U.S.Health Care System - Case Study Example

U.S Health System Question Introduction The US health care system has evolved over time. The system used to be simple with no much regulation and monitoring from the government. The parties involved were patients, physicians, nurses, hospitals and one kind of insurance. Times have changed. Technology has influenced the change. Government policies and involvement has also taken a key position in the health care system. Somebody might argue that US has the best Health care system considering the medical technology in play and state-of-the-art facilities that are used as symbols of system. But somebody else may argue that the health system still has a long way to go if you considered the huge amount of money spend but still people die for lack of medical covers. The high population increase means also an increase in the number of uninsured people. At the same time, new financing systems for medical cover have raised over years. The US government spends on Health care than any other country in the world. Despite that the rate of uninsured population is still high. With a population density of over 320 million people, majority of the US citizens are still living in poverty and cannot afford good medical care. In her book “Mama Might be Better off Dead: the Failure of Healthcare in Urban America,” Laurie Kaye Abraham says that not only do the poor get sicker but the sick get poorer. The author talks about the break out of measles in 1989. Brianna, the youngest daughter to Jackie didn’t get the vaccination, reason being the fact that her mother was busy trying to make ends meet. Though Brianna did not get sick that year, she was at a high risk considering the disease had killed about seven people in the area. The author’s concern is on how vulnerable poor people are to diseases. From the above statement, poor people are likely to get sick more frequent than people who are relatively well. The poor are more vulnerable to sickness (Abraham 39).The reason is the mere fact that the poor give little or no attention to preventive measures. Financial constraints do not allow them to focus on preventive measures. Apart from that, living standards, environment, lifestyle, diet and other factors related to basic needs can cause this. The author also talks of sick people becoming poorer. Medical care takes so much resource. When one is sick, they do not work. Therefore there is no income. As a matter of fact, money is used during this period. The family of the sick spends all available resources to try helping the individual. This makes the family deteriorate financially raising their poverty level. Sickness therefore results to poverty (Abraham 39). The story of Jackie Banes from the book reveals inadequacy in health care system that is also undermined directly or indirectly with effects of poverty. Individuals, who are poor, tend to become sick easily. When they are sick, their families quickly go down financially. Relationship between sickness and socio-economic status Socioeconomic status (SES) is widely associated to sicknesses. Whether you assess it by income, education, or occupation, the results are the same. Abraham, the author of “Mama Might be Better off Dead: the Failure of Healthcare in Urban America,” talks of how Jackie Banes, the main character, takes her grandmother to the hospital for check up. The doctor says that her blood pressure level is ‘good’. Realizing this, Jackie decides to withhold her grandmother’s antihypertensive medication in order to save money. Jackie also skips her grandmother’s appointments with specialists because she can’t afford to pay for the van they use for transport. The monthly cost to take care of Mrs. Jacksons high blood pressure, diabetes and other related problems would be at minimum $75. Medicaid at times picked up the tab but the problems were that her health was unpredictable. This prompted Jackie to ratio her frequent visits to the hospital. In case she went to the hospital and received medication, Jackie not let her use her pills from the brown bottles. (Abraham 59) The case above is the opposite from the one seen from the book by Timmermans and Buchbinder “Saving Babies? The Consequences of Genetic Newborn Screening Chicago’ in the book, the authors explain a case study of Renee and Scott Baio who are American celebrities. The family is well off and has financial capabilities. The family can afford the best medical services in the country from any health institution. Baio is having a baby (Baily). They decide to have screening for their newborn. This screening aims to test patients with any genetic conditions. Unfortunately Bailey is found to organic acidemia oxidation disorder. The family is devastated and tries their best to solve the condition. A series of test are done in the following 10 weeks and the results are deemed as being "false positive" This is not the truth of the matter. The false results are only aimed at reducing attention to their daughter and the family as a whole. This is because the family is famous and they would not want to be in the spotlight. (Timmermans and Buchbinder 36) The social status of this family allows them to have the best medical services. They can even afford to do screening for a new born. This would not be a priority in a family that is struggling financially. Subsequent tests and investigations are done. This means the family use more of finances. A most unexpected thing happens when the Baily’s parents decide to establish a foundation that will advocated for screening of new born. This is unexpected because of fact that the social class of the family was high and did not want to be seen as faulty. The impact of sickness to Renee and Baio is equally great to that of parents from a low social class the Jackie. Other aspects of social status can be related to sickness. In her book "The Spirit Catches You and You Fall Down", Fadiman illustrates how a refugee family of Hmong origin was faced with difficulty in copping up in California. The book is centered on Lia Lee who was diagnosed with severe epilepsy. According to the Hmong culture, this disease was associated with spiritual interference. Lias parents do not seem to understand explanations from the American doctors. According to them a spirit known as dad had captured their daughters spirit and wouldn’t release her. To the Lees, doctor’s treatment and interventions made her worse other than save her. They expressed frustration. One other challenge in this case was the fact that the Lees could not communicate well with the doctors because they did not understand English fully. The doctors found this as a major challenge. Their argument was that failure to understand English would lead to them administering wrong prescription to their daughter. The doctors recommended that Lia be taken to a foster home. Fadiman uses this book to show how social aspect like cultural beliefs can be a big hindrance to medication and health wellness. Lia was born at Merced Community Medical Center, she seemed health. Unlike her siblings, she got a better medical care at birth. This was not the case with her siblings who were born from home. As refugees, the parents thought that Lia would automatically acquire American citizenship. Newborn are delicate and need proper care. Their action of going to the hospital might have saved Lia. Relationship between sickness and poverty Abraham brings out a direct relationship between poverty and sickness. The poor are more likely to get sick due to their poor living standards. They are viewed to financially lack the access to medical health care. The poor hardly have the access to a decent health care service and encounter great hardships while trying to seek it (Abraham 22). This is also implied by the fact that the poor people are uninsured and the uninsured barely get quality and timely health care unless they are nearly dying. Abraham (25) also brings out the direct relationship by mentioning that the ailments of the poor are usually worsened by their delay in seeking medical health care with reasons like social problems such as miserable living conditions. The relationship is also indicated by the fact that the only physicians who work in the poor neighborhoods are those that are not qualified to work elsewhere. There is also a failure by Medicaid to sustain the health care facilities that serve the poor people (Abraham 38). Works Cited: Abraham, Laurie Kaye. Mama Might Be Better Off Dead: The Failure of Health Care in Urban America. Chicago: University of Chicago Press,, 1994. Timmermans, Stefan and Mara Buchbinder. Saving Babies?: The Consequences of Newborn Genetic Screening. Chicago: University of Chicago Press, 2012. Question 2 Doctor-patient relationship In general occasions, the doctor has the lead in the relationship with the patient. Their relationship is purely best of well being of the patient. The Doctor leads in doing the diagnosis, giving prescription and making other recommendations. The patient on the other hand plays a minor role. Taking instructions is their basic role. This is not always the case. Cases have been reported of doctors who got closer to their patients as a way of trying to help them recover. When a patient is under a doctor, the doctor automatically becomes the patient’s agent of social control. At this stage, the patient has been exempted from normal social responsibilities. (Armstrong 43) Recurring dilemma for socializing doctors In the process of getting close with the patient, a doctor slowly get attached to the patient. This creates a bond that between the two. The bond is even stronger if the patient is in a critical condition and their condition does not seem to improve. The doctor slowly become empathetic to the patient and this brings the physician in a dilemma on treatments to give the patient. In the book Fadiman (The Spirit Catches You and You Fall Down) the story of Lia shows how with time, the physicians interacted and got attached to her. They became concerned about her state and even recommended her to be taken to a foster home. That action is a clear indication of a clinical dilemma that a physician may face. The doctors knew how much Lia’s family cared and loved her. This was a hard decision to make. On the other hand, the doctors were more concerned about her well being. Considering Lia’s medical history, the doctors became exasperated and at times apathetic. There was no much that the doctors could do but still, the author questions how much effort they put in this case considering the fact that America has best medical services. In as much as the parents were against the medication, the doctors had an upper hand in ensuring that Lia is well taken care of. The doctors tried to get closer in order to understand the cultural beliefs of the Hmong. The fact that the parents didn’t believe in clinical medicine made the doctors curious. The doctors had problems because the parents would deliberately ignore their instructions. The doctors are faced with the dilemma to understand and accommodate the Hmong’s beliefs and cultural practices against giving Lia the standard medical prescriptions for her sickness. Effects of Doctor’s socialization Doctor’s socialization with their patients has its positives impacts and perspectives. Some medical conditions are more psychological than physical. Doctor’s attention to patients is an important factor to their recovery. The process of recovery goes beyond medication. Proper psychological approach from the doctors and other medical care givers helps patients recover fast. When a doctor socializes with their patient, a better environment for recovery is created. . (Salovey and Rothman 213) For doctors to treat patients to their level best, proper understanding of their medical background is important. It also goes beyond medical history in order to understand a patients cultural background, social status among other issues is equally important. This helps expand the doctor’s understanding of the patient’s case. Some sickness holds their background to the patient’s social life and set up. Information regarding such cases can only be acquired when a doctor interacts closely with the patient or the members of their family. The fact that doctors are working in an area that involves human lives, sensitivity and social awareness is vital. The only way a doctor would understand the reasoning of patients is by being closer to them. Human beings are different and there people who might not be free enough even at the first doctor interaction with them. They may fail to express their situation better to the doctor. With close relationship with the doctor patients start to open up concerning their medical state.Doctor’s interactions and socialization with patients is also important in evaluating patient’s progress with treatment. Closeness with the patient ensures that the doctor is able to realize change with the patient’s previous state. This helps the doctor in administering next prescription to the patient. Distance between the doctor and the patients may hinder proper follow up and analysis of a patient’s particular medical issue. Contact with the patients, comes with new circumstances which a doctor must deal with. Unlike in medical school, the doctor no longer feels under pressure from test put. The doctor has a new challenge which is to cope with steady stream of patients. The mindset of the doctor is quickly transformed for dealing with real life situations among people. (Becker and Geer 54) While interacting with the patients, doctors expand their knowledge on human behavior and experiences. This is important as the doctor will acquire skills and knowledge when such incidents happen in future. Most medical issues recur. With past experience, the doctor will handle the easily. Effect of doctor socialization to patients Patients find it encouraging having doctors interact and socialize with them. This in return helps them in the recovery progress. The recovery process if otherwise not taken care of might leave a patient under prolonged medication. On interaction with doctors, patients are able to build trust in the doctor. In return, their body will be receptive to the medication. Trust is important especially when a patient meets a new doctor. The patient may find it hard to freely take the doctor’s prescription. In response, they may make an extra step of consulting further from other sources before starting the medication. (Shore 142) According to (Tao 56) Trust is the most important aspect of doctor-patient relationship. For effective medication to patients, there is need for high level of trust that will ensure complete confidence to what the doctor instructs. Health care providers’ perspective over doctor socialization As an employer, the health provider is more concerned about delivery and performance from the doctors. The methods to be used do not really matter as far as the firm’s policies are not violated as well as the professional code of conduct. At the same time, health provider monitors such socialization to ensure that they are strictly concerned with the patients well being and not doctor’s benefits. Summary The US health care has undergone dynamic changes over the past few decades. Politicians have used health care as vehicles to office. Generally, positive changes have been made to improve the state of health practices. The latest reform, Obamacare officially known as Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA) has brought tremendous changes. The act was approved to law in 2010 and aimed at providing an affordable and quality health care for all Americans. The law also aimed at reducing huge spending in the health care. The affordable Care act of 2010 changed the countrys health care system by expanding the coverage of young adults to be under parents cover until they are at the age of 26 years. The act also outlawed lifetime limits set by private insurance companies. The future in the health care is promising. The US government is implementing new policies that are targeted and ensuring the health services are affordable to all people. The policies have also seen the government reimburse enough funds to hospitals through Medicare. In her book, (Abraham 47) says the government tried to control costs in hospital particularly how much was used in Medicare. Consequently, patients would be diagnosed and from that, Medicare would pay a predetermined rate. This affected patients because since the government released a fixed pay, the hospital would discharge as soon as possible. The results is that patients who would have improved from staying in the hospital longer are released "quicker" and sicker leaving their families with a big burden of taking care of very sick individuals. According to Hastie (45) new programs are being introduced to physicians as a form of improving their performance at work. Advanced training for clinical officers, nurses and physicians ensure patients get the latest service delivery. Medical training institutions have also stepped up their game. With more research on emerging issues related to health care, doctors graduate with wider range of experience. Their skills are also perfected through training with latest state-of-the-art facilities Works Cited Armstrong, David L. An Outline of Sociology as Applied to Medicine. Sydney NSW: Elsevier, 2013. Hastie, Anne. Flexible Working and Training for Doctors and Dentists: A Practical Guide. Buckinghamshire: Radcliffe Publishing, 2006. Press, Zephyros. ObamaCare Simplified: A Clear Guide to Making ObamaCare Work for You. Berkeley,CA: Callisto Media Inc, 2013. Salovey, Peter and Alexander J. Rothman. Social Psychology of Health. London: Psychology Press, 2003. Shore, David A. The Trust Crisis in Healthcare. Oxford: Oxford University Press, 2006. Tao, Julia Lai Po-Wah. China: Bioethics, Trust, and the Challenge of the Market: Bioethics, Trust, and the Challenge of the Market. New York City,NY: Springer Science & Business Media, 2008. Read More