Health Care Delivery Systems
Health Care Delivery Systems
Bursting the Health Care Bubble
A source states that, the 30 million uninsured Americans have forced the United States to put part of the responsibility of health care into the government’s hands (Terry 116). By 2014, the changes in the health care system will be life changing for some, while others will have little to no effect by the reform. A surgery specialist from New York states that, “…46 million people in America lack access to health care and… has been based on a person’s ability to pay” (Goldberg 6). Since 2010, the Health Care Reform Act already started making changes in our economy and will continue to do so until for many years, or the election of a new President. These changes will allow each person to have little to no excuse on why they are not taking responsibility of their health.
As I sat patiently in the waiting room for my doctor who was twenty minutes late, I sat and watched the clock every few minutes until a nurse came to greet me. I couldn’t help but look around at the other patients next to me thinking…“right, privilege, or responsibility?” Was it my right to be here, my privilege, or my responsibility? Going through the scenarios in my head, I could think of examples that could fall under each. A small child ran about the waiting room while her mom sat in her chair reading “Country Living”, an elderly couple sat holding hands to my left, also waiting patiently for someone to greet them. I could hear the medical assistants at the front desk gossiping and discussing insurance matters.
I couldn’t help but feel sorry for them after learning what pain insurance companies could be. Originally, while sitting there unwearyingly for the doctor and watching the people around me, I thought it was a privilege to get to be one of the lucky ones that had insurance, which better allowed me to take care and responsibility of my own health. This then lead me to my next thought, the reason that I am here right now is because I am the one taking responsibility for my own health (…and maybe the help of my parents until I am 26… hopefully). As the nurse called me back, I had finally come to a conclusion. Health care in the United States is a responsibility, not a right and no longer a privilege. The responsibility of healthcare if shifting everywhere, whether it be changing into the hands of patients, medical personnel, or the government.
According to www.dictionary.com, being responsible is being accountable. I feel that many American’s in the United States have trouble being accountable for their own actions, and like to put the blame on someone or something other than themselves. “Americans do not blame themselves for their health care problems…instead attributing the rising health care costs to the profits made by drug and insurance companies” (Blendon 636). Even from the standpoint of our country as a whole, many would like to believe that we don’t make mistakes and that we are better than the rest. Even on Google, there are many websites containing all the reasons that American’s think they are superior to other countries… and sadly, there is a long list. Reality has to hit at some point, and someday I hope many of us can recognize that we aren’t perfect, and that in fact we do make mistakes, mistakes that can hold even the lives and the decisions of others.
Thinking I am being proactive and taking responsibility for my own health, I finally get to see the doctor after not only a thirty minute wait in the lobby, but a two to three week wait just to see my family physician. Marshall Kapp, the director of Florida State University’s Center for Innovative Collaboration in Medicine & Law, states that “…practicing physicians in the United States are already extremely busy” he goes on to say that adding new patients to practices will only result in either more hours to the day or a longer wait to get into your doctor, depending on the physician because of the reform (418). Marshall Kapp fears that “…affordable health insurance… may still fail at actually providing medical care” (416). Because each physician will have more patients, will each patient be receiving the right quality of care? Or even the right medical care at all because of the long wait? In the same article he goes on saying, “According to an official of the American College of Physicians, ‘newly insured patients can anticipate difficulties gaining access to primary care, particularly in undeserved communities’” (416). More patients will then cause a shortage of physicians in the United States.
Another source goes on to say that “Americans’ are far less satisfied with the availability…of health care in their country than Canada and the British are with theirs… Nearly three-fourths of Americans in 2003 expressed dissatisfaction with the availability of health care in their country” (Blendon 629). Although Americans no longer have an excuse on why they aren’t taking responsibility, will the number of patients decrease the quality of care or the access to a physician? The Health Care Reform Act is predicted to reduce health care costs, which will then lead people to receive preventative care and will also allow Medicare patients to receive a physical with “no direct costs or low costs to patients” (Terry 116). Terry begins to then say that “preventative medicine and chronic illnesses-for instance, diabetic patients- are going to have incentives and better coverage (116). Edward J. Dougherty, Senior Vice President of B&D Consulting in Washington D.C.… says, ‘There is a greater focus on preventative care, on wellness, on patient education, and intervention before an acute event or episode occurs. That provides opportunities for anyone…” (Terry 116).
The wise words of Dr. Baker that will haunt my brain forever went a little something like this, “As I was shaving this morning, I looked in the mirror and saw the person who was responsible for high health care costs.” Every time I look in the mirror, I am now disturbed by these same words, as I’m sure many of my other class mates are as well. Dr. Davis Goldberg goes on to tell a story of Joe Skin, “Joe Skin died of metastatic malignant melanoma because he could not afford the $100 it would have to cost him to see a local dermatologist two years earlier, when he only had melanoma in situ. Unable to afford the original fee, he left his pigmented lesion untreated, until a seizure from metastatic disease ended with him having multiple surgeries at a cost of $350,000 to tax payers” (Goldberg 6).
I wonder if Mr. Skin looked in the mirror while he was shaving that morning to realize that he would be one of the reasons for high health care costs in America. Unfortunately, because Joe Skin didn’t have health insurance he decided to not take responsibility for his health, which then resulted in more problems than before and even resulted in death. This seems to be a popular trend in the uninsured Goldberg states, “The uninsured also tend to wait longer and get sicker before seeing a doctor” (6), he then states that a popular trend among the uninsured is that they are “…less likely to receive recommended preventative and primary care services, face significant barriers to care and ultimately face worse health outcomes” (6).
The overall attitude toward health care changes dramatically when you bring those who are uninsured into the health care industry. “Americans’ attitudes toward the health care system are related to difference between those with secure and comprehensive coverage, and those without it” (Blendon 628). A source states that, one of the purposes of the Healthcare Reform act is to better allow each person to take responsibility into their own hands, as well as “…lower health costs” (Terry 116).
The responsibility and the cost of health care have been taken out of the physicians and the medical staff’s hands, and into those of the governments. Nathan Kaufman, Managing Director of Kaufman Strategic Advisors states, “It is a brutal fact that hospitals can no longer afford to delegate the responsibility and accountability of cost and quality of care to an independent medical staff of physicians practicing…” (167). Like we have discussed earlier, the reform is supposed to help lower the costs, but Kaufman believes that “health care costs will contribute to the destabilization of the economy” (164). He then proceeds with Richard Foster, the chief actuary for Centers of Medicare & Medicaid Services, who also states that “…the new law will increase the nation’s overall spending on healthcare by $289 billion through 2019” (Kaufman 164).
This budget will then cut the spending in other important areas, which will then raise our taxes once again to pay back the borrowed money (Kaufman 164). Dr. Baicker also states that “… there is much less to fund public schools, roads, and other necessary public services” (Goldberg 6). Although the Healthcare Reform or PPACA seems to be a good idea in many ways, this is where it all seems to be a little bit fishy, and when life seems to be all great and dandy with the reform, we will eventually be hit with the reality of the damage that our government and what our decisions have caused us. Dr. Katherine Baiker also questions the concept of the PPACA stating, “Yet the question remains: What will work? What is the most effective way to ration health care?’ (Godberg 6). There are consequences to most every situation, and I do not know if physicians or patients are prepared for the consequences that the PPACA will bring us.
The question is not if there are consequences, but when will we be affected by them? According to “Americans’ Health Care Views of Care, Access, and Quality” states that American’s have little to no faith in their government and were ready for some sort of reform (624). With the Healthcare Reform Act already facing high disputes and the non-support from many health care providers and some politicians, and because we spend so much time building the reform up, our nation is not aware of what is about to hit. At some point, Americans are going to be forced with higher taxes, and I fear health care providers who are also not prepared for the consequences will be faced with, and will not get the benefits of the reform to its fullest. Dr. Blendon says that, “… when issues like health care rationing, increased taxes, and longer waiting times are raised, public alternatives fall sharply” (641). Later in the article, he also begins to say that “less than half” of the people agreed to pay higher taxes to achieve the goal of a “universal health plan” (Blendon 642).
Kaufman states, “Those who recognize the existence of a bubble and prepare for its brutal realities can benefit when the bubble bursts” (167). He also begins to say that, health care providers who do plan for the bubble bursting, “…will be able to treat higher volumes of patients at lower predictable costs per episode, demonstrating measurable high quality and providing an exceptional patient experience” (167-168). For those who do not prepare themselves for the “bubble burst” who will be responsible? Everyone involved in the health care system will be responsible for some of the “lack of thought” that has gone into this health care reform. One of the man purposes of the reform is to also help the quality of care, which is one of the many responsibilities that physicians face in the health care industry. Although doctors have many patients, if a patient is taking the responsibility of taking care of their own health, then it is the responsibility of the physician to provide the best quality of care. A source states, “Health reform policies currently envisioned to improve care and lower costs may have small effects on high-cost patients who consume most resources. Instead, developing interventions tailored to improve care and lowering costs for specified types of complex and costly patients may
hold greater potential for “bending the cost curve” (Kaufman 166).
Changing the quality of care isn’t done at no cost, but a source states that “…health care organizations must contribute on some level to promoting the highest quality of care, the greatest safety of the patient, and the best patient experience” (Liang 1426). Coming from personal experience, if a patient is satisfied with their visit(s) and receives the best quality of care and experience possible, the likelihood of them returning is much greater. In the article “Quality and Safety in Medical Care: What Does the Future Hold?”, brought up some interesting points about physician to patient relationships during their medical stay or the decisions made about their health. Doing so will make the patient more understanding and responsible for their own health. It is important for the physician and the patient to make decisions together and understand the benefits, consequences, and the outcome of each procedure. A source states that “…less than one-half of hospitalized patients stated they were always involved in the decisions about their treatment, and almost one-third of the patients indicated they did not know who handled their care in the hospital” (Liang 1426). Allowing a patient to take more responsibility for their health is a lot harder when they have no idea what is going on.
The quality of patient care affects the quality of a patient’s life. Dr. Blendon says, “…most Americans are satisfied with the quality of medical care they and their families receive, and they do not see the issue as a top problem” (648). A source states that “… the Institute of Medicine has defined quality as ‘the degree to which health services for individuals and population increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Schuster 3). When dealing with health care I believe that it is always the patients responsibility, but if the physician giving incentive to the patient stay proactive and understand what is going on, than how can the patient be responsible? The thoughts on health care are constantly changing, whether its people’s right to be provided with health care, whether it’s a privilege to be able to receive health care, or whether it’s the responsibility of those apart of the health industry and the patients to receive the right kind of health care. A source states that, “Finding ways of doing more with less will continue to be hospitals’ biggest challenge” (Hospitals are expected to do more with less 4). The health care reform will be in full force before we all know it. As a citizen and patient, I know that it is my personal responsibility to keep proactive on my health, help make decisions for my fellow American’s to make the best health system possible. So every morning, when I stare into the mirror, I know that the reason the health care industry is the way it is, was because I made it that way. Health care is a responsibility, not a right and no longer a privilege.