The Affordable Care Act and Emergency Rooms

Practitioners with a lack of formal education did medical care in the 17th century. Many women and laypeople in that time had lots of expertise in herbal medicines and folk antidotes to cure colonists. The first curer people would turn to if they were sick would be a neighbor or a family member. However, there was a new type of physician in the 18th century. This was usually a young man from a wealthy family who went to an elite university who didn 't see himself as a doctor, but more as a scientist. The new physicians learned anatomy through dissection, assisted researchers, and helped with medical experiments. They also observed surgical procedures, and sat through lectures about new advances in the department of medical science. Alongside the scientists, there were also surgeons. The military was where many surgeons

In the preindustrial era, 1800s, the United States fell behind other countries in health services. There was no medical training until around 1870 (Shi & Singh, 2013). Medical training began with students training under the supervision of physicians. Physicians saw patients by making house calls. Health care was delivered in a free market (Shi & Singh, 2013). No one had insurance so costs were out of pocket. For most Americans, this was a problem and some rural areas relied on folk medicine to heal the sick. The medical institutions during this era were not sanitized properly and nurses were not trained to practice safety and hygiene care. The government provided facilities for elderly, chronically ill patients, and clinics that offered free care.

External and internal influences are relevant in health care. These influences continue to affect the total operations of a health care facility. I will summarize the insights I have gained into the external influences of the new health care reform policy and quality initiatives. The recent health care reform legislation was passed in the house and senate this year. The senior vice president, that I have interviewed, states that health care reform is an “unknown” for organizations. In addition, I will research the quality improvement initiatives and how these external influences include implications for organizations and health care administrators.

Our healthcare system is in a state of constant change. Just as the industry was adapting to the demands of countless healthcare reforms, the fate of regulations like the Affordable Care Act (ACA) and others like it, dangle in the wind. As the country transitions to a newly appointed administration, there is an increasing level of uncertainty among industry leaders. Federal, state, and local mandates continue to drive the need to improve the quality, costs, and outcomes of care which add to an already overburdened and burnout system. These coupled with our highly secular society who is primarily focused on the treating and curing illness through advanced technology, medications, and procedures has resulted in a

Each year in the United States approximately 114 million people visit their local Emergency Department (ED), and 16 million of these patients arrive by Emergency Medical Services (EMS). (Board et al.) Health care in America has moved from an individual, fee-for-service health care system, towards a more integrated healthcare system i.e., The Affordable Care Act (ACA), which is a government controlled healthcare system, and is set up to be a value-based payment system. The ACA will expand and transform the roles of EMS within the healthcare system. EMS’s ability to survive and thrive in this new era of healthcare, will revolve, in part, on its ability to articulate its value to healthcare providers, healthcare organizations, hospital systems, and payers, as well as patients and family members. (Smith) EMS can thrive in the future, if it embraces change. John F. Kennedy had this to say about change, “Change is the law of life. And those who look only to the past or present are certain to miss the future.” (BrainyQuote) In order for EMS to thrive in the changes that the future is bringing, it must: focus on mobile integrated healthcare, be data driven in their clinical practices. There are three other areas that will be discussed at length, EMS agencies should be actively pursuing a community paramedicine program, EMS using remote telemedicine and EMS moving towards a value-based payment system.

Firstly, access to medical care. Years ago medical care in the 19th century was not very good. The hospitals were very basic, many beds in a large room (ward) there were very rarely curtains around the beds for privacy because in those days clothes were short and extra material would be made into clothing. Also, they may not have been very clean, they were hygienic to work in but for people that were very ill they may of made that person more poorly. Clinics were similar; they had the basic bed to check patients on and the small amount of medicines. Not all the time did they have the correct suitable medication for patients. So some patients may have had to suffer for longer than what they should off because it was hard to get medication that was going to cure

From the days of Butch Cassidy and the Sundance Kid era and up until the late 1800’s other countries, France, Germany and Great Britain to name a few, were way ahead of the United States in health care education and practice. This added to the fact that medical

As progress was made in medicine gradually with new medical technologies which could only be used in the hospitals, doctors started charging more, which was unaffordable for most people, with time, all this started to change as the industrialization of the American economy caused families and people to start relying on services from doctors and the

Everybody hates going to the doctors. I can agree with this statement I also agree that most people do indeed hate going to the doctors. But without them there would be outbreaks and illness all over the place causing many fatalities. I am focused on the Gilded age, one man I am particularly interested and focused on is Samuel Hahnemann. Samuel was the creator of homeopathy. He believed that if you gave a healthy person small doses of an illness their body would fight it off and build an immunization and adapt to the real illness. This is where his theory “Like cures like” comes from. Homeopathy was birthed of the idea “Like cure like” and went on to have effects on all sorts of medicines and cures throughout the Gilded age.

The new federal health-care law has raised the stakes for hospitals and schools already struggling to train more doctors. Evidence suggests there won’t be enough number of doctors to treat the newly insured millions under the ACA. At current graduation and training rates, America faces a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges. The greatest demand will be for primary-care physicians. Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more with longer wait times under the new health law. That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER

Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The answer is ‘Yes’ and ‘No’.

What aspects and characteristics of American health care of the 18th and 19th centuries have had a major impact on shaping today’s U.S. health care system?”

Healthcare industry in United States has been an important industry for a long time. It is one such industry that has representation from both public sector and private sector. The current health care system is segregated and fragmented in America. Some states have very effective and efficient healthcare system while some states lack the desired infrastructure. The evolution of healthcare system in USA can be traced back to 1750. The period from 1750 to 1849 is termed as preindustrial period where the care of sick people was primarily handled by families (Brian, 2010). The period of 1850 to 1969 is termed as postindustrial period which reflects the growth of organized medicine and systematic healthcare delivery.

There were doctors in Colonial America. When a doctor visits a patient to check upon the sick person's health, their pay will be in anything but money such as chopped woods, vegetables, et cetera for the poor people. The poor people did not have money as stated in A Visit to a Colonial Times Doctor’s Office. They usually rely on their farming to feed their families and things such as money were scarce. Those who are of the contrary to the low income and the rural settings have better access to health and opportunities as written in Colonial Medicine (5). They can pay their doctor on the spot and can even request their choice of doctors. In modern America, a new change to the health care business is arriving. With the currently new healthcare, everyone shall be able to hopefully

Before the nineteenth century, children had very little to no healthcare at all. Only the wealthier families could afford the transportation costs of travelling into the city for their child to receive medical attention. In times of need, such as the smallpox epidemic, most children were cared for at home by family and neighbors using “folk medicine”, homemade antibiotics (Hartley). In the middle of the nineteenth century, Abraham Jacobi began the study of pediatrics and his research led it to become a “medical specialty” (Mandal). The first hospital in the U.S. that was built for the medical attention of children was “opened in Philadelphia, Pennsylvania in 1855” (Hartley).