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Hospitals and other health care institutions, whether voluntary or for-profit, need to be financially solvent to survive growing market pressures. Describe how this “bottom line” focus has changed the nature of the US health care system
Complete ALL of the bullet points below:
- Health care planners could be more effective and efficient if they used the concept of the natural history of disease and the levels of prevention to design services that intervene at the weakest link in the chain of progression of specific diseases. Instead, most focus on high-technology solutions to preventable problems. Assess the characteristics of the medical care culture that encourage the latter approach.
- Hospitals and other health care institutions, whether voluntary or for-profit, need to be financially solvent to survive growing market pressures. Describe how this “bottom line” focus has changed the nature of the US health care system.
- The insurance industry plays a huge role in the American health care system and absorbs a significant portion of the health care dollar. A single payer system, whether it is a private company or the US government, would eliminate the complex insurance paperwork burden and free substantial funds that could be diverted to support care for the under-served. Why do you believe that so much resistance to a concept used in every other developed country has continued in the U.S.?
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Please submit one APA formatted paper between 1000 – 1500 words, not including the title and reference page. The assignment should have a minimum of two scholarly sources, in addition to the textbook.
They want it in APA with the beginning of the paper stating what it is about and conclusion at the end
Required Source: Sultz, H. A., & Young, K. A. (2017). Health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett. Read chapters 1 & 2.
Expert Answer and Explanation
US Healthcare System
The US healthcare system has experienced a lot of changes in terms of medical care methods and treatment protocols and financing. In terms of treatment, the US health system has been positively impacted by technologies such as electronic health records among other healthcare technologies (Sultz & Young, 2017).
These technologies have allowed healthcare professionals to provide quality and safe care. In terms of financing, the US health system has experienced huge reimbursement changes. Some of the policies that have changed US health financing include Medicare, Medicaid, and Affordable Care programs (Sultz & Young, 2017).
The purpose of this assignment is to explain characteristics of the medical care culture that have encouraged US care professionals to focus on high-technology solutions to preventable problems, how the “bottom line” focus has changed the nature of the US health care system, and why universal health care is resisted in the US.
Certain characteristics are common in a medical culture which encourages healthcare professionals to use high-technology solutions to preventable problems. The characteristics become visible during patient examination and provision of other care services concerning the technologies. It is vital to identify the players in healthcare culture to accurately determine their characteristics and motives.
In the US healthcare culture, two main players are the patients and healthcare professionals (doctors, nurses, and other specialists) (Sultz & Young, 2017). Other players include the hospital system and third-party payers (private and government insurance plans). One of the medical care cultures that encourage the latter approach is instant gratification.
According to Sultz and Young (2017), most healthcare planers focus on high-technology solutions to preventable problems because of the medical culture of instant gratification. Instant gratification means instant cure (Deo et al., 2020).
Most patients in the US need an instant cure for acute illness, chronic disease, and pain which cannot be provided by the former. High-technology solutions can provide instant care while the former cannot. When high technologies are used, the patient is cured almost instantly.
The second characteristic is work satisfaction. Sultz and Young (2017) noted that work satisfaction is highly associated with the use of high technology to provide cures and promote disease prevention. The main objective of healthcare professionals is to provide patient care using standardized interventions.
Healthcare professionals prefer to use high technology to attain healthcare goals because it prevents them from fewer difficulties as compared to the conventional approach which relies on identifying the history of the illness to create a treatment protocol (Harerimana et al., 2019). In other words, healthcare professionals use high technology to help their patients because it achieves their care goals faster than conventional methods and thus improves their satisfaction.
The last characteristic is improved coordination of responsibilities and communication. Healthcare professionals prefer care methods that allow them to effectively coordinate and communicate when providing care to their patients. High-technology methods provide them with the opportunity to coordinate and effectively communicate making it a preferred method of care provision among the players in the US care system.
Sultz and Young (2017) noted that US care providers have recently shown interest in Electrotonic Health Records as a tool to be used in providing care. The authors argued that the tool has helped healthcare providers easily and effectively coordinate and communicate with patients and other stakeholders to provide care. EHR technology provided healthcare professionals with a single platform where they can access patient data and communicate with peers, making the high-technology care provision method the preferred approach.
All healthcare organizations across the US strive to be financially solvent in the process of providing quality and safe care to their patients and this has greatly affected the nation’s healthcare system. One of the ways the “bottom line” focus has changed the healthcare system in the US is increasing the cost of care services.
Dieleman et al. (2020) noted that Americans are paying more for their care today than in the last decade due to healthcare organizations’ focus on the bottom line. Healthcare organizations are forced to increase the cost of care services to be able to pay for their human workforce and procure necessary products needed for care providers such as drugs, beds, ambulances, and many more (Ratna, 2020).
Healthcare insurance companies have also increased the number of premiums people are supposed to pay to receive care. The rise in the cost of care has created a gap between low-income and high-income people. Only high-income individuals can access care based on the impact.
The quality of care has also been impacted by the bottom-line focus. Healthcare organizations have focused more on making a profit than providing quality care because they want to achieve the bottom line and become financially stable. There have been instances where healthcare organizations turn patients away because they do not have insurance or cannot pay for the services they seek (Ratna, 2020).
For instance, some healthcare organizations turn away patients because they cannot pay for the services or do not have insurance plans. Other facilities diagnose patients and then refer them to a smaller health center because they are afraid of not getting paid and that the patients are not good for business (Ratna, 2020).
The bottom-line mentality has also led to health inequality in the US care system in that people without insurance plans or financial muscle cannot get the healthcare services they need.
Customer satisfaction has also been affected. Other healthcare organizations have resorted to employing less qualified healthcare staff to care for patients. The staff does not have the needed experience and skills to provide patient-centered care which makes patients less satisfied with the services they receive.
The universal healthcare system (UHS) is a model that is highly discussed in the US. Under the UHS model, the government is the sole payer of all healthcare costs (Sultz & Young, 2017). The coverage means that all people have equal access to healthcare services they want, where and when they need it without economic hardship.
The model removes the need for private insurance firms which often set rigid standards for individuals to access care (Giovanella et al., 2018). Though most of the developed economies have implemented UHS, the US has not yet adopted the system used to unending resistance. Healthcare insurance firms are among the stakeholders resisting the system.
They view the system as a threat to their insurance business because once the government pays for all healthcare needs, people will not have any reason to take private insurance (Zieff et al., 2020). These firms have waged war against any faction supporting UHS by lobbying politicians and other groups to denounce the success of the plan.
The firms and other interested parties are always ready to spend millions of dollars to lobby against any policy suggesting the adoption of UHS in the US. For instance, the battle about the contents of the Affordable Care Act generated about $1.2 billion in 2009 in lobbying alone (Zieff et al., 2020). The insurance industry spent over $100 to ensure that ACA did not affect private insurers.
The system has been facing a lot of resistance because American culture is mostly individualistic. In other words, Americans, especially conservatives believe strongly in classical liberalism. According to conservatives, the government should play limited in societal issues such as healthcare.
UHS goes against the beliefs of American conservatives and this has made it hard for the system to be adopted in the US. Zieff et al. (2020) argued that only a small number of the participants support the system. The majority of the people believed that government should provide limited support on matters of health. They believed that people are majorly responsible for their health and not the government.
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Certain characteristics are common in a medical culture which encourages healthcare professionals to use high-technology solutions to preventable problems. They include instant gratification, work satisfaction, and improved coordination of responsibilities and communication. One of the ways the “bottom line” focus has changed the healthcare system in the US is increasing the cost of care services.
The “bottom line” focus has also negatively impacted the quality of health and customer satisfaction and increased inequalities in care provision. UHS has received a lot of resistance in the US because the culture of the country is individualistic meaning that government should minimally impact social life. The interested groups have also channeled a lot of funds into lobbying against the policy, thus increasing resistance.
Deo, N., Johnson, E., Kancharla, K., O’Horo, J. C., & Kashyap, R. (2020). Instant gratification as a method to promote physician practice guideline adherence: A systematic review. Cureus, 12(7), e9381. https://doi.org/10.7759/cureus.9381
Dieleman, J. L., Cao, J., Chapin, A., Chen, C., Li, Z., Liu, A., & Murray, C. J. (2020). US health care spending by payer and health condition, 1996-2016. Jama, 323(9), 863-884. https://jamanetwork.com/journals/jama/article-abstract/2762309
Giovanella, L., Mendoza-Ruiz, A., Pilar, A. D. C. A., Rosa, M. C. D., Martins, G. B., Santos, I. S., & Machado, C. V. (2018). Universal health system and universal health coverage: assumptions and strategies. Ciencia & saude coletiva, 23, 1763-1776. https://doi.org/10.1590/1413-81232018236.05562018
Harerimana, B., Forchuk, C., & O’Regan, T. (2019). The use of technology for mental healthcare delivery among older adults with depressive symptoms: A systematic literature review. International Journal Of Mental Health Nursing, 28(3), 657-670. https://doi.org/10.1111/inm.12571
Ratna, H. N. (2020). Medical neoliberalism and the decline in US healthcare quality. Journal of Hospital Management and Health Policy [Internet], 4, 1-8. https://gs.alexu.edu.eg/new/upload/Students/0908/0908(1)703_2019-2020_Spring/0908-3-041_assignment_1.pdf
Sultz, H. A., & Young, K. A. (2017). Health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett.
Zieff, G., Kerr, Z. Y., Moore, J. B., & Stoner, L. (2020). Universal Healthcare in the United States of America: A healthy debate. Medicina (Kaunas, Lithuania), 56(11), 580. https://doi.org/10.3390/medicina56110580
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