What is it that makes Americans getting so excited over health care reform? A statement like “don’t touch my Medicare” or “everyone should have access to state of the art health care irrespective of cost” are, in my opinion, uninformed and arousing responses that show lack of comprehension of our health system’s past, present and future resources, and the challenges to funding that America will face in the future.
As we look around, we are all wondering if the health system has reached what many call an “episode of crisis. Let’s get some of the emotion from the discussion by examining briefly the way in which the health care system in our country began and how it created our culture and thought regarding health care. As a starting point, we can look at the benefits and drawbacks of the Obama health care reforms. Let’s also examine the ideas proposed by the Republicans?
Access to the latest healthcare facilities is something we all agree is beneficial for this nation. Being diagnosed with an illness that is serious is one of the most difficult challenges in life and facing it without the resources to cover the cost is truly terrifying. As we’ll learn, when we are aware of the facts, we’ll discover that the process of achieving this goal won’t be straightforward without our own contribution.
These are the issues I’ll touch on to attempt to make sense of what’s going on in American health healthcare and the ways we can each take to improve the situation.
A brief record of American health care. What caused the prices to be to be so high? The key elements that are part of Obama health care program Republican conception of health care: free market competition . Universal access to the latest health care – an admirable goal , but difficult to attain.
Let’s first get an understanding of the history behind American medical care. This isn’t meant to be a comprehensive review of the history, but rather an understanding of how our health care system as well as our expectations of it developed. What was the reason that drove costs up and higher?
For a start, let’s go back toward our first topic, the American Civil War. The war was fought using outdated strategies and the destruction caused by modern-day weapons that were in use at the time combined to create horrific outcomes. Unknown to many is that the majority of the deaths of both sides were not due to the actual fighting, but rather the aftermath of the infliction of a battlefield injury.
The first thing to note is that the evacuation of wounded patients was carried out at a snail’s speed which led to significant delays in the treatment of the injured. Additionally, numerous injuries were subjected to surgery for wounds, as well as related surgeries and/or amputations on the affected limbs, which often led to the onset of massive infections.
You could get a battle scar, but then die in the hands of medical professionals who, although good intentions, their actions were frequently fatal. Death tolls that are high can be explained by everyday ailments and illnesses in a period that had no antibiotics. There were around 600,000 deaths were attributed to all causes, which is more than two percent in all of the U.S. population at the time!
We’ll skip the beginning into the second half of 20th Century to gain an additional perspective, and also to bring us into more recent times. Following the Civil War there was a steady improvement in American medical practice, both in the knowledge and treatment of certain illnesses, as well as advanced surgical techniques and the education and training of physicians. For health care in Israel לבריאות all the modern facilities are available with cutting edge advanced testing techniques.
For the most part, the only thing doctors could provide their patients was the “wait and see” approach. The medical profession could treat bone fractures and even perform risky surgery (now mostly done in sterilized surgical areas) however, medicines weren’t yet in use to treat serious diseases.
Most deaths were caused by untreatable diseases like pneumonia, tuberculosis measles, scarlet fever or other related issues. Doctors became more aware of heart and vascular diseases as well as cancer, but didn’t have the resources to treat these ailments.
This basic overview of American medical history will help us to comprehend that up to the very recent (around in the 50’s) there was virtually no technology to treat major or minor illnesses. This is an important issue to be aware of; “nothing to treat you with” implies that doctor visits were limited to emergencies. In this scenario, costs are cut down. The reality is there was not much medical care available to doctors and thus almost nothing to stimulate the cost of health care.
Another reason for the low expenses was the fact that medical services that were given were paid out of pocket which means through the individual’s own resources. There was no health insurance, and certainly not health insurance that was paid through an employee. With the exception of those who managed to get their way to a charitable hospital, the cost of health care were entirely the responsibility of the person.
What does health insurance have in relation to health expenses? The impact it has on health care costs is, and continues to be until today, massive. When health insurance for individual and families was introduced as an opportunity for businesses to get out of wage freezes as well as to retain and attract employees following World War II, almost immediately, a huge amount of cash was made available to cover health insurance.
The money, due to the existence of billions of dollars of medical insurance companies, helped an ingenuous America to boost medical research. More Americans were covered not only through private, employer-sponsored health insurance, but also with increased government-funded health insurance that led to Medicare as well as Medicaid (1965).
Additionally, funds were made available to expand veterans’ health benefits. Finding a solution to almost everything has been extremely profitable. This is the main reason behind the huge range of treatments to choose from today.
I don’t want to suggest that medical advances are bad. Consider the tens of millions of lives saved, extended, improved and made more efficient because of. However, with a source of funding that has grown to the current size (hundreds in billions per year) the pressure to increase healthcare costs is inevitable.
Doctor’s advice and most of us require and receive access to the latest medical technology, which includes medical devices, pharmaceuticals, instruments for diagnosis and surgical procedures. The result is that we have more health care available to pay for and up until a few years ago, most of us were covered and the cost was largely covered by a third party (government or employers). Add in an endless and unsustainable demands from the public for accessibility to and care and we’ve got an “perfect storm” for higher and more expensive health care expenses. In the end, the health care crisis is only growing.
Now, let’s look at the most important questions that will guide us to a thorough review and hopefully a greater understanding of the health reform plans that are being discussed in the media today. Are the current trends in U.S. health care spending long-term sustainable?
Are we able to help America remain competitive in the world with 16% of the money that accounts for 20 percent of our national gross product , is devoted to health care? What are other industrialized nations paying for health insurance, and are they even near the same amount? When you include the politics of an elections year into the discussion data to help us determine these questions becomes vital.
It is essential to put time learning about the health care system and figuring out what we think about it. With the right knowledge, we can wisely assess whether certain proposals in health care could help or cause more harm to some of the issues. What can we do to address these issues? What can we do to help to solve the problems?
The Obama health plan for health care is complicated, certain – I’ve not seen a health insurance plan that wasn’t. Through a myriad of initiatives his plan seeks to address one of two issues:) growing the number of American who are covered by sufficient coverage (almost 50 million people aren’t) as well as) controlling costs in that the quality of care and access to health care are not negatively affected.
Republicans attempt to accomplish the same broad and basic goals, but their plan is portrayed as more market-oriented and not the government’s. Let’s take a look at what the Obama plan is doing to achieve these two goals.
Keep in mind, of course his plan was approved by Congress, and will begin to take effect from 2014. This is the path we’re currently following in our efforts to improve health care reform.
Through the insurance exchanges and the expansion of Medicaid, the Obama plan significantly increases the amount of Americans who will be protected under health insurance.
To pay for the costs of this expansion , the plan will require all people to have health insurance. There is a cost to be paid in the event that we fail to comply.It will supposedly provide money to states to pay for those that are added to the state-based Medicaid programs.
To pay for the additional costs there were new taxes enacted for the purpose of covering the increased costs. One is the 2.5 percent tax on the development of medical technology. Another tax increase in the tax on dividend and interest income of the wealthier Americans.
Obama’s Obama plan also incorporates concepts such as evidence-based medical accountable care organizations, research on comparative effectiveness and reduced reimbursements to health suppliers (doctors or hospitals) to manage costs.
The insurance mandate that is covered by the points one and two above an admirable objective, and many industrialized nations that are not part of the U.S. provide “free” (paid for with a relatively high corporate and individual taxes) health insurance to the majority but not all their citizens.
It is vital to keep in mind that there are a variety of limitations for which the majority of Americans are not prepared culturally. This is the most controversial part in the Obama plan: the insurance obligation.
The U.S. Supreme Court recently made a decision to hear arguments pertaining to the legality for the mandate to purchase health insurance the result of the petition of 26 state attorneys general who claimed who claimed that Congress had exceeded its power in the Commerce clause of the U.S. constitution by passing this provision of the plan.
The issue is that if there is a chance that Supreme Court should rule against the mandate, it’s generally accepted to be a sign that the Obama plan in its current form is likely to fail. It is due to the fact that its primary objective of providing health insurance coverage to everyone will be severely restricted in the event that it is not completely eliminated with a similar decision.
You can imagine that the tax rates mentioned in 3 above are not popular with the entities as well as individuals who must pay these taxes. Pharmaceutical companies, medical device companies doctors, hospitals, hospitals and insurance companies have all needed have to “give up” something that will either generate additional revenues or reduce expenses within their areas of control.
For instance, Stryker Corporation, a large medical device firm recently announced at minimum an employee reduction of 1,000 in order to pay the cost of these new fees. This is also happening with other medical device companies as well as pharmaceutical companies too.
The decline in high-paying jobs in these areas and the hospital sector could increase as the old cost structures have to be redesigned to meet the lower rate of reimbursement for hospitals. In the next 10 years, certain estimates place the reduction in costs for doctors and hospitals at one-half trillion dollars. it will be passed directly onto and impact the businesses which supply doctors and hospitals with the most modern medical technology.
This is not to suggest that efficiencies won’t be achieved by the changes or that additional jobs will be created. However, this may be a painful transition for a time. This helps us understand that reforms to health care will impact us both positively as well as negative.
The Obama plan aims to alter the way that medical decision-making is taken. Although basic and clinical research is the basis of almost all work in modern medicine doctors are also creatures of habit just like we are and their daily experiences influence to a significant extent the way they approach diagnosing and treating the conditions we suffer. The concept of evidence-based medical practice and studies on comparative efficacy. Both are attempting to create and use databases of data using electronic health records and other sources to provide better and faster the physicians with feedback on the effects and cost of the services they provide.
There is a lot of healthcare waste in the present, with estimates of up to one-third of the over two trillion dollars in health care expenditure annually. Imagine the savings likely to be realized by reducing unnecessary procedures and tests which do not perform as well to health care treatments which are more documented as efficient. The Republicans and other political parties don’t approve of these concepts since they typically define these in terms of “big government control” of your health care and mine.
To be fair regardless of their political beliefs, most people who have any knowledge of the concept of health care are aware that more accurate information for the goals discussed above are essential in ensuring that health care efficiency and patient safety as well as costs heading in the proper direction.
A brief summary of what Republicans and other conservatives consider health reform.
I’m sure they’ll believe that health care costs should be brought under control, and that more than fewer Americans are entitled to health care , regardless of their financial ability to pay. The main difference is that they believe that competition and market forces as the means to create the cost-savings and efficiency that we require.
There are numerous strategies to create greater competition between health insurance companies as well as health healthcare suppliers (doctors as well as hospitals) to ensure that consumers will begin to drive costs down through our choices. This can be done in many different sectors of our economy, but this method has demonstrated that the benefits are not real in the context of health healthcare. The main issue is that healthcare choices are a challenge even for those who are aware and connected.
The majority of the population is, however, not that well-informed. We have been taught to “go to the doctor” when we believe it’s required and also we have a culture which has given a lot of us the belief that health care can be found everywhere and that there is no reason not to avail it, regardless of the reason and even more, we are all convinced that there’s no way to alter the cost of health care to ensure its accessibility for those who have serious health issues.
Okay, this piece was not meant to be an exhaustive research since I wanted to be brief in an effort to capture my readers’ attention. I also wanted to allow for discussion on the ways we can assist in solving certain issues. It is important to realize that the resources available to healthcare are not unlimited. Any changes made to provide more insurance coverage and better access to healthcare will be more expensive. We must generate the money needed to cover these costs.
While we must reduce the cost of procedures and medical treatments, and limit the availability of non-proven or undocumented treatments, as we have the highest-cost healthcare systems in the entire world. And we do not necessarily have the best results when it comes to longevity or stopping chronic diseases sooner than is necessary.
I believe we require radical changes in how we view the health system, its accessibility and cost, and who will pay for it. If you think that I’m about to suggest that we need to arbitrarily and dramatically cut down on the amount we spend on health care, you’d be mistaken. This is for our fellow citizens – the cost of health care must be protected and preserved to those who are in need. To free the money, those who don’t require it or who can delay or even avoid it must take action.
We must first convince our elected officials that this nation needs a continuous public education regarding the importance of preventive health measures. This should be the top priority and has helped decrease the amount of U.S. smokers for example. If prevention could be a reality, it’s plausible to conclude that the number of people seeking health care for the many lifestyle caused chronic illnesses would drop drastically.
Millions of Americans are suffering from these ailments much earlier than they did in the ago, and the reason can be attributed to bad habits. This alone could make it possible to save a lot of money to pay for the health expenses of people in desperate need of medical attention, whether due to an crisis or a chronic illness.
Let’s explore the initial issue. The majority of us aren’t willing to to implement simple wellness techniques to our everyday lives. We don’t exercise , but we make a lot of excuses. We don’t have a healthy diet, yet we make a lot of excuses. We smoke, or consume alcohol in excess, and we provide a variety of reasons how we cannot do something about these as harmful personal health behaviors.
We do not take advantage of health checks which look at the levels of cholesterol, blood pressure and body weight, but we make a lot of excuses. We tend to ignore these aspects and the outcome is that we fall victim earlier than we should to chronic ailments such as heart disease, diabetes and hypertension.
We are prone to seeing medical professionals for many other regular issues due to the fact that “health care is there” and we believe that we are not responsible to reduce our dependence on it.
It’s difficult to hear these facts but it is simple to blame those who are sick. Perhaps they need to take better self-care! It could be the case or perhaps they suffer from an illness that is genetic and they are among the unfortunate because of through no fault of their own. But the fact is that both of us can take personalized preventive strategies to drastically improving access to healthcare for all others and lowering its cost. It is much more efficient to be productive taking control of something rather than shifting blame to others.