The Patient 's Current Health Condition

as defensive medicine practice, new technology, malpractice lawsuit and the uninsured. New technology is the biggest factor of the rising cost of healthcare to treated patient of their illness. New technologies have seemed to be the driving force of high healthcare cost in America. The technology accounts for 38 to 65 percent of healthcare spending in America (Johnson, 2011). The annual spending of health care increased from 75 billion in 1970 to 2.0 trillion in 2005 and is estimated to reach 4.0 trillion in 2015 (Kaiser Foundation, 2013). U.S. citizens spent 5,267 per capita for health care in 2002- 53 percent more than any other country” (2005). “America spent 5267 per capita and in Switzerland they spent 3074 per capita” about 1821 cheaper than ours (Starfield, B 2010). Controlling the technology isn’t easy thing to do because of technology prices are set by manufacturing and the installer of the new medical equipment’s. However, there other way

Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.

Within this case study I am going to use two of the Chapelhow et al. (2005) enablers to discuss and reflect on the care of a patient I have been involved with on placement over a period of 5 weeks. ‘Enablers are the essential and underpinning skills that come together to provide expert professional practice’ (Chapelhow, C et al. 2005, p.2). These include; assessment, communication, documentation, risk, professional decision making and managing uncertainty. The enablers work together to provide a holistic approach to the care of patients in health care settings. I am going to focus on and discuss two of the enablers, linking them both together, which will be assessment and communication as I believe these two enablers can be related most to my patient.

Critics believe that the present functioning of managed-care is degenerative to health care. Managed-care firms control costs by requiring patients to use a “network” of approved doctors and hospitals, and by reviewing the actions of doctors. Patients have to pay more to visit a doctor who does not participate in the “network.” Managed-care firms second-guess doctors, considering only the costs. Patients are often prevented from visiting specialists to reduce costs. A managed-care company might insist that its doctors prescribe inexpensive generic drugs instead of commercial products. Many patients must, also, receive the insurer’s approval before undergoing treatments or operations. HMOs have been criticized for refusing to pay when a patient goes

The financial liability for the patient is daunting and may keep some from coming to the hospital for treatment and others leaving against medical advice (AMA).

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.

As our country advances in the medical field, the costs of American healthcare expenditures are drastically increasing and the number of people purchasing medical coverage is declining. The United States healthcare system in contrast to others is recognized to be the most expensive and as a result more than fifty million American citizens are left uninsured, given the low income rate (Garson 1). Those who, in fact, purchase coverage are not properly protected, therefore other individuals do not bother wasting their money and purchasing healthcare. As soon as individuals are in need of medical attention, they happen to struggle with the preexisting conditions they suffer from because they cannot afford the desired aid. It is safe to say

American spends far more per person on the costs of litigation than any other state in the world. Some doctors would rather treat the multitude with policy and wealthy than people without. According to fragmentation issues in the health care system, nearly 50% of wellness aid outlay in the U.S. is publicly funded by Fed, State, and county floor governments through various entitlement programs such as Medicare, Medicaid, and the Veterans Administration (VA). The result is a compartmentalized and fragmented system. This is also true in the buck private health care sector, with over 1500 health insurers handling the private insurance market place, each offering unique health policies that have different deductibles. Some people should take health care more serious and take time out now to fix their problems. They may not think that nothing is wrong with them but you must take the risk of finding out now than taking the risk of risking your life. Take your life serious because the world we live in now is weird and many deaths come from health problems. Take care of your health, go see a doctor and don’t refuse medical attention where you need it the most because a healthier body is a healthier you. The costs of prescription drugs are rising even faster than the general rise in health care costs. Small businesses do not provide health insurance

The health care debate has been a tricky one over the years with legislators ongoing decision on whether rules should be put in place that would even out the playing field between regular folk and health insurance companies. Obtaining affordable health care has been difficult for many and has raised some eyebrows about how these health care companies continue to make billions of dollars a year while people’s health continue to suffer. In 2010, a health care reform, the Affordable Care Act or “Obamacare”, was signed into law which eliminated those obstacles and limitations set forth by the healthcare industry.

There has been times working in doctors’ offices that I watched doctor not provide the total care they should have because they were aware the patients insurance would not pay enough to cover the cost. These are sad times within our country and something should be done to prevent it from getting

As mentioned before healthcare is unlike any other industry because when you are a consumer of the industry often times you are not completely rational because you’re faced with the tradeoff of cost versus health. As a consumer, you do not weigh your alternatives or assess the costs, you simply pick your health. Healthcare is driven by fear, as a consumer of the healthcare industry, your decision making is clouded by that fear. This fear is what allows the healthcare market to charge prices they know that no one can afford, the ominous

When it comes to patients, patients commit fraud and abuse insurers and subsidized federal programs to obtain preventable services, payments, and medical procedures. Private insurers play their role in fraud and abuse by subsidizing federal programs in order to dishonor medical claims and keep away from financial responsibility for essential medical services. Increased costs of fraud and abuse results in increased insurance premiums, taxes, and costs for medical treatment.

My patient?s name is John T, age 41 was admitted to Bournewood Hospital in Brookline, MA. on September 16, 2015. He was severely depressed about his past and he started having suicidal ideals. John grew up with a mother, father and sister in Portsmouth, New Hampshire. They didn't have much money and his father was the only one paying bills while his mother was a housewife. John explained that living with his family was very uncomfortable. His father was a very mean and angry man; no one got along with him and everyone feared him. Being Italian, the meal must be plated once the husband got home. With that said, one day his father got mad at his mother about not having dinner on the table on time; things turned for the

Modern medicine has come a long ways in the past few decades. With those advances in medicine have come higher medical costs. Today, most people rely on health insurance to cover most of those costs. Unfortunately, it is all too common for health insurance companies to deny valid claims.

The most common types of fraud and abuse seen in healthcare occur in billing for services that have not been performed, or overbilling for services that have been provided, and most disturbingly, misdiagnosing medical conditions to prevent incurring the financial responsibility for the proper treatment of illnesses or diseases. A variety of individuals within our population can be affected when fraud and/or abuse occurs.