What is it that makes Americans getting so excited about reforms to health care? The statements such as “don’t alter your Medicare” and “everyone should be able to access modern health care, regardless of price” are, to me, insufficient and uninformed reactions that show a poor comprehension of our health system’s past, current as well as future resources, and the challenges to funding that America will face in the future.
We all have questions about how the health system has reached what many consider to be the crisis stage. Let’s take some of the tension from the discussion by looking at how the health care system has developed in the United States and the way it has shaped our beliefs and attitudes regarding health care. With that in mind, we can look at the advantages and disadvantages of the Obama health care reform plans. Then, let’s take a examine the ideas that are being proposed by Republicans?
Access to cutting-edge healthcare services is something that we can believe is an excellent thing for our nation. Being diagnosed with an illness that is serious is one of the biggest challenges that we face and facing it without the ability to cover it is truly terrifying. As we’ll learn, when we are aware of the facts, we’ll realize that reaching this goal isn’t straightforward without our own contribution.
These are the issues I’ll explore in an attempt to make sense of what’s happening with American health healthcare and the ways we can each take to improve the situation.
In the beginning, let’s take some historical context on American healthcare. This isn’t meant to be a comprehensive study of that past, but it can give us an understanding of how our health system and our expectations of it developed. What was the reason that drove costs up and higher?
Let’s begin by turning toward how the American Civil War. The war was fought using outdated strategies and the destruction caused by modern-day weapons from the time create horrific outcomes. Not widely known is that the majority of deaths of both sides weren’t due to the actual fighting, but rather what transpired after the infliction of a battlefield injury.
At first, the removal of wounded patients was carried out in a slow manner and caused significant delays in the treatment of injured. Additionally, numerous wounded were treated with surgery for wounds, as well as related surgeries and/or amputations on the affected limbs. This frequently led to the development of massive infections.
In other words, you could be able to get a treatment for a wound but then to die as a result of medical practitioners who even though they were well-meaning, 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 reasons, more than 2percent from all of the U.S. population at the time!
Let’s jump to the beginning into the second half of 20th Century to gain some perspective and for us to move to more contemporary times. Following the civil war, there was a steady improvement in American medical practice, both in the understanding and treatment of specific ailments, the development of advanced surgical techniques and medical education and training.
For the most part, the most doctors could provide their patients was an “wait and wait and” method. The medical profession could treat fractures in bones and more often attempt surgical procedures that were risky (now generally carried out in clean surgical areas) however, there were no medications yet in use to treat severe illnesses.
Most deaths were due to untreatable illnesses like pneumonia, tuberculosis scarlet fever, measles or related complications. Doctors became more aware of vascular and heart conditions as well as cancer, but did not have any treatment to treat these diseases.
This brief overview of American medical history will help us understand that up until a few years ago (around in the 50’s) there were no techniques to treat serious or minor illnesses. It is a crucial issue to be aware of; “nothing to treat you with” means that doctor visits or even a doctor were limited to emergencies. In the event of such an incident, costs are cut down.
The fact lies in the fact that there was nothing for doctors to offer , and consequently, there was nothing to stimulate healthcare spending. Another factor that slowed down expenses was the fact that medical services offered were paid out of pocket, which meant through an individual’s personal funds.
There was never a health insurance policy, and definitely not health insurance provided from an employer. With the exception of those who managed to get the way to a charity hospital, health costs were entirely the responsibility of the person.
What does health insurance do to health expenses? The impact of health insurance on costs is, and will remain to this day, massive.
The idea of health insurance for individual and families was introduced as an option for companies to avoid wage freezes and to keep employees following World War II, almost instantly, an enormous amount of money was created to cover medical care. The money, a result of the huge amounts of dollars in medical insurance companies, pushed an ingenuous America to boost medical research. More Americans were covered not just through private, employer-sponsored health insurance but also by increasing federal funding, which led to the creation of Medicare as well as Medicaid (1965).
In addition , funds were made available to expand veterans’ health benefits. Finding a solution to almost anything has been extremely profitable. This is also the main reason for the variety of treatments to choose from today.
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I don’t want to suggest that medical advances aren’t beneficial. Consider the millions of lives saved, improved, extended and improved due to medical innovations. However, as a funding source has that has grown to the current size (hundreds in billions each year) the pressure to increase healthcare costs is inevitable.
Doctor’s advice and the majority of us require and receive access to the most recent medical technology, which includes medical devices, pharmaceuticals surgical instruments and diagnostic tools. This means that we have more healthcare to pay for and, until the last few years, most of us had insurance and costs were paid for by a third party (government or employers).
Add excessive and unrealistic public need for access and treatment and you’ve got an “perfect storm” for increasing and more expensive cost of health care. The health care crisis is only growing.
Now, let’s focus on the main questions that will take us to a thorough review and hopefully, a better understanding of the health reforms being discussed being discussed in the media today.
Does the current trend in U.S. health care spending viable? Are we able to help America remain competitive in the world in a time when 16%, which accounts for 20 percent of our gross national production, is spent on health care? What are other industrialized nations investing in health services? And are they even near these figures? When you include the political climate and elections year into the mix the information needed to determine these questions becomes vital.
We should put in time understanding the importance of health care and the way we view it. With the right knowledge, we can effectively determine if certain proposals in health care could help or cause more harm to some of these issues. What can we do about these issues? What can we do as individuals to be a part of the solution?
The Obama health plan for health care is complicated, certain, but I’ve not seen a health care plan that’s not. However, through a range of initiatives, his plan aims to address one of two issues:) growing the number of American who are covered under an adequate health insurance (almost 50 million don’t) and b) controlling costs in as to ensure that the quality of care and access to healthcare is not negatively affected.
Republicans want to achieve the same basic and broad goals, however their strategy is described as more market-driven rather than government-driven. Let’s examine how the Obama plan will accomplish to achieve the two goals above. Be aware, of course the plan was approved by Congress and is set to begin to start to be implemented in the year 2014. That’s the direction we’re currently following as we try to improve health care reform.
Through the insurance exchanges and an expansion of Medicaid, the Obama plan significantly increases the amount of Americans who are protected through health insurance.
To fund the cost of this expansion, the plan will require everyone to have health insurance, with a penalty to be paid in the event that we do not meet the requirements. The plan will supposedly pay the states to help those who are added to states-based Medicaid programs.
To offset the increased costs, there were tax changes for the purpose of covering the increased costs. One is the 2.5 percent tax on the development of medical technology. Another tax raises taxes on dividends and interest income for the most wealthy Americans.
Obama’s Obama plan also incorporates concepts like evidence-based medicine accountable care organizations, research on comparative effectiveness and reduced reimbursements to health care suppliers (doctors or hospitals) to manage costs.
The insurance mandate outlined in the first and second points above is an important aim and the majority of industrialized countries that are not part of the U.S. provide “free” (paid for through very high corporate and individual taxes) health care to the vast majority but not all their citizens.
It is vital to keep in mind however that there are a variety of limitations for which the majority of Americans might not be prepared. The most controversial element in the Obama plan: it’s insurance requirements. It was the U.S. Supreme Court recently made a decision to hear arguments pertaining to the legality for the insurance mandate in response to the petition of 26 state attorneys general which claimed that Congress had did not have the authority to do so pursuant to the commerce clause in the U.S. constitution by passing the mandate.
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 purpose of providing health insurance coverage to everyone would be severely restricted in the event that it is not completely eliminated with a similar decision.
You can imagine that the taxes outlined in point 3 above are quite disregarded by the organizations as well as individuals who must pay these taxes. Pharmaceutical companies, medical device companies hospitals, doctors and insurance companies have all required the option of having to “give away” something that could generate new revenue or lower costs within their areas of control.
For instance, Stryker Corporation, a major medical device manufacturer recently announced at least an employee reduction of 1,000 partly to help pay the new costs. This is also happening with other medical device companies as well as pharmaceutical companies too.
The decrease in well-paying jobs in these industries as well as in the hospital industry will likely increase as 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 cost reductions for doctors and hospitals at half a trillion dollars . this will flow directly into and affect companies who supply hospitals and physicians with the most recent medical technology.
All of this is not to say that efficiency 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.
In the end, the Obama plan aims to alter the way that medical decision-making is taken. While basic and clinical research is the basis of almost all work in the field of medicine doctors are a creature of habit just like the rest of us , and their education and daily experiences influence how they approach diagnosing and treating the conditions we suffer from.
In the realm of evidence-based medical care and the concept of comparative effectiveness studies. Both seek to create and use databases of data from electronic health records as well as other sources to provide more accurate and faster doctors with feedback on the effects and costs of the treatment they provide.
There is a lot of medical waste currently, with estimates of up to one-third of the over two trillion dollars of health care expenditure per year. Imagine the savings likely to be realized by reducing unnecessary procedures and tests that don’t compare to health care procedures that have been proven to be efficient.
Today, the Republicans and other political parties don’t typically agree with these concepts as they typically label them “big federal control” of our health healthcare. However regardless of political affiliation those who know anything about health care in any way, are aware that more accurate information for the goals discussed above are essential for ensuring health care efficiency and patient safety as well as costs heading in the correct direction.
A brief summary of what Republicans and other conservatives are thinking about reforms to health care. I think they’d be in agreement that the cost of health care must be brought under control, and that more not less Americans need access to health insurance regardless of their financial ability.
The main differentiator is that these people consider competition and market forces as the best way to achieve the efficiency and cost reductions that we require. There are numerous suggestions for driving greater competition between health insurance companies as well as health healthcare service providers (doctors as well as hospitals) to ensure that consumers could begin driving costs down through making the right choices.
It works across many areas of our economy, but this method has proven that improvement is not always apparent in the context of health healthcare. The main issue is that the choices for health care are not easy even for those who know about it and are connected. The general populace, however, is not as educated and we’ve been taught to “go to the doctor” whenever we believe it’s needed and have a culture that has created in the majority of us the belief that healthcare is something that can be found everywhere and there’s no reason to not access it regardless of why and, even more importantly, we feel that there’s no way to alter the cost of health care to ensure its accessibility to people with serious issues.
Okay, this piece was not meant to be a thorough analysis, as I had to keep it brief to try to keep my readers’ attention and allow for discussion on how we can assist in solving some of the issues. We must first realize that the resources available to health care aren’t indefinite.
Any changes implemented to offer more insurance coverage and easier access to healthcare will incur more costs. We must generate the money needed to fund these changes. While we must lower the price of medical procedures and treatments and also limit the use of unproven or poorly documented treatments , as we have the highest-cost health service in the world. We do not necessarily have the best outcomes in terms of longevity or stopping chronic diseases early than is needed.
I believe that we must make an overhaul in how we view healthcare, it’s accessibility and costs, as well as who is responsible for paying for it. If you think that I will say that we must arbitrarily reduce the cost of health care, you are incorrect. This is for our fellow citizens – healthcare spending must be protected and preserved to those who are in need. In order to get this money, those who do not require it, or who can delay or avoid it should be proactive. We must first convince our elected officials that the country requires ongoing public education regarding the importance of preventive health practices.
This is a must and has been able to decrease the amount of U.S. smokers for example. If preventive measures was to become a reality then it’s plausible to conclude that the number of people who require health care due to the multitude of lifestyle caused chronic illnesses would drop significantly. Millions of Americans suffer from these ailments more quickly than in decades in the past, and it is due to poor lifestyle choices. 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 because of an crisis or a chronic illness.
Let’s get into the initial issue. The majority of us aren’t willing to take action to incorporate simple wellness techniques to our everyday lives. We don’t exercise , but we make a lot of excuses. We don’t eat well, but we make a lot of excuses. We smoke, or consume alcohol in excess, and offer a variety of reasons the reasons we aren’t doing anything to control the harmful personal health behaviors.
We aren’t taking benefit of the preventive health screenings which examine the levels of cholesterol, blood pressure and body weight, but we give a myriad of excuses. We tend to ignore these aspects and the outcome is that we fall victim earlier than is necessary to the ravages of chronic illnesses such as heart disease or diabetes, as well as hypertension. We are forced to see medical professionals for these and other routine issues because “health medical care is available” and yet we believe that we don’t have any responsibility for reducing the demand we place for it.