Health Care

One of the most controversial issues in politics today is healthcare, specifically ObamaCare, also known as Affordable Care Act (ACA), which has effectively insured millions of low-income American households. Under the ObamaCare, Medicaid has been expanded to states that want to participate. It plays an exceptionally crucial role in the healthcare coverage, and access for rural communities as they are more likely to “be poorer, less likely to have insurance, and less intense users of medical services overall” (Richards et al., 2016, p. 573). A study conducted by the Health Services Research found that Medicaid patients received appointments nearly 80% of the time in rural areas, but only 60% in nonrural areas (Richards et al., 2016, p. 570).

Primary care is the backbone of many industrialized nations, but is the US one of them? Unfortunately, the answer is no. The US lags behind such developed nations in its accessibility of primary care by a huge difference. The United States healthcare system fails to ensure the timely preventative and primary care for its residents. The current estimates indicate that there is merely one physician for every 2,500 patients. Not only Medicare beneficiaries, but also privately insured adults struggle in accessing the right primary care physician at the right time. Moreover, maldistribution of physicians only exacerbates the problem, especially for those residing in health professional shortage areas (HPSA).15 Approximately, sixty-five million Americans live in designated primary care shortage areas.13 Such underserved population faces higher disease and death rates and health disparities that then result in higher rates of hospitalizations and emergency department visits—in other words, expensive medical bills.21 More governmental control on the geographic location of primary care physicians can be a first-step to fixing the shortage problem.

Another threat is the current state of rural hospitals nationwide. According to the case study, about 25% of Americans live in rural areas and only about 10% of physicians actually practice in rural areas. There is a 15% gap in the ratio of rural citizens to available practicing physicians. This is a threat to ELH’s need to attract and hire more physicians. In relation to rural hospitals, citizens have longer drive times to their medical facilities. This causes them to delay routine visits which subsequently exacerbates

The projected physician shortage is well documented. Several estimates have been made as to the severity of the shortage with the Association of American Medical Colleges (AAMC) predicts required 46,000 physicians to meet demand and a study by Cowell et al putting the number at 44,000 by 2025 (1). The reasons for this increased demand are numerous. For starters, as John Prescott, AAMC chief academic officer, says, “There 's 10,000 more baby boomers every single day in the U.S. and those individuals tend to require additional care” (2). Those baby boomers requiring care will undoubtedly include retiring physicians; 2,504 family physicians are expected to retire in 2015 alone with that number only expected to grow in upcoming years (1). In addition to the increased care inherently required by elderly patients the Affordable Care Act (ACA) has expanded medical insurance to several that have never had access before; while this is great news to those with coverage for the first time it also increases the number searching for a physician. A report prepared for Congress stated that the ACA was poised to increase the shortage of physicians by 8,000 by 2025 (4). Even current clinics have been forced to turn down 250 potential patients a day due to a lack of physicians causing sick persons to drive hours to find care (3). Compounding the problem, new physicians tend to shy away from the 60-hour weeks worked by their predecessors instead looking for a better work/life balance (2, 3).

With an expanding and aging population, the demand for physicians has never been higher. Rural regions across the country are already experiencing physician shortages, specifically in primary care. According to the Association of America Medical Colleges, the United States will have a shortage of more than 130,600 physicians by 2025, equally split between general practitioners and other medical specialties. Although its true that the number of medical students being trained in the United States is increasing due to the opening of new medical schools and expansion of class size, the number of practicing physicians will not increase unless the number of residency slots is increased. The number of residency training slots is the bottleneck to increasing the number of practicing physicians. New doctors need to complete a residency-training program in order to practice medicine, and these training slots are becoming progressively more competitive. The programs are limited in size, and the increasing number of medical school graduates leaves medical doctors without a enough training slots. The looming doctor shortage will only get worse if medical school graduates continue to be left out of residency training programs, and are forced to wait till the following year to re-apply.

According to projections by the Association of American Medical Colleges, the nation will be short more than 90,000 physicians by 2020 and 130,000 physicians by 2025. Everyone deserves a better health maintenance, but sometimes there are not enough providers to make it happen. In the last two decades, the United States and some cities around the world have faced some serious problems because of the shortage in their health system structure. A shortage is when something in a certain area is not sufficient when it is the most desirable. That is the same thing that the country has experienced recently. There is a lack of physicians and nurses, who also characterize the primary care providers in the nation. The shortage results

The evidence shows that even with such increases, most of the new physicians will likely end up in already heavily supplied areas, and the areas which are really in need of new physicians will remain largely underserved. A new model should be adapted in trying to address this issue. Rather than a pure focus on increasing the number of physicians, programs to place physicians in heavily underserved areas should be emphasized. This can be achieved by recruiting students who are from these areas. For example, an article demonstrates that minority physicians (primary care and specialists) are more likely than their counterparts to practice in underserved populations, and care for other minority, poor and underinsured individuals. This can be employed to other populations – for example, people from rural backgrounds are also more likely to served rural populations (Walker et al, 2012). Other ways to improve this is through loan forgiveness programs aimed for physicians who practice in medically underserved regions. Telemedicine is also a creative means to provide access for areas which have great inaccessibility to health care. Furthermore, other professionals such as nurse practitioners, and physician assistants can aid in the provision of care to underserved

Schultz, A., Chao, S., & McGinnis, J. (2009). Integrative medicine and the health of the public. Washington, D.C.: National Academies Press.

Schultz, A., Chao, S., & McGinnis, J. (2009). Integrative medicine and the health of the public. Washington, D.C.: National Academies Press.

Proxy’s Perspective. Kelly and Dan are the primary moral agents and have a crucial role in decision making for the infant. The parents are responsible for making decisions for the good of the child’s treatment, but decisions can be overridden. They are also responsible for releasing, if they choose to, the infant’s medical information. It is unknown if the parents would approve for Jan (neighbor/friend/nurse at Memorial Hospital) to view the medical chart. Without the parents signing a medical release form for another individual to view, it is morally unethical for others to view. Only the health professionals responsible for the care and treatment of the infant can and should access the chart.

Private health insurance is made up of the three principal entities, which is commercial carriers, the Blues, and HMOs plus self- funded plans. The important of PHI as a source of financing for personal health care expenditures has increased slowly, but steadily (Williams & Torrens, 2010). Although there is no denying that some government health insurance programs such as Medicare deliver benefits at far less administrative cost per dollar of

Rising healthcare costs in the United States have made healthcare less affordable over time, creating a major public health issue for individuals without insurance. In a Health Affairs study about patient accessibility to care, the differences between adults with and without coverage has broadened from 2000 to 2010.1 The Obama Administration recognized this as an issue, and in 2010 signed into law the Affordable Care Act to make health insurance available and ultimately affordable to all US citizens, regardless of socioeconomic status.9 For 2016, it is projected that seven out of ten Americans who were renewing a health insurance plan received insurance for $75 or less per month, and eight out of ten received insurance for $100 or less.9 Now in an election year, universal health care in the United States is at a critical juncture for reevaluation. Should our nation continue on its noble path forward to improving its citizen’s health care accessibility, remain stagnant, or repeal and undoubtedly abandon the last six years of progress? Although there may be some limitations, the moral obligation to society, the increased health and well-being of individuals, and the overall economic benefits to our nation that will come with universal healthcare are justifications that make this healthcare model a clear option to consider.

There are many differences in health care reform and access between the United States and Germany. The United States health care exceeds all other countries by 17.1% as well as leading in new medical technologies, according to the Organization for Economic Cooperation and Development (OECD). Even though, the U.S. is a leader in health care, not all U.S. citizens have healthcare coverage. In Germany, the national healthcare spending in 2013 was 11.2%, much lower than the U.S. Every resident in Germany has health care coverage, be it through the public health insurance system or private insurance.(Squires and Anderson, 2015)

Despite the growth of the health care delivery system in the United States, economic and social forces have impacted the physician and nursing workforce. Impending retirements of older physicians and nurses, declining physician working hours, nursing deficits, aging populations and population health have and will continue to cause significant shortages in physician and nursing staffing (AAMC, 2017). The demand for care and reform for population health, supply will be greatly needed. These projected shortages will have a profound impact on the delivery of care, patient access, and economic effect. Currently, the country has approximately nine-hundred thousand practicing, full-time physicians, about half specialists and the other primary care

The United States is having major problems with crisis in health care such as high insurance cost, Medicaid and Medicare recipients, and uninsured people in America. The United States focus on Universal Health care or coverage. “The goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them (WHO, 2014)”. The cost of health care is continuing to rise and millions of people are without medical insurance. Business and facilities are closing, loss of jobs, high unemployment rates have become major crisis in health care in the United States. People who are