Health Care in United States - Report Example

Lecturer: Health care in United s The three core-problems of the U.S. health care system Three main issues including the uninsured, the quality of care as well as affordability and rapid escalation of costs characterize the US health system (Conrad and Leiter 1). These problems have always been considered as systematic since they reinforce each other through a number of fundamental causes that are interconnected to create the resultant issues. The first cause of these problems is the fact that health insurance is connected to employment and therefore if an individual is not employed, or if the employer does not offer health insurance, then the individual will not be covered. This is the case even though majority of the advanced economies have already moved away from this leaving the US as one of the few that still tie their health insurance to the working population. Another cause is the fact that the US depends on numerous insurance funds including those in the private and public sectors to insure its citizens (Wolper 41). This has led to a situation where the insurance companies prefer to exclude the people they consider as less healthy while insuring only those they see as healthy. Thirdly, the increased number of insurance companies has resulted in doctors and nurses having to deal with each one of them in a different manner. This situation can be viewed as either competition or pluralism but leads to the practitioners spending too much time dealing with more than one insurance company. The doctors refer to this as administrative hustle since on average; an individual practitioner has to deal with eight different companies with every company having three to four different plans for their customers. An individual practitioner is forced to spend approximately five to ten percent of their time addressing insurance issues while the nurses spend about a third of their time doing the same. Additionally, an average doctor employees a single clerk who is supposed to deal with the insurance forms leading to the creation of a monstrosity characterized by administrative complexity. There are numerous insurance companies in existence with multiple regulations that tie the hands of the doctors and the hospitals with their varying payment rates. Consequently, the doctors and hospitals are forced to strategize on how they can get the highest rate from the various insurance companies they have to deal with. Furthermore, the healthcare system of the US is fragmented since it was developed almost seventy years ago during a period when diseases were predominantly episodic with most of them being infectious. At present however, numerous people suffer from chronic diseases that need continuous care such as prevention through to hospitalization in the event that one experiences acute episodes. Unfortunately, the system is separated at all the levels and the doctors are forced to re-test the patient and ask them similar questions to those they had been asked before. This demonstrates that the problems in healthcare in the US are systematic, however, majority of the solutions that have been identified for these problems are patchwork (Patel and Rushefsky 261). Politicians acknowledge that there is a problem with the healthcare system in the US but they are more concerned with making it through their terms and leaving them to the people who will assume office in the next term. The best solution to this issues that arise in healthcare is depoliticizing health care in such a manner that if an outside party with no stakes develops a plan, then the plan can be examined and assessed without linking it to the democrats or the republicans. The Patient Protection and Affordable Care Act was enacted on March 23 in 2010 but was implemented fully on the first of January 2014 when the individual and employer responsibilities took effect. It is also at this time that state health insurance Exchanges began their operations and Medicaid expansions were instigated among other changes to the healthcare systems and in the process, there are a number of important intermediate phases that have to be implemented (Rosenbaum 363). The ACA was supposed to bring essential changes to the policy landscape where public health is practiced and even though the legislation took a long time to be implemented, it full meaning could be conceptualized at the point when it was enacted. Before the act came into operation in 2014, public health practitioners and policy makers seized the opportunities that were presented by the important alterations and worked with other parties so that they could rise to the challenges. Particular attributes of this law such as the availability of prevention as well as the funding of health center provide essential funding opportunities, which are important to different communities in the entire country that will influence the responsiveness of public health agencies and assistance to the coalitions that exist in the local communities. Considering the aspects of the Act from a conceptual and practical view, it is clear that they represent public health practices, which are comparatively familiar. The most interesting questions develop from the more nuanced opportunities, which were created by the new coverage, as well as the regulatory setting whereby public policy-making and practice will come into effect. For instance, the manner in which the role of public health in prevention was affected by the increased coverage as far as clinical preventive services were concerned in public and private is one of the questions. In the event that the public health became more involved in directly providing particular clinical preventive cares it had to make sure that the access could be realized. Some questions are also concerned with how Medicaid agencies as well as state Exchanges will attain various healthcare professionals who are required in order for the expansion of the existing sources of care to be successful. These and other questions continue to pose challenges to the implementation of the act that is meant to make healthcare better and more accessible for the people of the US. The Act obligates non-profit healthcare institutions to take part in major community health planning through demonstrating the manner in which their investments in terms of resources within the communities they serve reveals the priorities incorporated in their plans. This community health planning should also demonstrate the manner in which public health agencies collaborate with hospitals in planning and how the communities together with the agencies guarantee of optimal utilization of resources that have been invested in the planning activities (Grinols and Henderson 14). In the same context, the community health planning should demonstrate the manner in which public health agencies can connect with the employers to come up with wellness programs that incorporate health outcomes incentives. It should also demonstrate the ways in which the health agencies can collaborate with employers and their workers to assist them to achieve incentivized outcomes like immunization status, reduction in weight and effective ways of managing chronic health conditions. The Medicaid agencies of the state together with health insurance exchanges will essentially spend the next few years dealing with the massive challenges associated with the enrollment of millions of people. Most of the people who will be enrolled have never had insurance, others will be difficult to reach, and some of them will not be able to speak English fluently while other will have mental capacities that are limited. In this regard, the health insurance exchanges will be obligated to execute wider standards in connection with access and quality concerning the qualified health plans. Demonstrations concerning Medicaid and Medicare intended to improve health along with health care for people suffering from complicated and chronic conditions will also be implemented. Additionally, in the entire system, an enormous amount of data associated with enrollment, usage of health care and performance will be accessible and available with time. It is important to note that the Act left approximately twenty five million people without health insurance and in the process putting into question the role that can be played by public health for these people and the manner in which effective systems of care can be developed to safeguard them from the repercussions of insufficient access to health care. Overall, the ACA is transformational and huge challenges to its implements lie ahead, however, the opportunities for great advancements in public policy and practice cannot be equated. The Act stands for a single opportunity that will lead to the transformation of coverage and care and at the same time lead to the rethinking of the fundamental mission of public health in a country that has universal coverage. Re-emergence of the anti-vaccination movement in the history of health care in the United States America’s history of CAM is a long complicated one that has been influenced by various factors including social, economic and scientific aspects. A comprehensive rendering of its history is far beyond the scope covered by this report, thus, this section will provide a brief summary of recent developments that have been fundamental in shaping the existing status of CAM in the US and its prospects for contribution towards health and well-being of the country. The early American health care involved an extensive collection of systems, in fact, until mid-nineteenth century, botanical healers, chiropractors and homeopaths as well as various other healers who provided different herbs to treat different illnesses offered a large part of the primary care in the US (Savage and Ford 131). This started changing during the latter part of the nineteenth century, but with the creation and validation of the germ theory and other considerable scientific advances in antiseptic approaches, anesthesia and surgery. Starting from the late 1800s all the way to the twentieth century, there was a great revolution in medical education that assisted scientific medicine to evolve to become the dominant health care system in the US. With the development of the healthcare system came increasingly sophisticated methods of conducting diagnosis and dealing with chronic illness leading to the costs of health care increasing considerably. Between the mid-sixties and mid-seventies, the costs of national healthcare increased threefold and even though various employers and government initiatives covered some of these rises, expenditures out of the pocket increased twofold. During this time, medical pluralism started re-emerging in the US and this was encouraged by various intertwined and interconnected movements. From the fifties, the entire movements associated with foods and dietary supplements started changing the view Americans had in regard to food as something they required to stay alive and also as a possible therapeutic agent. In the late seventies, a holistic healthcare movement emerged in the US with emphasis on the whole individual regarding various dimensions of healing such as physical, ecological and psychological among others. holistic healthcare involved various practices and concepts associated with Eastern philosophy and varying traditional cultures such as usage of herbs, acupuncture and other relaxation methods approaches to conventional medical practices. The late seventies and beginning of the eighties saw the emergence of self-care movements, which provided sponsored events with the aim of assisting individuals and their families to increase, or decrease risks of illnesses associated with diets or lifestyle (Cutler 5). The years that followed have been heavily characterized by active time for movements concerned with personal fitness that has continued to utilize the approaches used by other methods of healing like massages and yoga. A distinctive trend in the integration of CAM therapies with the practice of conventional medicine is taking place and hospitals offer CAM therapies with the health maintenance organizations covering this type of therapies (Yoo, Le and Oda 336). Numerous physicians use CAM therapies and insurance coverage for these forms of therapies continues to increase with the establishment medical centers and clinics that have developed closer ties with medical schools as well as teaching hospitals. Idyllically, conventional tests and treatments are subjected to a sequence of challenges, which if met will enable testing and treatments to develop components of conventional practices in medicine. Nonetheless, exceptions must exist and some new practices provide dramatic and obvious benefits, which may arguably speed up their acceptance. In some cases, enthusiasm for intervention based on the plausibility of the associated benefits and the absence of acceptable alternatives and rates of acceptance exist regardless of a shortage. Since prominence on evidence-based decision-making is comparatively new, numerous current conventional medicine practices did not adhere to what is currently perceived to be the normative pathway in regard to translation since they were accepted practices prior to these pathways being fully established. Nonetheless, numerous practices, which are broadly accepted, are still scrutinized and they experience changing indications as research continues to identify the patients with the capacity to reap the most benefits from them. Coronary bypass surgery can be considered as an example since it was accepted before it was subjected to controlled clinical trials (Friedman, Furberg and DeMets 12). The clear usefulness of this procedure in the reduction of various symptoms led to great interest in the procedure with numerous clinicians having the assumption that its usefulness could be equated to the reduction of heart attacks and deaths associated with coronary diseases. After this procedure had become well established, various RCTs demonstrated that it had an ability to enhance life expectancies of patients who suffered from severe coronary diseases but it had very little effect on the patients who were mildly affected by this disease. Steps and challenges have escalated in the past several decades and process are likely to evolve further as the US seeks a healthcare system characterized by a co-existence of conventional practices and CAM working in close harmony. These processes will be applicable to newer testing and treatment associated with traditions of practice from both approaches. Nonetheless, various aspects are worth to note, to begin with, the sequence of steps stands for a logical progression but the process is not adhered to in a uniform manner as far as conventional medicine is concerned. Secondly, the most interesting CAM therapies are already existent in practice with patients utilizing these therapies already. The anti-vaccination movement is considered as an illogical trend of distrust towards vaccination that may be as old as the approach itself. This movement puts the blame on vaccines or the ingredients contained in them for a variety of maladies that contain rejected mechanisms or those that are yet to be explained by scientific research. A number of these maladies are typically childhood diseases with the aim of increasing the emotive factor surrounding the argument with the ubiquity of vaccination making it a soft target for this blame game. Diseases that can be prevented using vaccines have continued to be a major cause of illnesses, deaths and disabilities in the entire history of humanity. The introduction of contemporary medicine has resulted in considerable changes and most people in North America and various parts of Europe have no recollection of the pre-vaccine era during, which diseases such as mumps and measles were a commonplace occurrence with a potential to be fatal. Recently, there have been debates in the media and among doctors concerning the safety of vaccines particularly whether the side effects associated with the vaccines outweigh the risk of leaving the people without being vaccinated. Vaccines have been thought to cause various illnesses such as autism, which is a prominent example whose direct cause is still predominantly mysterious and perhaps wide-ranging but no specific cause or risk factor has been pointed out. Some prominent American citizens have been vocal concerning the theoretical dangers associated with vaccines. The US state laws supports the rights of individuals people to choose if they want to be vaccinated against any disease with forty states allowing religious exceptions for vaccinations that are compulsory while twenty have an allowance for exemptions based on philosophical or personal goals to vaccination. Works cited Conrad, Peter, and Valerie Leiter. Health And Health Care As Social Problems. Lanham, Md.: Rowman & Littlefield, 2003. Print. Cutler, David M. Your Money Or Your Life. Oxford: Oxford University Press, 2004. Print. Friedman, Lawrence M, Curt Furberg, and David L DeMets. Fundamentals Of Clinical Trials. New York: Springer, 2010. Print. Grinols, Earl L, and James W Henderson. Health Care For Us All. Cambridge: Cambridge University Press, 2009. Print. Patel, Kant, and Mark E Rushefsky. Health Care Politics And Policy In America. Armonk, N.Y.: M.E. Sharpe, 1999. Print. Rosenbaum, Sara. The Patient Protection And Affordable Care Act And The Future Of Child Health Policy. Academic Pediatrics 12.5 (2012): 363-364. Web. Savage, Grant T, and Eric W Ford. Patient Safety In Health Care Management. Bingley: Emerald Group Publishing Limited, 2008. Print. Wolper, Lawrence F. Health Care Administration. Boston: Jones and Bartlett Publishers, 2004. Print. Yoo, Grace J, Mai-Nhung Le, and Alan Y Oda. Handbook Of Asian American Health. New York: Springer, 2013. Print. Read More