Improving Healthcare In The United States
Improving Healthcare In The United States
On any given day in this country millions of American’s receive adequate health care which serves to restore, promote, and improve their physical and mental well-being. Unfortunately, a significant many do not. In a nation where celebrity icons, CEO’s, and political figures, to name but a few, enjoy a life of flagrant and superfluous material possessions and wealth, it is virtually unconscionable that any individual within this society should be denied the basic human right of health-care. However, more than forty-six million American women, men, and children are living without health-insurance (U.S. Census Bureau, 2006). In a 2009 address to a joint session of Congress, the President stated,
“The cost of our health care has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year. In our grasp right now is the chance to prevent a future where every day 14,000 Americans continue to lose their health insurance, and every year 18,000 Americans die because they don't have it”(President Barack Obama, February 24, 2009).
In fact, it has been well documented that individuals without health-insurance are in poorer health throughout their lives and die sooner than insured individuals (Axeen & Carpenter, 2008). Uninsured individuals often delay treatment due to the enormous cost of medical treatment; and the treatment they receive is often sub-standard when compared to insured individuals. To offer one such example, a study of heart attack suffers conducted by the U.S. Department of Health and Human Services (HHS), revealed that a mere twenty-one percent of eligible patients on Medicare were given beta-blockers; which have been shown to decrease the mortality rate of heart attack victims by more than forty-three percent (HHS, 2002). Evidence indicates significant variation in the types of services and disparities in the quality of services provided to the uninsured versus the insured.
Racial and ethnic minorities make up one-third of the US population; however, they comprise fifty-two percent of the uninsured. Although there are a number of explanations for the disparities in health services and outcomes with respect to individuals of minority status, access to insurance is one of the most significant contributing factors. The examples of the health disparities with respect to minorities are significant. African Americans, Latinos, and American Indians are more likely to rate their overall health as fair or poor in comparison to whites. Rates of diseases such as cancer, cardiovascular disease, diabetes, tuberculosis and HIV/AIDS are higher for most racial and ethnic minorities. For example, African American women have the highest rate of death from heart disease, breast and lung cancer, stroke, and pregnancy compared to women of all other racial and ethnic backgrounds (National Women’s Law Center; NWLC, 2006). According to a landmark report developed by the Institute of Medicine (IOM), the single most effective way to reduce racial and ethnic disparities in health is through the provision of access to care to uninsured individuals of all minority and racial groups(IOM, 2003; as cited in NWLC, 2006).
Health-care reform is not just a moral imperative, but an economic necessity, as well. In 2007, the cost to the United States economy resulting from the poorer health and shorter life-span’s of the uninsured amounted to 207 billion dollars (Cortese & Korsmo, 2009). A caucus conducted by the Mayo Clinic Health Policy Center uniting more than 2,000 stakeholders in health-care reform (e.g., patients, academics, medical personnel, and politicians) and spanning the last two years has recommended focusing health-care reform around several broad foundations. First, providers have a responsibility to create value through improved services to patients and greater health outcomes. The key to providing quality care while simultaneously preserving finite financial resources is establishing integrated, coordinated care through the utilization of information technology (IT). Coordinating care is especially important with respect the treatment of chronic diseases, which accounts for seventy-five percent of health care spending in this country (Cortese & Korsmo, 2009). Increased spending results, in part, due to the fact that individuals with chronic diseases often see a number of specialists and undergo an extensive amount of testing that lacks a coordinated treatment plan, resulting in unnecessary and redundant procedures which are both costly and seriously undermine the individual’s care and safety. Fractured care results in the increased probability of medical mistakes which have the potential to be life-threatening. For example, a study of injuries to patients treated in New York hospitals revealed that 13.6 % of victims of medical mistakes died as a result (HHS, 2002).
Furthermore, the Mayo Clinic’s caucus recommends reformation of the payment mechanisms, such as our reimbursement system, which rewards piecework and the performance of expensive, fragmented procedures rather than coordinated and appropriate care (Cortese & Korsmo, 2009). The United States government must fundamentally change its role in health-care from that of a non-system into one that demands value, outcomes, efficiency, and quality; which requires a complete overhaul of the health insurance industry and greater involvement in, if not control of, the mechanisms by which health care providers are paid for services.
Lastly, although certainly not the least of the concerns facing health care in this country, health care must be a basic birth-right of each and every individual within this nation, without exclusion. Therefore, a public health option must be established that assures affordable, quality health coverage for all Americans, ends barriers to coverage for people with pre-existing medical conditions, allows individual’s the right to maintain coverage when changing or losing a job, and promotes prevention and wellness. Additionally, health care practitioners must develop an awareness and recognition of the ways in which the socio-cultural backgrounds of their patient’s influence the patient's health. In a 2004 report developed by the National Women’s Health Resource Center it is recommended that practitioners utilize a model developed by Cornell University researchers called ESFT: Explanatory, Social risk, Fears and concerns, and Therapeutic contracting. Through this process, health care professionals instruct patients to explain their symptoms in their own words, attempt to understand the social or financial issues that may hinder patients from following prescribed treatment, ask the patient to express any fears or concerns regarding the treatment, and have the patient use a "teach back" technique to ensure that the provider has understood the information accurately (National Women’s Health Report, 2004).
Following from the recommendations presented herein, these steps must be taken….to ensure that no individual has to go without adequate, comprehensive, affordable, and culturally sensitive health care.
Axeen, S., & Carpenter, E. (2008). The cost of doing nothing: Why the cost of failing to fix our health system is greater than the cost of reform. Washington: The New America Foundation. Retrieved November 4th, from http://www.newamerica.net/files/NAF_CostofDoingNothing.pdf.
Cortese, D. & Korsmo, J. (2009). Health care reform: Why we cannot afford to wait. The People- to-People Health Foundation, Inc. Retrieved November 4th, from http://www.ahrq.gov/news/qualfact.pdf.
National Women’s Health Resource Center. (2004). Providing culturally sensitive health care. National Women’s Health Report, 26(5), (p.5).
National Women’s Law Center. (2006). Medicaid and minority communities: Why Medicaid is so important. Retrieved November 4th, from http://www.nwlc.org/pdf/Medicaid%20and%20Minority%20Communities%20_Jul%202 006_.pdf.
U.S. Census Bureau. (2006). Income, poverty, and health insurance coverage in the United States. Washington: U.S. Government Printing Office. Retrieved November 4th, from http://www.census.gov/prod/2008pubs/p60-235.pdf.
U.S. Department of Health and Human Services. (2002). Improving health care quality: Fact sheet. Maryland: The Agency for Healthcare Research and Quality. Retrieved November 4th, from http://www.ahrq.gov/news/qualfact.pdf.