...2015 Cyndie Miculan Healthcare Reform and Utilization The passage of the Patient Protection and Affordable Care Act (PPACA) has prompted considerable debate. While some believe that the Act will eventually serve as a foundation for the destruction of the healthcare system, others believe that the Act does not provide enough coverage to truly reform the system. In an effort to better understand the implications of reform to the healthcare system the current investigation considers how the PPACA has impacted access to care, how these issues may change care utilization, the concept of universal healthcare, the stakeholders involved in universal healthcare, and the roles emerging in the healthcare industry as a result of reform. Issues of Concern Reform and Access to Care The passage of the PPACA has been viewed by many as a boon to expanding patient access to care. In addition to the fact that the legislation ended the ban on pre-existing conditions—requiring healthcare companies to offer coverage regardless of the patient’s health—the legislation also mandated that all citizens have health insurance. Even though the individual insurance mandate has been highly contested it has provided a means for delivering healthcare coverage to more individuals than at any time in recent history. However, providing near-universal healthcare coverage has had some caveats. In particular, there is growing concern that the large number of patients entering the healthcare system—a projected 32...
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...TORT REFORM AND ELDER LAW: A TORT REFORM EXAMINATION THROUGH THE LENS OF ELDER CARE Older Americans are one of the fastest growing demographic subgroups in the nation. The healthcare needs of this discrete subsection are unyieldingly broad; drawing from variances in traditional emergency medical attention, additional routine healthcare inspections, and even to custodial long term care needs. With this weighty class and the immense healthcare needs and requirements, come intricate liability and legal concerns. Countless challenges await the elderly in attempting to litigate healthcare suits, from state policy variances, to damage caps, to demonstration of harm. It is abundantly clear the legal framework should be retuned, and retuned, specifically,...
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...upon piece of US legislation of the last decades. It stirred controversy among the general public, medical professionals, raising concerns of various nature, including public health, legal, and ethical, to the delight of hundreds of political analysts. “Chief Justice Roberts has handed a political weapon to the Republicans, who can portray the PPACA as a major tax increase. Another potentially disturbing element of Chief Justice Roberts's opinion is the limitations he places on the federal spending power… The federal government could place conditions on the new Medicaid grants, Roberts argued, but could not threaten existing Medicaid funding without being unconstitutionally coercive. This part of Roberts's opinion is unfortunate, making it more likely that a few red states will reject the Medicaid expansion for no compelling reason.” (Lemieux, 2012) From the public health perspective, the decision of the Supreme Court does not seem beneficial. It is obvious that PPACA was intended to address the social inequalities that prevent millions of low income, uninsured citizens to benefit of decent health care. The law aims to accomplish the following major tasks: to raise the quality of medical care, to offer care based on the patients freedom of choice, the affordability of such treatments, and a nation to share both the costs and the benefits of healthcare. However, these goals turned out not to please everyone. According to Sorrell, “one probable reason is that there are significant...
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...How Does Cost Affect the HealthCare Delivery System? An In-Depth Look at the Health Care Delivery System and Cost. | | Princess L. Brigham | 11/23/2010 | HSA 6414: Social Dimensions and Issues in Health Care | ABSTRACT How does cost affect the health care delivery system? This research focuses on the cost of the health care delivery system and how it affects today’s society. High costs, gap-ridden coverage, and sporadic quality are the health care problems that most concern Americans. Yet most of the policy discussion is focused on the issue of coverage. Health care is expensive because of the pervasive entitlement attitude held by literally everyone in the system: patients, providers, suppliers, insurers. Government insurance (Medicare, Medicaid, veterans, Department of Defense) covers 87 million; tax breaks subsidize 176 million in employer coverage; insurers and other third-party payers take care of the bills for 85 percent of Americans. There is little awareness of the full cost or value of medical treatment on the part of consumers or providers, and little opportunity for individuals to choose their own coverage or make informed decisions with their doctors about treatment. Health care costs are far higher in the United States than in any other advanced nation, whether measured in total dollars spent, as a percentage of the economy, or on a per capita basis. And health costs here have been rising significantly faster than the overall economy or personal incomes...
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...Medical Malpractice Tort Reform in the Healthcare Industry Medical malpractice reform, also known as tort reform, includes strategies to limit medical malpractice costs, deter medical errors and ensure that patients who are injured by medical negligence are fairly compensated. Tort reform has the potential to reduce health care expenditures by reducing the number of malpractice claims, the average size of malpractice awards and tort liability system administrative costs (Medical Malpractice Reform, 2011). Since the 1970s, medical malpractice has been a controversial social issue, which has caused physicians to have increasing concerns about the large number of lawsuits and the negative connotations that tend to go along with them. Physicians have started pushing for legal reforms to decrease the large monetary awards for damages whereas tort attorneys have argued that the negligence suits are an effective way of compensating the victims fairly and forcing the medical professions to follow a proper standard of care (Pozgar, 2013). An article from the Journal of Patient Safety estimates that between 210,000 to 400,000 people die every year in the U.S. from hospital medical errors and 1 in 14 U.S. doctors face a malpractice lawsuit every year (Corapi, 2014). Physicians and healthcare providers argue that the millions of dollars that are awarded in damages increase the cost of healthcare by passing this cost onto the consumer in the form of higher insurance premiums and...
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...Healthcare Trends in the National Market Franklin University Abstract Current studies by the Centers for Disease Control and Prevention indicate that age adjusted death rates are down for major causes of death like cancer and heart disease. Although these findings suggest the healthcare system is well regulated, Americans are not happy with it overall. Out of 12 concerns over healthcare in the United States each one seems just as important as the predecessor. Alzheimer’s disease linked deaths have spiked with unintentional incident related deaths climbing as well. These issues will surely be met by an adapting system as it reacts to the needs of a market. The industry is currently heavily regulated by the government but the citizens are calling for more change. Healthcare Trends in the National Market The Centers for Disease Control and Prevention (CDC) has near comprehensive data in a variety of areas including morbidity and mortality that give insight to important trends that have impacted the healthcare system in the United States of America. The system is and will continue to be ever changing and evolving as the United States has a reactive system that is prone to great sways as it is manipulated by trends in disease and treatments. The CDC reported data from a 10 year time span regarding deaths among males and females. The leading cause of death for both sexes was heart disease, which was examined along with cancer, strokes, chronic lower respiratory disease...
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...The Faces of the Uninsured: An Issue Brief Amber Anderson February 15th, 2014 The Faces of the Uninsured: An Issue Brief Amber Anderson February 15th, 2014 Important to Note: 1= Yes Health Insurance 88.2% 2= No Health Insurance 11.5% * Data extracted from CDC BRFSS 2012 Important to Note: 1= Yes Health Insurance 88.2% 2= No Health Insurance 11.5% * Data extracted from CDC BRFSS 2012 The topic of Health Reform and the uninsured is an issue at the height of concern in politics. In 2013, it was estimated that over 48 million Americans were uninsured (KFF). The Behavioral Risk Factor Surveillance System (BRFSS) is a United States phone survey conducted by the Centers for Disease Control that looks at behavioral risk factors. According to this data from the BRFSS 2012, as displayed in the table below, 88.2% of individuals surveyed reported having some form of health plan while 11.5% reported having no form of health plan, which estimates to be 54,801 people (CDC). HAVE ANY HEALTH CARE COVERAGE | | Frequency | Percent | Valid Percent | Cumulative Percent | Valid | 1 | 419328 | 88.2 | 88.2 | 88.2 | | 2 | 54801 | 11.5 | 11.5 | 99.7 | | 7 | 932 | .2 | .2 | 99.9 | | 9 | 624 | .1 | .1 | 100.0 | | Total | 475685 | 100.0 | 100.0 | | Missing | System | 2 | .0 | | | Total | 475687 | 100.0 | | | Why is this Important? The United States reportedly spent $2.6 Trillion on Healthcare in 2010. This is approximately $8,402 per individual. If the current health...
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...Healthcare-Outline The United States is faced with a myriad of social and economic issues every day. Among these issues, The Affordable Healthcare Act (more popularly known as Obamacare) is a recent policy that has caused a lot of controversy. The Affordable Healthcare Act is a federal, 1 social program that will give all citizens healthcare coverage through government funding via tax revenue (Lazarus, 2011). The argument of whether or not to implement The Affordable Healthcare Act is fiercely debated on by both politicians and ordinary, informed citizens. Unfortunately, there is no easy way to solve this debate, as there are many valid arguments on both perspectives of the issue. One side supports The Affordable Healthcare Act, claiming that Americans need healthcare and many cannot afford it. On the other hand, there are those who do not support The Affordable Healthcare Act, stating that it will hurt the economy, lower the quality of healthcare, and harm healthcare workers financially both reflect a complex issue and a compromise is needed. There are serious flaws with the current state of healthcare in America, and the side that supports The Affordable Healthcare Act has valid points as to why the current healthcare policy should be changed. In 2010, almost fifty million Americans were uninsured (Lazarus, 2011). Healthcare is unaffordable to many people in its current state, therefore, many individuals can potentially be denied quality treatment for serious illnesses...
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...------------------------------------------------- Health for life An AHA Advocacy Issue June 4, 2014 By: Dwayne Mathis HSM-541 Portia Bonnett, Instructor June 4, 2014 By: Dwayne Mathis HSM-541 Portia Bonnett, Instructor The U.S. government, healthcare systems, hospitals, and communities have placed a large emphasis on health reform in this country. Yet the problems with our healthcare system are well documented. Chronic illness, such as cancer and heart disease, is growing at an alarming rate. The quality of health services and delivery are not where they need to be. For the American population to be able to enjoy optimal health, they must have access to high quality health care services and they must learn to be proactive in establishing health living habits. “Health For Life” is an advocacy issue of the American Hospital Association (AHA) which focuses on the need for better health and better health care. This paper will discuss why this topic is an issue, problems associated with this issue, and its impact on the U.S. health care system. It will also discuss AHA initiatives and offer a recommendation to help resolve this issue. The “Health For Life” initiative offers a framework for health reform in America. The building blocks of this framework are a focus on wellness; coverage for all, paid for by all; best information; highest quality care; and most efficient, affordable care. These blocks tell the story of why this is an advocacy issue to begin with. There is a focus on wellness because...
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...significance and priority in each individual varies. In the United States there are two systems that cater to the healthcare needs of its citizenry and legal aliens alike who are residents. According to Wexler, the United States healthcare system is being looked to as a model by other countries because of the systems and coverage that the citizens enjoy (Wexler, 2011). However, there are flaws to the system as there is no perfect system to satisfy the society. Forces Affecting the Healthcare System Rising Cost of Healthcare. The shortcomings of the health care in the United States have become a significant moral issue. Being the only industrialized country that does not provide a universal health care, its citizens are left unattended. Other nations in the world have made health care as a basic right while the US consider it as a privilege and only accessible to those who can afford it. With this insight, everyone sees health care in the US as a commodity and not as a social service. Pohl writes that the uninsured Americans now number in tens of millions where most of them are those who are working hard to make ends meet (Pohl, 2002). Even with their employment (blue collar jobs, mostly), they still cannot access insurance because their employers do not provide them because of the high cost or these individuals are not eligible at all. Medicare/Medicaid. One of the biggest differences is Medicaid is a state governed program and Medicare is a federal governed program. Medicaid...
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...Current Healthcare Situation Given the state of the economy over the last few years, it is no wonder that many industries are facing difficulties. It express world renowned news that American banks were facing economic struggles and had to, “be bailed out by the United States government through the emergency Economic Stabilization Act of 2008” (Steverman, 2008). During the same year, the automobile industry requested $34 billion to aid in their economic struggles (Romney, 2008). Given this chain of events, it should come as no surprise that the health care industry is also facing economic constraints and states, in a frenzy to save money and federal programs, have been forced to slash budgets and cut services in the Medicaid sector. Not all healthcare services will remain at the clinic, but it is important that eliminations do not affect the majority healthcare needs of the Medicaid and Medicare population. These changes are in benefit flexibility, cost sharing, enrollment expansions and caps, privatization, and program financing. Enrollment Expansion and Caps With the economic struggles faced in the banking and automotive industries, millions of Americans found themselves unemployed. With unemployment come a lack of financial resources and an inability to afford some of life’s necessities, including private sector health insurance. Medicaid With slow job growth and lack of reserve finances, many Americans applied for and began receiving Medicaid, a federally and state...
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...high-level manager means always being, “between.” In other words, one’s concern about others of a kind is always likely to be shaped by one’s concerns about and working relationships with other stakeholders. Based on our textbook and course materials pick four (4) of the concerns of hospital administrators, identify the issues regarding each of the four, and then identify and discuss at least one challenge administrators are likely to encounter regarding the challenge of working with a combination of two interests. In today’s society hospital administrators (such as physicians, nurses, board members and accreditation organizations) face many challenges. Not only from their line of work that they have to do on an everyday basis but also from the public and other administrators they have to work with. Primary care physicians face a dizzying array of daunting challenges. For instance, today’s doctors cannot just practice medicine. I say that because of how things are looking now and seem to be headed in the future. Some issues they face are game-changing federal legislation, diminishing compensation, soaring financial and competitive pressures. They also have to manage people, manage knowledge about changing federal regulations and spend time consulting with accountants and other nonmedical professionals who help them function as much as entrepreneurs as doctors. It seems there are too many issues today which are making it increasingly difficult for many physicians...
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...Brian Ardizzoni Michael Neil English 1301, Composition 1 25 November 2012 Medical Malpractice For nearly forty years, tort reform constantly becomes an increasingly controversial issue affecting the medical community, the legal community and most of all, the victims of some very unfortunate accidents. Tort reform refers to laws passed on a state-by-state basis which place limits or caps on the type or amount of damages awarded in personal injury lawsuits. Those who advocate medical malpractice tort reform believe limitations should be set on the amount of damages a plaintiff or injured party can be rewarded by the court. These advocates usually include medical professionals and insurance companies. Their argument is that too many frivolous lawsuits lead to high malpractice insurance, the increasing cost of medical care and a burden on the taxpayers whose tax dollars absorb the extravagant litigation costs for these claims. They believe doctors will eventually be unable to practice medicine due to costly malpractice insurance premiums which may leave many Americans unable to obtain much-needed healthcare. In the past, as the rate of malpractice suits began to grow, so did the rate of malpractice insurance. This ended up having a dire impact on the medical profession. For one thing, many qualified doctors ended up leaving their practices and focusing more on preventative medicine. In other words, they...
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...Patient Protection and Affordable Care Act (PPACA) is one of the most substantial reforms in Medicare since 1965. This is now considered the law of the land according to Douglas Holtz-Eaton. The PPACA portrays a “coverage first” strategy. “Sadly, a review a of the state’s experience bodes poorly for the future of national reform.” (Point/Counterpoint 177) There are two major driving factors in which could propose a threat for this reform. The first factor is it costs too much. Many decades ago, healthcare spending was at a minimum and not the focal point of American citizens. The statics show during 1970, national health expenditures were $1,300 per person and consumed 7 cents out of every national dollar, 7% of the GDP. Since the 1970, the spending per person has grown 2% more each year than income per captia. Therefore, healthcare costs have been increasing at such a high rate and will continue to threaten many decades to come. The second factor is the skyrocket of health insurance. This obviously is not mindboggling due to the fact that it is a reaction to the rapid increase of healthcare. Insurance costs have tripled over the past decade, making it hard for the average citizen to afford such outrageous premiums. As a result, less and less people are opting out of health insurance, which is no longer an option due to the new federal law making health insurance mandatory. The PPACA reform is looked upon with a “cost first” approach. This approach allows quality care...
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...Current Healthcare Concerns Started in the 1960s, Community Health Centers have serviced the need for health care for low income and impoverished people in the inner-cities and rural areas throughout the country. Today Arroyo Fresco Community Health Center continues the tradition of community health. However, unlike the 1960s, many issues concerning health care today have affected the quality and economics in the health care market. It seems that there is a plethora of concerns about the delivery of health care that adds to the burden community health centers face. Health Reform (Affordable Care Law), Physician Assisted Suicide, Medical Errors, Universal Health Coverage, Medicaid/Medicare Expansion, just to mention a few. There are some issues that stand out as requiring more attention than others. Health Care Expenditures Health Care Expenditures measure spending for all privately and publicly funded personal health care services and products to include: hospital care, physician services, nursing home care, prescription drugs, clinical and ancillary services, equipment, etc. Expenditures vary by state. Hospital spending is included and reflects the total net revenue (gross charges minus contractual adjustments, bad debts, and charity care). According to the World Health Organization (WHO), the United States spent more on health care per capita ($8,608), and more on health care as percentage of its GDP (17.9%), than any other nation in 2011. Costs such as insurance program...
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