Get Your Knowledge On..Get It Out !

Get Your Knowledge On..Get It Out !: Death Panels Should Have Been Named Moral and Ethi...

2011-10-10T09:44:00.000-04:00

Get Your Knowledge On..Get It Out !: Death Panels Should Have Been Named Moral and Ethi...: What Broke My Father’s Heart James Wise Class: HCA300 Introdu...

We Truly Are What We Eat

2010-12-19T17:28:00.000-05:00

An Exercise in Good Diet

James Wise

Class: HCA300

Abstract

Our assignment this week had me do an exercise in tracking my food intake. An impressive government website allows entering your food intake for the day and tracking your choleric intake, nutritional values, and gives recommendations in all major food categories. I will reveal the results of my exercise and compare it to “MyPyramid” recommendation. I will begin with sharing my personal story in fighting my diabetes in regards to food intake. I will conclude with whether I am doing well here or if I need improvement in my diet.

My Personal Story

In attempting to control, diabetes through diet and exercise requires good knowledge and focus. This is an area of my personal focus for 5 years now and has yielded amazing results. When first diagnosed with diabetes I was eighty pounds overweight and a heavy drinker. My medication prescription ballooned into ten pills per day and eighty units of insulin. Truly, I had no focus on my health in general and I fault the structure of insurance companies’ policies as a contributing factor. In the beginning, I had the best of Blue Cross and Blue Shield with nearly unlimited resource to health care services and prescribed medications. These types of policies can blind the patient to personal responsibilities. It was not until I lost my insurance that reality came into focus that I had to take responsibility of my health issues if I were to stay well. After much research and discovery of my disease, I began to apply what I learned. In the beginning it was a two edged sword; when you are overweight fasting raises blood sugars from converting fat into energy. Unfortunate for diabetics, eating any type of food spikes sugar levels, so I must only eat small meals throughout the day. I also must stay away from empty calories found in most sugar type products; like soda or alcoholic drinks. To end my personal story I am now at my ideal weight only 12% body fat and on now medications what so ever. Therefore, when I had to do this exercise I was poised to do very well; let us look at my results.

Nutrient Intake

These results reflect the calculation of three days of the intake of the food I ate. I will show the results in six main areas starting with protein. My protein was double the recommendation at 119 vs. 56. My Carbohydrates was also over twice recommendation at 285 vs. 130. My total fiber was under the recommendation of 38 with my score being 22. My total fat score was 75.1, which was in the range of the recommended amount. My saturated fat score was below recommend amount, with a score of 19.8 vs. < 25.4. The last category is my sodium intake at 4001 vs. no more than 2300. I was surprised at this result considering I do not put extra salt on any of my foods and yet I scored so high. I was not surprised on my protein intake, Generally lean meats do not produce sugar spikes when they are broken down in contrast to say rice, bread, pasta to name a few. I was also surprised to see my carbohydrates so high, although this is not a true reflection when exercise is considered. I was not the least surprise that both my total fat and saturated fat was under recommendations since this has been my focus in fighting my diabetes. Finely I was shown that I am need of more fiber in my diet, which can be easily corrected. Let us now look at my pyramid recommendations.

My Pyramid Recommendations

These recommendations are calculated in five main areas starting with milk. I consume 3.8 in the milk category with the recommended amount of 3.0. In the category of Meat and Been intake was not surprising given my protein intake which resulted in a score of 11.4 oz. vs. 6.0 oz. My vegetable intake results were a little under recommendations at 2.1 vs. 3 cups. My fruit intake was expected resulting in .8 cup above recommendation, considering I usually snake on apples between meals. My grain intake was below recommendations at 7.0 oz vs. my score of 5.9, which is in line with needing more fiber in my diet.

Conclusions

One statistical result worth noting was my total energy/choleric intake resulting in only 71 point above recommendations without taking in account my exercise program. In life and in all things there is always room for improvement. With that said, I believe I am doing very well over all in my diet plan. This online tool is exceptional and will be used by me often now that I am aware of its existence. Which leads to my conclusion, society so disparately needs to know such government sites as this one exist; it truly brings into focus dietary concerns and helps empower people to make changes. Ultimately, the individual that takes responsibility of their health that yields the best results. Websites like this one should be nationally promoted, as I will do my part to promote this new finding on my websites and social networks.

Reference:

Mypyramidtracker.gov First accessed on November 5^th 2010 with results retrieved on November 7, 2010.

Death Panels Should Have Been Named Moral and Ethical Reasoning

2010-11-30T07:36:00.001-05:00

What Broke My Father’s Heart

James Wise

Class: HCA300

Introduction

This week’s course study took us down the path of reading a true story written by Katy Butler, regarding the end of life experience of her Father who was put on a pacemaker. The story was heart wrenching as may be expected considering the nature of our topic, death. Her family was upper middle class, her father a retired professor. They were known to be educated, even prepared for end of life experience with both having signed living wills. Katy suggests that the healthcare system is profit focused and towards that end keeps a person alive as long as possible, disregarding value of life. She explains that her father has dementia, and already he could not do all his ALD,s which was left up to her mother to perform on his behalf in changing diapers, giving baths and more. Her research lead her to lobbyist from drug and medical equipment companies who that pay over 500 million to get policies that reward doctor as she terms it as overtreatment.

She exclaimed that she is given more Government-mandated consumer information on a new car then medical procedure counseling, such is it a good idea to put a pacemaker in a man who barely has a mind. Ironically, her father was not for it but because of his dementia it was left up to mom. As well informed, as her mother was she was put in a life or death decision with the surgical team advising the pacemaker. Katy points out, that the new healthcare bill had a provision, called ”end of life counseling;” to determine value of life and if the procedure is worth the outcome of the patient. However, this was to become known as “Death Panels” and removed from the bill, the very thing that would have stopped the pacemaker from being put in her father. After years of grief, service in mom helping her estranged husband do to dementia, he passed away with the pacemaker still shooting electrical pulses to his now dead heart.

All About The Money

I am in complete agreement with Katy Butler concerning the money trail and underlining motivation. She also point out that 30% of elderly who are deathly ill wish for death or trade one good day then two more years of illness. Comparably, she showed statistics that 30% of Medicaid/Medicare cost is from overtreatment. Her rational is sound when she says, “if a patient says no to a procedure then there goes the money, no one is paid.” In my support of Katy, I have, in many other courses shown that the worse disparities in health care are formed when profit is the motivating factor. In her family’s case, it turned her joyful mother and their shared joy into a nightmare, resulting in thoughts that cause guilt because you want it all to end.

We are called the sandwich generation because science has created longevity of life. In today’s world many are raising their children and caring for their ageing mother or father as well. The young parents are now sandwiched into taking care of two generations and often times the ailing parent is harder to care for. This puts so much more stress in life and strains family systems to point of even breaking. Such was the case in my personal story when my mother in law moved in with our family. She was both mentally ill and physically incapable and she stayed with us for three years. Personally experiencing the downward spiral of my mother in law and the twenty so procedures to keep her going was the most depressing time of my life. In the end, it was one of the factors that broke up my marriage; an experience I still shutter over to this day. It was my first real glimpse in health care’s great machine, often playing on my ex-wife emotions they would get yet another procedure underway. In my mother in laws case it was overtreatment with each procedure as she worsened from each and everyone. Not only were the doctors paid but also my family paid the price as well with heated discussions that our predicament created. It was indeed a path into nightmarish madness watching a love one slowly and with no personal dignity left finely pass away.

Common Sense or Policy

I do not fault medical science, in fact I applaud each new breakthrough with much vigor. Medical science continues to enhance life in many ways. Policy drives market in the direction towards maximum profit and policy form from special interest groups or lobbyist. Anytime a policy is not based in common sense thent I almost guarantee a lobbyist was behind its creation. Who was behind the coinage of “Death Panels” when it was based in common sense not the automatic model that says maybe one more procedure will fix the problem. Simply there must be transparency in our health system that does not compromise value of life when achieving longevity.

Concerning life-supporting equipment such as pacemakers they have great use and help people live, long lives that they would have been deprived of. In contrast, I would highly question putting the device in a 81 year old man suffering from dementia in the story I summarized here. In such decisions in life, perhaps the hardest concerning death, needs good counsel with all considerations on the table. In my personal experience with my mother in law, it was always a hurried process when it came to a new procedure. We should have called death panels’ moral and ethical reasoning. In conclusion, I will order the Do Not Resuscitate bracelet and wear it from now on, because simply I do not want to trade quality of life for longevity.

Reference:

Butler, Katy (2010) What Broke My Father’s heart The New York Times

Retrieved on November 27, 2010, from

http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html?pagewanted=3&_r=1

Concerning Death & Free Choice

2010-11-27T20:34:00.000-05:00

Death and Dying is indeed a controversial topic with opinions than span both sides of the spectrum. So, let us look at both sides of the spectrum here, and try to determine what the answer is when it comes to how we handle death.

Highlighting Christopher Reeve mentioned in our discussion thread was in real life a Superman, which is ironic considering he played the role of superman in more than one Hollywood movie. Having suffered complete paralysis from his fall from a horse he was not daunted but rather with incredible determination became the champion for further research in healing paralysis. I recall one amazing thing he said that changed my life, “ Even though I am paralyzed from the neck down, I see others in this world that are more paralyzed from fear then I am concerning my own paralysis.” Truly, this statement has empowered me to address my own fears even the fear of death, which is really, what this discussion is addressing.

In contrast, let us look at Dr. Death or more respectfully Dr. Jack Kevorkian. Having the unique experience of living only two blocks from his practice in Pontiac Michigan, I know his case intimately; in fact, I was present at his trial. His core belief is that a person should have freedom of choice, even concerning death a belief he was prosecuted for. I ask why is it in life we have free choice throughout life, but then taken from us when we decide that death is better than living? Some say we are playing God I say there are times when the value of life has crossed the line that death is preferable. If I am left with no value, having being reduced to diapers or no mind left and science is the only thing keeping me going I would rather cross to the other side. Who are you the Government or Church to say otherwise?

Many may disagree so let us look at another case that happened in Florida. Does anyone remember Terri Schiavo who was on life support for 15 years after she had suffered from a cardiac arrest? I will not go into full detail but provide a link to this story. In the end after fifteen years her husband and family won the case and the state allowed her feeding tube to be removed resulting in her death by starvation. I ask which is more humane Dr. Kevorkian with the consent of the patient and family to be put to death by injection that causes the patient to go into a deep sleep and then die, or the state’s decision to allow someone to starve to death, which took days.

Shame on Government laws and church indoctrinations that take away freedom of choice when it means the most concerning death. We must understand that death is part of life and to put someone on life support for years when there is no value of life left is a waste of money and furthers the grief for the surviving family. Simply it cost major amount of moneys to keep people on life support when no hope of value of life can be achieved, better use of this money should go towards say, homeless families who have the potential to providing a better future. When I no longer can contribute to society and the greater good, when I become a burden to such means I want the decision to be able to say I am ready to meet my maker.

Reference:

http://www.usatoday.com/news/nation/2003-10-22-comatose-woman_x.htm

Accidents effect health care cost! Parents and Safety

2010-11-16T09:31:00.005-05:00

I look at what the discussion thread asks and I find myself very lucky in life when it comes to accidents. Not that I have never been in some sort of accident caused by risky behavior it just so happens I never had to be sent to the emergency room over the accident. Furthermore, none of my six children ever has hurt themselves to the degree of emergency services.

In contrast with my own life, I have heard many stories of children drowning in Florida, or gun accidents throughout the nation. It truly makes me question how attentive are parents today to be able to determine risk factors and practice safety in their own homes.

I honor my father and his mentoring that provided a safety net for his children, and by tradition, I passed this down to my own children. I grew up around guns, but was trained to respect how deadly they were and why it was not a plaything. I was taught how to clean a gun by first making sure there was no bullet in the chamber. At the age of nine, under my father’s supervision I fired my first 12-gage shotgun, which ended with me flat on my back. Believe me my respect for firearms grew that day! Never were the guns locked up, we always knew where to find the bullets, but we were taught respect of the deadly risk value they held. As children, we were content to playing with toy cap guns our rubber band guns remembering never to shoot at the face. I believe because of my father’s teaching the taboo was lifted from guns and answered to our curiosity and gave respect to leave them alone.

I grew up around pools and ponds as did my children, again following my father’s footsteps I took it a step further and had my 6 month olds knowing how to doggie paddle. I taught my older children to look after their younger siblings, creating a culture of safety and empathy. As I was enrolled in, Boy Scouts I did this as well with my children these organizations teach safety, with every merit badge pursued.

I always find it troublesome when laws are created because of parents neglect with the teaching of safety to their children. We are bound to have accidents but we can greatly curtail the severity by good nurturing, teaching, and respect of high-risk areas apparent in life. Ultimately, it is the responsibility of parents, not laws, that attempt to change behaviors that hold the greatest value. Whe need laws that promote family, considering the trend of single parent households. This raises the likely hood of accidents accruing when only two eyes are on the children verses four.

Lets talk about the "C" word Cancer! " Sun Worshipers needs to Know

2010-11-09T13:48:00.000-05:00

Cancer surely the most feared “C” word known to all. Anyone who has watched a close friend or family member go through Radiation Treatments and Chemo Therapy will give rise to personal nightmares. When our love one finely succumbs to cancer and dies, we are relieved and call it an act of mercy.

With that said we still see society throwing caution to the wind, or should I say the sun; let us begin with UV rays. Ironically, back in the renaissance age, milky white skin was considered a sign of royalty, and tan people where peasants’ who had to work in the sun. Today, tans are look at as luxurious living entertained by the wealthy, compared to the white skin folks having to work indoors all day. Simply, UV rays are damaging to the skin; it starts premature aging, and destroys skin cells immune system, crates skin cancer, and scaring.

Have I said enough about the sun worshipers? Not nearly, here are some freighting statistics from the state I reside in. Florida, “the sunshine state,” also known as the place of retirement has big issues here dealing with a skin cancer called Melanoma. Florida is 135% higher than national average, diagnosing 4.920 residents, and killing 626 of those diagnosed. In addition, the death rate of those over 50 years old has doubled since 1975. (EPA.Gov 2010). Which leads me to aging and the need for good lifestyle practices the older we become.

Aging of course is an uncontrolled variable, simply we all get old, but our chances of getting cancer increases. Perhaps the reasons for those over 50 years old in Florida, the death rate of skin cancer have doubled. As we grow older our immune system breaks down, it is harder for us to fight off virus and bacterial infections. This progression can compromise your immune system further and allows free radicals to form into cancer cells. How alarming, so what can we do, what variables can we control?

Realize if you will, Obesity and Age = Cancer! There are so many forms of cancer that develop because of obesity it would take another commentary to encompass its scope. Just say it is important to stay at your ideal weight if not start working! Stay away from fats, and Trans fats; peanut butter is high in both. Look to natural herbs that boost the immune system, teas that create better blood flow and herbs that enhance both hydration and oxidization. Eat fruits and power vegetables like cucumbers that hold much of what the body needs. Promote exercise, even if it just walking, or even better swimming. Many YMCAs’ have swimming programs for the seniors. Oh and stay out of the sun, or wear long pants and sleeve shirts with a large brim hat and protect your eyes with UV protected glasses.

In closing it is all about knowledge, I tend to think that many retirees that come to Florida do not know how harmful the sun is to them, or we would not have so many cases. Many I believe harm themselves without knowing. I have a new Slogan “Get Your Knowledge On!, Then Get Your Knowledge Out!”

Reference:

EPA.gov, 2010, Skin Cancer is the most common cancer diagnosed in the United Sates, Retrieved on November, 9, 2010, from http://www.epa.gov/sunwise/doc/fl_facts_print.pdf

Heart and Health, what is your state of being?

2010-11-08T10:15:00.000-05:00

Having been adopted in my early years I have no known access to my genetic heritage. With that said, with the exception of a heart defect at birth, heart disease is a variable we can control. Learned in our last week exercise is the importance of diet. One astounding find was my sodium or salt intake was double what it should be. Know that I do not put extra salt on any of my foods because of the known health risk this deadly spice carries.

Have you ever seen salt spilled on a slug? It quickly dissolves its moister and kills the poor specimen. Similarly, salt does the same in our bodies even retarding cell function. We are truly a society that throws caution to the wind as we throw salt over our morsels.

Not only diet is needed to maintain a healthy heart, but good sleep, and healthy release of stress. Suffering from sleep apnea, a condition where you struggle to breathe because you throat closes in on your airway, leads to fatigue, high blood pressure, stress, then stroke or heart attack. I question how many overweight people know they struggle with this serious condition. Know that the major cause of sleep apnea is overweight and obesity.

Stress, the body killer in general and must be addressed. Spas are affective here; Germany's health care plan revolves around the spas. Spas hold both exercise and relaxation services. Often teach meditation or yoga. Often society tries to relieve stress in unhealthy ways, binge drinking, or eating. Thus, the term “Comfort Food,” often thought of in terms of chocolates, grand deserts, simply the most unhealthy in food choices. Let us not forget the fellowship of good friends always relieves stress.

In short, it takes much work and self-discipline to choose to create a lifestyle to stay healthy and heart disease free. However, here is the profound reality created in taking your own health issues seriously. Creating my own path to wellness by fighting my diabetes through healthy life style choices it also cured my sleep apnea, lowered my blood pressure, put my cholesterol inline, and normalized my blood sugar. Now in my opinion that is a lot of BANG for your BUCK, and worth the work and effort, it takes to be responsible for your wellness. Being healthy is a vibrant state of being.

Addressing Chronic Disease & Addiction; the path to wellness

2010-11-07T19:56:00.000-05:00

Illness and the path to wellness
James Wise
Class: HCA300

Abstract

This work presented here will give us a glimpse into a life of an individual who suffers from alcoholism that lead him to the brink of death. However, by the grace afforded him through hero’s that are apparent in our society he was able to launch a program of recovery ending in achieving wellness. We will explore this journey in many aspects. Those who were the most influential, those who were not, and the willingness of the patient involved in the process. We will confer the holistic approach-involving mind, body and spirit and the reality that this approach is needed in defeating any major illness one may go through in the course of life. Simply what does it take to achieve wellness.

What is the human condition

When we are first born, we are innocent, naïve, ignorant to life skills. We become the sum of how we were raised, what we are taught in many venues, and our personal experiences; be it bad, or good. Our bodies are a fascinating organism that achieves balance through homeostasis, continually adjusting to maintain normalcy. Anything that continues to work against that balance can, “in time” overpower our natural state of homeostasis. Any bad habit practiced over time becomes an obsession or an addiction such is the case as we explore alcoholism. Many professionals in the area of health limit, homeostasis to just the physical aspect of the body, we challenge that thought as a limited perception that falls short of achieving true wellness. We believe that the mind, and spirit are the first to fall out of balance far before the body does before acute illness sets in. Let us now explore the journey of our alcoholic patient.

The Journey

Truth is convenient when it serves us, but an enemy when what we desire or believe goes against truth. In critical thinking there is an aspect that is called applied ignorance. This is when we will persuade others and ourselves that our actions or beliefs are based in fact or truth. When in reality it is just justification in what we do, and when the mind does not know the truth, it simply fills in the blanks.

The patient we are discussing did this for many years, (e.g., I am Irish I was born to drink, I did better than anyone in the program and I am the biggest drunk, Doctors say it is healthy to drink.) just to name a few fallacies. In time, our patient was diagnosed with Type II diabetes in 2000 and his doctor stated that he had to stop drinking and make a complete lifestyle change. After four months of service, the Doctor fired his patient for non-compliance to a new lifestyle changes. Rudimentary the patient could not stop drinking and the doctor never suggested any avenue of support only judgment over not caring about his health. Unfortunately, it was four long years later that help came his way.

furthermore, in that time the patient kept on losing in life, jobs, family, and insurance. With each loss came with it a loss of self-respect, which lead to self hate and more destructive behavior. Alcohol became the self-medicating process that helped him achieve oblivion.

The patient, through a depressed mind and wounded spirit, attempted suicide; no longer being able to deal with the losses that was so precious to him. Prior to the intervention which came from a mental health professional our subject was on ten different medications two of which were psychotropic an eighty units of insulin.

It was through addressing the cognitive nature of the mind and the holistic approach found in a therapeutic community that empowered the patient to first start down the road of recovery. Here is where we must address the spiritual aspect of any wellness plan. We have heard on many occasions that it is a point of insanity when a person continues to do the same things repeatedly and expects different results.

We do not agree it is insanity but rather it is more comfortable to do the same thing because we know what the results will be each time we follow the same path. In contrast, it requires faith to do something new and different because we do not know how it will the results end. It is here once we step out in faith and prayer that we begin to experience the power of a good lifestyle change. The yielding of the patient to new knowledge and the faith to pursue this new direction must be nurtured by the caregiver that it will actually work, if you work the plan; this must be at the forefront in treatment.

We must also realize that time perspective is out of balance as well and must be address. In any addiction, it is a quick fix by escaping negative, or depressed feelings which result in a lack of emotional growth or emotional intelligence. We must encourage the patient to go through hard feelings, and introduce journaling to understand that feelings are fleeting and journaling is a hard copy of the progression of time, and how our thoughts change along the journey. Simply there is no quick fix here, which leads us to our conclusions on what we view as affective and not affective in the realm of Health and Wellness.

Conclusions

Perhaps the two most destructive aspects of health care and why the achievement to wellness is often dismal, are in the design of insurance and pharmaceutical companies. Insurance policies take away the responsibility of the patient when they are able to have countless visits to Doctors and specialist who continues to treat, as the illness becomes worse. Couple this with the quick fix of a pharmaceutical cure. Psychotropic medication that treat depression often come with common negative side effects and once on the regiment it is very hard to stop taking them because it puts the body in a new norm. We can group others like cholesterol and blood pressure medication that good diet and exercise will accomplish the same results over time. In most cases, medication is like a Band-Aid for acute episodes, and seldom work in long term basis.

We however do not want to be one sided here but fair-minded and in some cases with severe disease such as HIV, Hepatitis C, and severe mental illness, to name a few has given value and longevity of life. From the experience we have shared here we conclude that good lifestyle changes produces the best results. The need to promote mental health is paramount and alternate treatment plans, that include Spas, Dieticians, Natural Herbal Cures, Massage therapy, and Yoga are only a few that come to mind. We as health care professionals must realize it took years to acquire many chronic illnesses and it will take years to reverse the affect and achieve wellness.

One last thought is education is a powerful force in the mix of achieving wellness. Furthermore, responsibility at the personal level results in personal freedom. Freedom form type II diabetes, freedom from alcoholism both achieved one day at a time through a lifestyle change. Where in the daily goal is for a better tomorrow. Perhaps America should self accountability approach.

Reference:

Edlin, Gorden, Golanty, Eric, (2010) Health & Wellness. Sudbury, Massachusetts, John and
Bartlett Publishers

Changing the eating habits of a nation VS. Tort law

2010-11-03T19:46:00.000-04:00

Health Care and lawsuits or tort law in general is an industry all of its own, ask any lawyer. Surely, it shapes public health policies and raises awareness to a proven health hazard. However, this is the only positive point I see, unless the party who won the large settlement would invest much of it back into the industry that harmed them. In most cases, we do not see that level of concern from people who win large settlements, making an easy judgment that they are out for the money.
Lawsuits also shape and reshape social norms or how we do business, for an example all lighters are childproof. This reflects lack of responsibilities or pure neglect on the part of the parent but the big industry suffered.

Considering lawsuits shape and many times restrict freedoms it accrues to me there must be a better way in promoting good eating habits. On the table right now, a lawsuit is attempting to restrict putting toys in the fun meals at McDonalds. Inciting that McDonalds are alluring children and parents to their brand that creates bad eating habits. I call it good marketing and it has created a tradition that should never be recalled by a lawsuit, it here that tort law is crossing the line.

When will Government wise up and start helping us, when the fix to unhealthy eating is at the agricultural level. Pricing or taxing impacts the competitive private sector in the direction it will go; the best price for the most goods. Reducing the price of healthy foods, fruits, vegetables, all organic foods and raising taxes at the slaughterhouse level would change the market in what product they will promote and sell. Raising the public awareness through large campaign ads, you know the ones that pharmaceutical companies run with vibrant happy people as actors.

In closing much of our young populist and children alike buy or are given the cheapest foods money can buy which happens to be the unhealthiest. Reshaping the price of agriculture would have much greater impact than removing toys from happy meals.

2014 changes our health care landscape!

2010-09-13T00:41:00.002-04:00

Policy and Politics in Health Care
James Wise
Class: HCA303

Abstract

Imagine for a moment the future of health care. Upon awaking we can look at our health monitor that tracks 300 aspects of our personal wellness plan with personalized definable health goals. Then with a few clicks, we can monitor our 90-year-old mother’s health status 1000 miles away because the monitor is connect to a health information system. We can set appointments through this portal, order our medications, and access reliable literature concerning our health care issues. Furthermore, we have access to all aspects of our health record with all the ability of my health monitoring transferred to my mobile smart phone. This is just one of the policy driven directions our government is taking. Another is health insurance for all by the year 2014. Focus has been put on preventative care in the area of obesity and smoking with movements like Lets Move.gov headed by the first lady, and quit smoking central dot com that gives you a national list by organization or state that offers free nicotine gum and patches. We will highlight these policies in the effectiveness of potential effect, costs, equity, and fairness.

Health Informatics

All that was suggested in the abstract concerning health monitoring is already a reality it is just the matter of plugging it all in on a national level. HealthInfoNet is a company funded by Government mandates is doing just that. In light of new federal rules, several of the services HealthInfoNet offers will help make many health care providers and hospitals adopting and using electronic medical records (EMR), eligible to receive federal incentive payments from the Centers for Medicare and Medicaid Services (CMS). Furthermore, on July 13 this year, Health and Human Services (HHS) Secretary Kathleen Sebelius announced two long awaited "final rules" that define stage one meaningful use and certification of EMR technology outlined in the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.

The stage one meaningful use criteria include fifteen "core" measures that must be demonstrated by both hospitals and physician practices. Hospitals and physician practices must also demonstrate compliance with five "other" criteria chosen by each provider organization from a "menu" of ten additional criteria. To trigger stage one meaningful use incentive payments, most providers and hospitals must demonstrate compliance with these criteria by April of 2012.

The one notable exception will be physician practices that qualify for incentive payments under Medicaid. These practices can secure meaningful use incentive payments prior to installing a certified EMR so that funds may be applied to the cost of investing in an EMR solution. Under the Act, health care providers and hospitals can qualify for Medicare and/or Medicaid incentive payments if they meet stage one meaningful use criteria. In total 17 billion in stimulus funding has been allocated in the future of information exchange and being the new reality by 2020, states HealthInfoNet (2010).

Policies Addressing the Obese

Obesity has been the new epidemic in America with 60% of our population overweight with 34% being obese. Asserts the New York Times(2010). The cost on health care is in the billions from complications and the onset of chronic diseases like diabetes or cardiac problems to name just two. The policies in this area are complicated because of the infusion of so many government programs that overlap each other. Policy is needed to unite the many agencies involved in governing the United States’ food and nutrition landscape. The U.S. Department of Agriculture (USDA), the National Institutes of Health (NIH), the Food and Drug Administration (FDA), the Department of Health and Human Services (DHHS), and the Centers for Disease Control and Prevention (CDC) are among the numerous federal agencies overseeing the nation’s food supply. These agencies sometimes work at cross-purposes and, such as in the case of the USDA, there are clear conflicts of priorities within the agency itself. The USDA establishes national nutrition policy, but it’s more important aim is to help the agriculture industry be profitable by maximizing food sales. The following are some examples of public policy changes that could be made in government to improve nutrition.

• Move nutrition policy and programs from the USDA to the Centers for Disease Control and Prevention. The USDA is typically headed by someone from the food or agriculture industry and exists to promote the business of agriculture, which is to sell as much food as possible. This priority often conflicts with good health policy.

• Design agriculture policy (such as the Farm Bill) with health as a principal consideration.

• Change the fundamental economics of food. Create incentives that help consumers buy healthy food, instead of incentives that make the unhealthiest foods also the most affordable.

We applaud the efforts of Lets Move.org; this is Government policy at its finest. The purpose is to reduce or eradicate childhood obesity in a generation. Their scope is complex and filters into school lunch programs, and local mandates to build parks, recreation centers, bike trails and more. Government incentives to help implement these programs, as well as building a rich resource to raise awareness with parents, Chefs being trained in nutrition in culinary academes. This effort could effectively lower obesity in America and provide billions saved in our health system.

A Smoke Free America

In the last two years many have noticed the price of cigarettes inflated, in some place as much as 50%. Simply, smoking is the most irrational behavior our society engages in that lead to major morbidity factors costing our health system billions once again. Government has not only raised the tax on cigarettes which has effectively resulted in many new non-smokers but have many state level programs that administer free aids in helping the smoker quite. This program has been very effective and continues to yield favorable results Among Americans, smoking rates shrunk by nearly half in three decades (from the mid-1960s to mid-1990s), falling to 23% of adults by 1997. It remains at 23.1% but with an increasing population since 1997 asserts the (American Heart Association, 2010). We conclude this as a good policy in promoting behavioral change in our populace by approaching both sides, the negative in taxes on cigarettes and the positive help in empowering the person to quit smoking in providing support and free aids.
Health Insurance for All

The new healthcare reform bill or as many call “Obama Care” has a slow timeline as we prepare to embrace so many entering a new open system. The leveling of the playing field does not take place until 2014, but make no mistake it is a leveling, and all preparation is taking place now to make the change happen.

The primus after all, is based on the ideology that health care is a rite of passage and no one should be left out. When we talk about natural rights we, as a nation knows it come with a dear price to maintain our freedoms. In the military, it takes hard training, personal discipline, and a desire to win the day. How do you achieve this is in a civilian populace without consequences to adverse actions that are counterproductive to our health system? The simple answer is you cannot without consequences, it is law that we must have auto insurance, because of the great risk of catastrophic event accruing in an accident. This will be reality for us in 2014 concerning health insurance and fines leveled for those who choose not to have insurance and can afford it. This is on a personal, family, and business level so all are affected. Let us take a look at the bill first on a individual level.

Require all individuals to have “acceptable health coverage.” Those without coverage pay a penalty of 2.5% of modified adjusted gross income up to the cost of the average national premium for self-only or family coverage under a basic plan in the Health Insurance Exchange. Exceptions granted for dependents, religious objections, and financial hardship.

And on a business level; require employers to offer coverage to their employees and contribute at least 72.5% of the premium cost for single coverage and 65% of the premium cost for family coverage of the lowest cost plan that meets the essential benefits package requirements or pay 8% of payroll into the Health Insurance Exchange Trust Fund. E&L Committee amendment: Provide hardship exemptions for employers that would be negatively affected by job losses as a result of requirement. Eliminate or reduce the pay or play assessment for small employers with annual payroll of less than $400,000 ( KFF 2010).

Furthermore, public health care expands Expand Medicaid to all individuals (children, pregnant women, parents, and adults without dependent children) with incomes up to 133% federal poverty level or (FPL). Newly eligible, non-traditional (childless adults) Medicaid beneficiaries may enroll in coverage through the Exchange if they were enrolled in qualified health coverage during the six months before becoming Medicaid eligible. Replace full federal financing for Medicaid coverage expansions with 100% federal financing through 2014 and 90% federal financing beginning in year 2015 (KFF 2010).

Affect on Insurance Stake Holders

Many may see this as the day of great reckoning, and the change to an open market. No longer will insurance companies deny you coverage because of a pre-existing condition, new regulations go into effect concerning premium levels, cannot drop a client from a plan or deny expensive life saving procedures. The plan creates a National Health Insurance Exchange, through which individuals and employers (phasing-in eligibility for employers starting with smallest employers) can purchase qualified insurance, including from private health plans and the public health insurance option. The public option has four plan tiers with the basic plan covering 70% of your medical encounters per year set in the context of your affordability based on income that sets the price of your premium.

Many believe this will infuse competition, a perspective we agree with in our personal vocation. Our company will be Medicaid certified next week in preparation of the new health care funding options that will happen. We work with the most disenfranchised souls in providing shelter for the homeless vets, department of correction, probation, and community release. We provide a therapeutic community and empower our clients through classes, counsel, to help them back into the main stream of society. The new Government policies will greatly increase our client base, being able to provide services for the homeless we could not reach before.

What is the Cost, Who’s Paying for it?

Universally speaking, everyone is shouldering the responsibility of a rite to health care then without the changes that are coming. Clearly, the Government is competing for the first time with for- profit insurance companies, setting the rules in their public health exchange require private insurance to comply. The Congressional Budget Office estimates the net cost of the proposal (less payments from employers and uninsured individuals) to be $1.042 trillion over ten years, of only half is pay for by new policy changes in mainly Medicare and Medicaid. So where does the 500.021 billion come from to finance our new health care bill? You may have guessed it, the redistribution of wealth.

The remaining costs are financed through a surcharge imposed on families with incomes above $350,000 and individuals with incomes above $280,000. The surcharge is equal to 1% for families with modified adjusted gross income between $350,000 and $500,000; 1.5% for families with modified adjusted gross income between $500,000 and $1,000,000; and 5.4% for families with modified adjusted gross income greater than $1,000,000. These surcharge percentages maybe adjusted if federal health reform achieves greater than expected savings. The largest source of new revenue will come from an excise tax on high cost insurance, which CBO estimates will raise $201 billion over ten years. Additional revenue provisions will generate $196 billion over the same time period CBO estimates the proposal will reduce the deficit by $81 billion over ten years (KFF 2010).

Conclusions

We have explored many areas of policy changes in health care concerns, proposed needed policies changes in our food production, and referenced clearly the policies that are soon coming. Preventative care is and needs to always be the focus point, changing behavior in a society is challenging for a Government in the context of freedom and choices. Dare we exist chained to our government even though this bill may holds aspects of this scenario? We agree in most part of the policy changes, and the simplistic but powerful approach to healthier children and obesity issues. The proven good direction in tobacco usage, simply a policy that has been holding ground for many years now. Information Health Management Systems have the most potential in lowering cost in major disparities in our current system. Efficiency is at the speed on electronics, vast databases with evident based favorable results will be accessed to determine proper cost effective procedures lowering mistakes and tort law cases. Administration cost will shrink when all information is in electronic format and storage, also eliminating many mistakes found in paper filing. Algorithms in these management information systems will find and highlight any abnormalities found in the progressing of a patient’s medical record (e.g., diagnosis does not match treatment). We cannot forget the personal empowerment spoken in our abstract and patient accessibility to their health records and monitoring your health condition. Nothing can be changed unless there is awareness to the issues; information technology continues to open the window to a broader awareness.

Without question the new health care bill opens access to everyone, makes everyone responsible to attain health insurance or pay the fine. It levels the playing field in Government competing with large insurance giants; it will break down barriers for new companies to come into this reformed market. The only issue is the redistribution of wealth in making the wealthy bear half of the cost. A better policy would have addressed this differently and not hold that aspect we mentioned earlier being a slave to government. A luxury tax placed on all non-inessential products and services, the higher the price of the product or service, the higher the percentage of tax. This does not target a particular social class; however, it will be the rich taxed the most in this policy.

Although, they will be taxed on some luxurious privilege, they want, and they will not feel the sting of being obligated to the Government to finance health care for all. It is our thought that this would generate more money because all classes are involved in a luxury tax. Here is where we see the new health care bill greatly flawed and singles out one social class from all others, and simply there is no equality in that action. It creates entitlements for many and payment for them from few. More wisdom is needed here and hopefully ratification, it strikes controversy in whether it is a violation of constitutional rights.

Reference:

Jonas, S., Kovner. A. (2008). Health Care Delivery in the United States. New York, NY.
Springer publishing company.

HealthInoNet.org (2010) HealthInfoNet Positioned to Help Providers Achieve Meaningful Use.
Retrieved on September 11, 2010, from http://www.hinfonet.org/news.html

The New York Times. (2010). Obesity Rates Hit Plateau in U.S., Data Suggest. Retrieved on
September 11, 2010, from http://www.nytimes.com/2010/01/14/health/14obese.html?_r=1

CDC.Gov. (1999) Overweight and Obesity. Retrieved on September 11, 2010, from
http://www.cdc.gov/obesity/stateprograms/index.html

Fastlane.Dot.Gov. (2010) DOT, First Lady and Childhood Obesity Task Force share Important-
Goals: Let’s Move. Retrieved on September 11, 2010, from
http://fastlane.dot.gov/2010/05/dot-first-lady-childhood-obesity-task-force-share-goal-lets-move.html

Let’s Move: America’s Move to Raise a Healthier Generation of Kids. (2010) Retrieved on
On September 11, 2010, from http://www.letsmove.gov/

American Heart Association. (2010). Cigarette smoking statistics. Retrieved on September 11,
2010, from http://www.americanstroke.com/presenter.jhtml?identifier=4559

Kaiser Family Foundation or KFF (2010) Health reform law, the patient protection and
affordability act, and health care and education reconciliation act of 2010. Retrieved on
September 11, 2010, from
http://www.kff.org/healthreform/upload/housesenatebill_final.pdf

Taking Your Health to a Personal Level

2010-09-10T02:15:00.000-04:00

Professor,

Well said! I believe patient behavior has been a complete disconnect concerning a wellness plan, when you are not directly paying for it and strains the system from scarce resources.

It was true in my personal journey when diagnosed diabetic, caring the Cadillac card of Blue Cross and Blue Shield at the time. I cared little to comply because my plan had no restrictions to health care and I continued to take the easy way out by medication, insulin, ER visits if my blood sugar became to high because I ate the wrong things that day.

Through one tragic experience to the next I lost coverage, could not afford to gap it with COBRA, and the walls went up and I had no access to health care. I had to spend down to lower paying jobs so I could get on a Government program for diabetics. Realizing that this was a self defeating course and would lead to poverty I had to take a hard look at my wellness plan.

I turned to folkways, and alternate medication found in natural herbs. I achieved 12% body fat through diet and exercise, I learned the value of meditation and how it greatly combats stress which causes sugar spikes. In short I reversed my chronic condition, caused by healthy life style changes alone.

I am no miracle, but stand in awe of what is possible, when you apply what you learn by incorporating it in every day living. Insurance companies do not support wellness or their policies would reflect that direction. Rather they exploit the system and lobbied for restrictive measures when profits fall. Through large contracts they get the better price, far bellow an individual cost with no insurance. This is why the system is not transparent to the general public. It would be refreshing to see a billboard of prices for services on the wall.

Policy Answers:

Deflating premium when less resources are used in a definable period for a policy holder. In contrast inflated premiums when more resources are used. This would promote wellness.

Concerning chronic disease, you have to be even more focused and disciplined so in that respect the same scale should be used in changing premiums. With diabetics, we have blood work every three months that gives you a blood sugar level average for the last 120 days. This is a definable scale on how well the patient is practicing good life style changes or just using the system as I once entertained.

I am convinced Large insurance giants are out for the quick profit when they should be striking a cord for sustainability. However, they can always rely on Government bailouts when their greed crosses the line to RED.

Why is My Health Insurance Premiums Rising?

2010-09-09T02:02:00.000-04:00

It is all in the new healthcare reform why prices in premiums are souring. It is the timeline in which the landscaping changes take place in our health system, none of which starts until 2014. Until then insurance companies are not being regulated or force to insure high risks, with no raise in premiums. Insurance companies are gaining profits in the front end of the plan, knowing that these margins will never be as great after 2014.

Here is what the plan details that year:

In 2014, most of the bill's most heralded benefits take effect. This is the year when the state insurance exchanges go on-line, with subsidized coverage available in the form of tax credits, and when Medicaid will be expanded to cover individuals making up to 133 percent of the Federal poverty level (currently about $28,300 for a family of four).

Insurers will be prohibited from denying coverage to adults with pre-existing conditions and charging higher premiums to individuals with chronic conditions starting this year, and they will be required to cover maternity care the same as all other medical procedures.

Furthermore, this year mandates kick in: individuals who do not have insurance and cannot prove hardship will pay a $95 fine, rising to $695 by 2016. Families without insurance will pay fines of up to $2,250, indexed for inflation after 2016. Employers with more than 50 employees that have any employees enrolled in subsidized coverage through the exchanges will pay a penalty of $2000 times the number of workers employed minus 30.

Some say that the Presidential Administration planned it this way for us to grow in rage towards insurance companies, but that would suggest Obama is despairing the people to bring his point home. I am more inclined to believe that the bill was pushed through to quickly without weighing all the cause and effects within the context of the complexities in stakeholders within our health system.

When you introduce change, it must come with the new restraints at the very beginning of implementation not wait four long years later. Because of this lack of vision, the bill is causing another crises in an already struggling economy. I dare say but this is just the beginning of the premium hikes, and increasing health care cost do to a flawed bill.

Reference:

Smith, Sandy (2010) Health care bill summery and timeline. Retrieved on September, 9, 2010, from http://www.huliq.com/8738/92142/health-care-bill-summary-and-timeline

The Unisured; Whats in the numbers

2010-09-08T10:44:00.000-04:00

The ability to pay is the core reason so many despair in being uninsured. The Employment Policies Institute issued a 48 page report breaking down the numbers bay first defining two categories, “voluntary uninsured and “involuntary” uninsured. EPI asserts 43% of 47 million uninsured are voluntary, leaving 53% with no choice and insurmountable barriers to access.

Let us explore the 53% more closely because the devils are in the details. We will look at the family unit which is the core of a thriving society. Single households 28.9 %, Single Parent 29.7%, Married no children 11.4%, and married with children represent 14.1% (EPI 2007) The single parent holds the highest percentage and is indeed alarming. The stress on a single parent is already great; couple with no access to healthcare is devastating and keeps the family in poverty. This is our young 29.7% of our nation’s future, you would believe that we would have better policies to support our future and family system in an ever increasing single parent category.

Another area worth noting here is the populist between that age of 18 to 64. This age category represents 20.2% of the involuntary uninsured. The majority are in the age range of 48 to 64, who have fallen through the cracks of our system. These makes up the pre-existing condition rule and locks them out of an insurance plan for twelve month as long as you pay the premium and receive no service of course.

This suggests we must pay more, and wait a year for access because we are sick. We are talking chronic disease, which in all cases needs continued maintenance, or the patient will worsen. To become impoverished at a later age in life, because you need the medicine and care makes life harsh for those who fall between the cracks of our system. Take it from the author, this has been his personal journey in what you must do when you have a chronic disease, and you slip between the cracks.

Reference

EPI(2007) “An Analysis of America’s Uninsured Population, Their Characteristics, and their health. Retrieved on September, 8, 2010, from http://epionline.org/studies/oneill_06-2009.pdf

Pro/Con, concerning electronic medical records

2010-09-06T12:08:00.001-04:00

Pro/Con of Electronic Health Records
James Wise
Class: HCA303

Abstract

With Change, there is always controversy and there is no exception with electronic health records. The computer age and technology leaps in information exchange the days of vast physical storage file systems and paper trails may soon be over. We will explore the positive aspects of electronic files and contrast concerns the system holds. Clearly, this will highlight the controversy and show a weighted scale in the direction we should go.

Highlighting the Positives

They are a myriad of positive areas that electronic filing impact. Let us first look at the environmental aspect. Still perhaps a decade away if all health records went electronic we would greatly reduce deforestation, giving room for replanting helping to reduce or achieve sustainability from the negative effects in the lost of our forest.

Efficiency, diagnosis and treatment written down on paper can sometimes be hard to read or can be incomplete. Having your total medical history (including all your prescribed medications, for example) can often be the key to solving a medical puzzle.

Coordination, electronic records mean doctors can communicate more easily, improving diagnosis and the quality of care. For example, your family doctor can share vital information with a specialist (or number of specialists), saving you time in the office or maybe even your life in an emergency; more so if you arrive unconscious and cannot answer important medical questions.

Empowerment, having access to important parts of your own health record when you want them will help you make vital decisions, such as treatment options, and stay informed, raise your literacy to make rational decisions with your wellness plan.

Concerns

There is only one concern but a large and complexes that has life changing negative effect. The concern is privacy; the core reason is explored in the enactment of the HIPPA laws. It was found that people with medical conditions were being discriminated in attaining a job, and or acquire a loan. This was having a negative effect on economy and was decided that no one should base these decision on a person personal health record and health record became privatize with many rules and regulations (hhs.gov 2010). The information exchange explosion is still morphing and as each new technology is introduced the game changes in new security concerns. In addition, the best medium for this exchange is the World Wide Web, which is full of predatory serious hackers trying to break codes and it has happened. Elizabeth Fernandez of the, San Francisco Chronicle asserts, information on thousands of UCSF patients was accessible on the Internet for more than three months last year, a possible violation of federal privacy regulations that might have exposed the patients to medical identity theft, The Chronicle has learned.

Government has been enacting policy in this area through Information technology Act 2000 consisted of 94 sections segregated into 13 chapters. Four schedules form part of the Act. In the 2008 version of the Act, there are 124 sections (excluding 5 sections that have been omitted from the earlier version) and 14 chapters. Schedule I and II have been replaced schedules III and IV are deleted. (Department of Information Technology 2010). As we can see, the laws are morphing as well, which increases the anxiety of privacy lost.
Conclusion

Using a simple scale, in weighing the positives to the one important negative regarding electronic health records, the positives win. The trend is rapidly moving towards this goal in major Government funding with more than $17 billion in stimulus funding, the government has been encouraging medical providers to adopt electronic medical records, “switching patient records from old paper files to sophisticated computer databases,” David Twiddy reports for The Associated Press. Are only hope is technology in addressing security breaches, grows as fast as this new way of doing business.

Reference:
HHS.gov (2010) Understanding Health Information Privacy. Retrieved on September, 5, 2010,
from http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html
San Francisco Chronicles (2008) Health care practices and UCSF patient records expose.
Retrieved on September, 5, 2010, from http://breachblog.com/2008/05/07/ucsf.aspx

Department of Information Technology (2010) View the IT act 2000. Retrieved on

September, 5, 2010, from http://www.mit.gov.in/content/view-it-act-2000

Gutierrez-Folch, Anita (2009) Government Pushes for Electronic Medical Records by 2014

Retrieved on September, 5, 2010, from

http://www.findingdulcinea.com/news/health/2009/October/Government-Pushes-for-Electronic-Medical-Records-by-2014-.html

Health Care: It's all about Education that produce an equilibrium in cost

2010-08-23T17:07:00.001-04:00

Healthcare Economics Assignment Two
James Wise
Class: HCA205

Abstract

We will explore health economics in the area of predictability of future demands for medical care, whether the demand will rise or diminish. Using the variables of the changing price of health care services, time, and the effect of income, we will contrast this to educational attainment within the community and the impact this has on market equilibrium and economic optimization.

The Changing Price of Health Care Services

The health care market is not unlike any other market in the respect of supply and demand. When more is desired by the consumer for a product or service then the price becomes more and when less is desired price falls. Furthermore other aspects are the same in all markets, including efficiency, competition, and opportunity cost. Efficiency is evaluated by how well resources are distributed to promote social welfare. Opportunity cost is a measure of how well a company can look at the next best alternative in the use of their resources. The core variable that drives price down is when many hands are in the mix causing competition or who has the best results in the fore mentioned variables, and the efficiency of those variables. However in the Health market differs from other markets in the respect of the human equation because it is not solely based on desire but also on need.

Addressing Time and Human Capital

Time has one positive and two negatives as it impacts health economics. The positive is found in the youth of our populace. Simply the younger you are the less need for medical services which provides health or better understood as not using health resources. This addresses scarcity in the respect how we distribute a limited resources. This is the based on the principle of give and take, we take resources from our youth who have less need and give this to the old who need it more. As we become older we need medical care more as our bodies begin to breakdown or simply the morbidity factor. Furthermore in time our population will increase causing an overall need which impacts our health resources, this will be explored further in our conclusions.

The Effect of Income

The median income found in different social classes has a direct affect on being able to obtain medical care, accessing preventative measures that promote a healthy lifestyle. At first glance and in short term analysis’s those who do not have the means to pay for medical services provides health, but in the long term causes a catastrophic effect on health economics. Within the lower classes of our society a health issue is often not addressed until the problem becomes acute, or even chronic in which case this class will seek emergency rooms to address their health needs coupled with the inability to pay for what is the most expensive service found in our healthcare system, acute care. This drives up price that is shared by all of society. We as a society must address this disparity with lower costing preventative care to our lower classes to prevent this cascading event of rising cost.

Concerning Education

Education is twofold both within the area of the provider and the consumer. Health economics assumes that the consumer is rational in their decision making when it comes to the human capital. However rational decision making is based on awareness of a given situation. Void from education many decisions are less than perfect when it comes to rationale, because of lack of knowledge of the problem that befalls them. Without education a person simply does not know how to address their health needs effectively, use preventative measures, or live a healthy lifestyle. Education will raise awareness and increase the provision of health. The more educated the provider the better the quality of health services in the realm of evidence based decisions, providing awareness to the consumer, and providing a safer delivery system that combats tort law cases more affectively. Truly education is the largest factor in health economics in lowering overall cost in the medical services (Healthy People 2020).

Conclusions

Statistically the cost of healthcare continues to rise in America. One major factor is the median age of our populace is growing older, as more and more baby boomers are turning sixty five and go on Medicare. Our population continues to grow increasing the demand on medical services. We conclude that education is the best answer in whether the need for medical services will increase or decrease in the future. We feel that education will at the very least cause equilibrium in the demand for health services if we are proficient and global when it comes to providing education. However if we fall short in educating our populace we predict that the demand for medical services will continue to increase.

Reference:

Dewar, Diane. (2010). Essentials of Heath Economics. New York. Jones and Bartlett.
SOPHE. (2010). Society For Public Health Education.

Taking Charge of your Wellness Plan, Provides the Best Results

2010-08-21T10:32:00.000-04:00

I just love stories of inspiration don’t you? It has that quality that pulls at something deep inside of us, and suggests, in the context of the human condition, we are able overcome anything. Just having read an article written by Larry O’Conner “Running for your Life,” inspired me to write about my personal journey into better health, and how the modernization of our health system continues to fail us.

Mirrored by tens of thousands, Mr. O’Conner’s story emanates from his childhood experience in a near death experience within the cold setting of a hospital. Modern medicine has critical focus on addressing symptoms but seldom addresses the person. In perhaps all cases, a wellness plan requires personal assessment and lifestyle changes and of course this requires compliance from the patient. This is a daunting challenge for any physician to provoke a permanent change in their patents, and they take the biochemical approach by prescribing a myriad of medication. Depending on the chronic condition, the patient must remain on this medication regiment for the remainder of their lives to advert feeling bad or even early death.

In 2000 I was diagnosed with diabetes, and immediately put on diabetic pills and suggested many lifestyle changes but with very little support to accomplish such alterations in how I lived. Some of the medications side affects actually caused weight gain, which is counterproductive in addressing diabetes. Jump 4 years later and now I am taking 10 different pills and injecting 80 units of insulin per day. Great for the pharmacological companies, but my body has become a biochemical quagmire, surely not healthy in any given since of the word.

Jump a year later and with the loss of my job, and insurance I am no longer able to sustain the price of this medicine regiment and forced me to take my wellness into my own hands if I were to survive. First, I began to raise my literacy concerning my diabetes, turned to folkways and alternative medicines in the area of natural herbs. I began eating six small meals a day to retard sugar spikes, which happens with a single setting of large meals. I started an exercise program and shed 80 pounds in 8 months. Jump 5 years later to present day; I am no longer on any pill or insulin. I reversed my worsening condition purely by changing my habits in seeking healthy lifestyle practices.

In conclusion, what happened to home doctor visits? If you are old enough, you can remember that not only was he/she your family doctor, but friend, the very person who set in the pew with you in church. Intimately a part of the community you live in and find support from in everyday living. We need a system that promotes empowerment of the individual, not just the treatment of symptoms, because in truth there really is no quick fix when it comes to personal health.

I implore you to read Mr. O’Conner’s article on “Running for your Life”, I hope you find it as inspiring as I have. Here is the link http://www.run4yrlife.blogspot.com/

Global Health Care, how do we stack up here in the U.S.

2010-08-20T21:39:00.000-04:00

Health Care Abroad and Here

James Wise

Class: HCA205

Abstract

This paper takes health care economics to a new level by taking a global view of different developing countries health systems. Addressing the differences in each system we can gain a new perspective when looking at what is working or need of reform. We will explore four health systems; America the origin of this paper, Sweden, United Kingdom, and Israel. We will start with Israel and introduce each country and the end of each section.
Israel’s Health System

Israel administers a national health insurance (NHI), funded by employers, wage tax and out of pocket which is among the highest in Europe. Health care expense is 9.1% of GDP or $1890 per person. There is no coverage for dental, medication or for anyone receiving service from a private physician. The core culture is Jewish with diversity in Arabians who are ether Christian or Muslim. Disparity does exist with the palatines stated by the Palestinian Red Crescent Society that 22 enclaves are without healthcare.

With that said however, Israel statistically is one the healthiest society in the world and have more doctors per capita than any other nation. Also the biggest factor that provides health is 95% of the populist is highly educated. The statistic that highlights this value best is in the fact that Israel is a terrorist zone and their consuming of alcohol is very low. They are a role model for a healthy lifestyle, making rational health decisions. What we can take away best from Israel’s culture in health is their focus on education which transfers to providing health into their system. Next we will explore the United Kingdom’s health care system.

United Kingdom Health System

The United Kingdom has the fourth largest economy in the world and cares for almost sixty million souls’. They employ a National Healthcare System (NHS) and everyone can receive services on a point basis, or anytime someone needs to see a physician or medical service it is free. The (NHS) is funded through income taxation and the Government distributes and regulates the system, insomuch setting the price for prescriptions. Sustainability has been a problem with the UK and bottle necks at the point of delivery has become a real concern. To address this the United Kingdom is allowing the private sector to have a larger foot print in their health system and allowing for private insurance plans for businesses and citizen who wish to opt out of the National Plan. This will open the bottle neck to those who wish to receive private insurance and faster service and at the same time relieve public centers.

Another point worth some attention is the United Kingdom implementing the United States founded DRG’s system to better regulate price for service. The Problems the UK has that are similar to the United States is the size of the population leads to the greater complexities and cost to the health system. The UK also suffers from high alcohol consumption, Obesity, and poor lifestyle choices not unlike America. Our critical thought here is a question, “Does entitlements in free health care lead to personal irresponsibility with health issues?” Next we will take a look at Sweden.

Sweden’s Health System

Sweden has nearly a perfect blend of high-tech capitalism and a social health system. They are also rated as having the highest level of healthcare in the world. Sweden also has one of the lowest infant mortality rate and a high average life expectancy. Furthermore the quality of life is evident and continually enhanced. Sweden has an extensive and comprehensive welfare state health care system and blends the funding with two main focuses. The first focus is comprehensive funding and treatment of the maternity and rearing process. All necessary medical needs are offered as well as funding for childcare for the first five years. Up to 480 paid days are given two the parent from birth of child to eight years of age. Simply the promote the family system and gives resources to enhance child rearing. The second focus is on Sweden’s old. In short they care for the old and those with mental problems. The funds are administered through the old pension fund and provide income to those who are unable to work. We find our way now in the middle of the age spectrum, the age that provide health. Through taxations the Government pays 85.3% of total healthcare expenditures, modest out of pocket cost make up the difference. These are set at yearly limits; $115.00 for doctor visits $230.00 for pharmaceuticals, and $10.25 per day for Hospital inpatient status. Once these caps are met per year all health care is free, including dental. Sweden is at 9% of GDP or per capita $27,271 in healthcare cost. Recently they have allowed private health care organizations in their health system to achieve sustainability. They provide between 5-15% of the populace and are geared for the rich. However, since the allowance of private industry they are already competing with the egalitarian system in terms of quality of service. We saved the United States for last; being the largest health system than any other we have touched on.

United States Health System

Comparatively speaking we have address populations of 6 million in Israel, 60 million in the UK, and 9 million in Sweden. In contrast each other nation has a core culture and limited diversity. In the U.S. we host 300 million souls with no noticeable core culture and people with vast diversity; the complexities this causes are beyond the scope of this paper, but are many. The U.S. are the pioneers in new medical technology and pharmaceutical discoveries. This of course has a great cost. Health care is funded through many sources, Government through Medicare and Medicaid, through private insurers obtained personally or offered through your company, and many HMO’s and PPO’s organizations. We have deep divides in basic access to health care services, concentrated in the areas of race, ethnicity, and socioeconomic status. Our heath cost is enormous 1.7 trillion, which is almost 15% GDP or $5,267 for every person on health care. We are 53% higher in cost then both the UK and Sweden, however our health statistics in infancy mortality and life expectancy are worst then the other three nations. Over all distribution suffers as well because we are largely a fragmented system. We will conclude with three thoughts.

Overall the universal health care system proves to be more efficient and lower cost with better results in health statistics. Our first thought goes to Israel and focus on education. This is important when you look at historical timeline; twenty years ago you could start a career with an A.A. degree that now requires a BA or BS degree. Ten years later it now takes a Masters degree. We need as a nation to better fund education. Our second thought takes us back to the UK who regulates the cost of pharmaceuticals but also rewards research. Our pharmaceuticals are out of control here, because it does not operate on a fair global market price. Our last thought takes us to those who do it best Sweden. We know that taxes for this system are high to fund focus on families and children coupled with long term healthcare. However the trade off is well worth the price. Focus on family and children relieve stress and empower the parent to put focus on their children. They dignify their aging with compressive coverage all the way to death. This system inherently relieves stress on their people and enhances life at all ages, it is no wonder they hold the best statistics in quality of health. In contrast we struggle here in America with accessibility, we allow our elderly to buy down to poverty and then they can receive Medicaid and long term healthcare. There is no focus on family, but allocations when the family becomes a single parent. America can learn from Sweden where for the most part they left capitalism out of the health care equation, seeing healthcare as a right not a responsibility. With focus on education, regulation that answers to a global market, family systems and complete accessibility we should succeed to a better system. Our final thought is healthcare systems should be on social venues with the invitation of private industry, but be regulated and operate to partner with the social value of the system.

Reference:

Holtz, Carol. (2008). Global Health Care: Issues and Policies. Sudbury, MA.
Jones and Bartlett Publishers

Concerning Sleep Disorders and Preventive Care

2010-08-20T09:10:00.000-04:00

Truly our body requires sleep, just as much as water and food. For five years, I whore a mask connected by a hose to a machine that forced air down my nose, because I was diagnosed with sleep apnea. This is a condition that causes you to stop breathing while you sleep. In time, it can be life threatening, because as you sleep your body also is struggling for air. It raises blood pressure, cause fatigue, and can lead to heart attack or stroke.

You can imagine that I looked like some kind of alien, or astronaut as I lay asleep with this contraption attached to my face; talk about stopping romance! Much like a fellow blogger, Amy Steelman-Prueter who suffers from another sleep disorder “narcolepsy” there is no quick fix.

As with many of my post here on current healthcare issues, we lack preventative care, which leads to behavioral changes, and promotes a healthy lifestyle. Through being tired of sleeping with this machine, I lost 80 pounds, stopped smoking, and in doing so reversed my condition. Simply it is a matter of choice to take responsibility of your wellness, no doctor can do this for you, only suggest.
If you are truly concerned about the high cost of health care, you can challenge yourself to make a change in your own health issues and by doing so provide health in our system by not having to take a myriad of pills, purchase costly machines as with sleep apnea.

Please take a moment and visit Amy’s website “Empowering Success” she is the expert on Narcolepsy. I find it ironic that her condition states she dreams too much, so she took those dreams and made it a reality, how wonderful! Here is her link http://empoweringsuccessonline.com/do-challenges-stop-you/

Preventive Care is our answer to lowering cost

2010-08-19T13:32:00.001-04:00

As we all know some businesses do it better than other businesses, thus the creation of competition and free market. In health care services, there are many hands in the mix from the small primary doctor offices, to the largest health care institutes. However, all are policy driven by federal, state, and local governments. In our great bureaucracy, these policies can be conflicting, even stifling at times. It has lead to fragmentation of our health system and caused large administrative overhead and cost.

We must face the facts that there are some very bad policies at work in our system that promote poor health habits, over medicating of patients’, bottlenecks access, which causes our lower socioeconomic class to find treatment in the most expensive area of our system, acute care; which fails to address any preventive measures.
Pharmaceutical companies have integrated themselves in every area of our health system and rewards doctors to prescribe their medications, while insurance companies raise premiums whenever they feel a Government policy retards their profits, which has been most noticeable in recent news. I could go on and on but then this would turn into a several page essay.

It is a simple rationale that it is far cheaper to advert a catastrophe then to address the malady that issues from one. So it is in health care and preventive measures and the integration of those measures within our system at every level, starting with the provider but ending in empowering the patient.

Prevention and treatment of chronic conditions similarly require regular (nonsymptom-driven) screening and counseling for health behavior change, involve ongoing plan care and proactive follow-up, depend on active patient involvement in decision making and adherence, and require links to supportive community resources and services (Glasgow, Eakin, et al., 2001).

To better integrate our health system, our focus must be on preventive care and open access to such care so lower socioeconomic class will seek help there then in an expensive acute care setting that address the malady but fails to address the underlining cause. National, state, and local performance mandates should issue greater reimbursements and payment for increasing performance policies as they raise health statistics within their area of control. Address Managed care regulatory standards that promote better performance measurements and accreditations (e.g., NCQA/HEDIS). Policies in health plan level: Organizational mandates/incentives, clinical information systems (e.g., health informatics systems) and technical assistance to promote favorable outcomes centered in evidence-based information. Office-level reminder systems, which details local opinion leaders, and finally individual provider level; CME strategies. (McKinlay, J. B., 1995).

Reference:

Glasgow, R.E., Orleans, C.T., Wagner, E.H., Curry, S. J., & Solberg, L.I. (2001). Does the Chronic Care
Model serve also the template for improving prevention? Milbank Quarterly, 79, 579-612.

McKinlay, J. B., (1995). The new public health approach to improving physical activity and autonomy
In older populations. In E. Heikkinen (Ed), Preparation for aging (pp.87-103). New York: Plenum.

Theories of Government Intervention in Health Care

2010-08-13T21:57:00.000-04:00

Theories of Government Intervention in Health Care
James Wise
Class: HCA205

Abstract

We will explore two conflicting theories concerning Government intervention in the health care market. The first theories we will explore are the special interest group theory (Becker, 1983) and second the public interest theory (Johnson-Lans, 2004). Once we introduce these two theories, we will contrast Government’s current intervention in the health care market. In conclusion we will share our view using fact-based rational.

Special Interest Group Theory

Entrenched in political survival, politicians create legislative programs that compliment a special interest groups’ agenda for the return for votes that keep political representatives in office. Lobbying for legislative changes is an expensive endeavor, including organizing a legitimate counter political movement, inform the public, gaining petitions, and finely engage in lobbying. With that considered it leaves the general public out of important decision making when it comes to the health care market. In this theory special interest groups receive wealth transfer in scarce resources causing the general public to pick-up the cost in inefficiencies created by this model. Furthermore the political negotiations process consumes large amount of money that would be better used in productive purposes.

Public Interest Theory

We introduce this model as the more perfect in theory when contrasting the special interest group model. The core of this theory is Government intervenes in the best interest of society. This means several interventions through encouraging competition, providing information, and reducing harmful externalities or the fatal phrase “redistributing income in society.” This encompasses addressing market failures, in imperfect information “lack of transparency”, and breaking up monopolistic behaviors. By now we can clearly see these two theories are in direct conflict with one another; both continuing to compete with each other for Government intervention. So our question is which theory is currently the prominent one in our health care market? We will explore this question in our next section Current Health Care Trends, with fact-based rational.

Current Health Care Trends

Let us take a look into mergers which is a reliable snapshot on which theory is dominate in our current health care system. Mergers and consolidations have been increasing in our health care system at an alarming rate and to a point where companies have formed to help companies in a merger. Woodard and Lindstrom assert that health care organizations are consolidating at an unprecedented rate. With the number of mergers and acquisitions not likely to abate, healthcare organizations will need to become involved in strategic planning to manage the effects of this transaction activity and exert more control over the direction it will take. In particular, healthcare organizations need to know how to respond when their organizations are approached about a consolidation opportunity and how to determine whether a consolidation transaction would be strategically advantageous.
Furthermore hospitals and long-term health care are becoming the largest mergers in our current health care system. Market Watch explains the trend in health care mergers and acquisitions for the last ten years. NORWALK, Conn., Apr 08, 2010 (BUSINESS WIRE). More than $7.5 billion was committed to fund 459 mergers and acquisitions of home health care companies announced during the 10-year period ended December 31, 2009, according to DealSearchOnline.com. The largest of these transactions, the acquisition of Apria Healthcare Group by The Blackstone Group for nearly $1.6 billion, was announced in 2008. The deal between Apria and Blackstone is almost twice the size of the next-largest home health transaction for the same 10-year period: the acquisition of Option Care, Inc. by Walgreen Co. for $850 million, which was announced in 2007. Option Care itself was on the buy-side in 27 of the home health care mergers and acquisitions announced during the same 10-year period, while Apria Healthcare Group was on the buy-side in 15 of the home health care mergers and acquisitions announced during the decade.
Clearly these fact based examples show the special interest groups is the theory most dominate in our current health care system. We will now contrast this to current Government intervention within the public interest theory in our conclusions.

Conclusions

So far we have only shown the dominate special interest theory; however our Government is making inroads to addressing public interest theory. The new health care reform has achieved greater access, eliminated penalties to pre-existing conditions, and continually informs the populist in a myriad of official government website that address every aspect of healthcare. Furthermore the Government is taking a hard look at antitrust laws under the rule of reason. Alonso-Zaldivar (2010) assert that Washington, in a blunt warning to the health insurance industry, the Obama administration said Monday it won't hesitate to block mergers that threaten to stifle competition. Justice Department antitrust chief Christine Varney told a lawyers' conference that vigorous enforcement of anti-monopoly laws is vital to the success of the new health care law, particularly in trying to control rising premiums. In conclusion we see these changes important in favor of public interest, but we are also seeing the price as it relates to special interest groups. Simply the Obama administration has acted upon public interest concerns rather than special interest groups causing perhaps political suicide in his acceptance rate. We admire his sacrifice in his attempt to make health care a more competitive market and closer to the perfectly competitive market.

Reference:

Sultz, Harry A.. Health Care USA, 6th Edition. Jones & Bartlett Publishers

Dewar, Diane, (2010). Essentials of Health Economics, Jones & Bartlett Publishers

Business Wire. (2010) Key Stats on Home Health Care Mergers and Acquisitions for 10-Year Period Ended
December 31, 2009 Generated by DealSearchOnline.com. Retrieved on June 5, 2010, from
http://www.marketwatch.com/story/key-stats-on-home-health-care-mergers-and-acquisitions-for-10-year-period-ended-december-31-2009-generated-by-dealsearchonlinecom-2010-04-08

Health Care Financial Management (1997) Analyzing and executing mergers and acquisitions –
managing healthcare mergers. Retrieved on June 5, 2010, from
http://findarticles.com/p/articles/mi_m3257/is_n5_v51/ai_19645353/

The Huffington Post (2010) Justice Department: Expect “Vigorous” Scrutiny of Health Insurance Mergers.
Retrieved on June 5, 2010, from http://www.huffingtonpost.com/2010/05/24/justice-department-health-
insurance-mergers_n_588150.html

A look into Health Economics

2010-08-13T21:46:00.001-04:00

Abstract

We will explore health economics in the area of predictability of future demands for medical care, whether the demand will rise or diminish. Using the variables of the changing price of health care services, time, and the effect of income, we will contrast this to educational attainment within the community and the impact this has on market equilibrium and economic optimization.

The Changing Price of Health Care Services

The health care market is not unlike any other market in the respect of supply and demand. When more is desired by the consumer for a product or service then the price becomes more and when less is desired price falls. Furthermore other aspects are the same in all markets, including efficiency, competition, and opportunity cost. Efficiency is evaluated by how well resources are distributed to promote social welfare. Opportunity cost is a measure of how well a company can look at the next best alternative in the use of their resources. The core variable that drives price down is when many hands are in the mix causing competition or who has the best results in the fore mentioned variables, and the efficiency of those variables. However in the Health market differs from other markets in the respect of the human equation because it is not solely based on desire but also on need.

Addressing Time and Human Capital

Time has one positive and two negatives as it impacts health economics. The positive is found in the youth of our populace. Simply the younger you are the less need for medical services which provides health or better understood as not using health resources. This addresses scarcity in the respect how we distribute a limited resources. This is the based on the principle of give and take, we take resources from our youth who have less need and give this to the old who need it more. As we become older we need medical care more as our bodies begin to breakdown or simply the morbidity factor. Furthermore in time our population will increase causing an overall need which impacts our health resources, this will be explored further in our conclusions.

The Effect of Income

The median income found in different social classes has a direct affect on being able to obtain medical care, accessing preventative measures that promote a healthy lifestyle. At first glance and in short term analysis’s those who do not have the means to pay for medical services provides health, but in the long term causes a catastrophic effect on health economics. Within the lower classes of our society a health issue is often not addressed until the problem becomes acute, or even chronic in which case this class will seek emergency rooms to address their health needs coupled with the inability to pay for what is the most expensive service found in our healthcare system, acute care. This drives up price that is shared by all of society. We as a society must address this disparity with lower costing preventative care to our lower classes to prevent this cascading event of rising cost.

Concerning Education

Education is twofold both within the area of the provider and the consumer. Health economics assumes that the consumer is rational in their decision making when it comes to the human capital. However rational decision making is based on awareness of a given situation. Void from education many decisions are less than perfect when it comes to rationale, because of lack of knowledge of the problem that befalls them. Without education a person simply does not know how to address their health needs effectively, use preventative measures, or live a healthy lifestyle. Education will raise awareness and increase the provision of health. The more educated the provider the better the quality of health services in the realm of evidence based decisions, providing awareness to the consumer, and providing a safer delivery system that combats tort law cases more affectively. Truly education is the largest factor in health economics in lowering overall cost in the medical services (Healthy People 2020).

Conclusions

Statistically the cost of healthcare continues to rise in America. One major factor is the median age of our populace is growing older, as more and more baby boomers are turning sixty five and go on Medicare. Our population continues to grow increasing the demand on medical services. We conclude that education is the best answer in whether the need for medical services will increase or decrease in the future. We feel that education will at the very least cause equilibrium in the demand for health services if we are proficient and global when it comes to providing education. However if we fall short in educating our populace we predict that the demand for medical services will continue to increase.

Reference:

Dewar, Diane. (2010). Essentials of Heath Economics. New York. Jones and Bartlett.

SOPHE. (2010). Society For Public Health Education.

Loop Holes in Heathcare Reform

2010-02-28T10:41:00.000-05:00

Healthcare Reform Controversy
James Wise
Class: HCA 202

Abstract

If members of Congress slow down long enough to read the detailed reports of their own Congressional Budget Office (CBO) or even its director's recent Senate testimony they will understand that many of the slogans they use to justify government intervention are false. Insofar as there is a cost shift, it derives from the government programs Medicare and Medicaid, which reimburse providers at rates roughly 20% to 40% lower than the private providers. ( Pipes, Sally). This article goes on to state that in recent events the passing of large reforms without proper scrutiny of facts will not achieve the goals it is proposing because of loop holes. The article also reveals the propaganda machine that plays on needs, fears, and attempts to engender hope of a better cost effective and quality healthcare system. I focused my research on cost because that is the cornerstone to sustaining a vibrant healthcare system. I will contras the actual facts to the Democratic point of view and their drive on getting the new healthcare reform passed quickly.

Health “Reformers” Ignore Facts

The Democrats' case to expand government health care is so full of holes that passing it quickly is their only hope. If Americans slow down and ask questions, they will be hard-put to come up with answers.
Status health-care reform, for example, is said to be needed to help the economy recover in a period of deepening gloom. The president has made this argument on numerous occasions, such as earlier this week when he announced Kathleen Sebelius as his pick for Secretary of Health and Human Resources. So too has Henry Waxman (D., Calif.), chairman of the House Energy and Commerce Committee. "The costly failure of our health care system affects the financial health of our businesses," Mr. Waxman said at a conference at Families USA, the national nonprofit dedicated to health care for all Americans. "It affects our competitiveness in the world. This isn't something to put off; this is something to do right now to help fix our economy."

Health care certainly plays a major role in the U.S. economy, and by almost any objective account a highly positive role. It employs 13 million Americans and accounts for one out of 10 jobs. But the assertion that the costs of providing health insurance cripple American corporations in the global economy is simply wrong.

CBO director Douglas W. Elmendorf explained this last week to the Senate Committee on Finance, which is chaired by Max Baucus, a leading proponent of government health care. The point is that for employers, health care is merely a part of total compensation: It reduces cash compensation for employees but it does not increase costs of employment. To argue otherwise is to argue for lower total U.S. compensation; that is, lower wages for U.S. workers. Mr. Elmendorf said, "The costs of providing health insurance to their workers are not a competitive disadvantage to U.S.-based firms."

Another common argument for more government insurance is that the uninsured shift costs to private payers when they avail themselves of the health-care safety net, thus jacking up healthcare premiums in the private sector. Many reform advocates make this claim, including Sen. Edward M. Kennedy (D., Mass.) and Sen. Baucus. This is not the case. In the first place, a recent CBO report ("Key Issues in Analyzing Major Health Insurance Proposals, " December 2008) is clear on one issue: Working to achieve universal coverage through expanding government's role in health care will increase total costs and therefore either increase premiums or taxes, not reduce them. As for the argument that the uninsured shift costs, Mr. Elmendorf was quite direct dispelling this myth in his testimony before Mr. Baucus's committee. "Overall," he said, "the effect of uncompensated care on private-sector payment rates appears to be limited."

In fact, insofar as there is a cost shift, it derives from the government programs Medicare and Medicaid, which reimburse providers at rates roughly 20% to 40% lower than the private providers. This has been detailed by the widely used and quoted health consultant firm, the Lewin Group. But this is conveniently ignored by those who want to expand government health care.

Preventative care, disease management and electronic medical records are also constantly cited as big cost-savers. The idea here is that if our healthcare system was set up to prevents disease rather than just treat it, and could do so without duplicative paper records, it could save money. It's a great hypothesis, but research does not indicate it amounts to much. "In many cases," as Mr. Elmendorf testified regarding such initiatives, "those studies do not support claims of reductions in health spending or budgetary reductions."

Americans like their current health care, its plethora of choice and its intensive, high tech approach to fixing our ailments. A Gallup survey in December reported that "on balance, Americans still favor maintaining the current system, 49% to 41%." But the CBO is very clear that saving money on health care involves doing less of the very things Americans like the most.
"Studies attribute the bulk of the cost of growth to the development of new treatments and other medical technologies," the CBO notes in a report issued last December, later adding, "Given the central role of medical technology in cost growth, reducing or slowing spending over the long term would probably require decreasing the pace of adopting new treatments and procedures or limiting the breadth of their application."
In other words, reducing costs means rationing the care of those who currently have private insurance and Medicare.

Reference:
Sally C. Pipes. Wall Street Journal. (Eastern edition). New York, N.Y.: Mar 6, 2009. pg. A.15
Sally Pipes is president and CEO of the Pacific Research Institute and author of "The Top Ten Myths of American Health Care" (Pacific Research Institute, 2008).

Barrack Obama’s healthcare reform proposal: http://www.barackobama.com/issues/healthcare/ Retrieved March 22, 2009.

Congressional Budget Office--CBO (NAICS: 921120 ), Retrieved March 22, 2009.

Democratic Party (NAICS: 813940), Retrieved March 22, 2009.

High Cost of Heathcare

2010-02-28T10:21:00.000-05:00

Running head: High Cost of Heath Care Services

High Cost of Health Care Services
James L. Wise
Class: HCA 209

High Cost of Health Care Services

There are several factors which lead to increased costs. First, the government (both federal and state) meddles in the matter; refusing, for example, to allow policies to be offered across all 50 states. Secondly, there are now just a handful of large insurers and they routinely violate contract law and antitrust law. By violating antitrust law, they drive up costs in the markets they control and reap larger profits than they should. That is compounded by their not paying legitimate claims as well; Linda Peeno, MD testified that she had often denied treatment just to save the insurance company money

Furthermore, the vast majority of health insurance policies are through for-profit stock companies. They are in the process of "shedding lives" as some term it when "undesirable" customers are lost through various means, including raising premiums and co-pays and decreasing benefits (Britt, "Health insurers getting bigger cut of medical dollars," 15 October 2004, investors.com). That same Investors Business Daily article from 2004 noted the example of Anthem, another insurance company. They said the top five executives (not just the CEO) received an average of an 817 percent increase in compensation between 2000 and 2003. The CEO, for example, had his compensation go from $2.5 million to $25 million during that time period. About $21 million of that was in stock payouts, the article noted. A 2006 article, "U.S. Health Insurance: “More Market Domination, More CEO Compensation" (hcrenewal.blogspot.com) notes that in 56 percent of 294 metropolitan areas one insurer controls more than half the business in health maintenance organization and preferred provider networks underwriting. In addition to having the most enrollees, they also are the biggest purchasers of health care and set the price and coverage terms. The results is double-digit premium increases from 2001 and 2004-peaking with a 13.9 percent jump in 2003-soaring well above inflation and wage increases. Where is all that money going? The article quotes a Wall Street Journal article looking at the compensation of the CEO of UnitedHealth Group. His salary and bonus is $8 million annually. He has benefits such as the use of a private jet. He has stock-option fortunes worth $1.6 billion. There is also the fact that of the folks who declare bankruptcy, more than half are over medical bills and 75% of those folks have insurance. So it is clear that insurance is not meeting its responsibilities because the actual purpose of it is not to pay for the "sniffles," but to be there for serious illness which can bankrupt a person.
One last insight is the Heath Care industry it is the only industry that has a lack of price transparency. The hospital cannot tell you because your healthcare insurance is a confidential contractual agreement. If you call your insurance carrier, they will say the price may be this or it may be that depending what the surgeons have to do. So in the end you do not know what it will cost you until services rendered. This makes it hard for the consumer to shop for the best value, and truly stops it from being a free market.

The answer is forth coming once you have seen all the statistics concerning the rising cost of health care. The insurance companies, as it stands, needs to be abolished. Putting all the moral issues aside which are many, the men/women that have put 12 years of academic study and all the clinical and only make 210,000 a year v. an insurance executive earning in the millions is just turned upside down in my opinion. Health care prices should be set by the government through global market research this will make it a free market “money transparency.” The pre-existing clause must go away. Insurance companies should be made into non-profit organizations, their focus changing to quality of service and financially rewarded by the government. I am in general proposing standardization and accountability in the heath care system, not to be confused with socialism. My thoughts on capitalism, well they are wavering in Today’s financial climate.

Bibliography

Dr. Peeno, Linda. (1996) The Doctor’s Testimony. Retrieved November 29, 2008 from
http://www.thenationalcoalition.org/DrPeenotestimony.html
Wally R. Smith, MD (2006) Health Care and Health Insurance. Retrieved November 29,2008 from http://www.hcrenewal.blogspot.com
Britt, (2004) Health insurers getting bigger cut of medical dollars, retrieved November 29, 2008 from http://www.investors.com

One possibilty in saving Medicare

2010-02-28T09:43:00.000-05:00

You did not lose me, you came over load and clear. I watched the debate today and was not impressed with our president elect. I am for the needed stance to take baby steps which seems to be a competitive thing for Obama. But with such a large problem and the magnitude of all that it effects it is just simply to large to take on as a whole. Why this is a truth is because you may have a calculated idea concerning cause and effect but in reality you never know how one part will effect another positively or negatively until implemented and then monitored and anilized.

What is more alarming is this is new ground for all of us we truly do not know if it will make things worse or better although everything seems to point to worse. That is why a more conservative approach is needed with baby steps. Say eliminating the pre-existing condition clause, and allowing insurance to cross state lines to infuse competition and making it more portable would be a excellent and agreed upon by both parties for a start.

Medicare is also in serious trouble for one main reason it is coupled to payroll tax. While the baby boomers are retiring at a torrent rate and with the millions of job's lost Medicare is bleeding out by losing all of those who are no longer paying into the program. So our wise congressman want to cut 500 billion and cause more disparity and strain on the system.

To me the solution is a simple one and would work. Let me framework this idea first. It is the first time in our history that Wall-street actually has been experiencing record profits while Main-street still despairs in our great recession one has always effected the other in the past. What this means is the upper class are maintaining their wealth as the middle class shrinks into poverty this process will implode and devastate our government in the process (i,e, massive debt).

The solution:

De-couple the funding of Medicare from payroll tax it proven not to be sustainable and the statistics grow ever worse. Put a broad-base value-added national sales tax on any non essential products or services. The higher the price of the luxury item or service the higher the percentage of the tax. Truly if I am rich enough to go out and buy a $200,000 car I can afford to pay 23 percent tax. Any foreign luxury item would have an embargo tax to eliminate run away companies. Furthermore eliminating the payroll tax will put more money in everyone's pocket to further help pay for medical needs or insurance.

This is not just targeting the rich but most of the middle class buys luxury items and indulge in many value-added services. I believe this would also put Wall-street and Main-street back into balance when the tax payers children, children as it stands now are going to be paying the bill.

To try and bring this back on topic, it is the hospital and all it's staff that is caught in the middle and it will have a direct effect on quality of care as well as recruitment of new doctors and nurses which both statistically are in shortage and continues to grow. Physician need is also problematic as more and more of the baby boomer generation retire.

Information Technology is changing Healthcare

2009-11-02T22:12:00.000-05:00

We have known for some time now that the exchange of information has great power in many ways. Take weather and storm tracking for an example. From satellites we are now able to track, see the size, and know the severity of a storm. With hurricanes we have a good 72 hours to flee or prepare for the on coming ravage of the storm. Before this time we saw a storm coming from those already effected by it and had little time to prepare or flee. It is this way with healthcare concerning information exchange, and the timeliness of that information. Simply like a storm if you have the patients medical history at a click of a mouse you can with this alone give better more informed service, even more so if the patient arrives incoherent, or un-responsive.

Through the push for electronic medical records by the Bush administration in 2004, set the Healthcare information technology in motion and the inertia is building. To solidify the speed in the implementation of this technology only one year later 87 percent of hospitals had already or were in the process of implementing electronic health record (EHR) system. (Christina Beach Thielst). Not only was this decision made from the obvious benefits that can be achieve through safer, quality care but it also nearly eliminates errors, abuse, and fraud issues.

As we have learned in our last class with information made available for favorable outcomes much less errors will be made in bad diagnosis to wrong procedures which will help money lost through tort law; less mistakes, less law suites. Also from the same author Christina Beach Thielst stated that Medicare is looking at payment reform based on quality, and favorable outcomes instead of volume of patient’s served.

Personally I see all these changes moving in the right direction to greatly enhance quality, safety, and the most cost effective way to deliver healthcare. Also keeping the patient more involved and informed through new venues as Telemedicine will achieve better compliance with their wellness plan. However, I feel for the time honored physicians that are of the old school and are not commuter savvy. Simply If I had graduated and have been practicing medicine for 30 years, the last thing I would want to do is go back to school and learn computer science. However, in implementation, focusing on the safety of the patient and showing the wizened physician the value that is added they would be more enticed to be less resistant, and hopefully be involved in a leadership role.

References:

Telemedicine at http://www.telemedicine.com/consulting.html retrieved on September 28, 2009.

Christina Beach Thielst, CHE, Health Administration and Management Consultant,
Santa Barbara, California Journal of Healthcare Management. Chicago: Jan/Feb 2007.

Ball, Weaver, Keil “Heathcare Information Management Systems” Springer 2004.