The US Healthcare Delivery System and Drivers for Change - Essay Example

The US Health Care Delivery System and Drivers for Change affiliation The US Health Care Delivery System and Drivers for Change Most developed countries, unlike the US that has a unique system of healthy delivery, have national health insurance programs run by the government and financed through general taxes. In this case, almost every citizen in these countries is entitled to receive health care services including a routine and basic health care. In other words, in contrast to the US, most developed countries have what is known as universal access to health care. While the U.S. health care delivery system has evolved in reaction to mounting concerns about access, cost, and quality, the system has been incapable of providing a basic package of healthcare at an affordable cost to the public (Berry, 2011). Among the barriers to universal coverage is the pointless fragmentation of the U.S. delivery system. Nonetheless, the gigantic challenge of expanding access to healthcare while containing overall expenditures and maintaining or exceeding the expected levels of quality continues to intrigue policy makers. The diverse delivery-system reform provisions of the Affordable Care Act and the Reconciliation Act and the Patient Protection, known together as the Affordable Care Act (ACA), all struggle to achieve “Three Part Aim”- a focus on the improvement of experience individuals in seeking healthcare, lowering per capita costs, and improving the health of populations. For the US to achieve these goals, not only does the existing payment models need to change or be reformed but also the entire health care delivery system (Sharfstein, Fontanarosa, & Bauchner, 2013). This will include taking on board the key drivers of change; for instance change in volume patients in need of medical care, a shift to non-hospital outpatient service, preventative care, changes in consumer demographics, and lastly wellness promotion and protection. Drivers of Change in the US Healthcare Delivery System The above drivers for change have had a great impact on healthcare. This shift to non-hospital services, for instance, has had a dramatic effect on hospital revenue. The overall number of outpatient surgeries has augmented, but the hospital share has dwindled. Between the year 1981 and 2005, hospital share of surgeries went from 35 percent to 45 percent, freestanding ambulatory centers, on the other hand, went from 2.5 percent to 38 percent, and physician office surgeries went up from 2.5% to 17% (Darling, 2010). Such a vivid change in the revenue stream has definitely affected hospitals to the extent of working on finding other ways to increase their sources of revenue. Cost of healthcare delivery continues to rise; this, linked to errors due to inefficiency, and lastly demand boil down to what we have been learning for the past eight weeks; cost, quality, and access. As mentioned earlier, changing in consumer demographics is another driver for change in the US healthcare delivery system. The increase in life expectancy means that there will be a skewed dependency ratio. The aging population, in general, will strain the existing health care infrastructure. As the number of elderly people escalates, there will be an upsurge in the need to provide long-term care. Overall, nursing homes do not have a splendid reputation as a place to take the aged so for many families this is definitely a choice of last resort. The main advantage with these homes is that elderly patients receive special services that they might need. Such services include speech or physical therapy. For most of the elderly population, however, they would prefer staying in their own homes instead. Another option the elderly have, actually a better one, is Senior Day Care. This is not for every aged person but for those with someone to care for them in their home but cannot be left alone at home during the day. Such a facility functions much like the common child day care except that there is usually a nurse on site to administer medication to the seniors. Reforms in health care One change that will have some of the greatest impacts on the future of the US health care delivery, to begin with, is the implementation of a working electronic medical record (EMR). There are particular reasons why an EMR is important. To begin with, as it is programmable, the EMR is accessible 24 hours, 7 days a week. Several caregivers can view the recorded information concurrently while being available from any location given the appropriate access is available (Odier, 2010). Unlike the paper record, the EMR is usually present and eligible since it is not prone to damage from weather or tear and wear. Secondly, with communication being a contentious issue in health care, the EMR provides superior communication between the health care providers. Messages can easily be passed between health care providers and will always be available for future reference on the patient record. An EMR, also, will assist with managing the usually intricate prescription history thus preventing medication errors or the common duplication of written prescription. Another great advantage with the EMR is that it will contain all the lab test and radiological studies a patient has gone through thus thwarting replication of services when patient is transferred to other healthcare givers. The EMR will be even more valuable as its alerts in decision support regarding health care will aid health care providers with better patient management skills. These alerts to any medication interaction will be invaluable in the reduction of medication errors (Chernichovsky & Leibowitz, 2010). Alerting health care administrator of critical lab results, allergies, and radiology reports is something only an EMR can do. If the implementation is successful, achieving cost effective, quality and easily accessible health care will be an easy target. Secondly, since in most developed and developing countries people use insurance across country lines, the United States consumers should be able to use theirs across state lines. Due to the development and industrialization in the United States, people move around quite often. Unfortunately, this has been known to poses a threat in terms of Individual health insurance since the insurance carriers are separate companies and differ from State to State in that health insurance never transfer across the State lines (California Health Insurance, 2010). It is very unfortunate that such essential laws such as those governing medical insurance can limit an individual’s access to health care; it should be possible to use insurance across the country. The implementation of polyclinics across the United States, thirdly, should be a priority the country should focus on. Grinnell Regional Medical Center has already introduced something along these lines in their community (Sparer, 2011). Grinnell operates numerous community clinics, including the Grinnell Regional Community Care Clinic (GRCCC). Their motto, which focuses on providing area residents access to free quality medical care (Grinnell Regional Medical Center, 2008, para. 2) has proven to be a success. The health care specialists at GRCCC volunteer a part of their time to the community in that if more health care providers would volunteer just time to see patients, then there could be care brought closer to more people in the society. The United States can borrow a lot from Cuba and their implementation of Community Care Teams and volunteering. Although a resource poor country, Cuba is health care rich. About forty years ago, they learned that health care comes first and should be made available and easily accessible to all. Currently, Cuba is exporting its vision of community health care with its medical students. If the US borrowed such an idea from Cuba, then the issue of giving back to the community would come out strong and this will help in ensuring that the relationship between patients and doctors is maintained and is bearing the required fruits. The Frontline program, on matters concerning health in Sick Around the world, states that there are precisely four models of health care. These models have something that the United States uses to make up its fragmented system. Mr. Reid, at the end of the documentary transcript, gives an excerpt from his book that sums up the US health care confusion splendidly. On the other hand, the last part of the documentary Salud depicts the exceptionally ambitious efforts of Cuba to provide students from all over the world, precisely the Latin America, Africa, and, unbelievably, the US with free medical training. In two notable cases, a lad from Honduras and a young woman from Caracas tell of being motivated to become doctors after watching the selflessness depicted by the Cuban doctors. If the US, as powerful as it is, borrowed such ideas from Cuba and instigated them on their healthcare delivery system, there would not be much trouble in implementing the aforementioned reforms. Conclusively, although there are already factors that are leading the shift in the drivers for change in how healthcare is delivered to the US citizens, it is unlikely that the country is prepared to cope with such change. That the US is a developed country yet the implementation of EMR and the revision of laws guiding interstate insurance are gnawing glitches is quite intriguing as it makes the whole implementation process of a cost effective, high quality and easily accessible healthcare a far cry. References Centers for Medicare and Medicaid Services (CMS), HHS. (2007). Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2008 rates. Federal Register, 72(162), 47129. Chernichovsky, D., & Leibowitz, A. A. (2010). Integrating Public Health and Personal Care in a Reformed US Health Care System. American Journal Of Public Health, 100(2), 205-211. Darling, H. (2010). US health care costs: The crushing burden. Information Knowledge Systems Management, 8(1-4), 87-104. doi:10.3233/IKS-2009-0137 Berry, D. J. (2011). Drivers Of High US Health Care Costs. Health Affairs, 30(12), 2457. doi:10.1377/hlthaff.2011.1193Letters Lerner, J. C., Fox, D. M., Nelson, T., & Reiss, J. B. (2008). The consequence of secret prices: the politics of physician preference items. Health Affairs, 27(6), 1560-1565. Newacheck, P. W., Stoddard, J. J., Hughes, D. C., & Pearl, M. (1998). Health insurance and access to primary care for children. New England Journal of Medicine, 338(8), 513-519. Odier, N. (2010). The US health-care system: A proposal for reform. Journal Of Medical Marketing, 10(4), 279-304. doi:10.1057/jmm.2010.17 Sharfstein, J., Fontanarosa, P., & Bauchner, H. (2013). Critical issues in US health care: health care on the edge. Jama, 310(18), 1945-1946. doi:10.1001/jama.2013.282124 Sparer, M. (2011). US Health Care Reform and the Future of Dentistry. American Journal Of Public Health, 101(10), 1841-1844. doi:10.2105/AJPH.2011.300358 Read More