Analysis: The Three Key Issues In The Healthcare Industry

Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (Eds.). (2008). The healthcare quality

Definitions of the quality of medical care are no longer left to clinicians who decide for themselves what technical performance constitutes “good care.” What are the other dimensions of quality care and why are they important? What has changed since the days when “doctor knows best?”

Creating a health care reform plan for the U.S. health care system is no easy task. Multiple things must be taken into consideration. These include making insurance affordable, making sure the plan is economically feasible, and creating a plan that will still work in the future. What hindered the reshaping of health care into a sustainable system in the past, are the health sectors interests that prefer the status quo. By continuing to cling on to yesterday’s model, the health care industry is creating its own peril (Schaeffer, 2007).

However, prior to the existence of the ACA, the American healthcare system left a lot to be desired and still today leaves room for improvement. The basic issues underlying efforts to improve the United States (US) health care system remain, as they have for decades, concerns for costs, access, and quality (Sultz, 2006). Even though knowledge, technology, and

The future of healthcare if left as is, the system will falter and eventually, a new reform will be realized as necessitous (Garman, Butler , & Brinkmeyer, 2006). When the system proposed fail to meet

As populations around the world continue to grow, it becomes more evident that health services provided worldwide are not growing at the same rate and instead will continue to put further strain on existing health disparities, and create new ones. In the United States alone, access to healthcare is a crucial topic of discussion principally as the American government continues to create initiatives and legislation such as the 2010 Affordable Care Act. Although, the United States has come a long way to legally create access to care to all its citizens, there is a disparity in the number of individuals that in actuality receive healthcare due to the geography of cities and the nation.

The passage of the Affordable Care Act (ACA) has prompted policy makers and healthcare providers to review the current system of providing services to individuals and families. The previous system of providing healthcare services was impaired by inefficient systems that had elevated costs, waste of resources, and in some cases obstructions that prohibited individuals and families in seeking care in a timely manner. The goals of the ACA is to improve the health of the nation, increase quality of healthcare services, and reduce costs of the overall system while providing health insurance options to all people across the country. The health insurance exchanges provide options for all Americans to gain access to health insurance options, but

Karikari-Martin (2010), states that the definitions of healthcare access are directly related to the concerns of the system. She continues saying that these definitions pertain most prominently to insurance, number of available providers and the efficiency of healthcare services (Karikari-Martin, 2010). Prior to enactment of the Patient Protection and Affordable Care Act (PPACA) in 2010, the United States population was held hostage by an insurance industry that was poor secondary to insufficient government controls. The insurance companies made good insurance policies more difficult to attain with premiums that were constantly increasing, denials of insurance for those with pre-existing conditions or premiums so high they couldn’t afford it.

Everyone has their own views on what they think the United States healthcare system should consist of. Consequently, the healthcare system has been flawed for many years and does not plan to change anytime soon. According to Luft (2006), “rapid and wide-reaching technological innovation, the ready access to care for the insured, and clinical and patient autonomy” (p.1). These are some of the strengths the US healthcare system are proficient in providing. In contrast, the weaknesses of the healthcare system outweigh the system’s strengths. Luft (2006) examined and acknowledged the following:

Better quality health care will affect the life expectancy rate and the expenses. Patients expect doctors and hospitals to deliver the best possible care. The major issue with the quality of health care is “medical errors result from faulty systems… not individuals” (Hughes). In order to ensure patient safety and positive outcomes, hospitals have to assess for themselves the various different aspects they need to improve on. For example, hospitals could have a shortage ranging from staff, medication, or equipment. Through universal health care, “doctors… can focus on patient care”, which will aid in improving treatments for each individual (White). Along with this, there will be more government funding to improve hospitals as a means to help patients. Countries under universal health care coverage have a better quality of care, while the “United States [is ranked] last overall” (“Right to Health Care”). These benefits of medical treatments of universal health care are vital to American

Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.

Quality indicators enable the health care system to identify inferior care in both process or outcome and structure while enhancing quality improvement in health care (De Vos et. al, 2009, p.1).

Quality is one of the most essential elements of healthcare. As stated by the Agency of Health Research and Quality, “Everyday, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function” (Agency of Health Research and Quality, 2014). Improvements have become vital to the success of health care organizations and in the Healthcare Quality Book, it is explained that quality in the U.S. healthcare system is not at the standard that it should be (Ransom, Joshi, Nash & Ransom, 2008). Although this has been a reoccurring issue, attempts to fix the insufficiency have been less successful than expected.

Our healthcare system needs major restructuring. Major improvements needs to begin with "all health care organizations, professional groups, and private and public purchasers should adopt as their explicit purpose to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States", (Crossing the ……, 2001).

By 2001 it was brutally apparent that the U.S. Health Care system was in dire need of a reform in regards to quality and patient safety. Following two separate reports issued by The Institute of Medicine (IOM), To Err is Human (1999) and Crossing the Quality Chasm: A New Health Care System for the 21st Century(2001) the U.S. Congress requested the IOM review quality processes across multiple government funded health care programs. And understandably, “these reports described America’s healthcare system as a tangled, highly fragmented web that often wastes resources by duplicating efforts, leaving unaccountable gaps in coverage, and failing to build on the strengths of all health professionals” (Brown J., p. I – 15, 2013). Thus, the Committee on the Quality of Health Care in America released 6 aims to address key dimensions that require improvement in our health care system. These aims propose that our system needs to strive to be more Safe, Effective, Patient-Centered, Timely, Efficient, and Equitable (STEEEP). All of which were created to help overhaul our current health care system and, more importantly, narrow the quality chasm.