Access to state of the art
health care services are some things we will all agree would be an honest thing
for this country. Experiencing a significant illness is one of life's major
challenges and to face it without the means to buy it's positively frightening.
But as we shall see, once we all know the facts, we'll find that achieving this
goal won't be easy without our individual contribution.
These are the themes I will be
able to touch on to undertake to form some sense out of what's happening to
American health care and therefore the steps we will personally fancy make
things better.
A recent history of yank health
care - what has driven the prices so high?
Key elements of the Obama health
care plan
The Republican view of health
carefree market competition
Universal access to state of the
art health care - a worthy goal but tough to realize
what can we do?
First, let's get a touch on the historical perspective on American health care. this is often not intended to
be an exhausted check out that history but it'll give us an appreciation of how
the health care system and our expectations for it developed. What drove costs
higher and higher?
To begin, let's address the
American war . therein war, dated tactics and therefore the carnage inflicted
by modern weapons of the age combined to cause ghastly results. Not generally
known is that the majority of the deaths on each side of that war weren't the
results of actual combat but to what happened after a battlefield wound was
inflicted. to start with, evacuation of the wounded moved at a snail's pace and
this caused severe delays in treating the wounded. Secondly, many wounds were
subjected to wound care, related surgeries, and/or amputations of the affected
limbs and this often resulted in the onset of massive infection. So you
would possibly survive a battle wound only to die at the hands of medical aid
providers who although well-intentioned, their interventions were often quite
lethal. High death tolls also can be ascribed to everyday sicknesses and
diseases during a time when no antibiotics existed. In total something like
600,000 deaths occurred from all causes, over 2% of the U.S. population at the
time!
Let's skip to the primary half
the 20th century for a few additional perspectives and to bring us up to more
times. After the war there have been steady improvements in American medicine
in both the understanding and treatment of certain diseases, new surgical
techniques, and in physician education and training. except for the foremost
part the simplest that doctors could offer their patients was a "wait and
see" approach. Medicine could handle bone fractures and increasingly attempt
risky surgeries (now largely performed in sterile surgical environments) but
medicines weren't yet available to handle serious illnesses. the bulk of deaths
remained the results of untreatable conditions like tuberculosis, pneumonia,
scarlatina, and measles, and/or related complications. Doctors were increasingly
conscious of heart and vascular conditions, and cancer but that they had almost
nothing with which to treat these conditions.
This very basic review of yank
medical record helps us to know that until quite recently (around the 1950s)
we had virtually no technologies with which to treat serious or maybe minor
ailments. Here may be a juncture we'd like to understand; "nothing to
treat you with means visits to the doctor if in the least were relegated to
emergencies so in such a scenario costs are curtailed. the straightforward fact
is that there was little for doctors to supply and thus virtually nothing to
drive health care spending. A second factor holding down costs was that medical
treatments that were provided were purchased out-of-pocket, meaning by way of
an individual's personal resources. There was no such thing as insurance and
positively not insurance paid by an employer. apart from the very destitute who
were lucky to seek out their way into a charity hospital, health care costs
were the responsibility of the individual.
What does health care insurance
need to do with health care costs? Its impact on health care costs has been,
and remains to the present day, absolutely enormous. When insurance for people
and families emerged as a way for companies to flee wage freezes and to draw in
and retain employees after war II, almost overnight an excellent pool of cash
became available to buy health care. Money, as a result of the supply of
billions of dollars from insurance pools, encouraged an innovative America to
extend medical research efforts. More Americans became insured not only through
private, employer-sponsored insurance but through increased government funding
that created Medicare and Medicaid (1965). additionally funding became
available for expanded veterans health care benefits. Finding a cure for nearly
anything has consequently become very lucrative. this is often also the first
reason for the vast array of treatments we've available today.
I don't wish to convey that
medical innovations are a nasty thing. consider the tens of many lives that are
saved, extended, enhanced, and made more productive as a result. But with a
funding source grown to its current magnitude (hundreds of billions of dollars
annually) upward pressure on health care costs are inevitable. Doctor's offer
and most folks demand and obtain access to the newest available health care
technology within the sort of pharmaceuticals, medical devices, diagnostic
tools, and surgical procedures. therefore the result's that there's more health
care to spend our money on and until very recently most folks were insured and
therefore the costs were largely covered by a third-party (government,
employers). Add an insatiable and unrealistic public demand for access and
treatment and that we have the "perfect storm" for higher and better
health care costs. And by and enormous the storm is merely intensifying.
At now, let's address the key
questions which will lead us into a review and hopefully a far better
understanding of the health care reform proposals within the news today. is
that the current trajectory of U.S. health care spending sustainable? Can
America maintains its world competitiveness when 16%, heading for 20% of our
gross national product is being spent on health care? What are the opposite
industrialized countries spending on health care and is it even on the brink of
these numbers? once we add politics and an election year to the talk,
information to assist us to answer these questions becomes critical. we'd like to
spend some effort in understanding health care and checking out how we expect
about it. Properly armed we will more intelligently determine whether certain
health care proposals might solve or worsen a number of these problems. What
are often done about the challenges? How can we as individuals contribute to
the solutions?
The Obama health care plan is complex needless to say - I
even have never seen a health care plan that may not. But through a spread of
programs his plan attempts to affect a) increasing the amount of yank that are
covered by adequate insurance (almost 50 million are not), and b) managing
costs in such a fashion that quality and our access to health care isn't
adversely affected. Republicans seek to realize these same basic and broad
goals, but their approach is proposed as being more market-driven than
government-driven. Let's check out what the Obama plan does to accomplish the 2
objectives above. Remember, by the way, that his plan was gone by congress, and
begins to significantly kick-in starting in 2014. So this is often the
direction we are currently taking as we plan to reform health care.
Through insurance exchanges and an expansion of Medicaid, the
Obama plan dramatically expands the amount of USA citizens which will be
covered by insurance.
To cover the value of this expansion the plan requires
everyone to possess insurance with a penalty to be paid if we do not comply.
it'll purportedly send money to the states to hide those individuals added to
state-based Medicaid programs.
To cover the added costs there have been a variety of latest
taxes introduced, one being a 2.5% tax on new medical technologies and another
increases taxes on interest and dividend income for wealthier Americans.
The Obama plan also uses concepts like evidence-based
medicine, accountable care organizations, comparative effectiveness research
and reduced reimbursement to health care providers (doctors and hospitals) to
regulate costs.
The insurance mandate covered by points 1 and a couple of
above may be a worthy goal and most industrialized countries outside of the
U.S. provides "free" (paid for by rather high individual and company
taxes) health care to most if not all of their citizens. it's important to
notice, however, that there are a variety of restrictions that many Americans
would be culturally unprepared. Here is the primary controversial aspect
of the Obama plan, the insurance mandate. The U.S. Supreme Court recently
decided to listen to arguments on the constitutionality of the insurance
mandate as a result of a petition by 26 states attorney's general that
congress exceeded its authority under the commerce clause of the U.S.
constitution by passing this element of the plan. the matter is that if the
Supreme Court should rule against the mandate, it's generally believed that the
Obama plan as we all know it's doomed. this is often because its major goal of
providing insurance to all or any would be severely limited if not terminated
altogether by such a choice.
As you'd guess, the taxes covered by point 3 above are
rather unpopular with those entities and individuals that need to pay them.
Medical device companies, pharmaceutical companies, hospitals, doctors, and
insurance companies all had to "give up" something that might either
create new revenue or would scale back costs within their spheres of control.
As an example, Stryker Corporation, an outsized medical device company,
recently announced a minimum of a 1,000 employee reduction partially to hide
these new fees. this is often being experienced by other medical device
companies and pharmaceutical companies also. The reduction in good-paying jobs
within these sectors and in the hospital sector may rise as former cost
structures will need to be addressed so as to accommodate the reduced rate of
reimbursement to hospitals. Over the subsequent ten years some estimates put the
value reductions to hospitals and physicians at half a trillion dollars and
this may flow on to and affect the businesses that provide hospitals and
doctors with the newest medical technologies. None of this is often to mention
that efficiencies won't be realized by these changes or that other jobs will
successively be created but this may represent painful change for a short time
. It helps us to know that health care reform does have an impact both positive
and negative.
Finally, the Obama plan seeks to vary the way medical
decisions are made. While clinical and basic research underpins almost
everything wiped out medicine today, doctors are creatures of habit just like
the remainder of us and their training and day-to-day experiences dictate to an
excellent extent how they are going about diagnosing and treating our
conditions. Enter the concept of evidence-based medicine and comparative effectiveness
research. Both of those seeking to develop and utilize data bases from electronic
health records and other sources to offer better and more timely information
and feedback to physicians on the outcomes and costs of the treatments they're
providing. there's great waste in health care today, estimated at perhaps a 3rd
of an over 2 trillion dollar health care spend annually. Imagine the savings
that are possible from a discount in unnecessary tests and procedures that don't
compare favorably with health care interventions that are better documented as
effective. Now the Republicans et al. don't generally like these ideas as they
have a tendency to characterize them as "big government control" of
your and my health care. But to be fair, no matter their political persuasions,
most of the people who understand health care in the least, know that better
data for the needs described above are going to be crucial to getting health
care efficiencies, patient safety and costs headed within the right direction.
A brief review of how Republicans and more conservative
individuals believe health care reform. I think they might agree that costs
must come in check which more, not fewer Americans should have access to health
care no matter their ability to pay. But the most difference is that these
folks see economic process and competition because the thanks to creating the
value reductions and efficiencies we'd like. There are a variety of ideas with
reference to driving more competition among insurance companies and health care
providers (doctors and hospitals) in order that the buyer would begin to drive
cost down by the alternatives we make. This works in many sectors of our
economy but this formula has shown that improvements are illusive when applied
to health care. Primarily the matter is that health care choices are difficult
even for those that know it and are connected. the overall population, however,
isn't so informed and besides we've all been mentioned to "go to the
doctor" once we feel it's necessary and that we even have a cultural
heritage that has engendered within most folks the sensation that health care
are some things that are just there and there really is no reason to not access
it for regardless of the reason and worse we all feel that there's nothing we
will do to affect its costs to ensure its availability to those with serious
problems.
OK, this text wasn't intended to be an exhaustive study as I
needed to stay short in an effort to carry my audience's attention and to go
away some room for discussing what we will do contribute mightily to solving a
number of the issues. First we must understand that the dollars available for
health care aren't limitless. Any changes that are put in situ to supply better
coverage and access to worry will cost more. And somehow we've to seek out the
revenues to buy these changes. At an equivalent time, we've to pay less for
medical treatments and procedures and do something to limit the supply of
unproven or poorly documented treatments as we are the very best cost health
care system within the world and do not necessarily have the simplest leads to
terms of longevity or avoiding chronic diseases much before necessary.
I believe that we'd like a revolutionary change within the
way we expect about health care, its availability, its costs, and who pays for
it. And if you think that I'm close to saying we should always arbitrarily and
drastically reduce spending on health care you'd be wrong. Here it's fellow
citizens - health care spending must be preserved and guarded for those that
need it. And to release these dollars those folks who don't need it or can delay
it or avoid it got to act. First, we'd like to convince our legislators that
this country needs sustained public education with reference to the worth of
preventive health strategies. this could be a top priority and it's worked to
scale back the amount of U.S. smokers for instance. If prevention were to
require hold, it's reasonable to assume that those needing health look after
the myriad of lifestyle engendered chronic diseases would decrease
dramatically. many Americans are experiencing these diseases far before in
decades past and far of this is often thanks to poor lifestyle choices. this
alteration alone would release much money to handle the health care costs of
these in dire need of treatment, whether thanks to an acute emergency or
chronic condition.
Let's go deeper into the primary issue. Most folks refuse to do
something about implementing basic wellness strategies into our daily lives. we
do not exercise but we provide tons of excuses. we do not eat right but we
provide tons of excuses. We smoke and/or we drink alcohol to excess and that we
offer tons of excuses on why we will not do anything about managing these known
to be destructive personal health habits. we do not cash in of preventive
health check-ups that check out vital signs, cholesterol readings, and weight
but we provide tons of excuses. briefly we neglect this stuff and therefore the
result's that we succumb much before necessary to chronic diseases like heart
problems, diabetes, and high vital sign. We finish up accessing doctors for these
and more routine matters because "health care is there" and somehow
we expect we've no responsibility for reducing our demand thereon.
It is difficult for us to concentrate on those truths but
easily responsible for the sick. Maybe they ought to take better care of themselves!
Well, which may be true or even they need a genetic condition and that they
became among the unfortunate through absolutely no fault of their own. But the
purpose is that you simply and that I can implement personalized preventive disease
measures as how of dramatically improving health care access for others while
reducing its costs. it's much better to be productive by doing something we
will control then shifting the blame.
There is an enormous number of free internet sites available
which will steer us to a more healthy lifestyle. A soon as you'll,
"Google" "preventive health care strategies", search your
local hospital's internet site and you'll find quite enough help to urge you
started. Finally, there are tons to believe here and that I have tried to
stipulate the challenges but also the very powerful effect we could wear
preserving the simplest of America's health care system now and into the longer
term. I'm anxious to listen to from you and until then - take hold and increase
your chances permanently health while ensuring that health care is there once
we need it
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