Tuesday, April 21, 2009

Health Care Reform

I had to go to the emergency room a few years ago because I had been sick for days and eventually reached a fever of 102 degrees. I was still in high school so my parents took me and I was covered under their insurance. I ended up being tested for mono and strep throat, had to undergo x-rays, a physical and a gynecological exam, even though I was not sexually active at the time. In the end, I was diagnosed with a mono-like virus and sent home with directions to stay in bed, drink a lot of orange juice and take ibuprofen for my fever and aches and pains. Thankfully the insurance paid for most of this. But all the testing was not what my parents and I were upset about. We stayed in the ER for over four hours because there were only two nurses on duty and had to call in an off duty doctor to examine me. Because of this, I just wanted to go home instead of having to undergo all of those unnecessary tests but the nurse insisted that I stay and wait for the doctor because there could have been something terribly wrong with me. But even after an hour of waiting and my fever decreasing, we were still waiting for the doctor and encouraged to wait. I do not know if this was solely because they want to make money or need a certain number of tests to run or patients to evaluate each day. The amount of workers, however, were definitely a problem and if there were more, I could have been treated and tested quicker and possibly not subjected to the expensive bill.

The health care system around the country is obviously lacking in the worker department. And something to think about it how necessary it is to actually admit someone to the hospital; this increases the patient to nurse ratio and ultimately results in medical mistakes and sometimes death. The heart of the matter really lies in how well people are educated about health, preventative medicine, and insurance coverage. People will wait until they absolutely have to go to the hospital, which can increase capacity and doctors and nurses have too many patients to properly care for. It’s definitely something for our government to think about changing.

Katy Lawrence

Thursday, April 16, 2009

US Health Care System

I am currently a junior studying abroad in Argentina, with a double major in CHE and Spanish, so I still have much to learn about the US Healthcare system but...

The need for a reform in the US healthcare system has become more and more evident within the last several years. Much of the American population is without health insurance or do not have enough health insurance to cover their expenses. Many people then attempt to pay for these costs out of pocket only to fail and in turn, end up missing preventative measures, treatments or follow-up appointments, and ruining their lives and credit in the mean time. In the long run, this ends up costing much more than if preventative action was taken in the first place!

Precisely because of this, I feel that the US should turn to Universal coverage. Currently, the US is one of the only industrialized nations without universal coverage. Instead of focusing on treatment, the US needs to be more prevention-oriented, so illness and disease don’t occur in the first place (ideally). Patients would consult with doctors, nurses and other allied health professionals by means of primary and secondary prevention, which would help keep costs down as well as being able to provide health care for all Americans. With lower costs, more services would be available to larger populations of people, which would improve access. It really is a cycle, in which effort for reform really will pay off in the end. Hopefully those in the position to make a big change see this opportunity and take advantage of it before more people lost the coverage they have.
Health Care Workforce
Maggie Butterfield

My journey into health care has taken many different paths. I am a director of a large family support entity. I am an early fifty woman who in the world of health care employees, I am not unusual. Health care is comprised of over 70% women. The health care workforce is aging as the economic view of our communities continues to be challenged. Many people similar to me have thought of retiring, retired and returned or are frightened at the prospect of retiring, due to the economy and often times due to a loss of a sense of purpose. My experience has totaled 27 years with the same organization, watching as it has grown, and being allowed to grow right along with it. I have a varied background of early childhood education, therapeutic intervention for hospitalized children, parent education, adult learning and leadership development. I relate to this environment, as it is the culture in many ways of which I have grown up since my early twenties.

I am this workforce in many ways and my experience as an educator, as a learner, as a leader and as a parent has all contributed to a greater understanding of what the employees of today and the future need to do to continue to build a greater health care environment of the future. Critical to the success of health care is the continued efforts of science to better understand how to successfully cure those that it can, and to successfully heal to the best of their ability those they cannot cure. Innate to this clinical greatness is an understanding of people, where they are in their lives and what impact their healthcare situation is thrusting upon them. Relevant to that is the impact not only on them, but their family and the family’s ability to survive. Every member plays an important part of the healing and wholeness. Health care workers of today and the future need to understand this, work collaboratively with all who can make a difference and to create the choreography of healing for each and every patient they may work with. The world of health care is about the strategic alignment of skills and to come together to play their part in the healing of one individual, in the prevention of long term health issues, in the provision of key resources to live an sustain within a community and in the overall wellness of people.

There are many players in the world of health care. I am not of the belief that more is better, what is better is a rich wealth of skills that can come together to make a difference in the health of another. The world of health care in the future will have to be diverse in the creation of how many, and the skill basket needed for success. One obviously is not enough…1000 not working together is not acceptable. A health care workforce of the future will need to play upon the complimentary skills of each other to make a difference. That is how we decide how many.

Wednesday, April 8, 2009

The hospital that I work at has recently received the very first National Database for Nursing Quality Indicators (NDNQI) Quality Award for Academic Medical Centers. This means nurses at this hospital have been recognized for prioritizing and achieving the highest quality, safety and patient-centered care. This particular hospital is striving for higher patient care outcomes, and has achieved its goals. It's refreshing for a nursing student who will be entering the field in January, to see a hospital so committed to excellence. It's a place any nurse would be lucky to work at. As far as changes, I believe more hospitals should be striving for outstanding nursing quality. This reflects higher on the profession and the hospital, and leads to higher patient care outcomes. With higher nursing quality it will also limit the amount of days that patients will have to spend in the hospital, therefore cutting down on cost. Working in the hospital environment I see several patients with health problems that could have been prevented with preventative medicine. In order to achieve health care reform, there will have to be a shift of focus from tertiary care to preventative health care.

Monday, April 6, 2009

Health Care Workforce

Health Care Reform-Workforce
Abby Butterfield
It is obvious to me that there are major changes that need to be made in today’s world of health care. In today’s economy, I seriously believe that some sort of a universal coverage system should be made available, with the option to have additional coverage if you wish to pay for it. Having care available to everyone is just the first step, though. We also have to build care delivery systems to get care to the populations that need it the most. In today’s age, doctors have been put on a pedestal, and I think that we need to seriously consider how much we are paying doctors and maybe try to re-delegate that money in a way that will benefit not only doctors but the general population as well. We need to offer quality care at an affordable price. Second to economic recovery, health care reform is the most important topic discussed in Washington. The reform we are looking for has to be a balancing act between being affordable without losing the quality of care people need.
In order to create a quality care, we need to spend money in order to produce quality physicians and surgeons. There is no compromise when it comes to surgical care especially, seeing as their training and expertise are unmatched by anyone else. I also think we need to better allocate how money is spent. For instance, instead of opting right for surgery, which could be very expensive, we should spend more money paying physical therapists, child life specialists, art therapy aides, or pet therapy aides in order to decrease the amount of money spent paying for pharmaceuticals, as well as decreasing the money spent on unnecessary surgeries.
According to Shi and Singh, the baby boomer population between 2000 and 2010 will require 1.9 million more health care workers, seeing as they will all be reaching retirement age. Another issue that must be addressed is more health care workers need to be trained in geriatric care, seeing as we have an aging population that will require special care. Also, as more women and minorities enter the workforce, there needs to be cultural competencies that people working in health care need to understand.

Citations
http://www.oshpd.state.ca.us/ April 5th, 2009
http://www.workforce.com/wpmu/washington/2009/03/20/health-care-reform-pitfalls-may-test-bipartisanship/ April 5, 2009
http://www.facs.org/ahp/hcreform08.pdf April 5th, 2009
Shi and Singh. Delivering Health Care in America: A systems approach.

Monday, March 30, 2009

Reform Proposal 3

I recently viewed the documentary "Sicko" by left-winged Michael Moore. Many feel this movie is unfair, biased and lacks a lot of beneficial facts about the health care system in America. However, I felt it truly represented what a lot of middle to low class families experience every day with their medical bills and hospital visits: frustration and overwhelming sadness. Much needs to be done to reform our health care system, including push from our new president. However, as much as President Obama wants to see new proposals and change in our system, he said that most of the legislation and ideas will need to come from Congress.

But what can be done within the health care workforce? For one, those that currently work in health care, and those, like myself, and many of my peers are going to school for right now, need to maintain an open mind about a health care overhaul that needs to take place immediately. A proposal that most likely will be introduced is that workers in the health care system may need to take a pay cut in order to accomodate all of those who need care, yet keep the care at a high quality rate. This is a small price to pay so that people can receive equal health care around the clock and not have to worry about going bankrupt. This is also something that can happen while still being able to use the great technology that our country has. However, if you examine the current programs in countries such as Canada, Switzerland, Great Britain and Germany, the U.S. clearly does not need the latest and greatest technology right away.

Another thing that workers can do is model after the British in preventive medicine and care. As documnted in the PBS Frontline special, "Sick Around the World," Great Britain is leading the world in preventive care. Not only would an increase in this kind of care reduce hospital visits and cost for medications, but it would allow workers to build better relationships with the patients. By thoroughly communicating with patients about proper hygiene, safe sex and drug use, dental care, and other daily health activities, workers will be doing their job, and not feel the consequences of overcrowded clinics and hospitals. This will ultimately result is less stress, overtime hours and worker and patient dissatisfaction.

Citations:
Reinhardt, Uwe E. Defining ‘Health Care Reform’. 27 March 2009. Economix Blog. The New York Times. Retrieved online 30 March 2009. <http://economix.blogs.nytimes.com/2009/03/27/defining-health-care-reform/>.
Moore, Michael. Sicko. Dog Eat Dog Films. 2007. Retrieved online 30 March 2009. <http://video.google.co.uk/videoplay?docid=6646340600856118396&ei=-ybRSdfeJ5DQ-AGZ1J2SAg&q=sicko>.
Sick Around the World. Frontline. 15 April 2008. PBS. Retrieved online 30 March 2009. <http://www.pbs.org/wgbh/pages/frontline/video/flv/generic.html?s=frol02p101&continuous=1>.

Monday, March 16, 2009

Health Care Reform Proposal 2

“Overall reform needs to begin by encouraging all health care providers, purchasers, consumers, and policy makers to think in terms of health agenda rather than a healthcare financing agenda”, Wisconsin Nurses Association. The United States is home to the best medical technology and best doctors in the world. Unfortunately, their services are a luxury that many Americans cannot afford. It is the responsibility of not only President Obama and Congress, but anyone that feels they can contribute their knowledge, time, or money to this long awaited change in American society. It is important to remember that when reforming the health care system that it will take some give and take from everyone. We will not be able to move forward without cooperation from everyone involved. As stated in reform 1, preventive care is the key to a successful health care reform. But, there many other actions that must be taken to have a successful health care reform.
The insurance and drug companies need to realize that making a profit and doing what is best for their companies is not what is best for the American population as a whole. Legislation should prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors. By reducing these preventable medical errors patients will have more confidence in their health system and money will be saved over time by preventing such errors.
In 2006 Massachusetts enacted a law that required all residents of the state to carry health insurance which dramatically dropped their total number of uninsured residents. The Massachusetts Health Care Reform Plan addresses one critical component of health care reform -- insurance coverage. Without an adequate supply of primary care physicians, however, the plan cannot guarantee timely access to care, creating a gap between coverage and actual provision of services. As a result, waiting times to see a primary care physician can amount to weeks and even months in some instances. It is clear to see that if our entire nation adopted a similar plan that our need for more primary care physicians would increase significantly. The government would need to put in place more scholarships and incentives to attract people to this field.
While all of the topics are important we feel that it is especially important to focus on the reform of the health care system paying close attention to the health care workforce. Physicians have an insight to the health care system like nobody else. It is crucial that we listen to their needs and ideas to improve the health care system inside and out. Administration should also be closely looked at to promote cost awareness in billing and reimbursement systems.


(2005). The Wisconsin Nursing Community Agenda for Health Care Reform. Retrieved March 16, 2009, from Nursing's Agenda For Health Care Reform Web site: http://www.wisconsinnurses.org/docs/WI%20Nursing%20Community%20AgendaFINAL.pdf
The Agenda-Health Care. Retrieved March 14, 2009, from The White House Web site: http://www.whitehouse.gov/agenda/health_care/
Arvantes, J (2008). Lack of Primary Care Physicians May Derail Health Care Reform Initiative . Retrieved March 16, 2009, from AAFP Web site: http://www.aafp.org/online/en/home/publications/news/news-now/professional-issues/20080130massachusettsreform.html
Gov. Doyle, J (March 11, 2009). Washington Should Look to Wisconsin for Answer to Health Care Reform. Retrieved March 16, 2009, from The Huffington Post Web site: http://www.huffingtonpost.com/gov-jim-doyle/washington-should-look-to_b_174107.html
Hatwell, K (2009, March 10). AMA Physicians Work for Health Care Reform. Retrieved March 16, 2009, from AMA Web site: http://www.ama-assn.org/ama/no-index/news-events/physicians-health-care-reform.shtml