In this country, many feel as though health care is a right of the citizens. I myself struggle with this idea as I do believe we need to address the health care needs of our country but do not feel responsible for those that make poor health care decisions on a daily basis and look for us as a country to care for them. With that same thought, I feel a responsibility to help those that are truly trying and are not offered health care benefits through their employers, and cannot afford to purchase health care insurance, as well as the underinsured. We have to take a stance of what is best for the whole. Our health system struggles with access to health services for everyone. The government is very focused on easing this access through its programs. In 1965, the passage of Medicare and Medicaid were revolutionary in that it provided coverage for the elderly and low income to include the disabled. While not perfect it opened more opportunities for access. In 2010, another revolutionary policy can into being with the passage of the Affordable Care Act (ACA). This pushes employers to either supply health coverage of face a penalty. For the smaller employers that offer coverage, in return they receive a tax credit. Again, this effort is to reduce those uninsured and underinsured in our country through federal policy (Kovner & Knickman, 2011). We are fighting an uphill battle with health care, because as we have tried to make health care more accessible to the citizens of this country we are seeing the cost rise at alarming rates. Kovner and Knickman (2011) points out that between 1999 and 2009 household income rose 38% while insurance premiums rose 131%.
This creates more underinsured and uninsured Americans to care for which is an economic crisis for this country that we must address. We have to find new and different ways to overcome the economic obstacles we face with rising cost. Thaler (2013), in his article in The New York Times, says no single change will allow our health care system to be transformed into one that we need and that we need to try many new approaches that are not in lined with the typical way of thinking. He offers some suggestions that make a lot of sense. He says we should first look to change our way of thinking about services. He says we should be paying providers for keeping their patients healthy instead of paying for test and procedures. The federal government should protect providers with a proven quality record of care and from malpractice lawsuits.
Patients can opt out of these providers care but who would realistically do that given the quality they receive? Evidence-based practices should be employed with care to avoid unnecessary tests such as CT scans and M.R.I.’s that many times leads to more unnecessary, unrelated tests. He also believe more energy needs to be spent to employ pharmacist, nurse practitioners, and physician assistants and allow to practice to the fullest extent to allow to allow primary care physicians to spend more time with patients. The idea of promoting health to avoid health care issues is far less costly than treating a disease process once it arises. I am a firm believer in preventative medicine and not enough energy is place on this type of health care. We are far too focused on what I call reactive medicine. Improved quality has been proven through research to be more cost effective. All care should be evidence-based to help improve the quality and decrease cost in the long run.
Kovner, A. R., & Knickman, J. R. (2011). Jonas & Kovner’s Health Care Delivery in the United States (10 ed.). New York, NY: Springer Publishing Company. Thaler, R. H. (2014, February 23). Overcoming Obstacles to Better Health Care. The New York Times. p. BU6. Response