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Encouraging physicians to strictly limit the budgets of each patient's care will surely drive down costs and may even conspire to encourage physicians to improve patient preventative care. But there is always the fear that patients will be denied necessary as well as unnecessary tests and procedures, and physicians may shy away from suggesting expensive but potentially life-saving treatments.
This new system essentially splits the interests of physicians and patients: the less care physicians give, the more physicians are paid. Furthermore, there is a strong disincentive to treat potentially uncooperative or risky patients. Patients who have mental health issues or who have chronic conditions that are unpredictable and difficult to treat, such as the obese and diabetics, may fall under such categories. However, these patients are often the individuals most in need of intensive, hands-on care and a close relationship with their physicians.
Impact on practitioners
Practitioners will be frustrated…
Because of these types of figures, it should come as no surprise that economists and others that analyze this type of issue are greatly interested in what type of role benefits play within the labor market.
Utilizing a simple theory of the labor market indicates that employers are generally concerned regarding the level of total worker compensation as opposed to the division between the wages that they actually pay and other compensation such as benefits. However, looking at this so simply ignores many of the important differences between benefits and wages. Generally it has been asserted that benefits represent what are called quasi-fixed costs, which means that they do not vary with the number of hours that are worked as wages do but rather they vary instead with the number of workers at the company. Because of this, what type of structure employee compensation packages have often influences the demand…
Ehrenberg, R.G. & Smith, R.S. 1994. Modern Labor Economics. New York: Harper Collins.
Buchmueller, T.C. 1999. Comparing benefit costs for full-time and part-time workers. Monthly Labor Review.
The third attempt in reducing the cost of healthcare service revolves around coordination of health services by the use of family doctors. This would enable patients to avoid the risk of double prescription of drugs. Patients should focus on directives from one doctor in the process of seeking medical attention. This would reduce the cost of obtaining healthcare services by the patients thus lowering down the total cost within the health sector. Invention of home-based doctors could help bring down the cost of healthcare (Wong, 2009).
The other approach revolves around minimization of infections in the process of treating patients. Patients suffer from infections due to ineffective health measures within the hospitals and other health organizations. These infections incur extra cost on patients who seek further treatment to solve the problems. Effective and efficient preventive measures during treatment should enable doctors and nurses to minimize chances of infections. This would…
Arnst, C. (2009, November 12) 10 ways to cut health-care costs right now. BusinessWeek,
Retrieved 10/07/2012 from http://www.businessweek.com/magazine/content/09_47/b4156034717852.htm
Lavizzo-Mourey, R. (2009). The Road to Reform.Retrieved 10/07/2012 from http://www.rwjf.org/files/research/2008presidentsmessageannualreport.pdf
Wong, V. (2009). How hospitals can slash costs (slide show). BusinessWeek, Retrieved
Managing the soaring health care costs due to litigation and mismanagement should be a key concern to any healthcare organization. Attempting to manage those costs oftentimes will run into barriers such as government regulations that require doctors and administrators to document each and every decision made in regards to patient treatment. Due to the extra paperwork and documentation needed to fulfill these requirements, doctors, nurses and administrators are put at odds with the very system that reimburses them for their time, efforts and expenses. The system also seems to pit the doctor's against the patients instead of working towards the patient's best interest.
A recent study determined that "everyone agrees that patients should be able to find cheap, safe, and efficient care" (Avaraham, 2011, p. 8) yet doctors are still under pressure to produce billings that justify their salaries, or worse yet, they are told to see more patients for…
Alonso-Zaldivar, R.; (2011) Obama starts drive for medical malpractice reforms, Stamford Advocate, accessed on November 6, 2011 at http://www.stamfordadvocate.com/news/article/Obama-starts-drive-for-medicalmalpractice-reforms-101424 '4.php.
Avaraham, R.; (2011) Clinical practice guidelines: The warped incentives in the U.S. healthcare system, American Journal of Law & Medicine, Vol. 37, Issue 1, pp. 7 -- 40
Troven, A.; Mello, B.; Mello, M.M.; (2009) Incremental health care reform, Journal of American Medical Association, Vol. 301, pp. 1814-1816
Executives of major companies, like Coca-Cola Enterprises in Atlanta, believed that -200 was especially helpful in rehabilitation and prevention of re-injury, as employees usually resumed work when their backs stopped hurting, thinking the injury was already treated. They, however, lost some functional abilities and remained vulnerable to the same injury and hurt. An experimental injury-prevention and rehabilitation project conducted at the Coca-Cola ottling Company showed that it reduced the incidence of back injuries among its employees by 32% at the average and workers days lost to these injuries by more than 78%. In comparison, the incidence of back injuries in plants, which did not participate in the project increased at an average of 32% and days lost to more than 300%. Other companies with similarly high incidence of back injuries and low success levels of treatment and rehabilitation took to aggressive prevention programs. One was Du Pont Company, which lost…
Bell, Nancy N. Oh My Aching Back! Many Companies Have Successful Programs to Reduce the High Cost of Employee Back Injuries. Business and Health: A Thomson Health Care Company, April 1991
Hirschman, Carolyn. Commuter Connections: Helping Employees Reduce Their Commuting Expenses Can Cut Employees' Costs Too. HR Magazine: Society for Human Resources Management, 2004
Hyland Stephanie L. Health Care Benefits Show Cost-Containment Strategies. Monthly Labor Review: United States Bureau of Labor Statistics, Feb 1992
Papalla, Mark. Class-Based Pensions. Journal of Accountancy: American Institute of CPA's, 2005
Instead, much of the money is being spent on other pork-barrel projects. It is time that the government realize that prohibition did not work in the 1920s and 1930s and it will not work any better in the 21st century. Since the smokers pay taxes already, making them pay for other health care costs is simply adding insult to injury by the chief drug pusher of all -- the federal government. It is the contention of this author that smokers should not pay for their own health care costs incurred from related-diseases.
"Smoke 'em if you got 'em, bum 'em if you don't" used to be the saying in the military prior to every smoke break. However, today, even the United States military is down on smoking. In this short essay, the author will illustrate how criminalizing the behavior of smokers will not cure them of the habit. It…
Adda, J., & Cornaglia, F. (2005). Taxes, cigarette consumption and smoking intensity. Bonn, Germany:
Institute for the Study of Labor.
Auld, C. (2011). Smoking, health care costs, and imprisoning drug users because they cost us money to imprison. Retrieved from http://chrisauld.com/2011/10/27/smoking-health-care-costs-and-imprisoning-drug-users-because-they-cost-us-money-to-imprison/ .
Cnossen, S. European Union, European Commission. (2006). Cesifo working paper no. 1718 tobacco taxation in the european union. Brussels, Belgium: European Union.
Smokers should pay for their own health costs.
Health care costs of smoking are expensive and smoking is reduced more to motivational determinants than to biological factors; the essay, therefore, recommends that smokers pay for their own health costs.
Smokers can abstain from smoking if they wish to. Self-efficacy is essential
"Analysis shows that the intention to stop smoking was dependent not only on the perceived health benefits but also on the subject's confidence that hey would succeed if they tried to stop… When the follow-up data are considered, reported attempts to quitting were strongly related to previously declared intentions " (iser et al., 1984, 321)
In a broadly quoted study that was conducted by iser and colleagues in 1984, researchers discovered that out of 1848 smokers surveyed, 797 had tried to stop smoking, 709 had reduced their consumption, and 164 had become abstinent. Analysis showed that success in quitting…
Eiser, Pligt, Raw, & Sutton (1985) Trying to stop smoking. Affects of perceived addictions. Journal Behav. Med., 8
Srinivasan, T & Tara, R. (2001) Smoking in schizophrenia -- all is not biological Schizophrenia Research, 56, 67-74
Zohrabian, A & Philipson, TJ (2010) External Costs of Risky Health Behaviors Associated with Leading Actual Causes of Death in the U.S.: A Review of the Evidence and Implications for Future Research
Mandatoy Ovetime Policies
Oganizational Cultue and Readiness Assessment
The esults of the Oganizational Cultue and Readiness fo System-Wide Integation of Evidence-Based Pactice checklist, which summaizes the suvey esults, ae discussed with egad to the eadiness level of the oganization, possible poject baies and facilitatos, and plans fo integating with clinical inquiy.
The oveaching chaacteistic of the state of eadiness of this oganization fo system-wide integation of evidence-based pactice is modeately encouaging, while still indicative of some concen egading baies to implementation success. The stakeholdes in the oganization ae awae of the impotance of evidence-based pactice and they ae fundamentally suppotive. The oganization povides esouces to suppot the integation of evidence-based pactice into the institution, howeve, the availability of skilled staff who can assist with the changes is limited (Battilana & Casciao, 2012). Two elated and high scoing items in the suvey have to do with the availability of quality computes…
references, and Perceptions of Critical Care and Emergency Department NursesCrit Care Nurse April 1, 2011 31:e1-e11
Hospital Staff Nurses' Work Hours, Meal Periods, and Rest Breaks: A Review from an Occupational Health Nurse PerspectiveWorkplace Health Saf November 1, 2010 58:489-497
Identification of Relationships between Work System Parameters and Fatigue in Registered Nurses: A Data Mining ApproachProceedings of the Human Factors and Ergonomics Society Annual Meeting September 1, 2010 54:364-368
Effects of Extended Work Shifts and Shift Work on Patient Safety, Productivity, and Employee HealthWorkplace Health Saf December 1, 2009 57:497-502
Estimates of injury risks for healthcare personnel working night shifts and long hoursBMJQS October 1, 2009 18:336-340
"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
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.
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.
" (Arnold & Reeves, 2009). ith medical services price at the present time, illness or some kind of complicated to medical services may take people deprived of health insurance years to reimburse for bills that are medical. Furthermore, I believe that individuals who lost their jobs also are uninsured for the reason that their employer gave health insurance is no longer paying for them. I understand that based on the statistic; there are "way too many around 1 million workers that have lost their health reporting in the first three months of 2009. I think that helping people buy health insurance coverage with low-cost with offering the health plans options for the uninsured is the healthcare reform that is really needed now. In this way, individuals that are without health insurance will be able to afford paying their medical insurance to uphold their well-being.
In conclusion, with the increasing rapidly…
Arnold, P.J., & Reeves, T.C. (2009). International Trade and Health Policy: Implications of the GATS for U.S. Healthcare Reform. Journal of Business Ethics, 63(4), 34.
Belcon, M.C., Ahmed, N.U., Younis, M.Z., & Bongyu, M. (40-74.). ANALYSIS of NATIONAL HEALTHCARE SYSTEMS: SEARCHING for a MODEL for DEVELOPING COUNTRIES - TRINIDAD and TOBAGO as a TEST CASE. Public Administration and Management, 14(2), 10-14.
Bolduc, C.R. (2008). The impact of healthcare reform on HMO administrators. Hospital & Health Services Administration, 17(9), 23-45.
Reiboldt, M. (2010). The Industry Responds to the Passing of Healthcare Reform. The Journal of Medical Practice Management, 18(6), 327-328.
WHO rates France as having the best healthcare ("World Health," 2000). In addition to universal healthcare, France also has non-profit supplementary providers, which means that the government subsidizes 70% of regular expenses but pays 100% of more expensive or long-term treatment plans (Sandier, Paris, & Polton, 2004). Money for subsidies comes from mandatory earnings contributions such as 5.25% salary, capital income, and gambling winnings (Sandier, 2004).
An argument that often arises is that people say they don't want the government deciding what medical procedures they can have. However, decisions regarding what procedures are covered by a particular health plan are made by the healthcare insurance companies, which are for-profit ("Insurance Verification," n.d.). Many people are denied treatment regardless of the illness. As already mentioned, some of the other nations with universal healthcare have supplementary plans in addition to the government plans that allow the patient more choice.
There are many…
Carrasquillo, O., Himmelstein, DU.,Woodhandler, S., Bor, DH. (1999). A Reappraisal of Private Employers' Role in Providing Health Insurance. NEJM, 340(1), 109-114.
"Insurance Verification & Eligibility Services." (n.d.). Retrieved from http://www.globaledgeusa.com/insurance_verification_eligibility_services/
Mahon, Mary. (2010, June 23). U.S. ranks last among 7 countries on health system performance. EurkAlert. Retrieved from http://www.eurekalert.org/pub_releases/2010-06/cf-url062210.php
Reid, T.R. (Producer). (2008, April 15). Frontline: Sick around the world [Television broadcast]. New York: Central Broadcasting Service.
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 .
(ennie; Fontanarosa, 2006)
Apart from financial reasons, millions are not bale to access healthcare due to a lot of barriers inclusive of geography, racial differences and immigrant status. The people who do not have access to required care, that might comprise incapability to get primary care chronic care, specialist care, or emergency care stand at risk for severe health consequences. As per a recent report, absence of health insurance was linked with considerably lowered application of recommended healthcare services for cancer prevention, cardiovascular disease threat reduction, and diabetes management within the lower-income as also higher-income adults. Apart from the concerns, trouble, and stress directly associated to their illness, patients those who lack insurance or are underinsured also encounter increased levels of debt, threatening calls from collection agencies, anxiety, and possible insolvency. (ennie; Fontanarosa, 2006)
Impact of reform measures on the nursing profession:
The U.S. healthcare system is considered among the…
Granger, David; Young, Audrey. (1999) "Healthcare and the Underserved: America's Poor and Managed Care." Project of the Standing Committee on Health Policy: American Medical Student Association. Retrieved 10 September, 2007 at http://www.amsa.org/pdf/hlthcareunderserved.pdf
N.A. (2002, Jun 1) "Collective bargaining in the nursing profession: salient issues and recent developments in healthcare reform" Hospital Topics. Retrieved 10 September, 2007 at http://goliath.ecnext.com/coms2/summary_0198-95081_ITM
N.A. (n. d.) "Nursing's Agenda for Healthcare Reform." The American Nurses Association
Inc. Retrieved 10 September, 2007 at http://www.needlestick.org/readroom/rnagenda.htm
Healthcare 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
Health Care Administration Profession
As a health care manager, the reason for choosing this profession and the day-to-day activities which fill my schedule are often vary different. As a health care professional, I entered this profession to make a contribution to the health and well being of my fellow soldiers. I chose to become a part of the support system which keeps the military functioning, and able to freely commit themselves to the defense of our country. As a health care manager, my time is filled with responsibilities which revolve around 4 categories that have little to do with the daily care of the soldiers and civilians who use our facilities. My job responsibilities focus on the Administrative, financial, legal, ethical, and financial aspects of keeping the medical care facilities operational (so that the other health card staff, such as doctors and nurses, can tend to the medical well-being of…
Kirkman-Liff, Brad. Keeping an eye on a moving target: quality changes and challenges for nurses. Nursing Economics. 11/01/2002;
South Florida Employees Face Higher Health-Care Premiums, Fewer Benefits. Knight Ridder/Tribune Business News. 10/12/2003
Shah, Bimal R. Reed, Shelby D. Francis, Jennifer Ridley, David B. Schulman, Kevin A The cost of inefficiency in U.S. hospitals, 1985-1997. Journal of Health Care Finance. 10/01/2003
(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
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.
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).
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
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.
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
The result is that a multilayered system which is inherently designed to maintain and improve our public health standards has instead become almost entirely designed by its profitability. The best opportunity we have for reversing this trend is the applying of pressure that only the federal government can bring to bear. Greater regulation of pricing, coverage and standards of care will shift the focus back to quality health outcomes rather than strict improvement of the bottom line at all costs.
- Is there a solution?
How can (or can't) public policy shape health care in the U.S. hat do you predict for the next year?
Public policy absolutely has the capacity to bring improvement to a highly dysfunctional system. The Affordable Care Act and many of its related sub-initiatives such as the Readmissions Reduction Program are indicative of this opportunity. Indeed, the continuing pressure upon hospitals to focus on producing…
Krueger, a. (2013). As ACA Implementation Continues, Consumer Health Care Cost Growth Has Slowed. Whitehouse.gov.
Health care reform has the objective of getting more people insured, and leveraging government bargaining power to lower the cost of health care. Our organization needs to be ready for this. We have the baby boomers joining Medicare, and Medicare is seeking to lower health care costs; so are private insurers. As an organization, we need to bring our costs down in order to remain profitable. This need not be hard -- every other country in the world does it. In this context, streamlining operations, eliminating waste, bargaining with suppliers and finding ways to streamline services to increase customer turnover are all measures that I would undertake in order to ready the organization for the full implementation of health care reform. Eliminating waste is a critical component of maintaining profitability within the health care system (Berwick & Hackbarth, 2012).
Something I would do differently with respect to health care planning…
Berwick, D. & Hackbarth, A. (2012). Eliminating waste in U.S. health care. JAMA. Vol. 207 (15) 1513-1516.
Farmer, J. & Nimegeer, A. (2014). Community participation to design rural primary healthcare services. BMC Health Services. Vol. 14 (130) [HIDDEN]
Olsen, E. (2008). SWOT Analysis: How To Perform One For Your Organization (Webcast). Virtual Strategist.
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 .
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.
For example, prior to 2007, there were approximately 1 million confirmed cases of hospital-acquired ("nosocomial") infections in American hospitals and other healthcare institutions (clinics, nursing homes, etc.), resulting in the premature and preventable deaths of nearly 100,000 patients who would otherwise have survived the illnesses or surgeries for which they originally received treatment in those institutions (eid, 2009).
Approaches to educing Healthcare Costs
Because the problem of treating those nosocomial infections alone was the source of an estimated $1 - $2 billion, the Centers for Medicare and Medicaid (CMS) terminated reimbursement for several kinds of urinary tract infections in healthcare institutions in 2007, to force healthcare providers to take the necessary steps to prevent those infections (eid, 2007). Another important component to fighting healthcare costs are the oversight mechanisms, such as the Health and Human Services Inspector General's Audit Services and Medicare's recently enacted ecovery Audit Contractor (AC) program. In…
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.
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
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).
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;
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
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…
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