Annotated Bibliography: Healthcare Cost And Quality

Rising health care costs became an issue after the Medicare and Medicaid programs were formed in 1965 and have continued to be a factor in the United States economy since then. “By1970, U.S. government expenditures for health care services and supplies had grown by 140%, from $7.9 billion to $18.9 billion.”() By the 1990s the annual increase in the government health care expenditures was finally brought under control and has fluctuated between a 5% and 8% increase each year since then. This essay will discuss the different factors contributing to the rising costs of health care in the United States, as well as how the cost of health care affects the accessibility and quality of medical care throughout American history.

Quality health care is an issue in America for everyone, despite our numerous tests and advances in technology. In his article, “Overkill,” Atul Gawande argues against a common assumption that our healthcare system is the best because of these medical advances. In fact, Gawande claims that our health care provides much unnecessary care that often causes harm and that costs a lot . He follows that claim by redefining “low-value care” as “no-value care” and provides considerable scientific data along with his own experience with his own patients to support his claim. He also states logical reasons by referring to expert authorities who critique our health care by viewing it from an economic perspective: like talking about information asymmetry where a doctor is more informed than the patient, thus the doctor has more power over the patient. All of these emphases strongly defend his controversial claim. But what stands out most is how Gawande uses several stories showing vastly different outcomes, depending on how informed the patient and doctor are including offering non invasive treatments. We need to explore how his unusual storytelling strategy exposes how surgeons and patients should care more about quality than the mere quantity of tests and what alternatives are available to change the unnecessary over testing and over-diagnosis which prevent good health care.

Medicare is another section that will feel some relieve from practices brought from the Act. As mentioned before, the cost of health care is expensive, therefore making it difficult for those under the Medicare plan to seek preventive services. Before moving forward on the effects of the Act on Medicare, one must first explain some of the benefits of Medicare. Medicare is the nation’s largest health insurance program, it serves more than forty-two million enrollees, and it was originally established to provide access to health services for the elderly (Carroll, 2009). One can grasp the idea that the nation, along with its government, has made constant efforts to support the health of all Americans. This especially true for the ever growing

Medicaid is a vital lifeline for some 72 million Americans. Two-thirds of all Medicaid spending supports senior citizens and persons with disabilities. Cutting Medicaid would jeopardize the quality of healthcare, long-term services, and nursing home care for tens of millions of Americans. There are significant cost issues in America’s healthcare system that must be effectively addressed, but these challenges will not be remedied by benefit cuts to vulnerable

The U.S. has experienced a dramatic change over the last decade. Health costs have continued to rise and have become unreasonable. Health care spending in the United States is expected to reach about $4.6 trillion in 2021.The spending of health care costs has affected the citizens of the U.S. as well as health care facilities negatively. Americans are not capable of paying for health expenses on their own. There are some reasonable options that have been suggested as a solution to this issue, but have not been successful. For example, aids such as health insurance and Medicaid help with a certain percentage of the overall cost, but people are still left to pay for health insurance premiums and the remaining expenses that the insurance does

With the Centers for Medicare and Medicaid (CMS) providing coverage for over 100 million citizens in the United States and being the largest care delivery system, it is hard to ignore their presence in the ever changing health care delivery system. Some say, that where Medicare goes, private payers will follow. Today, hospitals, health systems and other providers have been highly influenced by Medicare. Medicare, Medicaid, the Children 's Health Insurance Program, and the Health Insurance Marketplace are leading the way in the movement to provide coverage under this system. As the Affordable Care Act is ironed out, there are still billions of dollars being spent within the Medicare/Medicaid programs. In an effort to try and combat some of the overwhelming costs of these programs, the Accountable Care Organization (ACO) Model has slowly begun to integrate itself into the Medicare/Medicaid system. This has brought about some interesting changes with reimbursement, cost containment, and quality of care. Each making slow shifts towards change and developing new systems of providing quality health care.

It is no secret that the US healthcare has many issues in its system. Especially, when you compare it to other countries like: Great Britain, Japan, France, Canada etc. According to Sultz and Young states that “The United States ranks eighth behind all of these nations in life expectancy at birth, highest in infant mortality rate, and highest in the probability of people dying between the age of 15 and 60 years.” The US healthcare system has many issues like a large number of uninsured According to Sara R. Collins, Munira Gunja and Sophie Beutel in the 2014 census 33 million people were uninsured. Other issues are medical professional shortage, medical error or infection, people using apps to diagnose themselves, and rising cost of care. The main focus in these paper will be the rising of cost. The cost of current health care explains for most of the issues that is happening in this country.

Many health care leaders, authors, and professionals have given their time and effort to write and discuss quality. Quality is now recognized as one of the key aims in healthcare today. The Institute of Medicine (IOM) has had a profound impact on health care in America and the view of quality within health care facilities. The National Roundtable on Health Care Quality met six different times between 1996 and 1998 to look at changes regarding quality in health care. Within their conclusion they said, “Serious and widespread quality problems exist throughout American Medicine” (IOM, 1998). The terms underuse, overuse, and misuse evolved here to describe the errors occurring in health care. These errors were hurting more patients than the population realized and once published the trust towards healthcare was low and many had questions. Their review at the roundtable combed through what was currently the norm in health care. Based on the experience of the members of the roundtable, it was not up to par and a shift was necessary to improve healthcare outcomes.

As of 2008, the Center for Medicare and Medicaid Services (CMS) identified falls as a Hospital Acquired Condition (HAC). HAC is a complication or comorbidity that occurs as a consequence of hospitalization and is high volume and/or high cost, and be reasonably prevented using evidence-based guidelines (Radey & LaBresh, 2012). The Center for Medicare and Medicaid Services will no longer cover the cost of care as a consequence of an inpatient fall based on the presumption that falls are preventable by the organization (CMS,

The nation health care system is facing significant challenges that requiring immediate major reforms. Lately close attention is drawn to the uninsured Americans, such as the most painful dilemmas of health care system. The problem of uninsured and uncompensated care continues significantly contribute to the rise of the health care cost and has been a chief topic for public debates and political campaigns for a long time. The purpose of this paper is to describe the current extent of uninsured care and provide the strategies from the nursing point of view how to change the trajectory of this prevalent issue in the USA health care system.

Health care costs have become a major issue in the United States, both socially and politically. According to the U.S. Census Bureau, 50.7 million people, or nearly one in six U.S. residents, were uninsured in 2009 (Kaiser Health News, 2010).This is because the high cost of health care has driven the cost of insurance out of the reach of many Americans.

When you think about health care cost and what was done in the past to help people who could not afford it to be able to get coverage now. Many people will not be able to afford to get the mandatory coverage and if they do, they will not be able to afford to see the physician or take the medication that they needed. Some of the plans worked and others helped for short periods. With other countries, finding ways to make it work for them and stakeholders more worried in the U.S.A. over their assets. With the rise of the older generation living longer but having more health issues is a reason to look into getting better coverage that is affordable for all for health care.

The cost of health explains almost half of the budgets of the state from financing the Medicaid program to providing health care for the employees of the state and other less qualified population like the prisoners (Vanderbeaux, 2014). In America, thousands upon thousands of decisions concerning health care are made by State legislatures every year (Vanderbeaux, 2014). Some of those decisions involve how best to provide appropriate care more efficiently, and deciding on what age group of patients needs to be immunized (Vanderbeaux, 2014).

What would happen financially to a health services organization over time if its prices were set at:

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.