Good News On American Medicine Reflection

Rishi Manchanda is right about moving upstream: “Improving health where it begins will limit how often we visit the doctor’s office.” More specifically, we must move upstream to save the money wasted on healthcare that is focused on volume, not value. We seem to pay doctors on how much they provide, but not necessarily how effective those treatments and medications are. For instance, Manchanda makes a valid point in his presentation: “We need a health care system that stops bouncing you back and forth but actually improves your health, listens to you who you are, addresses the context of your life, whether you're rich or poor or middle class.” Receiving care from someone involved in more than just the protocol is an important concept in improving anyone’s health. Ultimately, moving healthcare upstream is important because it will give the chance to these doctors and nurses to give a better standard of care by being involved in the context of the patient’s life. Three main ways the US can work to improve and move healthcare upstream are to improve health throughout communities, improve patient care from doctors and physicians, and lower cost of specific treatments and services. Our lives do matter, so it is important we receive the care we deserve; therefore, we must work together

Over the course of our countries history, the delivery of our health care system has tried to meet the needs of our growing and changing population. However, we somehow seem to fall short in delivering our goals of providing quality, affordable and accessible healthcare to our citizens. The history of our delivery system will show we continuously changed the delivery of our system however never mange to control cost. If we can come up with efficient ways to cut cost, the delivery of quality care will follow.

A major change is occurring in the healthcare system as the United States continues to move toward enhancing patient care quality and access while also decreasing cost. This significant transformation is driven by a variety of forces, including changes in managed care, a shift from pay for service to pay for quality, and ever-evolving client characteristics. This paper aims to discuss each of these factors and the ways in which they make this major transformation a difficult one for the nation to undergo.

The Washington Post reported on June 16, “Once again, the United States has most the expensive, least effective health care system in survey.” It’s apparent that the United States healthcare system is in an economic crisis. Furthermore, the United States healthcare system is not only in economic turmoil, but the social systems currently in place offer little to no future economic resolve for the predicament we are currently situated in. The paradox that seems to have fallen upon American healthcare is that, “The system doesn’t want you to die, but at the same time doesn’t want you to get well.” Heineman (2012) It is bad business. In other words, medicine is a business and I have witnessed this approach towards business in medicine first hand in my over five years of clinical and business experience in the medical field.

For anyone who has kept up with the news, the US healthcare system has undergone major changes in recent years. Insurance providers are no longer able to deny someone coverage based on pre-existing conditions. The advent of healthcare marketplaces has changed the way people purchase health insurance. Children can stay on their parents' health insurance plans until 26. Leading the healthcare revolution is InnovaCare Health. This organization is a leading provider of Medicaid and Medicare Advantage plans. InnovaCare Health recently announced it would partner with the Health Care Payment Learning and Action Network. This is a significant private-public partnership that seeks to change compensation models to reflect the quality of care instead of quantity. This new partnership reflects InnovaCare Health's to affect change in compensation sooner rather than later. The current healthcare model focuses on reimbursing physicians based on the number of patients seen or procedures performed. This encourages "treadmill medicine," or a model that focuses on rapid turnover. This can often lead to detrimental effects on patient health. The new quality model would reward physicians based on practice targets. Potential goals include HbA1c goals for patients with diabetes, the percentage of patients who smoke, and hospital stay after surgical procedures.

It has been said that one cannot know where he or she is going until he or she knows where they has come from. This saying is especially true when discussing the current model of the United States healthcare system. The present day model of the United States healthcare system is the culmination of two hundred years of constant evolution due to ever changing societal norms. America has been in the forefront of major transformations throughout history and there have been integral factors that have been the catalyst for these changes. “Changes driven by

A big problem that the film addresses is the fact that the United States spends such a large amount of money on healthcare, but ends up with one of the worst outcomes. One of the factors that contribute to this is how doctors are encouraged to see as many patients in a small amount of time. PCP Dr. Erin Martin expresses her dissatisfaction with the constant pressure that productivity should be more valued than the patient’s care. This inevitably drives up the cost and decreases the quality. Unfortunately, medical industries are still striving to gain a profit from health care. Dr. Steven Nissen speaks out saying that “when medicine became a business, we lost our moral compass”. Unlike many other countries, the United States healthcare system is heavily governed by big industries. , hoping to gain money from people’s illnesses.

They collectively understood each other’s strengths and weakness. Cohen, Klein, and McCarthy reported this to be a great challenge in forming and operation of the ACO, but without this mutual understanding they would not have been successful. Dignity Health, a large catholic hospital system incorporated in this ACO, had “greater risks for hospital facility costs”, and Hill Physicians “accepted greater risk for professional services”. In this way each entity saw financial gains and losses in different areas, but overall saw similar savings. They accomplished reducing their spending by “$20 million in the first year” (Cohen, Klein, & McCarthy, 2014). There was also a “20 percent reduction in hospitalization cost – reflecting a 15 percent reduction in 30-day readmissions, a 15 percent reduction in inpatient days, and a 12.8 percent decline in the average length of a hospital stay from 4.05 to 3.53 days” (Cohen, Klein, & McCarthy,

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).

Health care disparities are the main crux of the American health care system because while American enjoys some of the most advanced health technology the world, it is very much market based, causing health care inequality. These inequalities force people of lower socioeconomic status without insurance to visit emergency rooms once their health problems are catastrophic, expensive, and difficult to treat. By transferring the health system to a proactive system with increased medical education and governmental subsidization, a patient will not only experience diminished health care costs, but also an improved quality of

Transitioning to this model is not as easy as it seems. Businesses such as hospitals will have to educate all health care workers on the foundations of a value based care system so that the highest quality of care is obtained for each patient and a satisfactory rate of patient outcomes are optimized. Health care providers may have trouble transitioning because there not used to being rewarded off patients outcomes, but rather off increasing revenue by preforming as many procedures as possible, some not even under the scope of evidenced based practice and medicine. Smaller

The United States can boast of being the country with the best technology in the health industry, the best expertise and also the best infrastructures. However, these services are not readily available to all due to the relative cost and mostly lack of health insurance. In some situations, the health insurance may be available but coverage is limited and with tentacles of restrictive clauses. For years these have been the measure of our healthcare system and long overdue overhaul that became eminent via the Obama Care in 2010 also known as the affordable care act. The rapidly rising health care costs over the decades have prompted the application of business practices to medicine with goals of improving the efficiency, restraining

Health care has moved forward with an emphasis on health care delivery and healthier people as a whole, as opposed to the traditional health care of the past. People used to go to different physicians to treat different conditions separately, and the physicians did not see the big picture of the patient’s health status, as they do in this day and age, by connecting these health care services under the same roof or network. Many times the patient would go to different physicians and would undergo the same tests, and their health insurance provider would have to cover these tests. Often times the patient would be sent out for testing that was not even necessary, and it would drive up the cost of health

The health care industry is an important aspect in the development of any nation in the world. The provision of quality health care is a universal need that every government endeavors to make available to its citizens. Just like any other industry, the health care system faces major challenges that inhibit the effective provision of health care services. The U.S. health care system invests immensely in ensuring that the citizens of America receive health care services. Despite the innovative nature of the health care system in the U.S., it is evident that there are challenges that are hindering the effective

The current health care sector is too costly and too fragmented with a lot of variation in care even with established evidence based guidelines. Providers lack the tools, support and information they need to offer the coordinated health management that can reduce cost and improve outcomes. Primary Care Physicians are constrained in their abilities to perform any proactive care that involves avoiding Hospital or ER visits, and influencing healthy lifestyles.