Different stakeholders in the health care system Essay

Week 1: Discussion 1: With so many different stakeholders in the health care system, many with powerful political lobbies, it is understandable that the government has been unable to effectively address the problems of cost, access, and quality. With the passing of the Patient Protection and Affordable Care Act of 2010 (PPACA), the government has taken a step towards reshaping the health care system. Answer the following question: How will the PPACA reshape the health care system in terms of access, cost, and quality? Discussion 2: In spite of its impressive accomplishments, the U.S. health care system is fraught with problems and dilemmas. There is a growing concern that health care is a big, complex, unmanageable business. In this week’s reading, six major stakeholders were identified, they are: the public, employers, providers, hospitals and other health care facilities, the government, and managed care organizations and other insurers. After reading this week’s text and other references answer the following questions: In what ways have the stakeholders contributed to make the current health care system in the United States is too complex and unmanageable? In your opinion, which stakeholder has had the most significant impact? Why? Who should take the lead in reforming the U.S. health care system? Why? Week 2 Discussion 1: An oversupply of physicians in many urban regions contrasts with continuing problems of access in rural and inner-city areas. After completing this week’s reading and viewing the video, discuss this topic using the following questions to help guide you: Why does the mal-distribution of physicians  persist in spite of the number of physicians graduated? Explore how these specialty medical practices affect access to healthcare, quality of care received, and costs associated with health care services. Do these same conditions exist in Canada or the United Kingdom? Why or why not? Discussion 2: According to Sultz & Young (2011), â€Å"Communication among providers and between providers and patients [is] problematic as medical technology progresses and time pressures on physicians increase† (p. 179). After completing this week’s reading discuss this topic using the following questions to help guide you: How might the increase in medical technology have a negative effect on communication among providers? Provide at least two examples. Are there any positive effects of increased technology on communication among providers? Why or why not? How does the increase in medical technology impact the provider-patient relationship? Provide at least two examples. Assignment: Disclosure of Physician Information The dispute over exposing the comparative performance of physicians on a wide spectrum of variables has been resolved in favor of the consumers of health care. Despite physician protests, a number of states have passed legislation that gives the public access to physician information, including disciplinary records, malpractice actions, and whether a physician has lost hospital privileges. In a three to four page, (excluding title and reference page), APA formatted, double-spaced paper, respond to the following questions: Are the physician reports cards fair and balanced? Take a position on this issue and explain your view. Provide at least two examples from references that support your position. Do physician report cards provide information consumers need to make medical decisions? Why or why not? Explain your answer. Support your position with two references in addition to the textbook. Note: one of the two references may be a professional website. Week 3: Discussion 1: The chapters assigned this week focused on hospitals and ambulatory (outpatient) healthcare organizations. Each has their own unique administrative and clinical requirements due to shifts in utilization. Choose one of situations presented below and discuss the implications for healthcare organizations, consumers, and the health care delivery system as a whole. Fully state and explain your position while providing at least two references (one may be the text). Situation 1: Overnight hospitalization has significantly declined as services have shifted to ambulatory care (care completed within a 24-hour period). What are some of the root causes for these shifts? What are the implications of this shift for hospitals, consumers, and the health care delivery system as a whole? Situation 2: More than half of all surgical procedures are now performed in ambulatory surgery facilities with the shift of surgery from the inpatient setting to outpatient. Explain the implications for hospitals, physicians and consumers. What are some of the root causes for these shifts? What are the implications of this shift for hospitals, consumers, and the health care delivery system as a whole? Discussion 2: According to Sultz and Young (2011), â€Å"with the multitude of tasks performed everyday by hundreds of employees in a busy hospital. Misunderstandings and information breakdowns in patient care are inevitable† (p.85). After completing this week’s reading discuss this concept as it relates to quality patient outcomes. Answer the following questions: In your opinion, do you agree with Sultz and Young (2011) that errors in the hospital setting are inevitable? Why or why not? Does the size of a hospital affect the quality that patients receive? Why or why not? Is there anything patients and/or their families can do to help ensure that they are receiving the best care possible? Assignment: This week, you will prepare an outline for your final paper. Please refer to Week 5 Assignment to assist you in choosing one of the four basic functional components of the U.S. healthcare delivery system (financing, insurance,  delivery, or quality). In your outline, identify future trends in U.S. healthcare related to your chosen functional component. Base your outline on the issues and questions listed in week 5 related to the one functional component you are choosing to focus on. The outline must reference at least five sources other than the course textbook. Only the title page and reference page need to be in APA format, as an outline does not have an APA form. While there is no standard for outline formats, you may choose to refer to the hyperlink for guidance: Outline . Week 4: Discussion 1: There are many factors influencing the increasing demand for long-term care services in the United States. Select two from the following list and discuss ways in which your two selected factors are affecting the market for long-term care services. Changes in the demographics of the U.S. population Social and economic changes in families Increasingly sophisticated medical technology Greater consumer sophistication and demands Increasing scrutiny of federal and state government financial involvement in support of long-term health care Discussion 2: According to Sultz and Young (2011), â€Å"there is no single ‘mental health system’ [in the United States] but a variety of systems that provide services. Those systems vary widely in what services are provided for whom, by whom, and in what setting† (p.329). Answer the following questions: Why don’t people with mental illnesses receive the same level of care as other illnesses? What barriers prevent people with mental illnesses from receiving the care they need? Are the barriers different in the U.S. as compared to other countries? Should the federal government take a more active role in the coordination of care and services to patients with mental illness? Why or why not? Week 5: Discussion 1: Critique the ways in which each of the following factors affects healthcare expenditures in the United States. 1. How do these factors impact the patients, individual providers, healthcare organizations, and insurers? Advances in medical care technology and diagnostic technology Changes in U.S. demographics Emphasis on specialty medicine Financing of healthcare Healthcare as a labor-intensive industry Consumer expectations How does healthcare spending/financing in the United States compare to other countries? Fully state and explain your position while providing at least two references. Discussion 2: Healthcare reform is underway in the United States. Given the history of previous attempts to reform the U.S. healthcare system and the current state of the U.S. economy, answer the following questions: Will the healthcare reforms now in progress resolve or worsen the key issues of access, costs, and quality? Can we achieve a system in which there is fiscal and clinical accountability for defined populations? Fully state and explain your position while providing at least two references. Assignment: The final paper should demonstrate an application of your knowledge of the U.S. health care system by synthesizing the information from the readings and class work into work and life experience. Your paper may include information and examples from previous experience as well as implications for future application. For your final paper, you will use the outline you created in week 3 to create an 8-10 page paper (excluding the title and reference pages). You will choose one topic to focus on for your entire paper: Delivery, Quality, Financing, or Insurance and: 1. Analyze future trends in U.S. healthcare related to that one topic. 2. Address the questions below related to that one topic: Delivery: What is society’s obligation to ensure access to a basic level of health care  for all its citizens and how can it be accomplished? Should government take a more aggressive role in reshaping the health care system or should the economy be allowed to continue exerting market-driven reforms? What lessons can be learned from healthcare delivery systems that exist in other industrialized nations? Hospital emergency departments continue to be used as a source of primary medical care by large numbers of the community’s medically underserved population. What are the implications of this practice for the patients, and on health care costs and quality of care? Identify the major factors that have resulted in the shift in utilization from inpatient hospitalization to ambulatory care services. What are the implications of this shift for hospitals, consumers, and the health care delivery system as a whole? Quality: How does the quality of healthcare in the United States compare to the quality of care in other industrialized nations? How can an acceptable quality of health care be assured for all? Will providing data in areas such as patient outcomes, compliance with national standards for preventive and chronic care, and comparative costs to the public be an acceptable measure of healthcare delivery outcomes? Though physicians believed that only physicians could and should judge the quality of hospital medical care, they found participation in such hospital peer review activities a most disagreeable obligation. What were the problems with the process? Managed care organization credentialing by the National Committee on Quality Assurance rapidly evolved as a standard of quality in the industry. Discuss the pros and cons on the value of credentialing by an independent organization to a managed care organization and to consumers. How does medical technology affect the communication between healthc are providers and patients? What affect does this have on the quality of care? Financing: How can the costs of health care be kept affordable for both individuals and society? Legislative attempts to address the problems of the health care system are always met by shifting alliances among well financed and, often, self-serving lobbying groups. How, in the American system of politics, can health care get more objective support on behalf of consumers? Since significant reductions are likely in the federally supported health care  programs that today account for about 40 percent of US personal health care expenditures, what will happen to those dependent on those programs for health care? How will the Patient Protection and Affordable Care Act of 2010 (PPACA) affect the costs associated with healthcare? Who will benefit the most in terms of the cost of healthcare? Who, if anyone, will experience an increase in the cost of healthcare? The single most important impetus for managed care was rising costs. Should the US have a two-tiered medical care system in which people who can afford it buy all the specialty care they want and others live within the managed care restrictions? Are there any lessons to be learned from the way in which healthcare is financed in other industrialized nations? Insurance: The insurance industry plays a huge role in the American health care system and absorbs a significant portion of the health care dollar. A single payer system, whether it be a private company or the US government, would eliminate the complex insurance paperwork and free substantial funds that could be used to provide care. Why is there is there so much resistance to a concept used in every other advanced country? Discuss the evolution of private health insurance and its effects on costs and access to services. The availability of hospital insurance removed an important cost constraint from hospital services and charges. What were the positive and negative consequences of that development? Steeply rising costs of medical liability insurance are a growing concern for practicing physicians, medical schools, and teaching hospitals. As a result, physicians are leaving high premium states, choosing to retire early, or reducing high-risk aspects of their practice to lower their insurance co sts. Discuss the evolution of private health insurance and its effects on costs and access to services. Writing the Final Paper Must be eight- to ten- double-spaced pages in length and formatted according to APA style as outlined in the approved APA style guide. Must include a cover page that includes: Title of paper Student’s name Course name and number Instructor’s name Date submitted Must include an introductory paragraph with a succinct thesis statement. Must address the topic of the paper with critical thought. Must conclude with a restatement of the thesis and a conclusion paragraph. Must use at least five scholarly resources, including a minimum of three from ProQuest. Must use APA style as outlined in the approved APA style guide to document all sources. Must include, on the final page, a Reference Page that is completed according to APA style as outlined in the approved APA style guide.