Using of Health Services - Assignment Example

Using of Health Services 1. What is access in regard to personal health services? Describe and explain the details of the behavioral model of health services use. How do you believe access influences the health of individuals? What other factors influence health? Describe a current unresolved access issue and your recommendation to address / resolve it. Access to healthcare means the ability of an individual or a family to avail of medical facilities and treatments if and when they need it most. Today, access to healthcare is available to only the middle classes in the United States. The country, in spite of being the world’s leading economic power, has failed to provide health insurance for a significant section of its population (nearly 50 million citizens) and provides only poor quality healthcare for the rest. For example, among all the advanced economies of the Western world, the United States holds the notorious distinction of poor health outcomes and high healthcare costs. Even our northern neighbor Canada has a better healthcare system, with the help of an effective public option (Krugman, 2010). The way in which the United States healthcare system works means that universal free basic health care had disappeared. Employers who previously provided insurance coverage for their employees no more have the necessary funds to continue such plans. Drug prices have gone up overall and patients end up paying for services that their condition does not warrant. Another major area of concern is the cuts to Medicaid, which had for so long supported children’s hospitals with nearly half its revenue. Congress’ impending cuts to Medicaid support, though may help reduce the federal deficit, certainly is bad news for pediatric care (Carter et. al. 31). Financial support for research grants is likely to reduce. When eventually these reductions would be enacted, pediatric centers would require tighter budgets in all areas. The one-size-fits-all approach to children’s health care is another area of concern. Children’s special needs and their unique physiology are overlooked in the prevailing medical practices. However, efforts on part of the FDA and other administrative organizations in getting child-friendly devices and methods implemented, is perceived as a move in the right direction. The fact that pediatric services do not generate substantial revenue for drug and equipment companies has been a major disadvantage in pushing for reforms in this area (Tepper & Terry 70). Even the former chief of the World Health Organization agrees that there is a disconnection between wealth creation and wider access to public health as a result of globalization. This excerpt is from a speech by Dr. Gro Brundtland, the former Director-General of the World Health Organization, at the World Economic Forum on January 29, 2001, emphasizes this point. “Technologies are spreading, communication is worldwide, people know what is available, and yet the dramatic gaps and lack of access become greater and greater. We must look upon the world as a shared responsibility so that we deal with the gaps and help those technologies become available for those who don't have access. That's the only way to keep globalization from becoming really unhealthy.” (Brundtland, 2001) 2. Who pays for medical care and in what amounts / percentages by general trends? How does this influence the provision of medical care? Identify several methods that have been used to contain health care costs and their impact. Describe a current unresolved cost issue and your recommendation to address / resolve it. A major worry here is the fact that the high costs of healthcare in the United States do not necessarily buy the best health care services. The chief concern for corporations like GM and Ford is the ever growing healthcare costs and massive healthcare liabilities. A recent trend has been for major industrial corporations to shift their bases across the border to Canada, where the government provides better support for employee health insurance. There is also a push for healthcare reform to mimic the Canadian system. In fact, under Bill Clinton, such a move was aborted in the last minute due to pressure from insurance and pharmaceutical companies. It is widely agreed that the current crisis in the US health care system is due to higher prices for pharmaceuticals, physicians and hospital care. Although there is consensus among policy makers as to what should be done to alleviate this problem, the required political will seems to be lacking. Rather than trying to reduce prices, attempts have been made by politicians to reduce access to healthcare and service consumption (Tepper & Terry). Even with the current estimates on projected Medicare and Medicaid savings, as well as savings from capping deductions for the rich, there is bound to be a “potential shortage of $300 billion to $600 billion of additional revenue because most estimates of 10-year cost of full coverage are in the range of $1.2 billion to $1.5 billion (with some estimates being as high as $2 billion)” (Wilensky, 2009). But we have to remember that a deficit of $300 to $600 billion over a ten year time frame pales in comparison to the $700 billion bailout that was handed to the failed financial institutions of our country. Surely, there is something sinister about our economic system, when privately owned and run banks are given preference over the health and wellbeing of millions of citizens. The true reason for the prevailing healthcare stalemate is the strong corporate influence over our democratic institutions. This is reflected in the choice of staff members in the executive branch of government, the handpicked appointments to posts in judiciary, the corporate funding of candidates during election campaigns, etc. Again, Wilensky fails to mention the crucial fact that the reason healthcare reform became an election issue last year is because of pressure from large business corporations such as GM and Walmart, to alleviate their expenditure toward employee health insurance (Richmond & Fein, 2007). This suggests that legislative changes take place in our country only when one or other of the corporate groups will the government to make favorable changes. It then begs questions about the nature of our democratic institutions and whether or not we have a functioning democracy in the first place. Such contrasting viewpoints on the reasons for the healthcare inaction are expressed by noted documentary filmmakers such as Michael Moore, as well as prominent left-wing intellectuals like Howard Zinn, Noam Chomsky, Paul Krugman, etc. According to these alternative voices of reason, meaningful progress, in healthcare or in other aspects of society and economy, will not come about, until we address the broader systemic flaws. 3. What is quality health care? How does the health care system assess and assure quality health care services? Does the United States provide the same quality of medical care to everyone? Why or why not? How is quality related to access and cost? Describe a current unresolved quality "issue" and your recommendation to address / resolve it. The litmus test for the efficiency and effectiveness of any public health system is its performance in a crisis situation. Civil societies have come to expect basic protections at the time of these crises. Such emergencies also test a government’s true ability to act under pressure. In other words, “they define a state's capacity to protect its population while exposing its vulnerabilities to political upheaval in the aftermath of poorly managed crises” (Gorin, 2002). In the context of economic globalization at the turn of the new millennium, more than ever before, the general public demand transparency and accountability in global public health systems during medical and natural disasters. To gauge the robustness of public health systems in this new globalization paradigm, we need to study recent cases of acute public health emergencies. In this context Hurricane Katrina is particularly relevant to this analysis. It was a reflection of the inadequacy of the American healthcare system that it “accepted bilateral and multilateral relief aid, a rare event in modern times”. (Burkle, 2006) Recognizing the present quality issues with the healthcare system in America, the World Health Organization report suggests a comprehensive array of changes to give Americans world class health care. These recommendations could have the widest impact on patients, families, and communities, including treatment of people with substance abuse and more aggressive management of obesity. “The report focuses many of its recommendations on improving care for patients with chronic health conditions. Other areas include evidence based cancer screening; preventing complications from the frailty associated with old age, such as falls and bedsores; and treatment of hypertension, immunization, and depression. A further eight areas are reducing medical errors; preventing infections; pain management; prevention of stroke; treatment of severe mental illness, diabetes, and asthma; and the prevention of risk factors for conditions such as coronary heart disease.” (Wakefield 262) Such recommendations were concurred by the Institute of Medicine, which advises the US Congress on medical issues. There is strong proof that shows that carrying out these proposals to the word will bring the healthcare industry’s performance on par with advances in medical technology. So, while the US healthcare system is more advanced in terms of technology, optimal use of the same is not being made as of now. (Coghlan). Furthermore, quality of healthcare is undermined due to the American government’s impotency to negate the influence of vested interests. Recently, the US government dismissed a connection between junk food and obesity in a confidential letter to the director general of the World Health Organization. This is not a good sign for the health and well-being of the American people. This episode is one more to the long list of events where private business interests have superseded all others, especially quality concerns. (Wakefield 266). Continuing in the same vein, the U.S. Food and Drug Administration (FDA) decision in May 2004 not to allow over-the-counter sales of the morning-after pill, Plan B, is but one troubling example of the increasing impact of politics and ideology on science and health policy. The agency's ruling, contrary to recommendations from an external advisory panel and its own scientific staff, is indicative of the growing gap between common sense and U.S. policies affecting the well-being of women and girls (Bodenheimer 799). What are needed at this juncture is progressive developments such as the Wakefield Act, which was successfully ratified by the Senate Committee on Health, Education, Labor, and Pensions. This legislation keeps alive efforts to continually improve emergency care for children. It focuses on reaching out, caring and providing solace for children engulfed by pain and suffering (Wakefield 266). 4. Write a letter to a current government official regarding a current health care issue that is amenable to government action. Ask for an appropriate reply to you from the official. Respected Sir/Madam, Social determinants of health such as geographical location, gender, age, ethnic origin, education level, governance and socioeconomic status are all factors that determine a nation’s public health system. Even as American society enjoys technology aided interconnectivity, hundreds of thousands of people are still living under hostile health conditions. While the rich among us are getting richer, a significant percentage of our compatriots are still confronting poverty, hunger, illiteracy and threat of infectious disease on a day to day basis. Such a situation betrays the socio-political realities of the region, with its attendant failure to invest in public health projects. Also, the US health-care system represents a competitive disadvantage for all other allied industries. And the need of the hour is a Canadian-style reform, although is unlikely to gain popularity with Corporate America. What needs to be dismantled are the numerous legislative grants intended to entrench private insurers, in spite of data indicating administrative pillage among private insurers consumes nearly 17% of US health-care spending. Hence, it is my humble request to you to look into such issues and act accordingly. Despite being the richest nation in the world, we lag behind our neighbour north of the border and other European nations in terms of quality of healthcare and the costs incurred therein. This is a blemish in an otherwise illustrious achievements of our nation, and it is high time that people in authority, like yourself, take constructive action in remedying the situation. I kindly request you to reply to me with your possible course of action in achieving this result. Primary Reference: Andersen, Ronald M., Rice, Thomas H., and Kominski, Gerald R. (Eds.). 2nd ed. Changing the U.S. Healthcare System. San Francisco: Jossey-Bass, 2001. Secondary References: Brundtland, G. H. (2001, January). Achieving Global Health Equity. Presidents & Prime Ministers, 10, 28. Burkle, F. M. (2006). Globalization and Disasters: Issues of Public Health, State Capacity and Political Action. Journal of International Affairs, 59(2), 241+. Eisenberg, J. N., Desai, M. A., Levy, K., Bates, S. J., Liang, S., Naumoff, K., et al. (2007). Environmental Determinants of Infectious Disease: A Framework for Tracking Causal Links and Guiding Public Health Research. Environmental Health Perspectives, 115(8), 1216+. Mann, J. M. (1997). Medicine and Public Health, Ethics and Human Rights. The Hastings Center Report, 27(3), 6+. Bodenheimer, Thomas. "Innovations in primary care in the United States. (Primary Care in the United States)." British Medical Journal 326.7393 (April 12, 2003): 796(4). Coghlan, Andy. "A health fad that's hard to swallow: dietary supplements are more popular than ever. But we don't know if they do us more harm than good." New Scientist 182.2442 (April 10, 2004): 6(2). Dyer, Owen. "US government rejects WHO's attempts to improve diet.(World Health Organization)." British Medical Journal 328.7433 (Jan 24, 2004): 185(1). Tepper, Carl D., and Terry R. Lied. "Trends in Medicaid prescribed drug expenditures and utilization.(Medicaid Highlights)." Health Care Financing Review 25.3 (Spring 2004): 69(10). Webster, Paul. "US big businesses struggle to cope with health-care costs: General Motors president Rick Wagoner caused controversy when he blamed the US health-care system for his company's near-bankrupt status. But, as Paul Webster explains, health care and the US and Canadian automotive industry's economic decisions are increasingly interlinked.(World Report)." The Lancet 367.9505 (Jan 14, 2006): 101(2). Richmond, Julius & Fein, Rashi (2007), The Health Care Mess: How We Got into It and What It Will Take to Get Out, Harvard University Press. Krugman, Paul (July, 2009), Why markets can’t cure healthcare, Column in New York Times, retrieved from http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/ Gail R. Wilensky (August, 2009), Healthcare Reform: A Work in Progress, retrieved from http://www.hfma.org/hfm/2009archives/month08/HFM0809EOW.htm> Read More