Friday, October 11, 2019
Policy of Medicare System Essay
With the evolution of new drug-resistant strains of maladies in the contemporary period, scientists are now going back to nature in pursuit of pristine defenses. Says Dr. Robert Nash, research director of Molecular Nature in the United Kingdom, Ã¢â¬Å"Dandelions, sea pinks, nettles, even bluebells were used to treat diseases. There is a good reason for going back to see if there was anything behind these traditional usesÃ¢â¬ (Amundsen 132). Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã In our backyard, there is a bed of bluebells and never had it dawned on me that bluebells prove to have anti-virus and anti-cancer properties. That they were used in the 13th century against leprosy (Amundsen 155). Not that I would really want to prepare for any possible leprosy case that may stem at home; but the thought of having nifty bluebells in the garden can give comfort on good health and brainy ancestors. Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã In the library, the books speak of one thing about healthcare; that it is the management of the resources of healing. Darrel Amundsen, in his book Medicine, Society, and Faith in the Ancient and Medieval Worlds, pointed up the wonder of natural medicines and traditional medicine. Stanley Reiser tells us of how medical care evolved from technological point of view. Dorothy PorterÃ¢â¬â¢s Social Medicine and Medical Sociology in the Twentieth Century talks about where the health care industry has drifted through different eras. It has had a major impact on how people perceive health on the whole. From the unborn and mothers to all the phases of childhood to the youth and the adults to the older people, health care has been in packages essential at various stages of the human being. Additionally, the practitioners have done a lot of education, investing awe-inspiring sum of finances and effort in educating the public. Professional patronizing and obscure terminology will give way to cooperative educational approaches, and client-oriented rehabilitation. This approach is estimated to provide the most appropriate package of health services suited to ensure a healthy well-being of all age groups. In every industrialized country, excluding the United States (U.S.), the provision of health care has become the financial responsibility of the state over the past 100 years. Taxes on both employers and workers and general tax revenues financed the health care insurance system. This was the procedure in Western Europe and Great Britain (Warner 360-368). Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã The exception of the U.S. can be credited to the native value the Americans placed on self-help and repulsion against dependency. After 80 years of anxiety, the federal government of the U.S. has accepted the system but with some degree of responsibility. When the medical care program was introduced to them, it has become a complex mix of public and private payments. The extent covered the maldistribution of resources and disproportions of access (Porter 9). Nevertheless, across the surveys, the U.S. health care system becomes the countryÃ¢â¬â¢s largest employer. Approximately, 597,000 are physicians, 137,000 are dentists, 1.8 million are nurses, and nine million are field workers (Warner 356). Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Administering the federal health care activities was charged to the Department of Health and Human Services. Health insurance comprises all forms of insurance against financial loss resulting from injury or illness. The most common health insurance coverage is for hospital care, including the physician services in the hospital. Major medical policies protect the insured against calamitous charges, paying a sum of that ranges from $10,000 to $1,000,000, after the policyholder has paid a preliminary deductible amount (Warner 371). Patients usually have out-of-pocket expenses since doctorsÃ¢â¬â¢ charges are not entirely covered by the insurance. Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Overheads for healthcare services in the U.S. alone have been mounting sharply for about over a decade. Insurance coverage is potholed. Coverage for home care of the chronically ill is nigh on absent. A fixed sum is paid for a service except for hospital insurance. More often than not, this payment must be supplemented by the patient (Warner 358). Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Problems also arose in the aspect of recruitment and distribution of physicians. About one-fourth of U.S. physicians were engaged in primary patient care. That included obstetrics, internal medicine, pediatrics, and family medicine. In the slums of big cities, physicians are sparse but profuse in the more affluent sub-urban areas (Porter 12). One of the more daunting areas of health care is the prohibitive cost of medicines. At present, there is no governing body that regulates the price of medicine. This means that the manufacturers dictate the prices. With this discretion, expectedly the prices could be set as high as excusably possible. To ornament with justice, their marketing strategy has spawned the mentality that Ã¢â¬Å"branded is better.Ã¢â¬ Came the managed healthcare system. The genesis of contemporaneous managed care can be trailed to the prepaid plans providing healthcare to rural, shipbuilding and construction workers in the U.S. in the 1920s and 1930s. Managed healthcare have likewise existed in ancient China when doctors were supposedly paid only while they kept their patients healthy. Although many of the procedures used by managed healthcare to regulate expenditures have existed in African countries for a time, it was only since the latter part of the 20th century that the concept of managed care has been both in full swing in an effort to provide Africa with low-priced quality healthcare and denigrated by others (Porter 10-11). But in the U.S., managed healthcare was only firmly established when briskly swelling healthcare costs in the 1970Ã¢â¬â¢s and 80Ã¢â¬â¢s led to the passing of legislation providing for the establishment of Health Maintenance Organizations (HMOs) (Warner 370). Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã HMOs and the government has since then been on the lookout for effective alternatives. The government and the private sector all face the problem of financing the uncontrolled inflation of cost in the medical care program. Others blame it on the growing numbers of people who seek care. Some on the greater use of laboratory costs and of specialists in diagnosis and treatment (Reiser 16). Needless to say, the synergistic force of the sectors wanted programs that were cheap but were at least, effective. Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Hospitals were responding to increasing cost demands. They attempted to introduce more competent management schemes. Proprietary hospitals have found greater earnings in chain operations. Other efforts to slash costs included hiring less-expensive professional workers, like nurses and paramedics, in the hope of getting basic care to patients at a lower fee (Porter 10). The health care system has indeed been an entrepreneurial idea. However, paradox has it that in due time, antibiotics, vaccines, and other vital medicines will be short of availability at least, among the 5.6 billion people, according to the World Health Organization (Porter 18). Scarcity of producers of medicines has nothing to do with it. Maldistribution and capitalistic exploitation will make the medicines inaccessible to the poor. Over 40 million Americans have some form of heart or blood vessel disease, and the combined costs of treatment and lost income exceed 50 billion dollars annually. About 4 million people, 10 percent of those with cardiovascular diseases, have coronary artery disease. Because of these findings, the Framingham Study considers cardiovascular disease as one of the leading epidemiological diseases in the country. A more distressing fact rings throughout the Third World countries whose healthcare programs are financed by their governments on less than 1 percent cut from the gross domestic product (Porter 15-16). At this reality, whose son or daughter will not be underfed? Every major city had slum areas that housed the poor and unemployed, and declining farm incomes created rural poverty. Amid the growth and confidence of the postwar years, United States leaders initiated programs of aid to help people at home and abroad improve their way of life. Programs of domestic aid included funds for education, medical care for the poor, and urban renewal programs. International air programs begun soon after the war sought to help United States maintain economic and political stability (Fusfeld and Bates, 1984). Poverty-stricken people suffer from the lack of many things they need. For example, they are less likely to receive adequate medical care or to eat the foods they need to stay healthy. The poor have more diseases, become more seriously ill, and die at a younger age than other people do. Poor people often live in substandard housing in socially isolated areas where most of their neighbors are poor. Many low-income families live in crowded, run-down buildings with inadequate heat and plumbing. The jobs most readily available to the poor provide low wages and little opportunity for advancement. Many of these jobs also involve dangerous or unhealthful working conditions. Financial, medical, and emotional problems often strain family ties among the poverty-stricken. Furthermore, the healthcare system of countryside Americans is dense. For instance, Indians are lacking relative to their urban equivalents in many important ways that shape their health: they are unduly economically inferior, proportionately lesser are of working age, and they have not fulfilled as much of education. Topographical access is of principal interest in several rural states. Indians who reside in remote areas, comparatively far from urban areas or centers, sometimes find it hard to get in touch with healthcare personnel or services. In respect of urban inhabitants, rural dwellers have to trek farther to care and tackle other problems such as mediocre road and rail network, and short of public transportation. These problems are distinguished yet their resolution escapes the labors of the U.S. Legislature, and local governments. Culture is another driving factor, including influential customs (Nabokov). The IndiansÃ¢â¬â¢ unfavorable health behaviors, employment of folk medication, the impact of traditional religion on healthcare, and estrangement from countrywide society all play a part to the way they care for their health. To make the decisions centralized, World Medical Association was founded as an organization of several of the worldÃ¢â¬â¢s national medical associations. Instituted in 1947, this medical society has embraced an international code of medical ethics and many other ethical pronouncements. The center of operations is in Ferney-Voltaire, France (Porter, 2000). One of the pivotal epidemiological methodologies for an improved healthcare provision is an informed public. If the individual does not understand what he or she must do to preserve health and reduce his or her risk of a probable epidemiological disease, if he or she does not recognize when he or she needs outside help, and if he or she or members of his family are not prepared to take the appropriate steps to obtain this help, then all of the worldÃ¢â¬â¢s medical knowledge will be of little value. The educational process that would prepare an individual to help preserve his or her own health and reduce his or her epidemiological risk should ideally begin in his or her youth when lifelong patterns are being formed, and continue throughout his or her adult life. A hospital managementÃ¢â¬â¢s role is twofold: helping to build good health habits in the young, and serving as agents in adult health habits through public information and education programs designed to teach preservation of health and raise the general health consciousness of the people. The practicing physician, emergency medical services, the clinic or neighborhood health center, the hospital as a whole stand to be prepared in implementing medical line of defense. Even at times the nonmedical person who is on the scene when an acute emergency occurs are relied on. In order to be effective, the hospital carrying out the epidemiological measures, together with these individuals and services, are obliged and expected not only to be capable of providing healthcare, but must be prepared to do so in a manner that is acceptable and accessible to, and understood by, the public. The epidemiological measures of a hospital in this area shall also address such things as professional education, healthcare standards, and public information regarding access to care and services. Another approach is that which serves as the underpinning of the rest of the strategies and plans; it is the biomedical research to identify such epidemiological factors as dietary fats, smoking, hypertension, etc., that adversely affect human health and to devise methods for preventing, diagnosing, and treating these conditions and the diseases to which they contribute. In this regard, the hospital has a unique role to play, in that while they cannot the huge sums needed for large-scale clinical trials or epidemiological studies, they claim to have an excellent mechanism for supporting young investigators who are juts beginning their research careers, helping them gain the experience and results necessary to compete for larger grants in the national and international arenas. The emphasis is practically placed on the support of quality research projects having high merit ratings. To adequately develop such improved measures by Medicare, it should have the hospital require a programmed effort that first takes into consideration the fact that the hospital cannot be all things to all people. It may have quite limited resources in terms of money, volunteers, and staff in other departments, and the need for each of these resources may always seem to exceed the supply. Since there are numerous programs and activities that are capable of improving health of the patients to some degree, hard choices must be made regarding the disposition of these resources. This implies priority setting, which is made more efficient by the establishment and implementation of a hospital-wide, goal-oriented, long-range planning process. Such a process helps the hospital focus its epidemiological measures on high yield, cost-effective projects that either help prevent the healthcare provision, or provide ongoing relief and control, yielding the highest return on time and money invested. All in all, medical institution evolved across time to deal with problems of health and disease using epidemiological measures that are based on mortality, morbidity, disability, and quality. More specifically, medical institution was perceived performing a number of key functions in modern societies. First, it treats and seeks to cure disease. Second, the medical institution attempts to prevent disease through maintenance programs, including vaccination, health education, periodic checkups, and public health and safety standards (administrative medicine). Third, it undertakes research in the prevention, treatment, and cure of health problems (preventive medicine). And fourth, it serves as an agency of social control by defining some behaviors as normal and healthy and others as deviant and unhealthy. Although health care can take its roots back when one of the greatest achievements of civilization was the naissance of medicine, real health comes from within. The quality of life of an individual is governed by the swelling bearing of his positive personal health-seeking activities and behaviors. And with the help of heath care, tomorrowÃ¢â¬â¢s health centers will fill out todayÃ¢â¬â¢s precision diagnostic services with equally scientific self-care and wellness programs. Future healthcare will increasingly concede to the empowerment of the individual. Perhaps the way healthcare began more than two thousand years back differs from the way it will continue in the next two thousand years or so. The gods may still have a role but not for the folks to plead to for kinder nature. A common Supreme Being might then take the place of them and be prayed to in exchange for a kinder world. If in the past, the causes of illnesses may have been shared between man and nature, from this time forth, diseases would be brought about by the caustic arms of industrialization. Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Whose healthcare would not be needed most in the midst of volatile worldwide climate and industrial population? Typhoons come and leave natural borne diseases. McDonaldÃ¢â¬â¢s open their stores and send resentful stomachs to the healthcare clinics. Who would not consequently draw a smart plot from the commercial appeal of healthcare? For healthcare, this means an upsurge in affliction as well as a digression of resources away from healthcare toward reform. The pandemonium disrupts food supplies, infectious diseases multiply, and alarm triggers stress-induced illnesses. The beginnings of medical care may have been deemed mad and laughable. Then again, its inheritance, with the help of worsened worldwide scenarios, is rendering the underprivileged mad and the moneyed having the last laugh. References Amundsen, Darrel W. (1996). Ã¢â¬Å"Medicine and faith in early Christianity.Ã¢â¬ Medicine, Society, and Faith in the Ancient and Medieval Worlds. Baltimore: The Johns Hopkins University Press. Chambers, Donald and Kenneth Wedel. Social Policy and Social Programs: A Method for the Practical Public Policy Analyst, 4th edition. Pearson Publishing. Fusfeld, Daniel R., and Timothy Bates. (1984). The Political Economy of the Urban Ghetto. Southern Illinois University Press. McDaniel, W. B. (1959). Ã¢â¬Å"A view of 19th century medical historiography in the United States of America.Ã¢â¬ The History of Medicine. Nabokov, Peter. Native American Testimony: A Chronicle Of Indian-White Relations From Prophesy To The Present (1492-1992). Penguin Publishing. Porter, Dorothy E. (1975). Social Medicine and Medical Sociology in the Twentieth Century. Cambridge, Mass.: Harvard University Press. Reiser, Stanley J. (1984). Ã¢â¬Å"The machine at the bedside: Technological transformations of practices and values.Ã¢â¬ The Machine at the Bedside: Strategies for Using Technology in Patient Care. Cambridge: Cambridge University Press. Warner, Martin S. (1985). Medical Practice and Health Care During the Revolutionary War and Early National Periods. Baltimore: The Johns Hopkins University Press.