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Healthcare Policy Analysis
The objective of this study is to conduct a healthcare policy analysis and recommend changes.
Presently, there is not an across-the-board implementation of Computerized Physician Order Entry (CPOE) or prescriptions and this can be critical in reducing adverse drug events. This study argues that the use of the Computerized Physician Order Entry (CPOE) should be implemented and utilized across the entire health care system.
Review of Studies on the Use of CPOE
The work of Steele and Derow (nd) states that computerized provider order entry (CPOE) is an electronic process "that allows a health care provider to enter orders electronically and to manage the results of those orders. CPOE has received increased attention, based on the Institute of Medicine (IOM) reports, To Err Is Human: uilding a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, and the recommendation of…
Steele, AM and DeBrow, M (nd0 Efficiency Gains with Computerized Provider Order Entry. Retrieved from: http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Steele_100.pdf
Berger, RG and Kichak, JP (2004) Computerized Physician Order Entry: Helpful or Harmful. J Am Med Inform Assoc. 2004 Mar-Apr 11(2) 100-103. PubMed. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC353014/
Walsh, KE et al. (2008) Effect of Computer Order Entry on Prevention of Serious Medication Errors in Hospitalized Children. Pediatrics 2008 Mar 121(3). Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/18310162
Potts, A. (2004) Computerized physician order entry and medication errors in a pediatric critical care unit. Pediatrics. 2004 Jan;113(1 Pt 1):59-63. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/14702449
An Overview of the Uninsured and Underinsured in America
An alarming number of people in the United States today do not have health-care coverage. Many of these people live in urban areas and their income is below the official government poverty line. However, some of them make up to 200% of the government poverty amount, and not all of these uninsured and underinsured individuals are inner-city minority individuals.
According to a recent press release put out by the Kaiser family foundation, 75% of individuals in the United States who don't have health insurance or who recently had a gap or lapse in their health insurance were working families. These people can work full-time or part-time, and some of them are the husband or wife of someone who is working.
These people are not uninsured because their health problems do not allow companies to provide them with insurance, or…
Blumberg & Liska, 1996.
Ginsberg, E, 1994. Improving health care for the poor. Journal of the American Medical Association 464-467.
Blumberg & Liska, 1996.
Healthcare Policy Systems: Hong Kong, Australia
VOUCHERS FOR THE ELDERLY
Healthcare Policy Systems in Hong Kong and Australia
Primary Health Care for the Elderly in Hong Kong
Primary care is the starting point in the healthcare process (PCO, 2011). A good one is made available to the public for a comprehensive, holistic, coordinated and in locations accessible to where people live or work. It also provides preventive care and optimal disease management. In Hong Kong, approximately 70% of clinical consultations are made with primary care practitioners belonging to the private sector. The public sector, on the other hand, acquires primary care from hospitals through outpatient services and the Department of Health for preventive public health services, health promotion and disease prevention and management programs and services (PCO; Woo, 2007).
Primary care has been emphasized as a priority in international for a and reports, such as the 1978 International Conference on…
Althaus, C., et al. (2007). The Australian Policy Handbook. Sydney: Allen & Unwin
BBC (20140. Australia profile. BBC News Asia. Retrieved on January 23, 2014 from http://bbc.co.uk/news/world-asia-15674351
Bridgman, et al. (2000). What use is a policy cycle? Plenty, if the aim is clear.
Controversy: National Cycle of the Institute of Public Administration. Retrieved on January 19, 2014 from http://www.dpac.tas.gov.au?_data/assets/pdf_policy_life_cycle.PDF
Healthcare System in South Africa
Influences on public health outcomes
Critical analysis of the pressures on the health care delivery
It is observed that there are numerous cultures, societies, political systems in the world. The governments regulate the social systems according to the political, cultural, and economic condition of a country. The structure of healthcare systems is also an extension of the country's political system. It is observed that the characteristics of each society and culture are major factors defining the healthcare system followed in a country. There are multiple models available in the world for healthcare systems. All have their own advantages and disadvantages for societies living in respective countries. An example can be quoted that United Sates healthcare system is different from most followed system in European countries. Similarly the systems followed in other parts of the world are also significantly different including Asia, Africa, and…
Clark, D 2009, South Africa: The People, Crabtree Publishing, USA.
Cooper, D, Moodley, J, Zweigenthal, V, Bekker, LG, Shah, I & Myer, L 2009, Fertility intentions and reproductive health care needs of people living with HIV in Cape Town, South Africa: implications for integrating reproductive health and HIV care services, AIDS and Behavior, Vol. 13, No. 1, pp. 38-46.
Coovadia, H, Jewkes, R, Barron, P, Sanders, D & McIntyre, D 2009, The health and health system of South Africa: historical roots of current public health challenges, The Lancet, Vol. 374, No. 9692, pp. 817-834.
De Haan, M, Dennill, K & Vasuthevan, S 2005, The health of southern Africa, Juta and Company Ltd.
Even with health care that lies outside of government control, cost can be an issue when it affects voter decision-making. Usually, however, politicians are much less concerned about the costs of private enterprise transactions.
Tax payers are always looking for value, especially in public services. Even when tax payers want health care -- and they usually do for seniors -- they still consider cost control to be an important aspect of that care.
Board members are oriented towards controlling the cost of health care, because when costs are controlled, profits are increased.
Staff members usually have little cost orientation, because they are not involved in the financial aspects of their jobs.
Quality of care within an organized hospital system:
Administrators usually are concerned about the quality of care, in balance with cost. Most organized systems like to offer a high standard of care, as this is a key point of…
Lack of a comprehensive education and lack of knowledge in EBP could lead many of the nurses that work in hospitals around the country to make errors, which would negatively affect the patient care and predispose them to increased chances of litigation. This issue also has the potential to undermine the support for evidence-based practice among many health care providers (Gerrish & Clayton, 2004).
Evidence-based practice is also not restricted to the context of the individual patient, but is extended to all areas of healthcare systems and healthcare policy-making. Evidence-based practice is therefore seen to be not only an important means to the improvement of the quality of medical care in this country, but also as an instrument to control the costs (Gerrish & Clayton, 2004).
In view of the scarcity of health care resources that are seen in this country, the decisions on allocation of care will need to…
Atkins, D., Siegal, J. & Slutsky, J.(2005). Making policy when the evidence is in dispute. Health Affairs, 24, 1, 102-113.
Brown, G.C., Brown, M.M. & Sharma, S. (2000). Health care in the 21st century: evidence-based medicine, patient preference-based quality, and cost effectiveness.
Quality Management in Health Care, 9, 1, 23-31.
Clancy, C.M. & Cronin, K. (2005). Evidenced-based decision making: global evidence, local decisions. Health Affairs,
Western Philosophical Thought and the Delivery of the Public Health System
Improving healthcare behaviors and access to public healthcare has been a key issue of debate among politicians and officials on all levels of the government for quite some time. The ability to improve individual behaviors that result in improved health have an impact on society. The healthcare system is already overwhelmed and there is an urgent need to convince people to take responsibility for their own health by making positive changes in their daily lifestyle. Access to healthcare among certain socioeconomic classes and cultural populations has been an ongoing problem in the public health arena as well. This research takes a multidisciplinary approach to developing public policies that will result in improvements in each of these areas. This research will result in recommendations for policies that will effectively achieve these goals.
In the United States, we…
Finnell, D. (2010). Transtheoretical Model. UB School of Nursing. Retrieved May 18, 2011 from http://nursing.buffalo.edu/Research/TranstheoreticalModel.aspx
Gutting, G. (2008). Michel Foucault. Standford Encyclopedia of Philosophy. Retrieved May 18, 2011 from http://plato.stanford.edu/entries/foucault/ .
Jones, R. (2009). The Durkheim Pages. Retrieved May 18, 2011. from http://durkheim.uchicago.edu/
Lewis, H. (2001). Boas, Darwin, Science, and Anthropology. Current Anthropology. 42 (1): 381-406. Retrieved May 18, 2011 from http://www.anthropology.wisc.edu/pdfs/Boas,_Darwin.pdf
Health Care Policy in the United States Today Under the Obama Administration: The Issue of Abortion
The objective of this study is to examine how well government's role in health care is working and how it may be improved and to evaluate the current health care policy in America and determine how it could be improved to please both the public and the government.
Current Policies on Abortion
Nine U.S. states including: (1) Alabama; (2) Georgia; (3) Idaho; (4) Kansas; (5) Louisiana; (6) Nebraska; (7) Indiana; (8) North Carolina; and (8) Arizona, has enacted laws prohibiting abortions at 20 weeks and in some states even earlier. The basis of these laws is the theory that a fetus "from 20 weeks onward can experience pain from an abortion procedure." (The Pew Forum, 2013, p.1) Arizona is reported to have enacted a fetal plan law that is very rigorous in that abortions…
Abortion Policy in the Absence of Roe (2013) State Policies Brief. Guttmacher Institute. 1 Mar 2013. Retrieved from: http://www.guttmacher.org/statecenter/spibs/spib_APAR.pdf
History of Abortion (2012) National Abortion Federation. Retrieved from: http://www.prochoice.org/about_abortion/history_abortion.html
Masci, D (2013) A History of Key Abortion Rulings of the U.S. Supreme Court. The Pew Forum. 16 Jan 2013. Retrieved from: http://www.pewforum.org/Abortion/A-History-of-Key-Abortion-Rulings-of-the-U.S.-Supreme-Court.aspx
U.S. Abortion Law (2013) Abort73.com. Retrieved from: http://www.abort73.com/abortion_facts/us_abortion_law/
" (2007, p. 284) Smith asks if "the desire to eliminate health disparities by rooting out the social disease underlying them inspire nursing to find itself again?" (2007, p. 284) Smith also asks if health disparities, being despicable and laden with shame can somehow, through the response of nursing, actually "serve a higher purpose" through "reawakening the caring" aspect of nursing? (2007, p. 284) Indeed, it is held by Smith that nursing "the premier profession for caring" may have very well "become contaminated...infected by a selfishness that is gaining ground, credence and sanction" within the society of today. (Smith, 2007) Smith holds that selfishness is a disease that "...in a mild form" results in a "loss of social capital and community engagement in the United States." (2007, p. 284) Smith notes that the work of Krugman (2002) states very candidly that "we live in the new Gilded Age where 13,000…
It is significantly affecting and endangering the future of millions of young people in the nation. Additionally, there are several challenges on the issue of the overall drug use in the United States. To understand the issue of drug and substance abuse fully, and the subsequent need for proper legislation to handle the challenge, it is crucial to assess the impacts of the issue in the country. According to the health expenditure report on the year 2011-2012 budget, the sectors spend a total of $29 billion on issues associated with drug and substance abuse treatment and care (Swartz, 2012). This is a gargantuan penalty to pay for a preventable case, only if the right provisions and regulations are in place.
The impacts of substance abuse on the individual are an unending string of interrelated issues. For instance, the negative impacts associated with the substance abuse on the health of the…
Swartz, J. (2012). Substance abuse in America: A documentary and reference guide. Santa Barbara, Calif: Greenwood.
Kleiman, M., Caulkins, J.P., & Hawken, a. (2011). Drugs and drug policy: What everyone needs to know. New York: Oxford University Press.
Hanson, G., Venturelli, P.J., & Fleckenstein, a.E. (2012). Drugs and society. Sudbury, MA:
Jones & Bartlett Learning.
Healthcare Policy & Financing
Obesity Prevention and Control Program -- eight atcher / alking Group
ONE (a): Define the problem that will be addressed in this paper
A significant proportion of the American public is becoming obese. According to the Centers for Disease Control and Prevention "…more than a third (34.9%) of adults was obese in 2011-2012" (CDC). That is approximately 78 million Americans that have put themselves at risk of diabetes, deteriorating heart conditions, cancer, and other diseases related to obesity. In particular, men between the age of 40 and 59 years have a higher rate of obesity (39.4%) than other sectors of the population. A healthy program for weight loss for men in the 40-59 age bracket is being promoted by a local clinic, thanks to grants totaling $344,000 from local foundations and from the federal government.
TO (b): Provide basic budget data that reflects the cost of…
Centers for Disease Control and Prevention. (2013). Prevalence of Obesity Among Adults:
United States, 2011-2012. Retrieved December 25, 2013, from http://www.cdc.gov .
Landau, E. (2012). Health care costs to bulge along with U.S. waistlines. CNN. Retrieved
December 25, 2013, from http://www.cnn.com .
The political system and the medical profession are entangled in many ways. The serious nature of medicine and healing the sick and ill requires a collective guide in order to ensure that proper and sustainable care is offered at all times. When problems arise due to changes in the environment or culture, government officials are often asked to solve these problems that influence a great number of people. In essence, public policy is in the public's best interest according to the democratic functioning of our local, state and federal government agencies that overlook the medical profession in a variety of ways and methods.
The purpose of this essay is to identify how problems become policy issues and how these issues result in the creation of health care policy. Additionally, this essay will address the controversial issue of abortion and provide an understanding of how this policy was created.…
American Medical Association (nd). Developing AMA Policies. Viewed 21 Feb 2015. Retrieved from http://www.ama-assn.org/ama/pub/about-ama/our-people/house - delegates/developing-ama-policies.page?
Field, M.J., & Lo, B. (Eds.). (2009). Conflict of interest in medical research, education, and practice. National Academies Press.
Hyman, M. (2014). Money, Politics, and Health Care: A Disease-Creation Economy -- Part I.
Lo, B. (2010). Serving two masters -- conflicts of interest in academic medicine. New England Journal of Medicine, 362(8), 669-671.
In essence, it incentivizes both wellness and economic responsibility (Kennedy, 2006; eid 2009).
Healthcare Information Technology in elation to Cost and Quality Control
In my clinical experience, modern healthcare information technology has impacted my practice beneficially in two principal ways: (1) by helping to eliminate provider errors in medication administration, and (2) by providing quantitative data to help identify weaknesses in healthcare delivery. The use of computerized medication logging has frequently flagged errors in medication administration that, in all likelihood, would not have been prevented without the computer system. Typical examples in my experience have included instances of overmedication, incorrect selection of medications, and contraindicated combinations of medications that had escaped the attention of prescribing providers and nurses responsible for actual medication administration.
With respect to the use of medical information systems to improve the quality of care, I have had the opportunity to see institutions use information systems successfully…
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.
isk prevention policy in practice
The proposed study looks at lateral violence in U.S. healthcare institutions, through the scope of policy formation as it pertains to medical malpractice and organizational behavior in healthcare institutions. In recent years, investigations into lateral violence (LV) in the practice setting have become increasingly important as professional liability to 'duty' in patient care has been put under the microscope.
In Tarasoff v. The egents of the University of California [S.F. No. 23042, Supreme Court of California, July 1, 1976], a wrongful death action filed against egents of the University of California, charged that psychotherapists at a university hospital and campus policemen, had failed to respond adequately to information of patient, Prosenjit Poddar's intention to murder Tatiana Tarasoff in October of 1969. Charges against the egents of University of California, alleged that Poddar confided homicidal ideation toward the victim Tatiana to Dr. Lawrence Moore, a…
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Spring, MD.: American Nurses Association.
Bartholomew, K. (2006). Ending nurse-to nurse hostility. Marblehead, MA 01945: HCPRO, Inc.
Camden, C. et al. (2009). SWOT analysis of a pediatric rehabilitation programme: A participatory evaluation fostering quality improvement. Center of Interdisciplinary Rehabilitation Research and the Estrie Rehabilitation Center. Quebec: Universite de Montreal.
Center for American Nurses. (2007). Bullying in the workplace: Reversing a culture. Silver Spring, MD: Center for American Nurses.
Health Care Policy on Nurses' Delivery of Patient Care
Health care policy is usually developed and enacted in order to address various issues relating to health care delivery with the aim of improving patient outcome. These policies are usually centered on addressing health care cost, quality or access, or a combination of these three factors. Given the nature of their interactions with patients, nurses are health care professionals who are well suited to be effective, knowledgeable advocates for their patients. Generally, health care policies have considerable impacts on nurses with regards to the provision of health care. This is primarily because competent nurses are required to show their commitment to action through being part of relevant decisions and policies that ensures effective patient care delivery in a cost-effective way (Milstead, 2013, p.1).
An example of a health care policy that was recently developed and enacted and has considerable impacts on…
Anderson, A. (2014, March 18). The Impact of the Affordable Care Act on the Health Care Workforce. Retrieved October 12, 2015, from http://www.heritage.org/research/reports/2014/03/the-impact-of-the-affordable-care-act-on-the-health-care-workforce
Milstead, J.A. (2013). Health policy and politics: a nurse's guide (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones & Bartlett Publishers.
Health policy in Florida basically entails the development and enactment of laws and regulations to govern the state’s healthcare system. The process of formulating healthcare policy in this state involves various initiatives by policymakers towards addressing the most pressing healthcare issues. Some of the recent healthcare policy initiatives in the state are shown in the legislative matrix below:
Sponsor & Co-sponsors
Senate Bill 8-A
Medical Use of Marijuana
Sponsor: Senator Rob Bradley
Co-sponsor: Senator Dana D. Young
Appropriations, Environmental Preservation and Conservation, Banking and Insurance, Criminal Justice, Judiciary, Rules, and Joint Legislative Budget Commission
Health Policy, Appropriations, Commerce and Tourism, Regulated Industries, Joint Committee on Public Counsel Oversight, and Communications, Energy, and Public Utilities
Direct Support Organization of the Prescription Drug Monitoring Program
Health Quality Subcommittee (Approved by Governor Rick Scott)
Health Quality Subcommittee
Prescription Drug Monitoring Program
Health Care eforms Legislation and Its Effect on Nursing Practice
One of the milestone legislations that President Obama signed into law in 2010 was the Affordable Care Act (P.L. 111-148) and the Health Care Education and econciliation Act of 2010 (P.L. 111-152). This policy, commonly referred to as the comprehensive healthcare policy has been widely supported by several nursing organizations including the American Nursing Association and the American Academy of Nursing. Indeed, the bid to have reforms in the health sector has been a central agenda since the mid 20th century which has culminated in several changes in legislations that are geared towards having a better health care system. The latest significant change in legislation has significantly put the practicing nurses in the forefront and the daily contribution and impact of the nurses in ensuring the success of the policy is evident as will be discussed herein (Institute of Medicine,…
American Nursing College, (2010). Implementing Health Care Reform: Issues for Nursing. Retrieved January 30, 2015 from http://www.aannet.org/assets/docs/implementinghealthcarereform.pdf
Barclay L., (2010). Healthcare Reform Legislation Effects on Nursing: An Expert Interview With Rebecca M. Patton, MSN, RN, CNOR. Retrieved January 30, 2015 from http://www.medscape.com/viewarticle/720857
Institute of Medicine, (2010). The Future of Nursing: Leading Change, Advancing Health. Retrieved January 30, 2015 from http://www.iom.edu/Reports/2010/The-future-of-nursing-leading-change-advancing-health.aspx
Medicare: Healthcare to Protect the Elderly
Medicare has been around for a long time, and is the main source of healthcare insurance for the elderly. If it were not for the government-funded Medicare, many elderly people in this country would have to do without much needed physician appointments and prescription medications because they would not be able to afford them. There are stories every winter about elderly people who suffer in their homes because they can either afford their medication or their heating bill, but not both. This is something that should not be happening, but no system is perfect, including those run by the government. Some elderly people do not have or cannot get Medicare, and some don't really need it because they are covered in other ways.
Some older individuals have other insurance, for example, such as through employers that the individual has retired from. There are still…
Bandow, Doug, & Tanner, Michael. 1995. Policy Analysis: The wrong and right ways to reform Medicare [online]. Cato Policy Analysis No. 230: available at http://www.cato.org/pubs/pas/pa230.html;Internet ; accessed 15 October 1997.
Bandow & Tanner, 1995.
Coughing Up. 1997. Finance and economics.
Federal Healthcare Policy
Howlett (2009) states that policy goals and means "exist at different levels of abstraction and application and policies can be seen to be comprised of a number of components or elements, not all of which are as amenable to (re)design as others." Successful policy design is reported in the work of Howlett to require the following:
(1) that policy aims, objectives and targets be coherent;
(2) that that implementation preferences, policy tools and tool calibrations should also be consistent; and (3) that policy aims and implementation preferences; policy objectives, and policy tools; and policy targets and tool calibrations, should also be congruent and convergent. (Howlett, 2009)
Policy instrument choices are reported to be such that are "nested or embedded" in the relationship that exists within "a larger framework of established governance modes and policy regime logics." (Howlett, 2009)
Required Health Care Coverage
This study intends to examine…
Health Care Reform and the Supreme Court (Affordable Care Act) (2012) The New York Times. 29 Jun 2012. Retrieved from: http://topics.nytimes.com/top/reference/timestopics/organizations/s/supreme_court/affordable_care_act/index.html
Howlett, Michael (2009) Governance Modes, Policy Regimes and Operational Plans: A Multi-Level Nested Model of Policy Instrument Choice and Policy Design. Policy Sciences. Vol. 42, No. 1 (Feb., 2009), pp. 73-89. Retrieved from: http://www.jstor.org/discover/10.2307/40270982?searchUrl=%2Faction%2FdoBasicSearch%3FQuery%3Dfederal%2Bhealthcare%2Bpolicy%26acc%3Doff%26wc%3Don&Search=yes&uid=3739256&uid=2134&uid=2&uid=70&uid=4&sid=56288483453 .
Harkness, Peter (2009) he Affordable Care Act: A Case Study for Cooperative Federalism? Governing the States and Localities. Retrieved from: http://www.governing.com/columns/potomac-chronicle/col-affordable-care-act-case-study-for-cooperative-federalism.html
Government Role in Health Care Policy
Describe the characteristics of the uninsured? Additionally, why are concentrated interests and diffuse costs important when predicting legislative outcomes?
The uninsured are usually less wealthy, less healthy, and less educated than the insured. Unlike the insured, who typically receive health care coverage through their employer, the uninsured bear the burden of health care coverage with no institutional support, save that of the government. Because many health care services are priced with insured consumers in mind, the price of health care services is often inflated far beyond the means of the average uninsured individual.
Concentrated interests and diffuse costs affect legislative outcomes through political lobbying and its effect on legislation. Concentrated interests, such as health care insurers, are very conducive to lobbying because they share very narrow and clearly defined economic interests that can be achieved through legislation. This allows lobbyists for concentrated interests such…
Australian Social Policy: Health
Australian Healthcare Policy: Fluctuations between Private and Public Systems
In Australia, one of the most politically divisive and publically discussed social policy domains is that of health. It has been an issue under discussion by political candidates at each Commonwealth election over the past seventy years due to the politically engrained differences in how the political parties have conceptualized managing the Australian healthcare system. These political divisions are in addition to the stakeholder positions that are usual to any healthcare system, with patient, provider, research, and insurance interests often having vastly different goals and motivations. Health policy in Australia is indeed reflective of the plurality of political parties and ideologies core to the Commonwealth's legislature (Gray 2003). The political tensions around health are no small matter, either, with the healthcare industry being the largest industry in the Commonwealth (Duckett 1999).
In light of the political fluctuations…
Australian Government. (2011) "About Medicare Australia" Retrieved from: http://www.medicareaustralia.gov.au/about/index.jsp
Australian Government. (2011). "Private Health Insurance Administration Council." Retrieved from: http://www.phiac.gov.au/statistics/membershipcoverage/hosquar.htm
Australian Government (2010). "Health expenditure Australia 2008-09" Retrieved from: http://www.aihw.gov.au/publication-detail/?id=6442472450&libID=6442472431
Australian Institute of Health and Welfare. (2011). "Services, Workforce, and Spending" Retrieved from: http://www.aihw.gov.au/services-workforce-and-spending/ .
In a single-payer system, a government entity is responsible for reimbursing all service providers for their costs and expenses, meaning that billing takes place in exactly the same manner for all patients and all providers (Healthcare NOW 2010). This means that instead of tens of thousands of different insurance companies, employers, and individuals that need to be contacted in order to receive payment, there is only one, and in making this move healthcare costs could be dramatically -- possibly by as much as half in some circumstances (Healthcare NOW 2010). In addition to providing far cheaper healthcare, a single-payer system operated by the government could guarantee payment for all medical services rendered, which does not actually occur in the present system. Instead, many people without health insurance receive emergency care when it is needed -- almost always at greater expense than regular preventative care would create -- and are then…
BLE. (2001). The U.S. Healthcare System: Best in the World, or Just the Most Expensive? The University of Maine Bureau of Labor Education. Accessed 18 December 2010. http://dll.umaine.edu/ble/U.S.%20HCweb.pdf
Healthcare NOW. (2010). What is Single Payer Healthcare? Accessed 18 December 2010. http://www.healthcare-now.org/hr-676/whats-single-payer/
President Obama & Proposed Tax
I think, President Obama should support the sin tax on all alcoholic beverages. The reason is that the youth of United States is getting involved in excessive drinking day by day; thus resulting in societal as well as personal harms. Excessive usage of alcohol is also a major reason for increased obesity in United States which is in turn causing healthcare problem in the new generation. (Garrett 21) President Obama would probably face resistance from some large alcoholic beverage producers for imposing sin taxes as implementation of this proposal is expected to result in decreasing the demand for Alcohol in United States.
How Much Tax?
At this point, it is very difficult to quote any definite percentage of tax to be imposed. Even if the Congress is in favor of the tax proposal, a higher tax percentage is proposed so that the prices…
Burns, Eric. The Spirits of America: A Social History of Alcohol. Philadelphia: Temple University Press, (2003), ISBN 1-59213-214-6, p.15-16.
Peck, Garrett. The Prohibition Hangover: Alcohol in America from Demon Rum to Cult Cabernet. Piscataway, NJ: Rutgers University Press, (2009), ISBN 0-8135-4592-7, p.21.
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.
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.
This paper will outline some of the high-level issues in the American health care system. At this level, the discussion centers around issues such as the political environment, the influence of key stakeholders and power structures. By analyzing the health care system through these lenses, the observer is able to better understand why (or why not) good ideas are implemented (or not). There are five central questions that will be addressed in this discussion, starting with the impact of socioeconomic and sociopolitical factors on US health care policy.
Socioeconomic / sociopolitical factors
One of the most critical issues in the US health care system is the socioeconomic disparity in health outcomes. This is typically driven by access to care. Lantz, House & Lepkowski (1998) found that mortality risk was a function of income, with the lowest-income groups in their study having the highest mortality risk. While there…
Foreign Health Care Policy
Over the last several years, issues affecting the U.S. health care system have been increasingly brought to the forefront. This is because rising costs are impacting demand for different services. What has been happening is these increases are forcing insurance companies, employers and providers to pass on more of these fees to the individual. This is problematic, as they are unable to afford these costs and premiums for coverage. When this happens, the total number of people who are uninsured will increase exponentially. Evidence of this can be seen with the fact that there are 48 million Americans who have no form of health care coverage. (Johnson, 2010) (Harrington, 2009)
While in Germany, the costs of care are lower and 90% of the population is insured. This is because they are using a different model. To fully understand which system is better requires comparing the two…
Armstrong, E. (2011). The Health Care Dilemma. Singapore: World Scientific.
Greenwald, H. (2010). Health Care in the United States. San Francisco, CA: Jossey Bass.
Harrington, C. (2009). Health Policy. Sudbury, MA: Jones and Bartlett.
Johnson, J. (2010). Comparative Health Systems. Sudbury, MA: Jones and Bartlett.
President Clinton's And Obama's Health Care Policies
President Obama's Healthcare policies
The Affordable Care Act (ACA) has drawn some comparisons to elements of past efforts, including Mitt omney's health care plan in Massachusetts and the Clinton plan from the 1990s. This paper will mainly examine the context of the Clinton Plan vs. The ACA. After winning office, President Clinton followed up on a campaign promise to provide health care to the 37 million uninsured Americans. This plan had motivation citing a strong sense of social justice, especially in light of America's tremendous wealth. There was majority public approval for the plan at the time. However, a single payer plan idea faced opposition and Clinton needed to create an alternative (Pfiffner, 1994).
The Clinton government recognized that a major overhaul was not going to find favor, so he sought to implement a plan that would expand coverage rather than dramatically restructure…
Pfiffner, J. (1994). President Clinton's health care reform proposals of 1994. Executive-Legislative Relations. Retrieved April 30, 2013 from http://www.thepresidency.org/storage/documents/President_Clintons_Health_Care_Reform_Proposals.pdf
Mary, W. (2010). The Affordable Care Act. Journal of Vermont Nurse Connection, 13(4), 3.
Ha, J. (2012). "Health Care Reform" vs. "ObamaCare": Partisan Framing of FOX, MSNBC,
NYT, and WSJ. Journal of Communication, Culture & Technology (CCT), 8(1).
President Clinton's And Obama's Health Care Policies:
Since the 1960's, universal health care has continued to be a major aspect of social reform to an extent that the right to health care for all Americans has been a central issue in political debates. The debate regarding universal health care was particularly fueled by the enactment of the Social Security Act in 1965 that guaranteed care services for the poor and elderly through Medicare and Medicaid. Despite of these attempts to provide health care to the poor and elderly, universal health care has remained a lurking legislative fiasco for more than four decades. During the 1990's, the then presidential candidate, Bill Clinton, propelled this issue to the vanguard of his campaigns as the focus shifted to health care reform. However, his administration failed to enact a health care bill because of a stubborn Democratic Congress. Universal health care was also a…
Klein, J. (2012, December 17). Obamacare vs. Medicare. Time, 180(25).
Levin, Y. & Ponnuru, R. (2012, February 6). Romney vs. Obamacare: What the Presumptive
Nominee Should Say, National Review, 34-35.
Santana, A. (2012). Obama vs. Clinton on Health Care. Slope Media Group.
Healthcare Delivery System Challenges
The American healthcare system has been criticized as favoring the middle and upper classes while ignoring the lower classes. Based on these speculations, the federal government has constantly tried to institute reforms in the healthcare sector though some of the proposals have failed to overhaul the industry. With rising insurance costs, the number of citizens barred from accessing quality healthcare has increased to more than 45 million uninsured Americans. On the same note, it is hypothesized that with time, the problems currently witnessed in the industry are likely to increase and finding solutions to them will be a tall order for the government (Stolberg & Pear, 2010). Despite the advent of new technology in the sector, which is likely to improve service delivery over the years, it is speculated that the cost of new tests and treatments will outweigh the savings. With the better technology, physicians…
Stolberg, S.G. & Pear, R. (March 24, 2010). Obama signs health care overhaul bill, with a flourish. The New York Times: p. A19. Retrieved March 1, 2013.
Woolhandler, S. & Himmelstein, D.U. (1997). Costs of care and administration at for-profit and other hospitals in the United States. The New England Journal of Medicine 336 (11): 769-774.
Swanson, E. (July 30, 2009). Health Care Plan: Favor / Oppose. Huffington Post.
Blumberg, L.J. & Holahan, J. (2009). The Individual Mandate: an Affordable and Fair Approach
(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
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 .
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 in Sweden
The healthcare system in Sweden is used as one of the model systems in the world. hen Johan Hjertoqvist from the Timbro Policy Group spoke before the Montreal Economic Institute in 2002, he said, "...you refuse to accept the consumer as an equal partner, you still look upon the client, the patient, as an inferior partner in the relation" and "you deny the need for good working condition when it comes to the staff, etc." (http://www.iedm.org/conference5_en.html).Moreover, he stressed the need to move interests and priorities away from the processes and production organization to "the quality of the outcome for the consumer" (http://www.iedm.org/conference5_en.html).Quality seems to be synonymous with healthcare in Sweden.
Two important characteristics of the Swedish healthcare system are that it is "decentralized and it is run on democratic principles" (http://www.si.se/docs/infosweden/engelska/fs76.pdf).All residents of Sweden are covered by the national health insurance system which covers medical care, pharmaceuticals,…
Fact Sheets on Sweden: The Health Care System in Sweden. Swedish Institute. May 1999. http://www.si.se/docs/infosweden/engelska/fs76.pdf .(accessed 06-27-2003).
Gennser, Margit. "Sweden's Health Care System." http://oldfraser.lexi.net/publications/books/health_reform/sweden.html.
A accessed 06-27-2003).
Hadenius, Stig; Lindgren, Ann. "Sweden: On Sweden Health care." Countries of the World. January 01, 1991.
However, they contradict themselves trough supporting one's right to commit physician-assisted suicide, since this would virtually mean that the individual who is no longer willing to live is not provided with health care meant to prevent him or her from dying (Epstein, 1999, p. 1).
Among those opposed to the fact that health care is becoming increasingly better are those who are in their twenties and are obliged to work hard in order to pay for their own medical insurance and for that of the underprivileged (Bonner, 2010).
Contemporary health care is basically provided by groups forced to pay taxes in order for others to benefit out of the process. The fact that health care is a privilege and not a right was made obvious ever since the 1954 foundation of the Department of Health, Education, and elfare. The name contained the term welfare with the intention of highlighting how…
Bloche, M.G. ed., The Privatization of Health Care Reform: Legal and Regulatory Perspectives (New York: Oxford University Press, 2003)
Epstein, R.A. Mortal Peril: Our Inalienable Right to Health Care? (Cambridge, MA: Perseus Books, 1999)
Heirich, M. Rethinking Health Care: Innovation and Change in America (Boulder, CO: Westview Press, 1998)
Sanders, B. (2009). Retrieved from the Huffington Post Website: http://www.huffingtonpost.com/rep-bernie-sanders/health-care-is-a-right-no_b_212770.html
People still die because they cannot afford health care, and that simply is not right in the most powerful nation on earth. People should not have to go bankrupt or lose their home because they cannot afford health insurance, and health care should be more affordable for everyone. An Indiana Congress member notes, "Expenditures on health-care lobbying last year rose to $325 million, as health-care providers, insurers, drug makers, medical professionals and others all worked to make sure their interests were served as Congress took up their issues" (Hamilton). Americans need to stop listening to lobbyists and start taking health care reform into their own hands for real health care reform to occur in this country.
Hamilton, Lee. "Who Lobbies for the est of Us?" Indiana University. 2004. 22 Jan. 2008. http://congress.indiana.edu/radio_commentaries/who_lobbies_for_the_rest_of_us.php
Montanaro, Domenico. "Kucinich Details Health-Care Policy." Firstead.MSNBC.com. 2007. 22 Jan. 2008. http://firstread.msnbc.msn.com/archive/2007/10/25/430486.aspx
Hamilton, Lee. "Who Lobbies for the Rest of Us?" Indiana University. 2004. 22 Jan. 2008. http://congress.indiana.edu/radio_commentaries/who_lobbies_for_the_rest_of_us.php
Montanaro, Domenico. "Kucinich Details Health-Care Policy." FirstRead.MSNBC.com. 2007. 22 Jan. 2008. http://firstread.msnbc.msn.com/archive/2007/10/25/430486.aspx
The issue of grey and black markets often arose as a result of the shortages of experienced health care personnel. The system could not adapt to a flexible environment as it was led by rigid official procedures and the mentality of the people who controlled it was commanding, their vision short-sighted and hardly beneficial in such a situation (Barr and Mark, 1996).
The breaking up of Soviet Union which brought crippling economic and political problems to the countries also aggravated the health care situation making it reach an all-time low. The collapse of the health care system ran by the government led to the belief that turning towards a market economy or more capitalistic notions and perceptions would have been a better idea. The competition in the private sector would have had improved efficiency and averted an inevitable collapse of the health care system in the Soviet Union. This transformation,…
Balabanova, D., Haerpfer, C., McKee, M., Pomerleau, J., Rose, R. (2004). Health service utilization in the former Soviet Union: evidence from eight countries. Health Services Research
Barr, D.A. And Mark G. (1996). The Current State of Health Care in the Former Soviet Union: Implications for Health Care Policy and Reform. American Journal of Public Health. 86, 3.
Lewis, M. (2002). Informal Health Payments in Central and Eastern Europe and the Former Soviet Union: Issues, Trends and Policy Implications. In Funding Health Care, European Observatory on Health Care Systems Series, edited by E. Mossialos, a. Dixon, J. Figueras, and J. Kutzin, pp. 184-205. Buckingham: Open University Press.
Mikesell, J.L. And Mullins, D.R. (2001), Reforming Budget Systems in Countries of the Former Soviet Union. Public Administration Review. 61. 5.
ef: The Health Care bill signed by Andrew M. Cuomo -- Governor for Treatment of Autism Spectrum Disorder
I wish to state that the legislation must have come in earlier than this. Autism is a condition that requires medication and care for children and the legislation passed by the Governor Albany, NY on November 1, 2011 requires that the treatment of Autism Spectrum Disorder be brought under the health care coverage. This is a laudable step in New York and it will be a blessing to such families with autistic children to afford the expensive health care costs. The law now makes it mandatory for the health insurance companies to provide coverage for treatment of autism spectrum disorders, and the companies however may resort to 'deductibles, co-pays, and coinsurance consistent with those imposed on other benefits.' (Cuomo, 2011)
Discussing the law Governor Andrew M. Cuomo said that the…
Cuomo, Andrew M. (2011) "Governor Cuomo Signs Law to Expand Health Care
Coverage for Treatment of Autism Spectrum Disorder"
Retrieved 12 November 2011 from http://www.governor.ny.gov/press/1112011Spectrum%20Disorder
National Conference of State Legislatures. (2011) "Insurance coverage for Autism"
Health Care Communication
As the nation's health care resources become more and more strained, health care professionals are being asked to do more with less. They are being pressured to find cheaper ways to improve the quality of health care they deliver. Given the current circumstances, this sounds difficult and even unreasonable, but it may not be entirely impossible.
One simple way for medical professionals to improve the quality of health care they provide is by improving their health care communication skills. Health care communication is "The art and technique of informing, influencing, and motivating individual, institutional, and public audiences about important health issues. The scope of health communication includes disease prevention, health promotion, health care policy, and the business of health care as well as enhancement of the quality of life and health of individuals within the community." (U.S.D.S.H.S., 2000, p.11-20).
In health care, as in all aspects of…
U.S. Department of Health and Human Services. (2000). Healthy People 2010: Volume I, Focus Area 11: Health Communication (second edition) Washington, DC: U.S. Government Printing Office.
Zachariae, R. et. al. (2003). The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. British Journal of Cancer, 88(5), 658-65.
Heisler, M. et. al. (2002). The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management. Journal of General Internal Medicine, 17(4), 243-52.
Safran, D.G. et. al. (1998). Linking primary care performance to outcomes of care. Journal of Family Practice, 47(3), 213-20.
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).
The heated nature of the current political debate in the United States upon the subject of healthcare is testimony to the idea that far less than economic numbers, cultural wars govern how healthcare is perceived and administrated. All nations face the problem of cost containment of an increasingly expensive healthcare system. People are living longer, and the nations of the developed world have populations with a far higher median age than in the past. Medical technology is also more expensive. Thus, some form of 'rationing' (as politically unpalatable as the world may be) is required, either based upon need, or based upon who can pay. The United States stresses that individuals can 'choose' to have healthcare or not, and implicit in this assumption is that individuals who can 'merit' better jobs that provide healthcare are making one choice, while Americans who work several jobs that do not offer healthcare --…
Anderson, G .F. & J.P. Poullier. (1999).Health spending, access, and outcomes: trends in industrialized countries. Health Affairs, 18(3):178-192
Creese, Andrew. (1994). Global trends in health care reform. World Health Forum. 15.
Sanders, Jeffrey. Financing global health systems. Current issues facing global health systems.
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.
ABC/123 Version X
Institutional Policy Analysis
Summary of the Policy (in your own words)
Explain if the policy is effective and provide a rationale
Describe the financial outcomes of the policy
Provide examples of policy violations
APNs' ability to practice is determined on a state-by-state basis, there is no specific policy in regards to practice scope (Kleinpell et al. 2014).
Given that nurses are credentialed on a state versus a federal basis and the healthcare system is largely regulated by the states versus federal policy, this seems inevitable in terms of how healthcare laws in the U.S. are structured.
Healthcare costs increase due to a failure to take full advantage of APN's expanded yet lower-cost care alternatives.
APN's roles in institutional leadership are not defined or restricted according to federal policy (Hain & Fleck 2014)
States are allowed to set regulations regarding the scope of…
Bakanas, E. (2013). Resistance to changing roles in the medical team Virtual Mentor. 15 (6): 498-503. Retrieved from: http://journalofethics.ama-assn.org/2013/06/ecas2-1306.html
Hain, D., Fleck, L., (2014). Barriers to Nurse Practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19 (2)2. Retrieved from: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Barriers-to-NP-Practice.html
Kleinpell, R., Scanlon, A., Hibbert, D., Ganz, F., East, L., Fraser, D., Wong, F., Beauchesne, M., (2014). Addressing issues impacting Advanced Nursing Practice Worldwide. OJIN: The Online Journal of Issues in Nursing, 19 (2) 5.
Copyright © XXXX by University of Phoenix. All rights reserved.
The topic of this research is "PPACA- Patient Protection an Affordable Care Act." PPACA has created a great impact in the healthcare industry of United States of America. The study is based on the critical analysis of the act by reviewing the performance since its inception.
Arguably the most prominent recent healthcare reform has been PPACA (Patient Protection and Affordable Care Act). PPACA is also known as the Affordable care act and Obamacare. It was signed by the President Obama in the year 2010 in collaboration with the Healthcare econciliation Act. This act is considered to be one of the most major reforms passed in the healthcare system of United States; the last such major reform was passed in the year 1965 in the form of Medicaid.
When this provision Act was passed in 2010, there were 50 million…
Barr, Donald A. Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America. JHU Press. 2011
Blendon RJ, Benson."Public opinion at the time of the vote on health care reform." N. Engl. J. Med. 362 (16): e55. 2010
Elmendorf, Douglas. "CBO's Analysis of the Major Health Care Legislation Enacted in March 2010." Congressional Budget Office. 2011
Feldman, Arthur M. Understanding Health Care Reform: Bridging the Gap between Myth and Reality. CRC Press. 2011
Managed Care Health eimbursement Systems in the United States
With health care costs skyrocketing consumers and health insurance companies alike are seeking solutions to the growing crisis in health care within the United States. This crisis revolves primarily around the lack of coverage that exists for millions of Americans. Employers are more and more dropping out of traditional health insurance programs and seeking new ways to provide employees with health care services. In response to the climbing costs of health care many reimbursement and health care cost containment programs are being developed.
There are many health care reimbursement programs available to patients that provide some form of medical care cost containment and coverage. Among the most popular of these or at least the fastest growing are managed care reimbursement programs. Managed care reimbursement programs are becoming more the norm rather than the exception to the rule.
Managed care programs have…
Barron, B.A. "The price of managed care." Commentary, 103(5):49
Camperell, K.J. & Mitchell, R.A. (1995). "Managed health care accounting." Journal of Accountancy, 179(4):68.
Cauchi, R. "Making the best of managed care." State Legislatures, 27(6):22
Dranove, D. (2000). "The economic evaluation of American health care: From Marcus
healthcare as an institution is, of course, the need to care for the sick and the injured. However, in the contemporary model of healthcare, effective communication during a crisis is not only important, but also vital. Communication by healthcare professionals takes the concern and worry out of the situation; offers a quicker resolution, makes better control of information possible, earns the trust of the public and individual families; and keeps the flow of information consistent and accurate, thus averting potential external problems. Based on my current experience in the nursing field, I realize that to advance my professional goals, as well as contribute soundly to the profession, I must expand my educational experience and am therefore seeking entrance into the Doctor of Nursing Practice (DNP) in Psychiatric Mental Health Nursing.
I believe I am well-qualified and motivated to undergo this program. Currently, I am a master's prepared Neonatal Nurse Practitioner…
The Greatest Challenge to US Healthcare
The role is played by the government
The role played by the government in healthcare is a divisive issue. Many healthcare organizations executives do support the idea of extending healthcare coverage to the uninsured, however, who this is implemented is the cause of concern. There are numerous changes that are taking place in the healthcare industry and the government needs to catch up quickly. Policy development is the role of government and there is a need to ensure that there are timely and applicable policies in place to govern the provision of healthcare services to the masses. As it stands, healthcare is moving from fee-for-service to value outcomes and there should be policies in place to support this advanced move. Providers have been moving towards value-driven care and the government policies should be able to mirror this movement. While not all providers will be…
Health Care eform Effecting Public Health United States
Healthcare reform is an integral part of the United States healthcare system. Below is an evaluation of the effects healthcare reform has had on healthcare in the U.S. Internet sources as well as peer-reviewed journals will be looked at so as to see the effects.
The cost of healthcare has been on the rise. Issues of healthcare quality ought to be paid attention to and healthcare access equity improved upon (Health Care Transformation). Given these causes, while some differences exist on what reforms to carry out, a majority of Americans hold the belief that the U.S. Healthcare delivery systems need some improving. For a long time ANA has been advocating for reforms in healthcare and several of the Affordable Care Act (ACA) provisions are in line with the Health System eform Agenda of the ANA. The ANA gave a chart that gives…
Kemp, C. (2012, October 11). Public Health in the Age of Health Care Reform. Retrieved January 21, 2015, from http://www.cdc.gov /pcd/issues/2012/12_0151.htm
How National Health Care Reform Will Affect a Variety of States. (2011, April 5). Retrieved January 21, 2015, from http://www.rand.org/news/press/2011/04/05.html
Healthcare Industry Accountability
After having read your article entitled the accountability crisis in healthcare, one may have several observations and suggestions concerning both the content and conclusions contained within. First are the generalizations indicting the healthcare industry, (particularly the not-for-profits), in terms of the alleged fragmentation between the parts that make up the whole; namely, according to your text, physicians, hospitals and insurers. One may also take umbrage at examples you employ to ensure accountability. While they appear on the surface to be worthy of merit, closer examinations reveal weaknesses in areas that may not be evident at first consideration. Finally, it appears that many of the examples cited as support for one point-of-view may support the opposing point-of-view equally as well. Let us examine the text more closely based on these issues.
The major generalizations made in the text are as follows:
Nobody is in control because…
Leatherman, S. President, Center for Health Care Policy and Evaluation, Minneapolis. Measuring up: performance indicators for better healthcare. Published on December 09, 2001. page 18. Retrieved June 17, 2003 from http://www.oecdobserver.org/news/printpage.php/aid/557/Measuring_up:_ performance_indicators_for_better_healthcare.html
Beckham, J.D. The Accountability Crisis in Healthcare. The Healthcare Forum Journal. San Francisco. Sept/Oct 1997.
Healthcare Regulations Manual retrieved June 17, 2003 from http://HCFA.gov. 2003
Health care economics can be understood in terms of a number of different economic concepts. One of the most basic economic concepts is supply and demand. Essentially, supply is how much of something available that there is in a market, and demand is how much that people want. The concept reflects the idea that where there are no constraints, supply and demand will be roughly the same. In the real world, of course, there are always constraints. Demand has a number of drivers, and health care providers need to be aware of these drivers. Older people require more health care, so demand increases as the population ages. Sick people require more health care as well. Thus, when rates of disease or illness increase, that increase demand. As people reach end of life, especially at an advanced age, they become prolific consumers of health care. Thus, while the aging baby boomers…
Healthcare Administration Mission Viejo Executive Summary
Over the last several years, the healthcare delivery environment has been continually evolving. This is because consumers are demanding efficient ways for receiving a variety of services. That is focused on reducing costs and enhancing quality. The result is that the entire system is continually changing to keep up with them. In the case of Golden Age Hospital (GAH), they are reaching a crossroads with rising number of seniors locally and nationally. This is in response to the rising demographic and many local facilities feeling overwhelmed. The new location can be utilized as an integrated business model that will achieve these larger objectives. In the long-term, this will make them more competitive and able to respond to changes in the way industry is operating. Those who are able to do this will see their employee turnover rates decrease and they can enhance the care…
Community Profile. (2014). City of Aliso Viejo. Retrieved from: http://www.cityofalisoviejo.com/wp-content/uploads/ApdxC_Community_Profile.pdf
Mission Viejo, California. (2015). U.S. Census. Retrieved from: http://quickfacts.census.gov/qfd/states/06/0648256.html
Rising Demand for Long-Term Care. (2014). CBO. Retrieved from: http://www.cbo.gov/publication/44363
Cuellara, A. (2006). Strategic integration of hospitals and physicians. Journal of Health Economics, 25 (1), 1-28.
(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
All spending includes state and federal expenditures. Growth figures reflect increases in benefit payments and disproportionate share hospital payments; growth figures do not include administrative costs, accounting adjustments, or costs for the U.S. Territories.
Federal Fiscal Year: Unless otherwise noted, years preceded by "FY" on statehealthfacts.org refer to the Federal Fiscal Year, which runs from October 1 through September 30. for example, FY 2009 refers to the period from October 1, 2008 through September 30, 2009.
Urban Institute estimates based on data from CMS (Form 64) (as of 12/21/11).
From this entire chart, the entire increase in expenditure of…
Clark, Cheryl et al. "State Medicaid Eligibility and Care Delayed Because of Cost." New England Journal of Medicine, 368 (2013): 1263-1265. Print.
Ellwood, Marilyn Rymer et al. An Exploratory Analysis of the Medicaid Expenditures of Substance Exposed Children Under 2 Years of Age in California. U.S. Department of Health and Human Services, 1993. Print.
Goodnough, Abby. "October 25th." The New York Times. 25th October. 2012. Web. 29th March 2013. [ http://www.nytimes.com/2012/10/26/us/spending-on-medicaid-has-slowed-survey-finds.html?_r=0 ].
Grannemann, Thomas W. And Mark V Pauly. Controlling Medicaid Costs: Federalism, Competition, and Choice. Washington DC: American Enterprise Institute, 1983. Print.
Healthcare Financial Management
To quote Jonathan Clark at the beginning of his article, "Improving the revenue cycle can be a daunting task due to the scope and complexity of the interdepartmental process." Of the suggestions offered by the authors, which concept(s) give you the greatest insight into creating an improved evenue Cycle process in the organization where you work (or one in which you are familiar)? Be sure to identify which article or author you are referencing.
In his comprehensive advisory article to improve the medical industry's revenue capturing capabilities, entitled Strengthening the evenue Cycle: A 4-Step Method for Optimizing Payment, Jonathan Clark provides a series of sensible solutions to the ongoing dilemma of payment optimization. David Hammer also provides guidance to healthcare finance professional in his article The Next Generation of evenue Cycle Management, by reminding them that the key performance indicators (KPIs) which dictated policy in previous years…
Clark, J. (2008). Strengthening the revenue cycle: a 4-step method for optimizing payment. Healthcare Financial Management, 62(10), 44.
Hammer, D.C. (2007). The next generation of revenue cycle management. Healthcare Financial Management, 61(7), 49.
Seddon, J. (2008). Think system. Management Services, 52(2), 10.
Wilson, D.B. et al. (2004). 3 steps to profitable managed care contracts. Healthcare Financial Management, 58(5), 34.
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in…
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.
3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
Hadley, Jack, John Holahan, Teresa Coughlin, & Dawn Miller. (2008). Covering the uninsured in 2008: Current costs, sources of payment, and incremental costs. Health Affairs, Web
According to Hadley (et al. 2008), "the cost of expanding coverage to the 16% of Americans who are uninsured would add 5% to national health spending" (Hadley 2008: 399). This cost is considerable, yet the cost of allowing the status quo to remain is far greater. In the article, "Covering the uninsured" the authors use quantitative analysis to determine how much care uninsured persons currently receive, how much of it remains uncompensated because of an inability to pay, and how much more coverage would be consumed if all Americans did have health insurance (Hadley 2008: 399). Their data encompasses interviews of 102,000 people who were part of the Medical Expenditure Panel Surveys; data from government budgets and health care providers; surveys…
Hadley, Jack, John Holahan, Teresa Coughlin, & Dawn Miller. (2008). Covering the uninsured in 2008: Current costs, sources of payment, and incremental costs. Health Affairs, Web
Health Care Reimbursement and Billing
Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the United States.
Discussion of Mrs. Zwick's coverage under Medicare Parts A, B and C
Medicare Part A (often called "hospital insurance") (U.S. Department of Health and Human Services, 2011, p. 15) assists in covering inpatient hospitalization and skilled nursing facilities, hospice and home health care (U.S. Department of Health and Human Services, 2011, p. 14). There is usually no monthly premium if you and/or your spouse paid Medicare taxes while employed (U.S. Department of Health and Human Services, 2011,…
Ethical implications of Mrs. Zwick's incurring costs related to her hospital-acquired condition are applicable despite the rehabilitation facility's exemption from POA/HAC Medicare laws. Having no first-hand knowledge of the cause of the urinary tract infection, no clear indication that I work at the rehabilitation facility and neither the privilege nor the duty of diagnosis, it would be unethical for me to tell Mrs. Zwick about my suspicions. Rather, a nurse is required to maintain his/her professional boundaries (American Nurses Association, 2001, p. 6). Simultaneously, a nurse is supposed to assure "responsible disclosure of errors" to patients and act to stop bad practices and promote best practices (American Nurses Association, 2001, p. 6). Consequently, a nurse in my position faces a dilemma: lack of personal knowledge and authority vs. my concern for the patient's well-being and constant improvement of the profession. In the face of this dilemma, I would: contact the rehabilitation facility's newly-hired nurse and advise/remind him/her of the duty to report to the appropriate supervisor and responsible disclosure to Mrs. Zwick; contact Mrs. Zwick's personal physician and explain the entire situation; direct Mrs. Zwick to discuss her health issues with her personal physician, who can review, diagnose and discuss the ramifications of her medical records, including but not limited to the urinary tract infection (American Nurses Association, 2001, p. 7). The desired outcomes would be: the rehabilitation center's absorption of Mrs. Zwick's costs related to her hospital-acquired infection through pressure exerted by its own nursing staff and Mrs. Zwick's personal physician; Mrs. Zwick's awareness of the true cause of her infection by health care providers who are directly responsible and capable.
Explain how the COBRA will allow Mr. Davis to continue his insurance coverage while he is out of work.
Due to Mr. Davis' termination from an employer of more than 20 employees, he can obtain coverage for himself, his spouse and his dependent children for up to 18 months (U.S. Department of Labor, 2012). In addition, due to his chronic cycle cell anemia, he may be entitled to an additional 11 months' extension for disability (U.S. Department of Labor, 2012). His employer is required to give a qualifying event notice to COBRA; then, COBRA sends a notice of the right to elect to continue coverage and an explanation of the steps that must be taken to continue coverage; Mr. Davis, his spouse and either or both of them in behalf of dependent children may elect for continuation of coverage
The penalties for being out of compliance when OSHA comes knocking should be enough to motivate any healthcare facility to devise a plan to make sure that they are in compliance with OSHA's regulations. The startling thing is that it took an initiative like NEP to wake these facilities up and get them thinking about being compliant. Since they deal with people and their well being on an everyday basis, these are things that they should have been doing all along and not just because there is an increased probability of getting into trouble by OSHA.
Harris, S. (2012). OSHA in Health Care: Out of Sight & Out of Mind? etreived from http://ohsonline.com/articles/2012/04/01/osha-in-health-care.aspx
Healthcare workers. (2012). etrieved from http://www.cdc.gov/niosh/topics/healthcare/
New OSHA inspection initiative focuses on healthcare. (2011). etrieved from http://www.puresafety.com/public/workingwell/?p=1209#.UAa4aFJ6EM
Occupational Safety and Health Administration ("OSHA") Targets Nursing and esidential
Care Facilities. (2012). etrieved from http://www.hancocklaw.com/p/OSHA_Newsletter_212_May_H1768037.PDF
Prepare Your Facility…
Harris, S. (2012). OSHA in Health Care: Out of Sight & Out of Mind? Retreived from http://ohsonline.com/articles/2012/04/01/osha-in-health-care.aspx
Healthcare workers. (2012). Retrieved from http://www.cdc.gov /niosh/topics/healthcare/' target='_blank' REL='NOFOLLOW'>
Realistically this compliance and assistance should be sought and used before, during and after negotiations with other health care organizations with which this organization might merge or enter a joint venture. Furthermore, the proposed contract itself should be passed by the FTC's Office of the General Counsel or its designee for approval before final ratification of the contract.
In order to merge and operate in a joint venture acceptable to the FTC, the organization must be mindful of Title 15 of the U.S. Code, specifically Section 7 of the Clayton Act, 15 U.S.C. § 18, Sections 1 and 2 of the Sherman Act, 15 U.S.C. § 1, 2, and Section 5 of the Federal Trade Commission Act. In addition, due to the FTC's recent special interest in the mergers/joint ventures of health care organizations, particularly but not solely in connection with price fixing, the organization should assume that…
Cornell University Law School. (n.d.). Legal Information Institute - 15 U.S.C. Section 1. Retrieved on March 19, 2013 from www.law.cornell.edu Web site: http://www.law.cornell.edu/uscode/text/15 /1' target='_blank' REL='NOFOLLOW'>
Health Care eform:
One of the major topics that have had a long history in the United States is health care reforms, which has been characterized by huge debates. Following decades of failed attempts by various Democratic presidents, a new law was enacted by President Obama to overhaul the country's health care system. The enactment of this legislation came after a year of harsh partisan combat with the purpose of ensuring access to health care insurance for millions of Americans. In addition to being the most controversial topic, health care reform law was the largest single legislative accomplishment of President Obama. Notably, this legislation will cost America's government approximately $940 billion over the next decade based on an analysis by the Congressional Budget Office. The office has also estimated that the law will lessen federal deficit by about $138 billion during the same period and a further reduction of the…
Cannon, M.F. (2010, March 1). The Best and Worst Health Care Reform Ideas. Retrieved December 15, 2011, from http://dailycaller.com/2010/03/01/the-best-and-worst-health-care-reform-ideas/
Cohn, J. (2011, January 20). About that Whole "Replace" Thing & #8230; Retrieved December 15,
2011, from http://www.tnr.com/blog/jonathan-cohn/81821/about-whole-replace-thing
"Health Care Reform.." (2011, November 15). The New York Times. Retrieved December 15,