical Nurses that are licensed also called LPNs, Nursing Assistants that are certified also called CNAs and Specialists from the allied health sciences. These professionals would be hired both from the area of the metro city as well as the suburbs and placed within the hospitals, the neighborhood medical centers, Adult care facilities, clinics, and rehabilitation centers.
The mission of the Allied Healthcare Staffing Agency is to provide the best opportunities of employment both to its collaborators which are the local healthcare organizations as well as serving the entire nursing community to provide amply amount of job opportunities to choose from in a time when the turnover of…
Bureau, U.C. (2000). Census 2000 Demographic Profile Highlights:. chicago illinois, fact sheet .
commerce, U. d. (2010). bear facts, state illinois. bureau of economic analysis .
directory, a. h. (2010). free stats & national stats. Retrieved september 7, 2011, from american hospital directory: www.ahd.com
Lindberg, R.C. (1991). To Serve and Collect: Chicago Politics and Police Corruption from the Lager Beer Riot to the Summerdale Scandal. chicago: praeger publications.
"What is the role of Congress in policy making process"?
Policy is a plan to identify goal or possible course of actions with administrative or management tools to accomplish these goals. n the other hand, policy is the authoritative decision made by the U.S. executive, legislative, judicial branch of government to influence the decision of others. Government is a key player in decision-making process and congress plays important roles in decision-making . In the United States, both House of Representatives and House of Senate fulfill the congressional policy responsibilities, and congress plays important role in health policy, which includes obesity prevention measures or health insurance program. Congress is an important arm of government that makes law. Important strategy that congress uses to make policy preference is by passing a bill into law. Typically, the congress could make a decision to pass or not to the policy of the…
Oregon Department of Human Services.(2008). The impact of federal policy on Oregon's health care reform efforts: Opportunities and barriers within Medicaid and the State Children's Health Insurance Program. Medical Assistance Programs.
Waller, M. (2005).Block Grants: Flexibility vs. Stability in Social Services. Brookings Institution Policy Brief.
Zuckert, M.P. (2002). Launching Liberalism: On Lockean Political Philosophy. Lawrence: University Press of Kansas.
While there are some differences according to jurisdiction, in general, if the defense is allowed by the judge to go to the jury.
The term illness of the mind is solely a legal notion. In the case of Bratty v. Attorney-General (Northern Ireland) (1963), Lord Denning declared that the foremost mental illnesses, which the doctors identify as psychoses, like schizophrenia, are plainly illnesses of the mind. Whether or not drug-associated psychosis will be considered to qualify as an illness of the mind will essentially depends on the division amid a fault of cause resulting from an underlying condition and a fault of cause caused by something external.
There is justifiable societal concern about the links between violence and illicit substance use. Such concern finds a focal point at the debate around the boundaries for the insanity defense where drug-associated psychoses are involved. This article outlined three potential approaches that…
In 2001, the trial court judge stated that clear and convincing confirmation demonstrated that Ms. Schiavo would have selected not to be given life-prolonging action beneath the conditions that were present. This decision was also confirmed by the Florida appeals court and the family was deprived of a hearing by the Florida Supreme Court. When Terri Schiavo's feeding tube was taken out for the second time, in 2003, the Florida legislature fashioned Terri's Law to supersede the court decision, and the tube was for a second time put back. This law was consequently stated an illegal breach of the separation of powers (Quill, 2005).
Terri Schiavo's case fascinated the nation for quite a bit of time during March of 2005 as the dying woman laid in Florida hospice. Mrs. Schiavo had been in a vegetative condition for many years, and her husband Michael Schiavo effectively asked the Florida state courts…
Calabresi, Steven G. (2006). The Terri Schiavo Case: In Defense of the Special Law Enacted by Congress and President Bush. Retreived October 6, 2010, from Web site:
Cruzan v. Director, Missouri Department of Health. (2010). Retrieved October 6, 2010, from Answers Web site: http://www.answers.com/topic/cruzan-v-director-missouri -department-of-health
Cruzan v. Director, Missouri Department of Health et.al.497 U.S. 261 (1990). Retrieved October
In the case of pill mills, participating physicians and pharmacists bill insurance companies or Medicare for prescription drugs, allowing participating beneficiaries to resell those drugs to criminal middlemen. The pharmacy then repurchases the drugs at a lower cost. According to the USGAO, any misuse of beneficiary identification information is a felony.
Criminals may also steal beneficiary information by creating drop boxes. The drop box scheme involves establishing a phony health care company in order to obtain insurance or Medicare payments. Like the drop box scheme, the pill mill scheme, and the rent-a-patient scheme, third-party billing also involves felony acts. Illegally obtaining beneficiary identification numbers, a criminal can use third-party billing agents to receive insurance payouts. The third-party billing company may not even be aware of the scheme. In other cases, the third-party billing company is a part of the scheme, defrauding by tacking on fraudulent claims to legitimate ones and…
Cornell University Law School. "Health Care Fraud." Retrieved Aug 7, 2008 from http://topics.law.cornell.edu/wex/healthcare_fraud
United States General Accounting Office (USGAO). "Health Care Fraud." Retrieved Aug 7, 2008 from http://220.127.116.11/search?q=cache:NcKXTYWPgDEJ:www.gao.gov/new.items/os00015t.pdf+health+care+fraud&hl=en&ct=clnk&cd=5&gl=us&client=firefox-a
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…
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.
Improved confidence, communication and collaboration: If these transformations are embraced, there will be enhanced practices and ideas that are utilized. This is because everyone must learn the proper techniques for communicating and working with each other. These concepts are used to create a change in the environment and how different individuals are interacting with each other. When this happens, there is a change in attitudes and ideas among the various stakeholders. (Wilkinson, 2008)
Part III: Critique. You are to provide your reaction (insightful, critical, and logical) to the points that the author tried to make, or an overall critique of the entire article. A simple statement of agreement or disagreement is not enough. While you may make such a statement by way of introduction to your reaction, you must clearly and logically state the reasons for the post that you have taken. If you are summarizing a case,…
Farrell, M. (2001). Breaking Bad News. Journal of Advanced Nursing, 36 (6), 765 -- 775.
Wilkinson, S. (2008). Effectiveness of a Three Day Communication Skills Course in Changing Nurses Communication Skills. Palliate Medicine, 22 (4), 365 -- 375.
The respondents also believed that premiums should be adjusted based on an organizations willingness to introduce and enforce health and safety standards.
5. Safety representatives-these representatives serve the purpose of serving notices or organizations when breaches in safety and health standards take place.
6. Occupational Health and Rehabilitation -- a significant percentage or respondents believe that there needs to be greater access to occupational health services for employees. The respondents also believed that there should be a "new focus on the provision of rehabilitation services for injured and sick workers."
7. Financial Incentives-finally the respondents believed that employees needed financial incentives to encourage cooperation as it pertains to health and safety standards.
The HSE used all of the information gathered to create new strategies for dealing with Health and Safety issues in the workplace. One of the primary trends that developed was that of enforcement. In an effort to have…
"A strategy for workplace health and safety in Great Britain to 2010 and beyond"
"Enforcement Management Model." (2002). Health and Safety Executive
Enforcement Policy Statement. Health and Safety Executive
Environmental Health Policy Improvement Committee (20 April 2004) . Health and Safety Commission
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"
Health Care Law
Read: Compliance needs a shrewd strategic plan
Discuss the reasons why healthcare organizations should include a compliance program into their strategic planning?
In short, the Cerrato story linked above discusses and makes clear, more or less, that it is a non-optional part of doing business in the healthcare business and sphere. He noted that healthcare providers must comply with "a long list of healthcare-related laws and regulations" and that it remains "a major challenge for provider organizations around the country" (Cerrato, 2013). Just a short list of reasons why compliance should be a focal point within the broader strategic planning sphere for healthcare organizations is because doing otherwise can open a company to civil liability, can open up a company to agency sanction, can open up a company to criminal charges (in extreme cases), can lead to a degradation or failure to improve patient…