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Reductions in provider payments are sometimes considered as suitable options for reducing excessive Medicare spending (Medicare Reform Options). Nevertheless, we are deemed to believe that such reductions will also affect the benefits for the elderly, due to decreased spending.
However, Medicare programs for elderly are not only based on free pharmaceuticals or free medical care. Several programs target different affections specific to the elderly population. A Medicare test program, for example, introduced in seven states, was imposed to help senior citizens quit smoking through free therapy (Medicare Targets Elderly Smokers). Nursing homes offer the Program of All-Inclusive Care for the Elderly (PACE), as an optional benefit under the Medicare and Medicaid programs (http://www.medicare.gov/Nursing/Alternatives/Pace.asp).
Medicare remains a problem today because of an unmatched difference between the need to include prescription drug coverage and free medication into the system and the capacity of the Medicare system to financially sustain such an inclusion.…
1. Medicare reform returns to Congress. The Star Ledger. July 2007. On the Internet at http://www.nj.com/business/ledger/index.ssf?/base/business-7/1183441774140490.xml&coll=1.Last retrieved on July 16, 2007
2. Medicare Reform Options. June 2007. Medicare Steering Committee of the Health Practice Council. On the Internet at http://www.actuary.org/pdf/medicare/options_june07.pdf.Last retrieved on July 16, 2007
3. Medicare Targets Elderly Smokers. November 2002. On the Internet
http://www.cbsnews.com/stories/2002/11/21/health/main530344.shtml.Last retrieved July 16, 2007
It was also interesting to see some of the reforms that are being discussed to help lower costs and that if something is not done now, Americans under the age of 54 probably won't have Medicare when they are ready to retire.
As with many government programs, it seems that Medicare is mired in red tape and not enough money to go around. It seems that people my age will not have any federal funds to fall back on when they are ready to retire if something isn't done, and that our Social Security and Medicare money is going to go to people who are retiring now or in a few years. People in Congress need to work together to reform these social programs before they go broke, and they need to stop fighting about it and just get it done, so Americans that need it the most aren't left…
Hensarling, J. (22 Feb. 2008). Medicare and entitlements. Retrieved 13 March 2008 from the Washington Times Web site: http://washingtontimes.com/article/20080222/EDITORIAL/625269691/1013 .
Medicare Health Care eform
The Medicare is an American health program that is administered by the federal government and serves as a health insurance for people aged 65 years and above. The Medicare is also designed for people with disabilities and people diagnosed with the renal disease. (Davis, Cathy, & Stuart, 2013). The Medicare is currently being funded by the premiums, payroll tax, surtax from general revenue. In 2015, over 55 million American enrolled for the Medicare services where 46 million people are people aged 65 years and above and 9 million are young people. On the average, Medicare covers half of the health costs and the enrollees are to cover the remaining costs through a separate insurance, supplemental insurance, or out-of-pocket. Since the inception of the Medicare, the cost of funding the program continues to increase, and the rising costs of funding are becoming unbearable both for the current…
Blum, J. (2011). Improving Quality, Lowering Costs: The Role of Health Care Delivery System. Center for Medicare Management.
Davis, K. Cathy, S. & Stuart, G. (2013). Medicare Essential: An Option to Promote Better
Care and Curb Spending Growth, Health Affairs 32, no. 5: 901 -- 9.
Golberstein, E. Kayo, W. Yulei, H. et al. (2013). Supplemental Coverage Associated with More Rapid Spending Growth for Medicare Beneficiaries, Health Affairs, 32, no. 5. 873 -- 81.
The Act creates a positive balance between government interests to save money and the interests of Medicare recipients to receive a wide range of drugs for their specific needs. The current ban on government negotiations with pharmaceutical companies serves to protect Medicate recipients by using the positives of the free market, such as the experience and purchasing power of PBMs. hile there are serious potential problems with this approach, such as the potential for fraud between pharmaceutical companies and private interests, overall the ban on government negotiations with pharmaceutical companies provides a good balance between recipient and government interests.
American Legislative Exchange Council. Prescription Drugs. 19 October 2005. http://www.alec.org/2/4/talking-points/7.html
Barry, Patricia. New Salvos in the Prescription Drug ars: Class action suits are exposing schemes that gouge consumers. AARP Bulletin, January 2005.
19 October 2005. http://www.aarp.org/bulletin/prescription/a2005-01-06-salvos.html
Dealey, Sam. Drug Dealings: Democrats had it right before. National Review Online, May…
American Legislative Exchange Council. Prescription Drugs. 19 October 2005. http://www.alec.org/2/4/talking-points/7.html
Barry, Patricia. New Salvos in the Prescription Drug Wars: Class action suits are exposing schemes that gouge consumers. AARP Bulletin, January 2005.
19 October 2005. http://www.aarp.org/bulletin/prescription/a2005-01-06-salvos.html
Dealey, Sam. Drug Dealings: Democrats had it right before. National Review Online, May 05, 2004, 9:12 A.M. 19 October 2005. http://www.nationalreview.com/comment/dealey200405050912.asp
American Health Care
After leading the world in the health of its citizens throughout most of the 20th century, the United States has fallen behind virtually all other wealthy nations in that regard, not to mention having fallen behind several nations that once relied substantially on U.S. aid (Dykman, 2008). While most of the developed world has already embraced the concept of universal government-funded national health care systems, the U.S. still relies on a for-profit model that has proven to be incapable of meeting the health care needs of society in any manner that is efficient, cost-effective, and equally available to all members of society. Even worse, the ongoing political influence of lobbyists for the for-profit health insurance industry continues to succeed in undermining meaningful health care reform (Kennedy, 2006), including by watering down the historic Affordable Care Act that eventually passed into law in 2009. Finally, the available evidence…
Dykman J. (2008). "Five truths about health care in America." Time, 172(22): 42-51.
Kennedy E. (2006). America: Back on Track. New York: Viking.
Reid T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin.
Tumulty K., Pickert K., and Park A. (2010). "America, the doctor will see you now."
On April 16, 2015 an Act called the Medicare Access and CHIP Reauthorization Act (MACRA) was passed, which is a piece of history of bipartisan legislation. Eventually, on October 14, 2016 the Centers for Medicare & Medicaid Services, the department of Health and Human Services, and the regulatory agency which takes care implementing and putting into practice MACRA, gave out an ultimate rule with a comment duration putting into practice the provisions of MACRA. MACRA revokes the highly denounced Sustainable Growth Rate Formula together with its schedule for Medicare Physician Fee (MPF) cuts, substituting it with the Quality Payment Program, which is a new model that focuses on cost measurement and quality, as well as payment and reporting adjustments. Physicians and their assistants, clinical nurse specialists, nurse practitioners, and certified registered nurse anesthetics are all part of the eligible clinicians indicated in Medicare Part B and their QPP includes the…
For a long time, the Health Care concern has been a centre of discussion in the society as well as among the representatives in a bid to find out which would be the best way to cushion Americans from the ever increasing burden of having to take care of themselves medically. Efforts have been made but still there is no single solution to the issue hence a combined effort between the citizens and the government is very essential in ensuring that the ultimate goal is achieved and each American has adequate Health care assurance. This is the aim of the Health eforms that was passed into law at the behest of the current president, Obama.
Provisions of the Health eform
There are several benefits that the Health eforms are expected to bring to the American population in general. One of the central changes is the fact…
Ben LaBolt, (2010). Senator Obama Introduces Bill to Strengthen Emergency Medical Care
Systems. Retrieved November 13, 2011 from http://www.emsvillage.com/articles/article.cfm?id=2185
Bill Atkinson, (2010). What Obama's health care bill means for EMS. Retrieved November 13,
2011 from http://www.ems1.com/ems-advocacy/articles/779154-What-Obamas-health-care-bill-means-for-EMS/
The subject of healthcare reform set the country ablaze last year, proving to be one of the most contentious issues that has swept through American political discourse in recent decades. One reason that healthcare reform might have proven to be such a contentious issue -- bringing out the worst and shrillest elements of the American public -- was that healthcare is one of the most important issues in the lives of many and even most Americans (Christensen and Jason, 2009).
All of us will face serious illness at some point in our lives, whether our own or that of a loved one. The fact that so many Americans do not have any healthcare at all or have very limited access to healthcare makes the issue a personal one, and this alone should have made it central to the public discourse. However, while the above was no doubt the…
Christensen, Clayton and Jason, Grossman. The Innovator's Prescription, New York: McGraw Hill, 2009.
Mahar, Maggie. Money-Driven Medicine: The Real Reason Health Care Costs So Much. New York:Harper/Collins, 2006.
Reid, T.R. The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care. New York: Penquin Books, 2009.
Obama's health care reform will make health care more accessible and more affordable and make insurers more accountable, as well as expand health care coverage to every American and make the health care system sustainable by stabilizing family budgets, the economy and the Federal budget.
The cost of Obama's overall health care bill will cost approximately $940 billion over 10 years, according to the Congressional udget Office. The bill will include that by the year 2014 there will be significant health access reforms. Insurers will be prohibited from denying coverage to people with medical problems of charging them more money (CS 2010).
While these numbers do sound manageable, Congress has not responded kindly to Obama's health care reform ideas. When Obama has even mentioned the idea of health care for illegal immigrants, the president was rudely interrupted by a heckler yelling, "you lie" ( ). Under Obama's proposal of health…
CBS News. "What's in a health care bill? Take a dose." Retrieved on June 1, 2010, from the Web site:
CNN.com. (2010) "Obama calls for congress to face health care challenge." Retrieved on June 5, 2010, from the Web site:
Health eform Act
The work of Flanagan, Miller, Pagano, and Wood (2010) entitled "Employee Benefit Plan eview -- Meyerowitz, Health care eform Is Here -- Now What?" states that health care reform laws are expected to have an impact that is significant in nature and this is on the health insurance industry as well as on employee benefit issues as well. The Patient Protection and Affordable Care Act (PPACA), which was then supplemented and modified, less than one week later, by the Health Care and Education Tax Credit econciliation Act (HCEA)." (Flanagan, Miller, Pagano, and Wood, 2010) Those two laws are referred to as "Health Care eform" or "Health eform Laws." (Flanagan, Miller, Pagano, and Wood, 2010) The Health eform Laws are reported, while being extremely lengthy and in depth and very detailed to "leave open a host of issues that will have to be resolved either through agency regulations…
Current Internal Revenue Code (Standard Federal version), SEC. 45R. EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL EMPLOYERS (2010) WK_ Current Internal Revenue Code SEC 45R EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL EMPLOYERS.pdf
Part III - Administrative, Procedural, and Miscellaneous Section 45R -- Tax Credit for Employee Health Insurance Expenses of Small Employers Notice 2010-44
National Tax Advisory (2010) What you need to know now about the tax aspects of health reform litigation. 6 Apr 2010.
IRS Rulings & Other Documents (2002-Current), Rev. Rul. 2010-13, Internal Revenue Service, (May 3, 2010) WK_ IRS Rulings Other Documents 2002-Current Rev Rul 2010-13 May 3, 2010.pdf ©2010 Wolters Kluwer.
(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
The ultimate House vote was two hundred and twenty to two hundred and seven. The senate vote was fifty three to forty three. The republicans were collectively opposed in both chambers (3 June 2010, 3).
The Future of the Health Care ill
Subsequent to disagreements as political enemies for more than a year, the Obama administration and the health insurance industry realized that they require one another.
oth have huge stakes in the success of the new health care law (14 May 2010, 1)
The political destiny of President Obama and Congressional Democrats rely on their capability to interpret it's assurance into realism for voters. This can be attained by restraining health expenses and making insurance accessible to everybody at reasonable price. Similarly, the fiscal future, in fact the continued existence, of the health insurance industry relies on the government. That is on set of laws being written by federal…
1. "Critics Question Study Cited in Health Debate, " New York Times, 2 June 2010, sec. a, p. 1.
2. "Health Reforms," New York Times, 26 March 2010, sec. a, p. 1.
3. "Two Health Care Adversaries Find a Need to Collaborate, " New York Times, 3 June 2010, sec. B, p.3.
4. "Companies Try to Shape Rules, " New York Times, 15 May 2010, sec. a, p.22
In Canada, a much higher percentage of the population lives in remote areas whereas covered healthcare services are often concentrated in large cities (eid, 2009).
Medicare Expansion and Mandatory Health Insurance Issues and Concerns
From the perspective of middle and upper middle income families in the U.S., the expansion of Medicare and the mandatory provision of healthcare by employers would be a tremendous benefit. From the employers' perspective, the associated costs could be prohibitive. Mandatory requirements for individuals could be problematic for those at the lower end of the group income spectrum; however, it would be no less fair than the current situation that forces everyone who pays for healthcare to (in effect) subsidize those who choose not to (Kennedy, 2006). In all likelihood, the only way to make mandatory health insurance work would include expanding Medicare, at least to compete with private health insurers. Naturally, this interferes with their…
Kennedy, E. (2006). America: Back on Track. Viking: New York.
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
Health Care 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,
Health care reform has the objective of getting more people insured, and leveraging government bargaining power to lower the cost of health care. Our organization needs to be ready for this. We have the baby boomers joining Medicare, and Medicare is seeking to lower health care costs; so are private insurers. As an organization, we need to bring our costs down in order to remain profitable. This need not be hard -- every other country in the world does it. In this context, streamlining operations, eliminating waste, bargaining with suppliers and finding ways to streamline services to increase customer turnover are all measures that I would undertake in order to ready the organization for the full implementation of health care reform. Eliminating waste is a critical component of maintaining profitability within the health care system (Berwick & Hackbarth, 2012).
Something I would do differently with respect to health care planning…
Berwick, D. & Hackbarth, A. (2012). Eliminating waste in U.S. health care. JAMA. Vol. 207 (15) 1513-1516.
Farmer, J. & Nimegeer, A. (2014). Community participation to design rural primary healthcare services. BMC Health Services. Vol. 14 (130) [HIDDEN]
Olsen, E. (2008). SWOT Analysis: How To Perform One For Your Organization (Webcast). Virtual Strategist.
President Bush came into the hite House with a history as a 'tort reformer.' True to his record, the President backed a 'tort reform' bill last year that was passed by the House of Representatives but floundered in a Democratic controlled Senate. The President has recently renewed his call for the legislature to approve a tort reform bill that relates mainly to medical malpractice. It remains to be seen whether President Bush is successful in getting his proposals approved this time around as debate still rages among the supporters and opponents of the reform bill. This paper looks at the pros and cons of the issue and includes the following:
summary of the proposed public policy on tort reform
The impact of the policy (who shall be affected?)
The lobbying efforts in favor of and against the tort reforms
The present tort reform proposal is restricted to…
Horowitz, Michael. "Can Tort Law Be Ethical? A proposal to curb ill-gotten gains." Hudson Institute. First published in the Weekly Standard March 31, 2001. May 18, 2003. http://www.hudson.org/index.cfm?fuseaction=publication_details&id=810
HR 5: A cruel Proposal in Congress." Center for Justice and Democracy. N.d. May 18, 2003. http://centerjd.org/HR5.doc.pdf
President Announces Framework to Modernize and Improve Medicare." White House Press Release. March 4, 2003. White House Web Site. http://www.whitehouse.gov/news/releases/2003/03/20030304-5.html
Sebok, Anthony J. "Can an HMO Be Sued For Medical Malpractice Based on Its Coverage Decisions?: A Recent Federal Appeals Case Says Yes." February, 27, 2003. FindLaw Website. May 18, 2003. http://writ.corporate.findlaw.com/sebok/20030227.html
sound reforms in the operations and structure of United States Congress. The paper also discusses the reasons why reforms are needed in this powerful institution of our country.
EFOMING THE CONGESS
Congress may be the most powerful institution in the United States government but it is certainly not the most efficient. The powers that Constitution has granted this body have resulted in the creation of an oversized inefficient institution, full of self-serving politicians who are quite out of touch with country most pressing problems. It is extremely important to bear in mind that reform of Congress has been proposed a million times which indicates that the clash between public and the Congress is not something new. Yet the lack of any sound measures has only added to public anger and frustration. There are several important ways in which Congress can be reformed but we must first be familiar with the…
TOM KEAN, CONGRESS MUST REFORM CAMPAIGN FUNDING NOW., The Record (Bergen County, NJ), 03-25-2001, pp 01
Thomas E. Mann, Cynicism Curbs Reform of Congress., Newsday, 03-29-1994, pp A39
To Reform Congress, Reform the Dollar, Freemarket Gold & Money Report: 1998
Maybe for some things are well enough, but for most Americans they are far from it. Most Americans spend their days worrying about being just one layoff away from joining the 50 million other men, women and children in the ranks of the uninsured. The average household income in this country is just about $50,000. This means that most people are not in a position to pay a fourth of their family's annual income, before taxes, just to cover health insurance premiums. More and more people face paying thousands more of our hard earned dollars in out-of-pocket expenses before the coverage we pay so dearly for actually kicks in (ichard, 2009).
In the past many Americans who have been enrolled in employer-sponsored health insurance plans have been able to rely on their employers to pay the biggest share of the premiums, but the truth is that fewer and fewer Americans…
Benefits of Health Reform. (n.d.). Retrieved February 19, 2010,from Organizing for America
Web site: http://www.barackobama.com/issues/healthcare/
Doctors Debate Universal Health Care: Pros and Cons From the Experts. (2010). Retrieved
February 19, 2010, from Organized Wisdom Web site:
The SG2 report (2010, p. 9) also mentions academic medical centers (AMCs), which will have enter into affiliation agreements in order to comply with the reformed care laws. This will furthermore mean more integrated physician networks and it integration, as mentioned above.
Two further important factors are mentioned by Moyers (2010). She notes that the inclusive nature of health care definitions for occupational therapists is a significant step forward in terms of recognizing the profession as a legitimate health care service. Occupational therapy, for example, is specifically included in the "Innovations in the Health Care Workforce" section of the new legislation. This is significant, because occupational therapists will now be eligible for state workforce grants, slots on the national commission on workforce, and other similar privileges enjoyed by other health care providers.
Other items, excluded from the bill, is the second item the author mentions. She notes that one of…
Davis, P.A., Hahn, J., Morgan, P.C., Stone, J., and Tilson, S. (2010, Apr. 23). Medicare Provisions in the Patient Protection. Retrieved from: http://www.nasuad.org/documentation/aca/CRS%20Reports/April%2023%20-%20Medicare.pdf
Moyers, P. (2010, Mar. 25). What Health Care Reform Means to Occupational Therapy.
Retrieved from: http://otconnections.aota.org/blogs/moyers/archive/2010/03/25/what-healthcare-reform-means-to-occupational-therapy.aspx
Sg2 Special Report: (2010, May). The Impact of Health Reform
The result is that a multilayered system which is inherently designed to maintain and improve our public health standards has instead become almost entirely designed by its profitability. The best opportunity we have for reversing this trend is the applying of pressure that only the federal government can bring to bear. Greater regulation of pricing, coverage and standards of care will shift the focus back to quality health outcomes rather than strict improvement of the bottom line at all costs.
- Is there a solution?
How can (or can't) public policy shape health care in the U.S. hat do you predict for the next year?
Public policy absolutely has the capacity to bring improvement to a highly dysfunctional system. The Affordable Care Act and many of its related sub-initiatives such as the Readmissions Reduction Program are indicative of this opportunity. Indeed, the continuing pressure upon hospitals to focus on producing…
Krueger, a. (2013). As ACA Implementation Continues, Consumer Health Care Cost Growth Has Slowed. Whitehouse.gov.
Not only do these practices discourage preventative care and monitoring, they also diminish the quality of the good that insured individuals are buying from the health insurance companies. Insured individuals are paying for insurance and paying for most of their healthcare costs in addition because of the exorbitant deductibles. PPACA's prohibition of these practices ultimately forces health care companies to raise the bar and give health insurance customers more value for money.
Public-Private Partnerships Prevent ureaucratization of Health Care
There are widespread misconceptions that the PPACA will provide health insurance through some government-run bureaucracy. Actually, PPACA is built on close cooperation between health insurance companies and the government. Under PPACA, the government does not operate hospitals nor does it provide medical insurance to individuals. Actually, it requires individuals to carry some form of private health insurance or suffer a penalty. The only time the government becomes involved is when an…
Patient Protection and Affordable Care Act. Public Law 111 -- 148. Available at http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf
Patient Protection and Affordable Care Act - Summary. http://thomas.loc.gov/cgi-bin/bdquery/z-d111:HR03590:@@@L&summ2=m&summary
"An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act,
Letter to the Honorable Evan Bayh." Congressional Budget Office. Douglas W. Elmendorf. November 18, 2009. Available at http://cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf .
overwhelming connections between healthcare costs and the macroeconomic performance of the U.S. economy. The impact of healthcare industry on the macroeconomic performance is evident from the fact that in 2009 healthcare expenditure of the U.S. was 18% of the gross domestic product (GDP) of the country. It was also estimated that should the healthcare costs continue to grow at historical rates, 34% of the U.S. GDP will compose of healthcare spending by 2040 (Whitehouse, 2009). The major sources of funding the healthcare costs are the Federal, State, and local governments of the U.S. Medicare is a healthcare program that subsidizes healthcare for citizens above 65 years of age. Medicaid subsidizes healthcare delivery for people below a certain income level. Approximately 50% of the healthcare expenditure is bore by governments at the federal, state and local level. It is also estimated that Medicare and Medicaid spending of Federal and State governments…
CMS. (2013, Nov). National Health Expenditure Projections 2012-2022. Centers for Medicare & Medicaid Services. Retrieved from: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html
Kolstad, J.T., & Kowalski, A.E. (2012). Mandate-based health reform and the labor market: Evidence from the Massachusetts reform (No. w17933). National Bureau of Economic Research.
The Whitehouse. (2009). Deficit-Reducing Health Care Reform. The Whitehouse. Retrieved from: http://www.whitehouse.gov/economy/reform/deficit-reducing-health-care-reform
CBO. (2011, March). The Economic Case for the Health Care Reform. Congressional Budget Office: Executive Office of the President Council of Economic Advisers. Retrieved from: http://www.cbo.gov/publication/22077
Health Care Reform Federal Deficit
The American Health Care Crisis and the Federal Deficit
The United States spends more than any other country on medical care. In 2006, U.S. health care spending was $2.1 trillion, or 16% of our gross domestic product. At the same time, more than 45 million Americans lack health insurance and our health outcomes (life expectancy, infant mortality, and mortality amenable to health care) are mediocre compared with other rich democracies. We spend too much for what we get.
Nothing is new about these sobering realities. The Nixon administration first declared a health care cost crisis in 1969. Four decades later, the United States still has not adopted systemwide cost controls because the politics of health care make it extraordinarily difficult to control costs. I explain below why this is so (Marmor, et al., 2009).
The starting point for understanding the politics of cost control is…
1. Eakin, Douglas and Michael Ramlet. (2010) "Health Care Reform is Likely to Widen Budget Deficits -- Not Reduce Them." Health Affairs, 29, no.6:1136-1141. Eakin and Ramlet examine the underpinnings of the Congressional Budget Office's projection that enacting the Patient Protection and Affordable Care Act will decrease deficits, and conclude that it is built on a shaky foundation of omitted costs, premiums shifted from other entitlements, and politically dubious spending cuts and revenue increases. A more comprehensive and realistic projection suggests that the new reform law will raise the deficit by more than $500 billion during the first ten years and by nearly $1.5 trillion in the following decade. This is an excellent article with regards to my article, written by two policy commentators at the forefront of their field. This article shows expertise in medical economics and offers compelling, clear arguments for the increase in the federal deficit due to the massive spending on entitlements as a result of passing the Patient Protection and Affordable Care Act. They project deficits, opposing the Congressional Budget Office, through their insightful analysis.
2. Marmor, Theodore, Jonathan Oberlander, and Joseph White. (2009) "The Obama Administration's Options for Health Care Cost Control: Hope vs. Reality." Ann Intern Med. 150:485-489. Controlling the costs of medical care has long been an elusive goal in U.S. health policy. This article examines the options for health care cost control under the Obama administration. The authors argue that the administration's approach to health reform offers some potential for cost control but also embraces many strategies that are not likely to be successful. Lessons the United States can learn from other countries' experiences in constraining medical care spending are then explored. This article offers evidence for the lack of cost containment in the Obama administrations' plans for health reform. It gives a good analysis of the international scene in health care as well.
3. Collins, Sara, Michelle M. Doty, Karen Davis, Cathy Schoen, Alyssa L. Holmgren, and Alice Ho. (2004) "The Affordability Crisis in Health Care." Commonwealth Fund Biennial Health Insurance Survey. Published in 2004, The Commonwealth Fund Biennial Health Insurance Survey, conducted from September 2003 -- January 2004, presents new and timely information on where the American public stands on solutions to reform the health care system. The survey finds widespread support for federal efforts to extend health insurance to more people, as well as a widely held belief that the financing of health care should continue to be a shared responsibility among individuals, employers, and the government. The survey also uncovered potential reasons for such strong support for health care reform. Among the insured and the uninsured alike, there is concern that health care security in the United States is eroding. People are experiencing reductions in insurance coverage that are threatening their financial security.
4. Etheridge, Lynn (1984) "An Aging Society and the Federal Deficit." The Milbank Memorial Fund Quarterly. Health and Society, 521-543. This article serves as early warning sign of the deficit battles to come. It argues that the conflict between the growing needs of an aging society and a federal budget which cannot afford its current commitments has become one of the nation's most difficult government policy dilemmas. Assistance for the elderly through Social Security, Medicare, and other programs-is already the federal government's largest fiscal responsibility. In 1985 these programs will require nearly half of all domestic program spending an estimated $256 billion. The future costs of these commitments will rise rapidly well into the next century, accounting-with national defense and interest costs-for virtually all of the spending increases in the projected $200 to $300 billion deficits. Etheridge asserts that the decisions about the nation's assistance to the elderly -- and about reaffirmation, reform, and/or retrenchment of these commitments-will thus be central to the coming budget debates.
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
" (Arnold & Reeves, 2009). ith medical services price at the present time, illness or some kind of complicated to medical services may take people deprived of health insurance years to reimburse for bills that are medical. Furthermore, I believe that individuals who lost their jobs also are uninsured for the reason that their employer gave health insurance is no longer paying for them. I understand that based on the statistic; there are "way too many around 1 million workers that have lost their health reporting in the first three months of 2009. I think that helping people buy health insurance coverage with low-cost with offering the health plans options for the uninsured is the healthcare reform that is really needed now. In this way, individuals that are without health insurance will be able to afford paying their medical insurance to uphold their well-being.
In conclusion, with the increasing rapidly…
Arnold, P.J., & Reeves, T.C. (2009). International Trade and Health Policy: Implications of the GATS for U.S. Healthcare Reform. Journal of Business Ethics, 63(4), 34.
Belcon, M.C., Ahmed, N.U., Younis, M.Z., & Bongyu, M. (40-74.). ANALYSIS of NATIONAL HEALTHCARE SYSTEMS: SEARCHING for a MODEL for DEVELOPING COUNTRIES - TRINIDAD and TOBAGO as a TEST CASE. Public Administration and Management, 14(2), 10-14.
Bolduc, C.R. (2008). The impact of healthcare reform on HMO administrators. Hospital & Health Services Administration, 17(9), 23-45.
Reiboldt, M. (2010). The Industry Responds to the Passing of Healthcare Reform. The Journal of Medical Practice Management, 18(6), 327-328.
The Constitution is based on several key principals the most notable would include: separation of powers as well as checks and balances. Separation of powers is when there are clearly defined powers that are given to the various branches of: the government, the federal government and the states. Checks and balances is when one branch of the government will have the power to the check the authority of another branch. (Wood) for example, the Constitution would specifically spell out various powers of the executive branch. During the course of exercising these different powers, a citizen brings a lawsuit against the government in the judicial branch. Where, they claim that the actions that the executive branch is taking are unconstitutional. In this particular case, the executive branch would work off of the powers given to them in the Constitution. When they begin to overstep these boundaries, another branch of the government…
"British Political Parties." Politics Resources. 2010. Web. 29 Apr. 2010.
"Fuel Efficiency Standards Hiked for 2011." MSNBC. 27 Mar. 2009. Web. 28 Apr. 2010.
"Key British Political Parties Pursuing Lilly Allen." One Indie. 2010. Web. 29 Apr. 2010.
"Markets in New Territory in Three Party Britain." Thompson Reuters. 26 Arp. 2010. Web. 29 Apr. 2010.
On the contrary, a comprehensive medical care solution that tackles the main issues driving up health care costs in America is possible. The main problem experienced by the average American is that health insurance premiums are cost prohibitive for the middle-class, but being uninsured can bankrupt a family forced to deal with even a minor catastrophic illness. Therefore, a national health insurance program has to be part of the solution. However, one cannot overlook the role that unpaid medical bills and exorbitant malpractice premiums also play in the modern healthcare crises. As a result, the solution must include a way to reduce malpractice premiums through tort reform, and a way to reduce the percentage of medical bills that go unpaid. The proposed three-prong approach would tackle all of those issues, without forcing any unwilling person to participate in a nationalized healthcare program.
American Tort Reform Association. "Medical Liability…
American Tort Reform Association. "Medical Liability Reform." ATRA Issues. 2007.
American Tort Reform Association. 6 Nov. 2008 http://www.atra.org/show/7338.
Kershaw-Staley, Tracy. "Miami Valley Hospital Files Lawsuit Over Unpaid Medical Bills."
Dayton Business Journal. 2008. Dayton Business Journal. 6 Nov. 2008 http://dayton.bizjournals.com/dayton/stories/2008/01/07/story5.html .
At the same time, 25% of Americans do not have any kind of health insurance coverage or not enough to pay for all of their expenses. (Amadeo) This can have an impact upon their financial well being, as a person must spend money that they do not have, to treat different conditions that could be life threatening. Once this begins to occur, is when the total number of bankruptcies will begin to rise sharply. As nearly half of all the filings that are made are: medical related, due to the overwhelming costs and the inability to pay them. (Amadeo) These different challenges are creating sudden shift in the economy that are: having short- and long-term impacts upon economic growth.
What is happening is rising health care costs are beginning to become a hidden tax on: businesses and consumers. As they are slowly eating away at any kind of added investments…
"The Boomer Stats." BBHQ, 2011. Web. 10 Mar. 2011
"The Economic Effects of Health Care Reform." The White House, 2010. Web. 10 Mar. 2011
Amadeo, Kimberly. "Health Care Reform." About.com, 2011. Web. 10 Mar. 2011.
Francis, Diane. "Health Care Reform is Smart." Huffington Post, 2010. Web. 10 Mar. 2011.
As a result, millions of Americans remain unable to bear the heavy financial toll of medical expenses. Indeed, the problem of a lack of insurance for many is related to the problem of the cost of healthcare. So confirms the article by Consumer Reports (CR) (2008), which finds that "health-insurance premiums have grown faster than inflation or workers' earnings over the past decade, in parallel with the equally rapid rise in overall health costs. Industry spending on administrative and marketing costs, plus profits, consumes 12% of private-insurance premiums." (CR, 1) This reiterates the case that the undue imposition of costs by the healthcare industry -- a reflection of a free-market industry with little to no regulatory oversight -- has negatively impacted the accessibility and quality of healthcare for many of the poorest users.
Moreover, these users are most vulnerable to the long-term economic damages provoked by unexpected healthcare costs. So…
Bureau of Labor Education (BLE). (2001). The U.S. Health Care System: Best in the World, or Just the Most Expensive? The University of Maine.
Childress, M. (2010). Poverty is on the Upswing, but Metric is Out of Date. The Washington Independent.
Cockerham, W.C. (2004). Medical Sociology and Sociological Theory. The Backwell Companion to Medical Sociology.
Consumer Reports (CR). (2008). High Health Care Costs. Consumer Reports Health.org.
AMEICA'S HEALTHCAE EFOM
Your Chosen Title
The overhauling of America's Health Care Systems has been a highly debated topic because it affects the quality of life, of virtually all residents living in America. A large portion of America's budget is spent on the healthcare system, however many Americans live day-to-day without healthcare coverage or medical insurance. It is surprising to know that although Americas has one of the strongest economies in the world, it lacks in this area. This resonates in the minds of many troubled Americans, who find themselves in serious economic problems due to their inability to provide healthcare coverage for themselves and their family.
Members of government and of the political arena understand that a demand exists, this demands is one that calls for healthcare coverage for all in America. In March 2010 congress responded to this demanded passed what is known as The Patient Protection and…
Health Care Reform Bill Summary: A Look At What's in the Bill - Political Hotsheet - CBS News. (n.d.). Breaking News Headlines: Business, Entertainment & World News - CBS News. Retrieved July 25, 2011, from http://www.cbsnews.com/8301-503544_162-20000846-503544.html
Sultz, H.A. (2010). Health care USA: understanding its organization and delivery By Harry A. Sultz, Kristina M. Young. Sudbury Mass.: Jones and Barlett Learning.
Staff of The Washington Post. (2010). Landmark: the inside story of America's new health care law and what it means for us all. New York: Public Affairs.
Healthcare Reform Models
Health Care Reform Models
Shim and colleagues (2012) argue for taking advantage of provisions within the Patient Protection and Affordable Care Act (ACA) of 2010 that emphasizes preventive and integrated care. They propose that the primary care setting is ideal for screening patients for signs of mental illness and associated risk factors. A mental health wellness program could also include coaches and other experts that interface with patients on an individual basis, including at the patient's home.
Long-Term Behavioral Health Care
Bao and colleagues (2012) examined four patient populations defined by disease severity and ability to pay, and then assessed how these four groups will fare under the behavioral health provisions in the ACA. Patients with private insurance and suffering from mild to moderate mental illness will probably receive the best care at a Patient-Centered Medical Home (PCMH). The authors suggest that the presence of…
4). Cooper and castle feel that the universal aims of the program, coupled with the program's redistributive intent, will prevent congressional fence-sitters from voting against a plan that is so obviously in the best interests of the vast majority of working Americans. Ultimately, the bill's appeal to social justice will bridge the partisan divide, and provide President Barack Obama with a firm foundation on which to build future change.
Of course, change, especially necessary change, is in the eye of the beholder, as are partisanship and bipartisanship. Cooper and Castle call their piece a "bipartisan view," but appear to spell out a largely Democratic approach to healthcare reform, one that seems specifically designed to entrench President Obama's position, and guarantee his reelection. They laud the expected, intended, or proposed actions of a man who has not yet taken office. Many of the authors' supporting arguments have already been rendered moot:…
Cooper, Jim; & Castle, Michael (16 January 2009). Health Reform: A Bipartisan View. Health Affairs 28, no. 2 w169-w172.
Unintended Consequences of Health Care Reform
Consequences of Health Care Reform
My discussion is related to the individual mandate of the Patient Protection and Affordable Care Act (PPACA) of 2010.
The policy problems addressed by the Patient Protection and Affordable Care Act (PPACA) of 2010 are the high cost of health insurance that is untenable for low and middle income earners and the discretionary criteria for enrollment and coverage exercised by medical and health insurance carriers. The PPACA is an excellent policy solution to these issues in the United States and, absent socialized medicine, is a robust response to what has been an intractable and escalating problem in the U.S. Many people who have unable to obtain medical insurance are now able to do so.
The Patient Protection and Affordable Care Act was designed to significantly reduce the number of people who are uninsured through the provision of a continuum…
Second, the fact that medical costs are billed to health insurance companies is responsible for an industry-wide culture of financial irresponsibility where little concern is given to avoiding unnecessary or duplicated costs of healthcare services (Kennedy, 2006; eid, 2009). Unfortunately, political opposition to healthcare reform throughout 2009 made it impossible for the Obama administration to achieve this essential goal but it is likely that the current system cannot be sustained without bankrupting the nation.
One of the main reasons that there is so much political opposition to meaningful healthcare reform in the U.S. is precisely because current laws permit excessive influence by special interest groups in Washington (Kennedy, 2006; eid, 2009). Specifically, the private for-profit health insurance industry alone accounts for as many as 5 industry lobbyists per elected government legislator in Washington. By pledging financial support to political campaigns in return for opposition to any legislative reforms that could…
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.
The United States is relatively unique in the world community for offering healthcare through a variety of employer-provided and government insurance systems. While most US citizens obtain healthcare via their employers, others have health insurance via a variety of government-provided programs such as Medicaid or Medicare. Still others purchase their insurance from health insurance companies themselves because they do not receive employer coverage and are unable to qualify for Medicaid. This suggests that cooperation between insurance companies, providers, and the government is necessary to improve delivery, reduce costs, and expand access to all patients.
One of the first presidents to attempt to orchestrate broad-sweeping healthcare reform, Bill Clinton, recently underlined the need to embark upon reform in a collective and unified effort. “The former president called on attendees to embrace evidence-based medicine as a means to bend healthcare\'s cost curves and lauded Medicaid expansion as a means to keep health…
Q1. Personal Fitness Trackers
Even when personal fitness trackers present the same information, they can visually display the information in different ways. Regardless, the theory behind such trackers, and the ability to see how many steps, calories burned, and activity in relation to the activity engaged in the past, is that people are more motivated when they have concrete evidence of their improvement. What cannot be measured cannot be consciously changed. However, according to a study in The Lancet Diabetes & Endocrinology, in a randomized control study (the gold standard of academic research), using a fitness tracker had no effect on any measure of health or fitness (Finkelstein, et al, 2016). The fitness tracker used in this particular study was a clip-on tracker without a significant graphical interface. It is possible that the results may have been different, had the tracker been more pleasing in its presentation.
But even a…
Evolution of Nursing oles in an Enlarged National Health Care System
The Affordable Care Act enables the provision of health insurance to 30 million people above the coverage figures prior to the enactment of the law. Because of this precipitous rise in the number of health insurance members, access to care as a function of the availability of primary care providers has been a leading issue in the transition to the nation-wide system of health care insurance. Public health models and nursing practice arrangements are changing in order to meet the immediate and anticipated care needs that have been brought to bear on the health care systems.
Public Health and Nurse Managed Health Centers (NMHCs)
From the earliest days of public health, the roles of nurses have been embedded in the social, educational, and political needs of communities. Health education has functioned as a springboard to community organizing, patient advocacy,…
Centers for Medicare & Medicaid Services. (2005, January). CMS.gov. Retrieved from http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html
Kulbok, P.A., Thatcher, E., Park, E., & Meszaros, P.S. (2012, May). Evolving public health nursing roles: Focus on community participatory health promotion and prevention. The Online Journal of Issues in Nursing (OJIN), 17(2). DOI: 10.3912/OJIN.Vol17No02Man01. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No2-May-2012/Evolving-Public-Health-Nursing-Roles.html
National Conference of State Legislatures. (2012, September). The Medical Home Model of Care. Retrieved from http://www.ncsl.org/research/health/the-medical-home-model-of-care.aspx
Reid, R., Haggerty, J., & McKendry, R. (2002, March). Final Report. Defusing the confusion: Concepts and measures of continuity of healthcare. Canadian Health Services Research Foundation, the Canadian Institute for Health Information, and the Advisory Committee on Health Services of the Federal/Provincial/Territorial Deputy Ministers of Health. Retrieved from http://www.hpm.org/Downloads/Bellagio/Articles/Continuity/cr_contcare_e.pdf
Thereby we can conclude if their support or lack thereof for healthcare reform is based on understanding of facts, or is being shaped by other factors, ostensibly the information being made public by politically affiliated media and elected officials in support of one party or the other.
The Survey: Healthcare eform
I voted for President Obama
I support healthcare reform
I have health insurance or Government Program
I have Medicare
I have Medicaid
I have CHAMP/VA
I have TICAE
I have group benefit insurance
I have private health insurance
The Health Insurance Privacy
And Portability Act applies to me
The Employee etirement Income
Security Act applies to me
CNN (2009). Brown Wins Massachusetts Senate Race, CNN Politics, found online at http://www.cnn.com/2010/POLITICS/01/19/Massachusetts.senate/index.html, retrieved February 1, 2010.
Monette, D., Sullivan, T., and DeJong, C. (2008). Applied Social Research: A Tool for Human Services, Thomson Books, Belmont, CA.
The first phase, implemented in 2010, provides immediate access to a high-risk insurance pools for individuals excluded from healthcare coverage because of pre-existing conditions; it also allows children to remain covered under their parents' insurance plans until the age of 26 and provides tax credits to small employers that give their employees health insurance (Tumulty, Pickert, & Park, 2010). The second phase begins in 2011 and will require private health insurance companies to spend at least 80% of premiums on healthcare services; in 2013, Medicare payroll taxes will increase on the wealthiest individuals and families to enable that program to overcome the aby oomer problem (Tumulty, Pickert, & Park, 2010). In 2014, most Americans will be required to obtain health insurance to reduce the collective cost of treating the uninsured (Tumulty, Pickert, & Park, 2010).
Unfortunately the primary reason that healthcare reform was not able to incorporate more wide-sweeping reforms…
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.
Tumulty K, Pickert K. And Park a. "America, the Doctor Will See You Now" Time, Vol.
175, No. 13; (2010).
Nursing Practice Expected to Grow and Change
Ageing of population and healthcare providers, coupled with reforms to healthcare, will raise demands for professionals in the field, also expanding existing professionals' required skill sets and roles. Physicians, physician assistants, nurse practitioners, nurses, and medical assistants are included in this growth area. Fortunately, healthcare is characterized by a swiftly expanding and large workforce (with 23000 new entrants every month, nationally); this sector progressed even in recent economic recessions (Survey, 2013). Registered Nursing (RN) is one of the leading U.S. occupations which is projected to grow 26% and add the highest number of jobs by 2020 (an estimated 1.2 million RNs overall), as per U.S. ureau of Labor Statistics (Survey, 2013). This stems from a projected rise in demand, as well as a need for replacing the current ageing RNs. Nursing careers are being pursued in America increasingly; the number of students enrolled…
Buerhaus, P., DesRoches, C., Applebaum, S., Hess, R., Norman, L., & Donelan, K. (2012). Are Nurses Ready for Health Care Reform? A Decade of Survey Research. Nursing Economics, 329.
Dunbar-Jacob, J. (2011). The Changing Role of Nursing in Health Care Reform. Pittsburgh: Pitt Nurse. Institute for Nursing Centers Survey (2008). Retrieved from http://nursingcenters.org/PDFs/INC%20Highlight%20Report%2010_6_08.pdf.
NURSE-MANAGED HEALTH CENTERS. (2011). Retrieved from: http://www.nncc.us/pdf/NMHC_Quality_Standards.pdf
Pohl, J.M., Tanner, C., Barkauskas, V.H., Gans, D., Nagelkerk, J., & Fiandt, K. (2010). Nurse-managed health centers' national survey: Three years of data. Nursing Outlook, 58(2), 97-103
payer healthcare systems: Pros and cons
One of the most controversial concepts in American health care is the idea of single-payer health insurance, or the notion that healthcare will be supported by taxpayer dollars, versus funded by private insurance companies. In many Western industrialized nations such as the United Kingdom and Canada, the concept of single payer-health insurance is the norm and embraced by the majority of the population. In the United States, the rhetoric of socialism and state support has caused people to fear the concept. Even the Affordable Care Act (ACA) was painted by some aspects of the media as a move towards a single-payer system because it exerted somewhat greater control over individual's health-related choices, such as mandating that all American citizens have health insurance. However, the ACA was far from socialized medicine given that it continued to ensure that the majority of Americans not on Medicaid…
Cooper, E. & Taylor, L. (1994). Comparing health care systems. Good Medicine. 39: 35.
Retrieved from: http://www.context.org/iclib/ic39/cooptalr/
Massachusetts Healthcare Reform: Six years later. (2013). Kaiser Family Foundation. Retrieved https://kaiserfamilyfoundation.files.wordpress.com/2013/01/8311.pdf
McDonough, J. (2015). The demise of Vermont's single payer system. New England Journal of Medicine. 372: 1584-1585.
Prescription for Health Care System Stakeholders
Discuss Dr. Wilson's "prescription" for the private sector, business, and government. Do you concur with this prescription? Why, or why not?
Dr. Wilson believes that healthcare reform is among the biggest priorities that will challenge the entire spectrum of people who are involved, either directly or indirectly, with the healthcare system. There are many different perspectives that are involved in the series of reforms who are at different levels. However, treating patients in an efficient and effective manner, while also providing the best health outcomes possible, is the basis for guiding reforms; albeit, many of the different stakeholders have significantly different ideas about how to achieve such objectives. Dr. Wilson further believes that there are four points of major friction in the system and offers the prescription for challenges that will be present in order to make health system reform a success: medical liability,…
Butler, M. (2014, September). Healthcare DIY: Empowering Consumers to Optimize their Healthcare through Health Information. Retrieved from AHIMA: http://library.ahima.org/doc?oid=107435#.V223Omf6vWI
Wilson, C. (2010, August 2). A prescription for health care system stakeholders. Retrieved from amed news: http://www.amednews.com/article/20100802/opinion/308029956/5/
Then, when you combine this with the fact that Medicaid serves 53 million people with an annual budget of $329 billion, means that rising costs is severely affecting this program. ("Medicaid Reform," 2005) the inflexibility of this program has contributed to problem as a one size fits all approach is taken. Then, when you combine the different state programs offered through Medicaid, means that an uneven standard of inflexibility is used. An illustration of this can be seen by looking no further than the overall focus of Medicaid, where an emphasis is placed on addressing major health issues. This is problematic because like with Medicare, an approach must be taken of dealing with the patient once they are facing major health issues. Then Medicare has to engage in multiple functions to include: comprehensive acute / primary care, long-term care services (for those who qualify), a source of funding for uncompensated…
Medicaid Reform. (2005, June 15). Retrieved March 3, 2010 from National Governors Association website:
President Cuts Medicare, Medicaid to Help Reform Costs. (2009, June 15). Retrieved March 3, 2010 from California Health Line website: http://www.californiahealthline.org/articles/2009/6/15/president-outlines-cuts-to-medicare-medicaid-to-help-cover-reform-costs.aspx
Anderson, L. (2009, July 9). Research Project Finds Medicare Part D Increases Spending on Prescription Drugs.
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.
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…
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+.
Assessing the ability of these individuals to perform basic tasks in their daily lives can also have much significance (Marshall, Warren, Hand, Xie, & Stumbo, 2002). Many older Americans are able to feed and clothe themselves without apparent problems, but others are not as fortunate (Marshall, Warren, Hand, Xie, & Stumbo, 2002). If they are unable to do these things correctly without help, their nutritional status will often suffer (Marshall, Warren, Hand, Xie, & Stumbo, 2002). Patients who are older should be assessed for their ability to do these simple tasks, and also for their ability to perform slightly more complex tasks such as fixing their own meals, cleaning their house, and balancing their checkbook (Marshall, Warren, Hand, Xie, & Stumbo, 2002). Sometimes cognitive impairment will lead to a lack of nutrition, and when this is the case, it often shows up in forgetfulness and an inability to perform even…
Bartholomew LK, Parcel GS, Kok G, & Gottlieb NH. 2001. Intervention Mapping: Designing Theory and Evidence-Based Health Promotion Programs. Mountain View, CA: Mayfield Publishing Company.
Collinsworth, R., & Boyle, K. 1989. Nutritional assessment in the elderly. Journal of Gerontological Nursing 15(12): 17-21.
Gambrell, K.A. 2003. White House rolls out Medicare reform plan. United Press International.
Industry Group 91, 2000. President Clinton releases new state-by-state report demonstrating urgent need for Medicare reform. Regulatory Intelligence Data.
Healthcare Legislative Bill
The expanded and improved Medicare for all Acts
The Expanded and mproved Medicare for All Act was introduced to the House of Representatives in 2009 and seeks to lobby for the implementation of a common single-payer health care system throughout the United States o0f America. The bill if enacted would require that all medical care costs be paid for automatically by the government instead of private insurances for the same. The move will significantly alter the role of private insurance companies as merely offering supplemental coverage especially when the kind of medical care sought is not all that essential (McCormick, 2009).
With the Expanded and mproved Medicare for All Bill, the country's national system will be paid for through taxes and the monies that will replace the regular insurance premiums. Proponents of the bill argue that by eliminating the need for private insurance companies in the national…
Institute of Medicine of the National Academies of Science, (2010), Insuring America's Health: Principles and Recommendations
The American Journal of Medical Practices, (2011), The Impact of single-payer Medicare
Program, New York
First of all only a scant few of these Veterans groups will acknowledge the "promise" of free health care; for the most part these groups will tout the benefits already promised by the Veterans Administration and assert that cuts in these benefits are the same a broken promise-or contractual breach in legal terms. The idea of the United States military making a "promise" or forging a legally binding agreement between individual veterans or groups of veterans is barred by the United States Constitution. As will be demonstrated in the Literature eview, specific Constitutional language from Article I give Congress and only Congress the express authority to make laws and regulations pertaining to the armed forces. Therefore, the idea the military breached a contract with service members is, ultimately, inherently inaccurate. Combining the lack of specific language within the materials provided by any governmental agency with the clear language of the…
.... (n.d.). The RETIRED MILITARY ADVOCATE. The RETIRED MILITARY ADVOCATE. Retrieved November 29, 2010, from http://mrgrg-ms.org/
Best, R. (2003, August 7). Military Medical Care Services: Questions and Answers. Congressional Research Service, 1, 1-17.
Birkey, a. (2010, July 21). Fraudulent vets charity raised big money in Minnesota. The Minnesota Independent, p. 3.
Burrelli, D. (2008, August 12). Military Health Care: The Issue of Promised Benefits. Congressional Research Service, 1, 1-14.
history of the League of Women Voters rightly begins with the very inception of the Women's Movement and the fight for liberation in the United States. During the early history of the United States there was little, if any respect for the principles of women's rights. In an intensely patriarchal society a man " ... virtually owned his wife and children as he did his material possessions. If a poor man chose to send his children to the poorhouse, the mother was legally defenseless to object." (Women's History in America) The history of women's movements in the United States is largely a reaction to this system of exclusion and male-dominance.
The start of the history of the fight for women's rights begins with a tea party hosted by Elizabeth Cady Stanton, in New York. Mrs. Stanton expressed her feelings of discontent at the situation of women in society. This meeting…
A biography of America: The sixties. learner. February 13, 2005.. http://www.learner.org/biographyofamerica/prog24/feature/
Eisenberg B. And Ruthsdotter M. Living the Legacy:
The Women's Rights Movement 1848 -- 1998. February 12, 2005. http://www.legacy98.org/move-hist.html
LEAGUE OF WOMEN VOTERS. Houghton Mifflin. February 13, 2005.
Even with all of this federal intervention, however, the issue of Americans being able to afford healthcare would rear its ugly head time and time again in the succeeding decades. This issue would be tossed about like a political hot potato until the election of President Bill Clinton, when then First Lady Hillary Clinton embraced the issue of affordable healthcare for all Americans and made an attempt to institute a nationalized healthcare system, much like the ones that have worked in nations like Canada and Great Britain. The Clintons unfortunately met with intense resistance to the plan on the federal level, and their system never came to full fruition. Ironically, however, the Clintons did manage to make meaningful change in American healthcare through their proposed plan. The mere threat of federal control over the monopolies that many American healthcare companies enjoy led in many cases to the freezing of rates…
Behreandt, D. (2005, September 5). The Best Healthcare in the World: Our Healthcare, Though Impeded by Government Intervention, Is Still the World's Best. Adopting a Single-Payer Socialized System Would Lead to Shortages, Frustration, and Failure. The New American, 21, 21+.
Dionne, E. (1997, January 17). The Democrats Are More United Than They've Been for Years. But They Still Cannot Suppress Deep Divisions on Fundamentals. New Statesman, 126, 26+.
Gottschalk, M. (2000). The Shadow Welfare State: Labor, Business, and the Politics of Health-Care in the United States. Ithaca, NY: Cornell University Press.
Heirich, M. (1998). Rethinking Health Care: Innovation and Change in America. Boulder, CO: Westview Press.
Healthcare professionals offer their services to the community whilst taking care to fully respect people's dignity. Doctors need to earn public confidence by dedicating their skill all equally, and to the best of their ability. A number of professional organizations supporting doctors in ensuring public safety exist, two of which are the ANA (American Nurses Association) and the AMA (American Medical Association). In this paper, the two aforementioned organizations' standards and functions will be analyzed.
A clear identification of the professional boards
The ANA represents its 3.6-million-strong registered nurse (RN) workforce's interests. Its goal is attempting to advance the profession of nursing through the promotion of superior practice standards (American Nurses Association, 2016). Meanwhile, the AMA represents a professional organization chiefly engaged in publishing studies geared at advancing public health, in addition to advocating for licensed doctors' interests. It participates in the areas of Obamacare implementation, healthcare IT, Medicare/Medicaid, improvements…
Drug costs have gone from 26% of health care spending by private insurance companies in 1990 to 44% in 2006 (Kaiser Foundation, 2008). This issue has not been adequately addressed by health care reform. Instead, a deal appears to be made for $80 billion in concessions from the pharmaceutical industry in exchange for its support of health care reform (Kirkpatrick, 2009).
The underlying trend in each of these major issues in health care reform is controlling the rising cost. Malpractice reform seeks to control the cost of insurance to health care providers, so that they can pass those savings along to consumers. The public option provides a plan for affordable health care coverage for uninsured and underinsured Americans. This is deemed necessary because private insurers will not offer insurance to those it feels will demand too much in terms of health care costs going forward. Reducing the cost of health…
Carey, Nick. (2009). Uninsured Americans hope reform brings health coverage. Reuters. Retrieved October 7, 2009 from http://www.reuters.com/article/topNews/idUSTRE58F0NO20090916
The White House. (2009). The Obama Plan: Stability and Security for All Americans. Retrieved October 7, 2009 from http://www.whitehouse.gov/assets/documents/obama_plan_card.PDF
New York Times. (2009). Malpractice and Health Care Reform. New York Times. Retrieved October 7, 2009 from http://www.nytimes.com/2009/06/17/opinion/17wed2.html
Kaiser Family Foundation. (2008). Prescription Drug Trends. Kaiser Family Foundation. Retrieved October 7, 2009 fromhttp://www.kff.org/rxdrugs/upload/3057_07.pdf
The benefits to joining this and other professional nursing associations around the nation include having a strong voice and a fellowship with others who spend their careers helping patients and families during times of need.
There are several ways that affiliating with a professional nursing association can provide this including:
Federal lobbying on issues important to nursing and health care.
State lobbying through our State Nurses Associations and nationwide state legislative agenda on issues vital to your scope of practice.
epresenting nursing where it matters, including the Environmental Protection Agency, Department of Labor, the U.S. Department of Health and Human Services and many others, right up to the White House.
Speaking for nursing through the media including stories in the Wall Street Journal, Chicago Tribune, USA Today, 60 Minutes, NBC Nightly News, CNN, and NP to name a few (Your guide to the benefits of membership... (http://nursingworld.org/member2.htm)."
American Nurses Association (ANA): Become a Member Today!
Discounts on products and services
Discounts on online degrees
Discounts on certification exams
Career center access
Professional liability insurance products
Subscriptions to periodicals
Mission of the ANA: "Nurses advancing our profession to improve health for all,' ("About ANA," 2012).
Interested in public policy reform and political activism related to healthcare?
You've come to the right place!
One of the express functions of the ANA is "lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public," ("About ANA," 2012). "Through ANA's political and legislative program, the association has taken firm positions on a range of issues including Medicare reform, patients' rights, appropriate staffing, the importance of safer needle devices, whistleblower protections for health care workers, adequate reimbursement for health care services and access to health care," ("Statement of Purpose," 2012)
"FAQ's," (2012). Retrieved online: http://www.nursingworld.org/FunctionalMenuCategories/FAQs#member
Nursezone (2012). Retrieved online: http://www.nursezone.com/Advancing-My-Career/professional-organizations.aspx
"Statement of Purpose," (2012). AMA. Retrieved online: http://www.nursingworld.org/FunctionalMenuCategories/AboutANA/ANAsStatementofPurpose.html
usiness Management: Staffing Practices & Selection Tools:
Analysis of a Pharmaceutical Organization
In the past few decades, globalization and technology are two emerging trends that play a significant role in any organization's staffing practices and selection tools used to meet current and future employment needs. oth globalization and technology pose dilemmas for any pharmaceutical company with a large number of promising drug candidates. This paper examines and analyzes the staffing practices of Pfizer in its position as a leading worldwide pharmaceutical company. Pfizer is a good example of a company whose staffing practices have met their current employment needs and continues to meet future employment needs. This company is in an excellent position, as demonstrated by the fact that its overall sales exceeded $45 billion in the last year, up 40% over the previous year (Pfizer, 2004). This strong financial performance has its roots in the employees that comprise the…
International Monetary Fund. (2002). Globalization: Threat of Opportunity? Retrieved
May 31, 2005 from the International Monetary Website:
Pfizer. (2004). Pfizer. Retrieved May 31, 2005 from the Pfizer Website:
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.
In 2000 legislation was presented by Ralph Klein to the legislature, demanding that provinces be permitted to allow private hospitals. That same year, more budget cuts slammed the health systems, when the "Federal udget offers 2 cents for health care for every dollar of tax cuts." (Health Coalition) in 2002 the Romanow Royal Commission on the Future of Health Care in Canada was created to investigate the health-care situation in the nation and to foster (and witness) public discussion on the subject. Their report was presented in Ottawa towards the end of the year, and in 2003 some of its suggestions regarding intelligent use of federal funding were implemented. The commission, in general, supported the continuation of universal care. However, the 2003 "Health Accord" did not include any ruling against the use of federal funding contracted out to for-profit institutions (a situation that some critics claim is part of the…
Axworthy, Lloyd & Spiegel, Jerry. "Retaining Canada's health care system as a global public good" Canadian Medical Association Journal, Aug 20,2002; 167 (4), 365-366
Canadian Institute for Health Information. Health Care in Canada.
Canadian Institute for Health Information: Ottawa, 2004.
Choudhry, Sujit. "The Enforcement of the Canada Health Act" McGill Law Journal, vol 41; 462-510
eimbursement Ethics and Compliance: Impact of Health Care eform on Medical Coding and Billing
"Medical billing and coding lays the foundation for any successful healthcare provider," yet its common practices are undergoing significant changes under the recent proposal for health care reform (Griffey, 2013). The nature of medical coding and billing is increasingly becoming more and more complicated. The recent healthcare reform legislation, passed in 2010, promises to complicate the situation even further. Such reforms will undoubtedly have a huge impact on medical billing and coding processes.
The reform bill was a monumental piece of legislation passed by Pres. Obama and his Democratic supporters in 2010. There are a number of stipulations which aim to help increase access to appropriate health care for millions of Americans who are currently without any coverage, helping lower the cost of premiums too much more affordable rate for most Americans but also increasing the…
Eastaugh, Ben & Sternal-Johnson, Chris (2010). What will health care reform do to medical billing? MD Alliance Billing. Web. http://mdalliancebilling.wordpress.com/2010/03/22/what-will-health-care-reform-do-to-medical-billing/
Griffey, Kimberly. (2013). Medical billing and coding and health care reform: What you need to know. Ultimate Medical Academy. Web. http://info.ultimatemedical.edu/blog/bid/276367/Medical-Billing-and-Coding-and-Health-Care-Reform-What-you-Need-to-Know
Hart, Bradley. (2012). Ethics in Medical Coding: Theory and Practice. McGraw Hill.
Jackson, Jill & Nolen, John. (2010). Health Care Reform Bill summary: A look at what's in the bill. CBS News. Web. http://www.cbsnews.com/8301-503544_162-20000846-503544/health-care-reform-bill-summary-a-look-at-whats-in-the-bill/
Healt Care Policy
Te government of te United States can influence ealt policy in many ways. Specifically, Congress as te autority to pass laws affecting te ealt care system in te country. Most recently tey debated te new ealt care law tat was passed in 2009. Tis debate was primarily between te Republicans in Congress, wo felt tat easier access to existing private insurance plans was te key to overauling te system, and te Democrats, wo preferred a government run plan to compete wit te private plans (Keefe, 2009).
Te President as te role of ceerleader and adviser, witout a direct role in passing laws. President Obama went on te campaign trail to try to rally people to is side and convince tem tat is plan to cover te uninsured, lower costs, and improve care (Stolberg, 2009). Te President can elp steer te discussion towards te direction e would like…
Antos, J. (5 Aug 2010). A mistaken prognosis for Medicare. The American. Retrieved from:
It appears the dangers of a commercialized healthcare system have demonstrated that this beastly practice of profiting off the sick is not good for the society at many different level it contains.
Healthcare discussions of this matter do not belong in a committee that is dedicated to commercial purposes. Medicare and Medicaid were successful in the past in spite of the many governmental forces that played a role in their existence, but like all things these are old and obsolete ways of dealing with this current crisis of confusion.
A philosophical mindset, absent from this meeting, that included individual responsibility and preventative efforts to maintain health should be emphasized from leaders. Safety can never be guaranteed, neither can good health, so to offer such promises of universal coverage is over-idealistic if not criminally negligent. Like the answer to most problems, the solutions are local and come from within communities and…
Health Care eforms
Healthcare reform has been a national issue for some time and the ability to afford citizens the opportunity to adequate healthcare services is an interesting debate with many ideas and arguments both for and against the practice. To help understand the finer meanings of what health care reform laws can impact on a region it is necessary to examine the impact of such reforms on a selection of states.
The purpose of this essay is to compare and contrast the varying health care reform laws of three differing states. This essay will examine Maine, Vermont and Massachusetts transformations in healthcare laws to help contextualize the law and demonstrate its feasibility, or lack of feasibility within the real world
The impetus for the attention given to health care reform has no doubt started due to the efforts of the Federal Government's involvement in regulating medical treatment through policy…
Bragdon, T. & Allumbaugh, J. (2011). Health Care Reform in Maine: Reversing "Obamacare Lite.." The Heritage Foundation, 19 July 2011. Retrieved from http://www.heritage.org/research/reports/2011/07/health-care-reform-in-maine-reversing-obamacare-lite
Grubb, L. (2013). Lessons From Vermont's Health Care Reform. The New England Journal of Medicine, 4 April 2013. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMp1212974
Maine.gov (nd). Individual Health Insurance in Maine. Viewed 6 June 2014. Retrieved from http://www.maine.gov/pfr/insurance/consumer/IndividualHealth.html
Vermont State Senator Tim Ashe Website (2011). Vermont Health Care Reform Explained. March 2011. Retrieved from http://www.timashe.com/vermont-health-care-reform-explained-in-simple-terms/