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Managed Care Essays (Examples)

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Manage Care Simon A Case
Words: 958 Length: 2 Pages Document Type: Term Paper Paper #: 97429468
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The red and swollen appearance could be an on-site reaction to the administered medication. A change of type of antibiotic medication may be necessary.

Question 5: Simon begins to complain of chest tightness he is beginning to get distressed what may be occurring and what interventions need to be undertaken.

An asthma attack partially brought on by the psychological stress of the surgery and being in the hospital, combined with the physical trauma is likely. Simon, physician permitting, should be allowed with assistance to treat his asthma in the usual fashion, after screening for potentially more serious conditions that can manifest in chest tightness, such as a cardiac condition.

Question 6: You notice that Simon has become disoriented and is complaining of a headache what may be occurring and what interventions need to be undertaken?

Signs and symptoms of a concussion, the result of head trauma, are not always immediately…

Works Cited

Fractures of the tibia and fibula." (2008). Chapter 21: Practical Plastic Surgery. Retrieved 23 May 2008 at  http://www.practicalplasticsurgery.org/docs/Practical_21.pdf

Managed Healthcare Approach the Value
Words: 802 Length: 3 Pages Document Type: Annotated Bibliography Paper #: 83180834
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Cox, T. (2010). Legal and ethical implications of health care provider insurance risk assumption. JONAS Healthcare Law, Ethics and Regulation. 12(4):106-116.

How healthcare providers really feel about managed care and other forms of insurance is very important. If doctors and hospitals do not feel good about the payments they receive from specific managed care organizations, they may choose not to work with those organizations. That can leave a large number of patients without care in their local area that is included in their provider network - and that is not going to be beneficial to the growth of managed healthcare in the future.

Cox, T. (2006). Professional caregiver insurance risk: A brief primer for nurse executives and decisionmakers. Nurse Leader, 4(2): 48-51.

The different kinds of insurance offered for those who want or need medical coverage is very important. Managed care is part of that insurance landscape, but it is…

Whether managed healthcare can reduce overall costs and allow for better and more comprehensive preventative care is a serious topic for discussion. Anything that will allow for better treatment of patients and a reduced cost to those patients and their insurance companies should be explored. It is the aim of managed healthcare to do this, but whether that aim is being met is significant.

Kongstvedt, P.R. (2001). The managed health care handbook, (4th ed). NY: Aspen Publishers, Inc.

A deeper and clearer understanding of managed care is needed overall. Many people think it only means an HMO or a PPO. Some have no real concept of what managed healthcare is designed to do, and whether it is meeting the goals that were created for it at its inception. Without an awareness of managed care as something that affects everyone in the country, future decisions cannot be adequately made. Naturally, that poses a serious issue for those who will need healthcare well into the future.

Care Bill Law's Impact on
Words: 1415 Length: 5 Pages Document Type: Term Paper Paper #: 74392003
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In addition the effect of bill has changed the documentation awarded through the state as of a certificate toward a license and authorizes a doctor to pass on duties to a PA with the purpose of managing physician's scope of performance however Another effect of bill has enabled Indiana's doctor assistants to widen their area of the health care services and also provided an innovative average of patient care (Stephanie, Matlock (27 April, 2007). Health care bills gives right to patient to know what health care should be known by the plan as well as several limits on care, kinds of health care be not enclosed, any treatment diagram required to endorse in advance. Yearly planning about on disburse to physician and health providers, file a complaint regarding any, disagreement between patient and the plan, and also procedure to make complaint, allowance to access emergency room twenty four hours a…

Bibliography

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

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

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

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

Managed Health Care and Evaluates
Words: 1605 Length: 6 Pages Document Type: Term Paper Paper #: 6549719
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"

The bulk of quality improvement measures are working for managed care by providing insight as to what can be done to improve care therefore reduce mortality rates, and maintain a high level of customer satisfaction which in turn helps to build the managed care health business.

Population Health Focus

Population health refers to the physical, social, cultural, and economic environment in which we work and live (adzyminski, 2006)."

This has become a focus of many managed health care organizations as they work to reduce the risks to their local consumers by way of stress, environmental factors and other elements that have a direct impact on the consumer health concerns.

The goal of population health is to maximize the health of any given population. In doing so it contains elements of program development, development/evaluation of health care policy, and program and systems evaluation. It uses an approach that concentrates on…

References

Jacobson, Peter (1995) Washington State Health Services Act: implementing comprehensive health care reform.(Medicaid and State Health Reform)

Health Care Financing Review

Exton, Lee (2002) Defined contribution health plans: cutting edge? (an Advertising Supplement: Staffing & Employee Benefits).(cost containment strategies for employee health care) Los Angeles Business Journal

Fletcher, Meg (1995) Managed care use rises for workers comp plans.

Managed Health Care Plan Types
Words: 653 Length: 2 Pages Document Type: Essay Paper #: 35612645
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Health Insurance & Managed Care

There are four main types of managed care plans. First, it helps to have a basic understanding of what managed health care is. Managed care "combines healthcare delivery with the financing of services provided" (Green & owell, Chapter 3). In a typical managed health care system, the payer restricts the patient with respect to what facilities and doctors the patient can use. The facilities reduce their fees in exchange for the promise of substantially more business from the managed health care organization. Managed health care takes six distinct forms, according to Green and owell (2013, Chapter 3).

The first of these is the exclusive provider organization (EPO), which "provides benefits to subscribers who are required to receive services from network providers." In this model, the patient coordinates care within this network, with the primary care physician. Under this plan, the EPO coordinates the network of…

References

Green, M. & Rowell, J. (2013) Understanding Health Insurance: A Guide to Billing and Reimbursement, 11th Edition. Delmar Cengage Learning.

Enhancing the Access of Education and Healthcare in the US
Words: 985 Length: 2 Pages Document Type: Essay Paper #: 30230001
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Care Coverage and Inequalities in the Education System

Traditional Care Coverage vs. Managed Care Coverage

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

References

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

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

Healthcare the Impacts of Case
Words: 4123 Length: 12 Pages Document Type: Research Paper Paper #: 44424148
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"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).

Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…

References

Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as

Told by One Client. Health Affairs, 24(1).

Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.

Annals of Internal Medicine, 142(10), 847-54.

Concerns on Healthcare Delivery
Words: 1485 Length: 5 Pages Document Type: Application Essay Paper #: 8778723
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Medical Care Services

The current delivery of health care services represents one of the most important subjects for discussion both in the Obama Administration as well as the epublican one and the Administrations that preceded the Bush one. egardless of political color, it must be pointed out that the health care system in the United States does not only depend on the ideological orientation, but also on the people and their own beliefs in terms of human action and interaction. It is a clear fact that "Ten years ago, the U.S. healthcare system was declared "broken," and it has not improved. Fixes promised by managed care have not materialized. Premiums are rising. Hassles for patients and physicians abound. Nearly 45 million Americans are uninsured." (Garson, 2000)

One of the most severe problems facing the health care system in the United States is the discussion that is being held between those…

References

Garson, Arthur. "Current Perspective. The U.S. Healthcare System 2010. Problems, Principles, and Potential Solutions" 2000. Available at  http://circ.ahajournals.org/content/101/16/2015.full#sec-7 

ImpediMed. "Pre-emptive vs. Reactive Models of Care: Pre-emptive Care Model Prospectively Managing Lymphedema in Breast Cancer Patients" 2012. Available at  http://www.impedimed.com/knowledge-center/health-insurance-providers/pre-emptive-versus-reactive-models-of-care.htm 

Yale School of Medicine. "The PA Profession." 2013. Available at  http://medicine.yale.edu/pa/profession/index.aspx

Heath Care Health Care Plans Health Care
Words: 988 Length: 2 Pages Document Type: Essay Paper #: 32060505
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Heath Care

Health Care Plans

Health Care

Types of Health Insurance

Indemnity Insurance

This type of insurance is also known as a traditional or fee-for-service plan. The benefit of an indemnity plan is the flexibility; this plan allows members to choose any doctor or hospital. However, members must pay an annual deductible and then a percentage of each medical bill. Although these plans offer the greatest freedom to select any doctor, they are usually the most expensive option.

Typically, the member or the provider sends the bill to the insurance company. These plans usually have an annual deductible before the insurer starts paying. Once the deductible has been met most indemnity plans pay a percentage of what they consider the "Usual and Customary" charge for covered services. The insurer generally pays 80% of the Usual and Customary costs and the member is responsible the other 20%, known as coinsurance. If…

References

Rich, R.F. & Erb, C.T. (2005). The two faces of managed care regulations and policy-making. University of Illinois at Urbana-Champaign. Retrieved July 30, 2011, from  http://igpa.uillinois.edu/system/files/WP114.pdf 

"The Types of health insurance." (2011). Health insurance guide. Retrieved July 30, 2011, from http://www.healthinsuranceadvice.org/types.html

American Healthcare System Has Been at the
Words: 1322 Length: 5 Pages Document Type: Term Paper Paper #: 52133197
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American Healthcare System has been at the center of debate for many years. One of the most pressing issues confronting the healthcare system is Medicare and its beneficiaries. The purpose of this discussion is to focus on the ramifications of moving Medicare beneficiaries into managed care organizations (MCOs). Our investigation will illustrate that moving the Medicare beneficiaries into MCOs are a bad idea because there will not to be any real cost savings and many individuals are likely to be denied needed care.

Cost Savings

An article found in American Economic Review explains that Medicare is the second largest government entitlement program in the United States. The cost associated with running this program is astronomical. The article asserts that in 1999 the government spent $230 billion or 13% of its budget on Medicare and its beneficiaries. (Antos and Bilheimer)

The major issue with Medicare is that it is expected to…

Works Cited

 http://www.questia.com/PM.qst?a=o&d=5000772968 

Angell, Marcia, and Arnold S. Relman. "Patents, Profits & American Medicine: Conflicts of Interest in the Testing & Marketing of New Drugs." Daedalus 131.2 (2002): 102+.  http://www.questia.com/PM.qst?a=o&d=96539841 

Antos, Joseph R., and Linda Bilheimer. "Medicare Reform: Obstacles and Options." American Economic Review 89.2 (1999): 217-221.  http://www.questia.com/PM.qst?a=o&d=95229758 

Fischer, Pamela P. "Parkinson's Disease and the U.S. Health Care System." Journal of Community Health Nursing 16.3 (1999): 191-204.  http://www.questia.com/PM.qst?a=o&d=5001999538

Rural Healthcare Facilities Context of
Words: 5552 Length: 20 Pages Document Type: Term Paper Paper #: 48009947
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Provide sustained technical assistance (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)

Evaluation of the process in rural and small communities includes: (1) scope of the project; (2) goals; (3) critical success factors; and (4) technical assistance." (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Community grants have been focused on the provision of 'personal digital assistant (PDA) systems in assisting with the decision support role. The initiative is stated to include: (1) development of toolkits; (2) leveraging known tools; (3) developing capacity; and (4) disseminating best practices. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)

Ormond, Wallin, and Goldenson report in the work entitled: "Supporting the Rural Health Care Safety Net" (2000) state: "The policy - and market-driven changes in the health care sector taking place across country are not confined to metropolitan areas. Rural communities are experiencing changes impelled by many of the same forces…

Bibliography

Healthcare and Healthcare Insurance Country Report: India (2004) Tata Consultancy Services and Microsoft. WebHealthCentre.com. 2004 August. Online available at http://download.microsoft.com/documents/customerevidence/7144_WebHealth_CS.doc

Expert Panel Meeting: Health Information Technology (2003) Agency for Healthcare Research and Quality (AHRQ) 23-24 July 2003. Online available at  http://www.ahrq.gov/data/hitmeet.htm 

Silberman, P. And Slifkin, R. (nd) Innovative Primary Case Management Programs Operating in Rural Communities: Case Studies of Three States. Working Paper No. 76 North Carolina Rural Health Research and Policy Analysis Program.

Ormond, Barbara a.; Wallin, Susan Wall; and Goldenson, Susan M. (2000) Supporting the Rural Health Care Net. 15 May 2000 Urban Institute

Nursing Changing Health Care the
Words: 1413 Length: 4 Pages Document Type: Term Paper Paper #: 93490418
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Some of the most pressing problems in the world today are global health care needs. There are so many different health issues facing the world, from HIV / AIDS to tuberculosis and malaria in many third-world countries. We can wipe out these diseases in modern times, but because of living conditions and limited resources, they continue to reappear and take lives. Education is one way to eliminate some of these issues, but nursing is another way to address and improve global health care needs. For example, many children die of malnutrition and dysentery every year, even in these modern times. Nurses in the field could not only assess these children and help them get the care they need, when they need it, they could educate families and other health care workers, as well. They could even help countries develop programs to address these issues, as well. They could help countries…

Clinical Integration Healthcare
Words: 3527 Length: 11 Pages Document Type: Essay Paper #: 71289994
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Healthcare: Clinical Integration

Item Page

What is clinical integration

History of clinical integration

Goals of clinical integration

Importance of clinical integration

Health reform

New payment models

IT advancement

Barriers to clinical integration

Legal barriers

Lack of practitioner alignment

Lack of interoperability

How to achieve success in clinical integration

Incentive alignment

Knowledge alignment

Behavioral alignment

The future of health care systems

Physician acquisitions vs. clinical integration

HIEs -- solution to clinical integration?

Policy makers are beginning to appreciate the fact that only systemic change can effectively change, for the better, the manner of health care delivery in the U.S.; and that anything less would only alter the system's edges - with little or no substantial effect on cost-control, innovation-promotion, effectiveness of reward incentive schemes, coordination and coverage (AHA, 2010). Clinical integration has been found to be crucial to the change needed for the achievement of the aforementioned goals (AHA, 2010). Despite…

References

AHA. Clinical Integration -- the Key to Real Reform. Trend Watch. Retrieved from [HIDDEN]

Athena Health. (2014). History of the Clinical Integration Model. Athena Health. Retrieved from https://www.athenahealth.com/knowledge-hub/clinical-integration/clinical-integration-model.php

eHealth Initiative. (2012). The Rise of the Private Health Information Exchange and Changing Role of Public Exchanges. eHealth Initiative. Retrieved from [HIDDEN]

Fridsma, D. (2013). Interoperability Vs Health Information Exchange: Setting the Record Straight. Health IT Buzz. Retrieved from  http://www.healthit.gov/buzz-blog/meaningful-use/interoperability-health-information-exchange-setting-record-straight/

Strategic Planning in Healthcare -
Words: 759 Length: 3 Pages Document Type: Term Paper Paper #: 92718143
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Toward that same end, the new strategic plan must also include provisions for a comprehensive centralized governance system.

The second most important reason that MUSC requires a new strategic plan relates to the impact of managed care, HMO insurance, and the healthcare crisis that accounts for many uninsured patients.. Evolving legislation delineating the respective funding responsibilities of federal and state government programs may place additional financial burden on healthcare institutions, particularly those that are engaged in providing education services, those that maintain research programs, and those that furnish medical services to a large proportion of patients who cannot afford to pay for their share of those services. Therefore, a comprehensive plan must allow for subsequent change within its formulation, because MUSC maintains educational programs and research programs, in addition to serving a large needy and/or uninsured constituency.

Finally, the new plan must address the formulation and integration of comprehensive communications…

As South Carolina's only comprehensive academic, research and point-of-service health center, the Medical University of South Carolina provides a full range of programs and services in the biomedical sciences that would otherwise be unavailable to many South

Carolinians. The Medical University of South Carolina is dedicated to serving the community by ensuring that all patients get the treatment they need irrespective of their ability to pay. Located on more than 50 acres in the city of Charleston, the MUSC campus serves more than 2000 healthcare students from six colleges and MUSC programs provide essential residency training for more than 500 post graduate healthcare professionals. The MUSC program faculty includes a teaching staff of approximately

850 full-time and 1600 part-time faculty members. Our dedicated staff and faculty are committed to providing the best and most up-to-date programs and to continually adapting to changes in both the science and the need for our services to enable us to achieve the ultimate goal of modern medicine: patient care, health, happiness, and well- being.

Healthcare Financial Management to Quote Jonathan Clark
Words: 1064 Length: 4 Pages Document Type: Research Paper Paper #: 20934207
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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…

References

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.

Health Care to an Indigent Population As
Words: 1349 Length: 4 Pages Document Type: Essay Paper #: 89737654
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health care to an indigent population.

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

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

References:

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

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

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

Evolution of Health Care Information Systems
Words: 1425 Length: 5 Pages Document Type: Essay Paper #: 22301011
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Evolution of Health Care Information Systems

The objective of this study is to compare and contrast a contemporary healthcare facility or physician's office health care facility or physician's office operation of 20 years ago and to identify at least two major events and technological advantages that influenced current HCIS practices. The physician's office and health care facility of 20 years ago was a paper-based operation. All records were paper records, appointments were written on calendars and prescriptions were handwritten, notations on the patient's health records was done by writing on the physical paper record and all hospital orders were written by hand. During the 1970s hospital growth and expansion occurred and the expenditures for Medicare and Medicaid were on the rise. At this time mainframes were still in use and microcomputers became available and not only were they smaller but they were also less expensive. However, transformation did not come…

References

Costs and Benefits of Health Information Technology (nd) Evidence Report/Technology Assessment Number 132. Southern California Evidence-based Practice Center, Santa Monica, CA. Retrieved from:  http://www.ahrq.gov/research/findings/evidence-based-reports/hitsys-evidence-report.pdf 

Friedman, S. (nd) Facts About Health Care Information Systems. eHow Retrieved from: http://www.ehow.com/about_6117257_health-care-information-systems.html

History and Evolution of Health Care Information Systems (nd) Chapter 4. Retrieved from:  http://www.slideserve.com/paul/history-and-evolution-of-health-care-information-systems

Health Care Reform Several Years
Words: 2680 Length: 7 Pages Document Type: Term Paper Paper #: 13950798
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Contracts with doctors often contain a clause which doesn't allow the doctors to discuss

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

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

Works Cited

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

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

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

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

Health Care in America The
Words: 1623 Length: 5 Pages Document Type: Research Proposal Paper #: 69015620
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Conclusion

What direction is the quality of health care and delivery of health care moving in; it is not moving in a direction at all. Like the pendulum, the direction of health care remains suspended to the far side - right or left, depending upon which side of the political isle one is on. The pendulum remains frozen in time, and it reflects chaos in the delivery of health care and the quality of patient care. Health care remains the captive audience to managed care company stockholders and executives whose business focused decision making on what benefits can access, when, and where remain guided by an archaic DG system that was implemented more than twenty-five years ago.

If there is a direction for American health care access and quality of care, it is that direction of circling the drain before it falls into the black abyss of the unknown, and…

References

 http://www.questia.com/PM.qst?a=o&d=109671234 

Altman, S.H., Reinhardt, U.E., & Shactman, D. (Eds.). (1999). Regulating Managed Care: Theory, Practice, and Future Options. San Francisco: Jossey-Bass. Retrieved October 14, 2008, from Questia database:  http://www.questia.com/PM.qst?a=o&d=109671238 

Birenbaum, a. (1997). Managed Care: Made in America. Westport, CT: Praeger Publishers. Retrieved October 14, 2008, from Questia database:  http://www.questia.com/PM.qst?a=o&d=27467039 

Nickelson, Daniel J., and Saksena, Sanjeev (1994). The Pendulum Swings: Reappraising Prepaid Health Care Systems. Placing and Clinical Electrophysiology, 17/10, pp. 1676-1677.  http://www.questia.com/PM.qst?a=o&d=6966140

Healthcare in the United States Where We
Words: 2445 Length: 8 Pages Document Type: Essay Paper #: 5665201
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Healthcare in the United States: Where We Have Been, Where We Are Going

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

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

Reference List

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

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

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

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

Healthcare Reforms From 1990s Till
Words: 1184 Length: 3 Pages Document Type: Term Paper Paper #: 41667635
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(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…

References

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

Health Care A the Different
Words: 2409 Length: 9 Pages Document Type: Term Paper Paper #: 52518976
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Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.

Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…

References

Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.

Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.

Moore, G.T. (1991,

April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.

Healthcare Trends
Words: 1742 Length: 4 Pages Document Type: Term Paper Paper #: 81332878
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Strategic Management of a Healthcare Facility in St. Louis

In the late 1800's and early 1900's St. Louis was a major center for automotive and other heavy manufacturing but the industrial restructuring of the Midwest during the latter half of the century has resulted in consistent economic decline of the St. Louis region. Today however as the rest of the country faces a slowing economy this region is showing new signs of growth. [Kotkin, 2002] Due to changing socio-demographics, the demand for health care and advanced medical technologies is growing consistently with a concomitant rise in health expenditure. [Zhou 2001] Health expenditure in the U.S. has risen from 7.4% of the GNP in 1970 to 15% of the GNP in 1995.[Zhou, 2001] The Health care sector deals with not only the clinical medical services, but also include methods which finance them, for e.g. insurance, benefit schemes, Medicare and Medicaid. eforms…

References:

1. Kotkin, J, 2002 St. Louis: On the Way to Somewhere? Rebuz Inc.

2. Author not available, 1997, Economic Report of the President. Government Printing Office, Washington, D.C. [accessed on 4/4/03]:  http://www.umsl.edu/services/govdocs/erp/1997/chap3.htm 

3.Author not available, 1996, Focus... Non-Elderly Missourians without Health Insurance, March 1996, Vol. 30, No. 1 [accessed on 4/4/03]: http://www.dhss.state.mo.us/MonthlyVitalStatistics/March96Vol30No1.html

4. Author not available, January 1999, Focus... Managed Care (MC+) in Medicaid Population, January 1999 Vol. 32, No. 11[accessed on 4/4/03] at http://www.dhss.state.mo.us/MonthlyVitalStatistics/Jan99Vol32No11.html

Healthcare Contract Negotiations A Strategy
Words: 563 Length: 2 Pages Document Type: Research Paper Paper #: 48279875
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Shuttling the results from an outside provider, because the health insurance agency will only reimburse outside screening, forces the patient to wait and possibly incurs more costs, if the delays in obtaining diagnostic information worsen the patient's condition. This can ultimately result in more prolonged treatment. Many patients may also be put at risk because of the logistics of being transported to outpatient facilities for essential screening and rehabilitative services, while they are still convalescing.

Being able to conduct all necessary tests in-house results in great efficiency, swifter screening, and improves coordination between the different providers involved in the case. Our hospital has extensive resources for patients, and can provide a wide range of treatment options, particularly in its specializations of cardiac and orthopedic care. And improvements in technology that are keeping extremely sick patients alive for longer periods of time also mean that, quite often, patients require attention from…

References

Mertens, Maggie. (2010, October 4). More Medicaid payment for some doctors. But will it last?

Shots. NPR Blog. Retrieved November 24, 2010 at  http://www.npr.org/blogs/health/2010/04/will_medicaid_payment_follow_u.html

Improving Healthcare Safety Policy Interprofessional Collaboration
Words: 785 Length: 2 Pages Document Type: Term Paper Paper #: 66438847
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Within some managed care systems, physicians who perform more procedures and spend more time with patients than is deemed necessary are penalized or physicians are simply paid based upon their number of patients, rather than the extent of the care they give to patients (Jecker 1998).

Managed care was designed to reduce the tendency of physicians to please patients with 'good' health insurance by allowing them to take drugs (such as brand-name medications or antibiotics) when they were not strictly necessary or have tests for which there was little indication that they would be beneficial for the patient. One of the most controversial aspects of managed care was the insistence that patients obtain referrals for specialists and the need to remain 'in network' for treatments. This was despite the fact that medical opinion might vary widely in terms of the best way to treat an illness. A patient with cancer…

References

Berwick, D. (2002). Escape fire: Lessons for the future of health care. Retrieved from  http://www.commonwealthfund.org/usr_doc/berwick_escapefire_563.pdf 

Institute of Medicine of the National Academies. Crossing the quality chasm: The IOM Health

Care Quality Initiative. Retrieved from http://www.iom.edu/Global/News%20Announcements/Crossing-the-Quality-Chasm-the-IOM-Health-Care-Quality-Initiative.aspx

Jercker, Nancy. (1997). Ethics in medicine: Managed care. Retrieved from  http://depts.washington.edu/bioethx/topics/manag.html

Security in Healthcare the Recent Advances in
Words: 3250 Length: 10 Pages Document Type: Essay Paper #: 29687447
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Security in Healthcare

The recent advances in technology -- databases that store personal medical records and information -- are bringing tools to patients, doctors and other healthcare professionals that were simply not available just a few years ago. There is hope that eventually, a doctor in Hawaii that is treating a medical emergency for a tourist from Florida, will be able to access the digitally kept medical and healthcare records for that injured tourist. In other words, there will likely be in the foreseeable future a national database -- that perhaps links state databases with each other the way the FBI and local law enforcement agencies are linked -- that will be of enormous benefit to citizens and their healthcare providers.

But before that nationally linked database can become a reality, there are a number of potential problems that need to be ironed out. For example, legislation needs to be…

Works Cited

Dogac, Asuman, and Laleci, Gokce B. (2005). A Survey and Analysis of Electronic

Healthcare Record Standards. ACM Computing Surveys, 37(4), 277-315.

Glaser, John, and Aske, Jennings. (2010). Healthcare IT trends raise bar for information security.

Healthcare Financial Management, 64(7), 40-44.

Healthcare Incurred but Not Reported
Words: 800 Length: 3 Pages Document Type: Term Paper Paper #: 70173801
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NPV and IBN

Net present value analysis can be used with respect to IBN in a real life investment situation where healthcare organizations are looking to decide where to invest revenues or capital for future expenditures. It may help healthcare organizations calculate the value of cash flows within the organization over varying time periods. Net present value analysis allows organizations to consider the difference in future cash flow values compared with the cost of raising capital for future investments. Organizations can use this analysis to decide whether or not to incorporate certain expenses into IBN.

A healthcare organization can use net present value analysis for example to pick between varying investment projects for example. A hospital could for example decide whether to invest more of its resources in improved technology and security measures or whether to invest more resources in research geared to finding new treatments for cancer patients that…

References

McLean, Robert A. Financial Management in Health Care Organizations. Canada:

Thompson Delmar Learning, 2002.

Ryan, Bruce and Clay, Scott B. "An Overview of IBNR - Incurred But Not Recorded

Expenses and Liabilities." Healthcare Financial Management, November 1994. 8, October 2005:

Corporate Health Care it System
Words: 2123 Length: 7 Pages Document Type: Thesis Paper #: 36886014
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Managed care and utilization review (U) play an integral part in patient care and reimbursement (Mahmoud, E and ice, G, 1998). Scott echoes it experts Brian P. Bloomfield, od Coombs, David Knights, and Dale Littler (2000), who say:

IT system enjoys what one might call a special relationship with esource Management. Its role as depicted in the review is one centred on the improvements and furtherance of a 'balanced' dialogue between doctors and managers. A corollary of this is that it must be neutral politically speaking (see Bloomfield 1995). Thus the review authorizes the introduction of the new it system by subordinating it to the cause of dialogue between doctors and managers. The review represents the information requirements of hospital doctors and management and thereby portrays the it system as fulfilling a preexisting need. The narrative structure here is founded on the discovery of a state of readiness on the…

References

http://www.questiaschool.com/PM.qst?a=o&d=79104775

Bloomfield, B.P., Coombs, R., Knights, D., & Littler, D. (Eds.). (2000). Information Technology and Organizations: Strategies, Networks, and Integration. Oxford: Oxford University Press. Retrieved October 16, 2008, from Questia database:  http://www.questia.com/PM.qst?a=o&d=79104777  http://www.questiaschool.com/PM.qst?a=o&d=5001408217

Mahmoud, E., & Rice, G. (1998). Information Systems Technology and Healthcare Quality Improvement. Review of Business, 19(3), 8+. Retrieved October 16, 2008, from Questia database:  http://www.questia.com/PM.qst?a=o&d=5001408217  http://www.questiaschool.com/PM.qst?a=o&d=57140362

Smith, H.J. (1994). Managing Privacy: Information Technology and Corporate America. Chapel Hill, NC: University of North Carolina Press. Retrieved October 16, 2008, from Questia database:  http://www.questia.com/PM.qst?a=o&d=57140363

Healthcare Crisis US Health Care
Words: 1617 Length: 5 Pages Document Type: Thesis Paper #: 87102656
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Universal healthcare is the only saving formula for this nation, which is doomed in a health care crisis of unprecedented proportions. There is a urgent need to transform healthcare from its present state of commercialism towards the humanitarian approach which guarantees 'healthcare for all' independent of their social or financial circumstances. A shared and collective responsibility of healthcare management is the only viable formula for America. It is high time we learn from Canada, UK and other European nations and restructure the current broken state of our healthcare. The successful passing of the USNHC act (H.R. 676) is the only way for America to wake up from its healthcare nightmare. Will the powerful insurance industry hold its ground yet again and resist this awakening leaving all the citizens doomed? This is an important question for all the citizens of our country.

ibliography

1) Science Daily, 'American Values lamed for U.S.…

Bibliography

1) Science Daily, 'American Values Blamed for U.S. Healthcare Crisis',

Accessed May 11, 2009, Available at,  http://www.sciencedaily.com/releases/2008/12/081204160558.htm 

2) Laura K. Altom, BS, MSIII and Larry R. Churchill, PhD, Ann Geddes Stahlman

'Pay, Pride, and Public Purpose: Why America's Doctors Should Support

Technologies Impact on Healthcare Level
Words: 1489 Length: 5 Pages Document Type: Term Paper Paper #: 14958513
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This is necessary to provide a seamless platform on which health solutions can be effectively integrated and deployed. Without using such a platform, the development of electronic health care facilities will be more difficult to deploy. In other words, Tele-health is part of the overall healthcare ICT (Information Communications Technology) solutions that enables healthcare to be pushed out to the edge, for local delivery, and to be more evenly, efficiently and effectively distributed.

Broadband communication is the underlying technology of choice when discussing electronic applications. It is certainly important for inter-healthcare provider communications delivering sufficient bandwidth capacity between sites. The delivery of home care electronic should not rely on the broadband technology is not universally accessible, particularly in rural and remote areas, and it can also be prohibitively expensive. Some broadband technologies can be delivered to remote locations, such as satellite-based technology, but this is impractical and too costly to…

References

Goldberg, a. (2002, April 29). Internal Report: Telehealth, Privacy, & Health Care: Review, Expectations & Proposals. Goulston & Storrs, Boston, MA.

Lovata, F. (2000, May 21-24). Telemedicine via the Internet: Successful Program Strategies. American Telemedicine Association Conference,

Puskin, D., Mintzer, C., & Wasem, C. (1997). Chapter 14, Telemedicine: Building Rural Systems for Today and Tomorrow. In P. Brennan, S. Schneider, & E. Tornquist (Eds.), Information Networks for Community Health. (p. 276). Computers in Health Care Series. Springer-Verlag.

Telecommunications: Protecting the Forgotten Frontier. (2001, August). SC Magazine-Info Security News, 12 (8), 36-40.

Healthcare Finance
Words: 1288 Length: 4 Pages Document Type: Term Paper Paper #: 91573084
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Americans healthcare delivery in the United States has been via a market driven system, 1 usually through purchase of health insurance, participation in HOs or other types of collective agencies. For those who qualify enrollment in edicare and edicaid programs will cover or defray costs of healthcare.2 For a growing number of people in the U.S. medical care costs are not covered by insurance or government programs, for them out of pocket and indigent services are their only options.3 This paper will look at the how financing healthcare affects both costs and use of healthcare services.

Private Health insurance.

Private health insurance in the United States developed around the 1930's during the Depression4 and grew during the economic expansion of the post-WWII years. "Under most private insurance and Blue Cross -- Blue Shield plans, fee-for-service, with physicians determining the economic value of their own services, became the established method of…

Martin Ruef, "Social Ontology and the Dynamics of Organizational Forms: Creating Market Actors in the Healthcare Field, 1966-1994,"

Journal article by; University of North Carolina Press, 1999

Zelman W., and McLaughlin C. (1990). "Product Lines in a Complex Marketplace: Matching Organizational Strategy to Buyer Behavior." Health Care Management Review 15:2 (Spring),

Managing Risks in Healthcare
Words: 1021 Length: 3 Pages Document Type: Essay Paper #: 66500622
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Healthcare Management

isk management in healthcare organizations includes activities that integrating the recognition of risks, assessments of risks, coming up with strategies to be used and mitigation of these risks that have been identified. The focus on this paper is how to proactively prevent risks in healthcare organizations. The area of focus in financial risk management is risks that are managed using trade financial instruments such financial management systems, appropriate EM, coding, billing, collections, general accounting, budgeting, expense management, managed care contract strategy and vendor relations processes. isks are unavoidable and are present in every human situation .T he most common concept that appears in all definitions of risks is the uncertainty of the outcomes involved in the risks. Due to the uncertainty of the nature of risks the healthcare systems should have proactive measures in place to ensure that these risks are prevented and do not take place at…

References

University of California (2008). Ways to Reduce Risk. Retrieved March 24, 2014 from http://map.ais.ucla.edu/go/1000570

ECRI Institute ( 2010). Sample Risk Management Plan for a Community Health Center Patient Safety and Risk Management Program. Retrieved March 24, 2014 from http://bphc.hrsa.gov/ftca/riskmanagement/riskmgmtplan.pdf

Berg H., (2010). Risk Management: Procedures, Methods and Experiences. Retrieved March 24, 2014 from  http://gnedenko-forum.org/Journal/2010/022010/RTA_2_2010-09.pdf 

The World Bank Group, (2014).Better Risk Management Can Unlock Opportunities, Prevent Crises, and Protect Poor amidst Disasters and Shocks, Says World Bank . Retrieved March 24, 2014 from  http://www.worldbank.org/en/news/press-release/2013/10/06/better-risk-management-unlock-opportunities-prevent-crises-protect-poor-amidst-disasters-shocks

Africans Had Poor Health Care in the
Words: 1577 Length: 5 Pages Document Type: Essay Paper #: 90177845
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Africans had poor health care in the 1950s

There is much that still remains swept under the proverbial carpet about America's treatment to its African immigrants. One of the chapters, little known and often left untold has only recently started to emerge and concerns American health care system and its using Blacks as guinea pigs.

Attorney and author Vernellia . Tandall tells the story in her book 'Dying While Black' showing how America's health care system was built on the bodies of African-American individuals from the 19th century continuing to present days. Some f the information is unbelievable at best shocking at worst such as her allegations that AIDS was created by a government-sanctioned health care for the purposes of medical advancement.

Countless stories from Black residents of both North and South tell about how they were unwillingly and unknowingly abducted and exploited for medical experiments. There were the 'night…

References

Brooking Institute (2008) "Meeting the Dilemma of Health Care Access" (PDF). Opportunity 08: A Project of the Brookings Institution. Retrieved on 2/19/2011

http://www.opportunity08.org/Files/FD.ashx?guid=98a417e5-5972-4031-b361-e11e00981f55

Orlando Sentinel. (Dec., 04. 1993). Clinic On Wheels To Take Health Care To Elderly Poor . retreived 11/7/2011 from  http://articles.orlandosentinel.com/1993-12-04/news/9312040190_1_clinic-project-care-seniors 

Skloot, H. (2010) The immortal life of Henrietta Lacks NY. Random House.

Healthcare Reform Review of Literature
Words: 6070 Length: 20 Pages Document Type: Literature Review Paper #: 45810582
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(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

U S Health Care System 2010 Saw the
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U.S. Health Care System

2010 saw the passage of the landmark Patient Protection and ffordable Care ct, the most striking transformation to the health care landscape since Medicare's enactment in 1965. The bill focuses on two critical issues facing the overall U.S. health care system: cost and coverage. Because the U.S. health model is not defined by a single payer or "socialized medicine"; the delivery system has created a significant lacuna in coverage and access for individuals primarily based on income and affluence. Further, the cost of care and coverage has outpaced national income growth over the last decades. "The U.S. is projected to spend over $2.5 trillion on health care in 2009, or $8,160 per U.S. resident, accounting for 17.6% of GDP. In 1970, U.S. health care spending was about $75 billion, or $356 per resident, and accounted for 7.2% of GDP" (Kaiser Family Foundation. March 2009. P. 1).…

A common phrase that is trumpeted by entrenched interests in the health care industry is that the U.S. has the finest health care in the world, yet a mountain of statistics proves otherwise. "The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance" (World Health Organization.org. 2000. P. 1) according to the World Health Organization. This ranking reflects core problems of the delivery model which has left some 49.9 million uninsured in 2010 (U.S. Census Bureau.gov. 2010. P. 27), leaves "one third of U.S. adults without recommended care, and one fifth of U.S. adults having major problems paying medical bills" (Schoen, C. Osborn, R. Squires, D. Doty, M. Pierson, R. & Applebaum, S.P. 2). A point that does resonate however is that income is the ultimate "Mendoza Line" for individuals receiving health services. "The uninsured rate was higher among people with lower incomes and lower among people with higher incomes" (U.S. Census Bureau.gov. 2010. P. 27). As a result the proclivity for individuals without insurance coverage is to ignore the necessary care, mainly preventative, which could dramatically impact the long run cost curve downward on health service affordability.

Access and Cost

The Affordable Care Act expands the pool of the insured through private sector exchanges, tax credit enhancements, and greater access to Medicaid. Affordable coverage under either a private health plan, or Medicare and Medicaid allows individuals to utilize the services requisite for long-term health. A legitimate question however, is whether expansion of coverage will in fact explode costs even beyond their already significant upward trajectory? With coverage expansion there will be greater demand pressure on providers, yet this should also drive competitive rigor, allowing for cost containment across the system. As such the Commonwealth Fund, a private health reform organization, estimates that "expenditures for the whole health care system will be reduced by nearly 600 billion in the first decade" (Orszag, P. & Emanuel, E. August 12, 2010. P. 2). The bending of the cost curve downward though requires that the delivery system change concomitantly; with focus on coordinated care across "three 'I' platforms: information, infrastructure,

Ron Paul on Healthcare Quality
Words: 637 Length: 2 Pages Document Type: Term Paper Paper #: 79478274
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Gingrich believes that there is a great need to repeal and substitute the huge government health bill with actual solutions that will lessen costs and enhance health outcomes. In addition to opposing the Obamacare because of its failure to accomplish universal coverage, he proposes the Patient Power Plan that will change the current system into a coordinated and innovative system rather than a broken and fragmented one.

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

References:

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

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

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