The Impact Of Gatekeeping On Health Care Systems Essay

The U.S. health care system is way more complex than what meets the eye. A major difference between the health care system in the U.S. and other nations, is that the U.S. does not have universal health care. Lack of a universal health care opens up the doors for competition amongst insurance, physicians, technology, hospitals and outpatient services.

Universal Healthcare sounds appealing, but it actually lowers the quality and quantity of healthcare services that are rendered to patients, thus downgrading the healthcare system as a whole.  Not having to pay, with everyone having coverage leads to longer wait times for medical service and many people overusing health care services. Implementation of Universal Healthcare in the United States would lead to a detrimental crippling of the nation’s health system. For those countries that have implemented Universal Healthcare or a system similar to it, all or most aspects of the coverage such as cost and care is generally provided by and tightly controlled by the government, a public-sector committee, or employer-based programs, with most of the funding essentially coming from tax revenues or budget cuts in other areas of spending. This paper will conclude with comparing the US healthcare system to others and how the US has one of the most advanced systems in the world.

The United States health care system is lacking the needs to create a reliable system to achieve quality, access, cost, and educate for the consumers. Despite the efforts of the government to find a common ground to meet the standard for the societies, the system has yet to have a major improvement. These issues must be reexamined to fix the broken system. The United States health care expenditure is another issue that needs to be addressed to achieve the future goals of the healthcare system in the United States. Healthcare societies will need to interact differently by incorporating consumer’s empowerment, technology, and education to meet the future goals of the health care system. Also, the consumer must be highly educated on the purpose of preventive care to lower the risk of chronic diseases which account for a lot health care spending. The process of correcting the United States health care system will take time and effort from all individual to achieve greatness.

Health care costs have continued to rise. To combat these rising costs, health care providers have altered their menu of offerings. The evolution of the health care menu is predicated on keeping costs under control while providing critical health care services. While the evolution of coverage continues many providers have adopted some form of managed care. Manage care operations (MCO) are not a new notion to health care. The origins of managed care can be traced back to at least 1929, when Michael Shadid, a physician in Elk City, Oklahoma, established a health cooperative for farmers in a small community without medical specialists or a nearby general hospital. Michael Shadid sold shares in order to raise

The lucrative healthcare companies in America have created an immeasurable gap between good healthcare only being for the privileged upper class Americans which has left a horrible effect on the middle and lower class Americans. As modern medicine achieves new heights, the prices of healthcare seem to tread right behind maintaining an unbroken pattern that American classes have grown accustomed to over the past few decades of paying more for less. Leaving many Americans uninsured, underinsured, or even in debt. In a speech Bernie Sanders a U.S. Senator from Vermont spoke at a presidential campaign October of 2015 which he discussed the unruly problematic healthcare trend of price gouging, that is the medical industry getting the most it can from American citizens. In a blog Bernie Sanders states that “46 million Americans today have no health insurance and even more are underinsured with high deductibles and co-payments” (Sanders). 18,000 Americans die every year from preventable illnesses because they cannot cover the cost and don’t go to the doctor when they should. Sanders summed this situation up with this “Health Care is a Right, Not a Privilege” (Sanders). After researching the issue of healthcare, I have come to the conclusion that the American healthcare system is disintegrating due to the ravenousness of modern medical industries, first I will discuss a few reasons to why the healthcare system is failing the modern American

Therefore, in the event that health experts don 't have a clue about the significance of advancing hostile to unfair practice, they will probably oppress the administration clients and other staff at work. Healthcare suppliers ought to be aware of the dynamic advancement of hostile to biased practice so that the administration clients can get quality care at their own advantage. On the off chance that care suppliers don 't go along to work in a hostile to oppressive practice, administration clients will be not treated decently and their decisions would not be regarded or contemplated. On the off chance that the care associations don 't consent to advance a hostile to biased practice, administration clients will be ignored and disempowered and this can make the administration clients to feel useless as a person.

Some people say America has the best health care system in the nation, is this

An issue that is widely discussed and debated concerning the United States’ economy is our health care system. The health care system in the United States is not public, meaning that the states does not offer free or affordable health care service. In Canada, France and Great Britain, for example, the government funds health care through taxes. The United States, on the other hand, opted for another direction and passed the burden of health care spending on individual consumers as well as employers and insurers. In July 2006, the issue was transparency: should the American people know the price of the health care service they use and the results doctors and hospitals achieve? The Wall Street Journal article revealed that “U.S. hospitals,

Quality healthcare in the more rural areas of the United States is not only getting more difficult to obtain, but difficult to afford. American citizens living in rural areas have the highest rates of chronic disease, higher poverty populations, less health insurance, and there is less access to primary care physicians. When the economy is at its lowest point it causes an increase in a number of access and health issues that have already had prior problems in communities and in rural areas, therefore the main goal of the national health care tax of 2010 was to allow coverage to all residents of the United States, and also by transferring necessary health care to places that were farther away, such as the

Another measure enacted by managed care organizations to control costs is limiting the amount of services a member can access. First, managed care organizations control the type of drugs that members get by offering only specific drugs that are in line with cost control measures. This means that pharmacies in the network might not offer drugs deemed to be expensive or unfriendly to the demands of the organization. Secondly, organizations limit the doctors that members can have access to. If one’s personal doctor is not in the list of doctors provided by the organization, a member is forced to switch by choosing one from the organization’s listed doctors. Managed care organizations also control costs by limiting the number of days a member is admitted in the hospital. Doctors are encouraged to discharge patients faster in order to reduce care costs.

Health maintenance organization’s (HMOs) use of the primary care physician (PCP) as the “gatekeeper” initially had MCOs view restrictions as a negative approach to patients’ choices. However, some necessary steps have started to be implemented which reduce unnecessary utilization by enforcing some restrictions.

“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that

A gatekeeper is a primary care provider who acts as an agent for patients. They coordinate medical care so that patient receives appropriate services and also provide referrals to specialists. Typically, primary care physicians include family practitioner, generalist physician and pediatrician. Ideally, gatekeepers are much like family doctors, they focus on the health of the person as a whole instead of a single organ. They help emphasize prevention care and establish appropriate health screening based on the patient. On the hand, there are concerns that the system of gatekeeping makes urgent care inconvenient. The pros and cons surrounding the system of gatekeeping really question its effectiveness. On the other hand, no system is

The healthcare system plays a key role in the economic stability of our country, as every year trillions are spent in attempt to combat disease and health issues that plaque humanity. As it makes up a significant amount of the expenditures in the economy, so the costs associated with health care of those in pain from illness and injury, including lost productivity, increased need of assistance in living and also the cost of death in some cases, is important to the economic stability and over all standard of living in our country. The key to economic prosperity is balancing the need for care with the costs of illness to keep as many people healthy and well without breaking the bank of collective society. The costs of healthcare have been increasingly problematic in recent years with so many issues surrounding the current system. With the “total health care spending in the United States expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970, meaning that health care spending will account for nearly 20 percent of gross domestic product (GDP), or one-fifth of the U.S. economy, by 2021” (Aetna). With this in mind it is apparent that as we look at the trillion-dollar industry of the medical community it seems that it needs to be a major focus of our nation as a whole and with the many issues come many creative solutions. First let us analyze the reasons behind the current cost and the major problems facing this industry and than discus what

The current state of United States’ health care system is one of the most polarizing subjects of debate among scholars and other health care professionals across the globe. This can be attributed to the fact that at one extreme end, there are some who argue that that Americans have the best system of health care in the world (MePhee, 2013). Perhaps the availability of the state-of-the-art facilities and free medical technology that have become highly symbolic of the various industries in the United States have motivated the idea of the country’s health care system being unparalleled to others. However, there is a common belief that the fight for universal health care can only be successful if its current state of health care is described as a failure in the modern era as emphasized by MePhee (2013).