Health Care Delivery

Running head: HEALTH CARE DELIVERY1

Health Care Delivery

Student's Name

Title of the Course

HEALTH CARE DELIVERY1

Health Care Delivery System

Introduction

The issue of health care and health care reform in the United States has probably been one of the most discussed and debated issues. Health care, of course, is everyone’s concern and part of everyone’s life. Therefore, having adequate health care is so very important to each and every citizen. But, the health care delivery system is not what it could be, but possibly better than the critics would admit.

Health Care Delivery System

The United States health care delivery system consists of everyone and everything that that is involved in providing care to the individual who is sick and in need of care, or the individual who wants to preserve health. It includes the clinic doctor who sees homeless people and families with no health insurance, to the hospital surgeon who performs state-of-the-art surgeries for thousands of dollars. It includes the nurse’s aide who wipes up vomit and the executives and other business people who make decisions about health care that influence millions of people. But, it also includes the government officials who are desperate to improve health care to the American people.

The “system” could also be considered as the small, urgent care offices that have recently sprung up, and the tertiary care hospitals that are expanding to the point that an aerial view resembles amoebae, along with doctor’s offices, medical helicopters, and mental health clinics. It is the care given to the American people by the providers of the care.

The United States has the most advanced medical care in the world, although some people would argue with that. That is not to say that it is perfect, or that there everyone receives the optimum health care. And, there are treatments available in some places that are not available here in the United States. But, whether critics want to admit it or not, most Americans receive health care that is adequate, or even excellent, under the current system. There are many problems with the health care system in the United States, it is true.

For those Americans who are insured because they can afford private health insurance or get health insurance as a benefit of their employment, the current health care system usually works. However, millions Americans do not have health insurance. Some of the uninsured people work for companies that do not provide health insurance, and some are denied medical insurance because they have existing medical conditions. Others are unemployed or cannot afford private insurance, but they may not be poor enough to qualify for government assistance.

Most people without health insurance cannot afford preventative care—such as regular physicals or immunizations—which helps maintain one's health. Or, unfortunately, there are many people that are not educated as to how to protect their own health. People that have no nutritional education or come from cultures or family units that have unhealthy eating habits may not even realize the health risks. Small problems, or preventable problems can then turn into serious medical problems. The uninsured are sometimes left with no choice but to seek treatment in hospital emergency rooms or the “urgent” care clinics, which is extremely costly for hospitals. If patients cannot pay for their care, the hospitals must either absorb the loss or pass the cost on to paying patients as costs rise for everything from doctors' services to aspirin. Sometimes hospitals turn away uninsured patients to avoid the expense of treating them, except of course, when it is a medical emergency.

Hospitals deliver a wide range of services today, from emergency care, to nutritional counselors, exercise/wellness classes, high technology testing and treatments, and much more. Many hospitals have meals to order, rather than the “yesteryear” comedy hospital food. Records are computerized and the computer can be taken from room to room as needed. There are many professionals that were probably not even thought of years ago, including floor managers, medical assistants, physician’s assistants, nurse practitioners, and medication aides. Gone are the days when the only professionals were doctors and nurses.

Health care delivery also can include mental health services, substance abuse treatment, elderly care, hospice, and rehabilitation. Many of these services are recent types of care. For instance, hospice care can be in the home, or in a particular hospice facility. It is specifically designed to make the end of life more comfortable and allows family and friends to be a part of the process. Not so many years ago, when a person was dying, it was likely in a cold, drab hospital room with a few selected immediate family members in attendance.

Rehabilitation is another rather recent type of health care that is allowing patients with severe injuries or surgeries to stay temporarily in a rehabilitation facility with therapy and care until the patient is ready to go home. This replaces either a long hospital stay, or permanently residing in a nursing home. This situation saves money, and allows people to go back to their homes after proper therapy.

Health insurance has become big business, and there is tremendous competition. As a result, the price of health insurance has gone up, even while the coverage of services and treatments has become more limited and restricted. The costs for health care in America are among the highest in the world. Most Americans agree that health care costs must be reviewed and cut back somehow, but few can agree on how to do this. Many reforms have been proposed, from minor improvements to broad sweeping changes. The debate has gone on for many years and there is no end in sight.

In 1965, the Social Security Act established Medicare and Medicaid, providing medical insurance for retired persons and disabled who received Social Security (Medicare) and for those on welfare, or receiving Supplemental Security Income (Medicaid). Other than that, however, there was little change in government assisted health care in 30 years. The working poor assumed the most risk under these conditions because they did not qualify for Medicaid and generally worked for employers who did not offer medical insurance. From the 1960s to the 1980s, health-care costs continued to rise rapidly because of economic trends and technological advances in medicine. By the 1990s, even employers with health-care benefits found it difficult to continue to provide the level of protection to which workers had become accustomed without raising employees' premiums or reducing their benefits.

Health maintenance organizations (HMOs; prepaid group health plans) sought to lower insurance costs by focusing on preventive care rather than corrective medicine. HMOs also sought to reduce medical costs by requiring certain procedures to be authorized in advance by insurance companies. Family doctors were replaced by larger groups of salaried physicians, which lowered overhead costs for the HMO but made healthcare less personal. Despite these cost controls attempted by the HMOs, health costs and insurance premiums continued to rise.

Calls for health-care reform came from across the nation, but lobbying from special-interest groups such as the AMA often got in the way. In 1991, more than three dozen health-care reform bills were introduced in the U.S. Congress. None of them passed. The following year, President George H. W. Bush presented a health-care reform plan that promised to provide coverage for the more than thirty-five million Americans without health insurance and to stop the spiraling costs for the Medicare system. This legislation, too, died in Congress.

Finally, in 1993, President Clintonattempted to remedy the crisis by choosing First Lady Hillary Rodham Clinton, to lead efforts to reform the Americanhealth-care system. In October of that year, President Clinton unveiled the plan developed by Mrs. Clinton's task force. The National Health Security Plan proposed to overhaul U.S. healthcare. All Americans would receive health insurance coverage under the plan. The plan would have been financed through a combination of savings in existing programs, new revenues, and a series of subsidies or grants. Employers would pay 80 percent of their employees' health insurance premiums, with the government providing subsidies to low-income workers and some small businesses. There would have been a seventy-five-cent per-pack cigarette tax. All insurance would be purchased through regional health alliances under government control. The plan also required half of U.S. medical school graduates to specialize in primary care.

Whenever national health insurance or similar terms are used, lots of people get the idea that medical care will be forced by the government, that people will only be able to go to certain health care providers, or that the country is headed on a straight path to socialism. In order for Clinton’s plan to have been more successful, there should have been numerous cut-backs to balance out the added programs. For instance, there are medical programs which give free care to mothers and multiple birth children, no matter if the parents have an income of a million dollars or more, and whether they have other insurance or not. That is one program that could be cut. There are many such programs that are not “bad” but are actually unnecessary or superfluous. The American people, and the politicians, are not going to accept new, expensive programs without cutting something that is already in place that is out-dated, or not needed.

Another failing in the Clinton plan was the idea of raising taxes on cigarettes. While sounding admirable, the thought of raising taxes on anything seems to rile up the general public.

Conclusion

The United States does have a tremendous health care delivery system. It has its faults, and truly, millions of people are not covered by insurance. However, there are “stop gaps” and for the most part, this country has better care for more people than any other country in the world. But rising costs and fewer employer health insurance programs have been pushing people out of the “mainstream” and the health care delivery system is going to begin to fail if something is not done. Many programs have been proposed, and almost all have been turned down. It seems to be the time now that the health care delivery system must be augmented by some government assistance for those that are not covered.

References

Agency for Health Care Policy and Research.[1998] (Accessed September 27, 1999).

American Association of Health Plans.[2009]

“Change, Challenges, and Innovation in Health Care Delivery” (2009)The Health Care System, Gale. Retrieved December 5, 2011 from

Families USA.[2010] (Accessed December 5, 2011).

“The U.S. Health Care System” (2009) The Health Care System. Wekesser, Carol, ed. Health Care in America, Opposing Viewpoints. San Diego, Calif.: Greenhaven Press, Inc, 1994.