The Supreme Challenge To Us Healthcare Nursing Assignment (Essay Sample)

THE SUPREME CHALLENGE TO US HEALTHCARE
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THE SUPREME CHALLENGE TO US HEALTHCARE
Introduction
The USA spent about $2.8 trillion on its healthcare system in 2012 (Lyons, 2016). This accounts for more than 17 percent of its gross domestic product. When compared to other developed countries, the healthcare expenditure per capita was higher in 2012. Although the US spend such an enormous amount on healthcare, most of its residents had no health insurance, and when several aggregate measures of data from other developed countries were compared to the US, they were superior to those of the USA.
Some of the key drivers to America's high healthcare costs include an increase in numbers of people with and the prevalence of chronic diseases, medical technologies, high intensity of care, lack of evidence on the effectiveness of treatment options and lack of patient engagement.
The unexpected health outcomes recorded in the US are also attributed to problems with access to health care, gaps in medical coverage and unhealthy lifestyles.
The US Government plays a major role in making sure healthcare is affordable and accessible to all its residents. Among high-income countries, the US is the only one without nearly universal health care coverage (Phillips, 2015). Some of the roles include:
Apart from Medicare and Medicaid, the US has attempted to achieve universal healthcare since the 1940s. Medicare and Medicaid provide coverage for pregnant women, poor and near-poor residents, seniors, children and persons with disabilities. Some form of progress towards universal care was established with the execution of the Affordable Care Act. Although the Act requires almost all legal residents be insured, it is expected that only a part of inhabitants who are not insured will get coverage.
Through the Affordable Care Act key provisions are provided that enhance the facilitation of quality health care while ascertaining accessibility to the vulnerable in society.
The enlargement of Private Insurance Coverage to cover the vulnerable assists the poor in accessing health care. Furthermore the Act provides subsidies to assist individuals and families to purchase the required health insurance through health care exchanges. The persons and families have an obligation to have incomes below 400% of the federal poverty level to get subsidies ("Provisions of the Affordable Care Act, By Year", 2010). It also has a requirement that all residents and documented immigrants have health insurance. Failure to have the coverage will result in penalties after the phase-out period ends in 2016. The Act expanded the Medicaid coverage to every person with revenue below 138 percent of the federal poverty level. The expansion was made optional at the state level after a ruling by the Supreme Court. The national government will cover all the related costs for the first few years and reduce 10 percent successively (Soni, Hendryx & Simon, 2017).
Moreover it provided for the formation of an Independent Advisory Board that will make recommendations to contain an increase in the fee for service Medicare costs if they exceed the growth in GDP by more than 1 percent. The Act included the stipulation for reductions in capitation rates of Medicare Advantage plans after it was established that the payments for such plans exceeded their costs. The Act introduced incentives and penalties for a high and low quality of the programs, while also offering preventive services will be covered without co-payment with the patient.
Health care costs are minimized by current trends in healthcare that enhance quality through adoption of emerging technology. For instance apart from diagnosing diseases, counseling patients and predicting epidemics, Artificial Intelligence has proved its worth in healthcare delivery by enabling a better patient experience. Artificial Intelligence is utilized to make sense of the mass of medical information in healthcare systems, and tap into the gathered knowledge of diverse healthcare providers and patient visits, thus enabling doctors to analyze which treatments work best and when ("Editorial Overview—The Role of Information Systems in Healthcare: Current Research and Future Trends", 2011).With the use of AI, physicians can recommend a line of action in clinically challenging situations and also monitor health and medication in chronic conditions.
The increase in biomedical innovation has greatly reduced costs in cancer and other chronic diseases. Advances in Proteomics Research have introduced a strategy to study the genome. Rather than analyze the genetic code, the research studies the creation of the genetic code in the form of proteins conveyed by DNA (Moseley, 2001). Since the majority of drugs targets proteins, Proteomics offers a wide range of benefits in the field of drug discovery.
To have insight on which cancers are related and how Proteomics is utilized to learn which proteins are up-regulated and down-regulated. When the relationship is established it will give a perfect course for analysis and cure.Advance in proteomics has resulted in the potential identification of mechanisms in neurodegeneration in Alzheimer's disease. Studies using proteomics have produced clues to the proteins involved in pathology including structural abnormalities of significant proteins.
Another technological advancement that has influenced healthcare costs is Mobile healthcare, through introducing the concept of an out-of-clinic patient that uses software applications and other wearable devices that are plugged into a Smartphone or tablet. Current trends indicate an increase in Smartphone devices for medical use such as weight scales, blood pressure cuffs and pulse oximeters in patients' homes. The use of Smartphone apps and devices not only records and stores data but also show the data in wide-ranging image formats such as graphs which communicate trends and comprise explanations of relevant ranges of health metric. The apps are enhancing patient engagement through eschewing the need for tedious data collection while emphasizing patient education. Smartphone compatibility has integrated previously dominant medical devices found in hospitals or doctors' offices only into the patients' hands. Devices such as ophthalmoscope for optic disc visualization, otoscope for inner ear visualization, ECG for heart function, stethoscope for body sound analysis and spirometer for lung function are now conducted at home using Smartphone applications (Kabachinski, 2011).
Health Informatics is utilized in health care institutions to improve the exchange of information. In addition the use of electronic health records (EHR) will shape the American health care system in the coming years. The meaningful, secure exchange and use of electronic information in healthcare information technology are some of the issues that the U.S. Department of Health and Human Services faces. The challenges of ensuring privacy and security of healthcare information, encouraging electronic exchange of information and guarding against fraud can be met by practitioners in health informatics. This saves time and minimizes costs of employing more workers in a health care institution.
Health informatics involves gathering, storing and sharing medical information. The use of EHR for hospitals and healthcare organizations was legislated under the Health Information Technology for Economic and Clinical Health Act of 2009. It requires Centers for Medicare and Medicaid services to have EHR or risk losing EHR incentives. Hence all HER compatible are able to provide low cost care.
The health care industry has Various Stakeholders and Influencers who their actions influence the cost of health care and have major impacts on US health care system.
Although the insurance organizations are revenue driven, their style of service ought to not be focused on profit because financial hardships are making it harder to obtain adequate healthcare. The current premiums are very high, and the impact of strict requirements is keeping many people from obtaining health insurance. Since insurance companies focus on profits rather than affordability, they institute tight regulations that result in mostly healthy individuals being selected for their plans. This means the selected patients do not use costly procedures as compared to persons with chronic diseases. The results of the unethical behavior by the companies are reducing health care to a revenue oriented industry thus preventing those who require from accessing it.
Due to the reliance of patients on their products, pharmaceutical companies play a critical role in the healthcare system. The lack of caps to prevent the rising prices of drugs from reaching extravagant prices impacts negatively on the healthcare system. Although pharmaceutical companies cite research costs as the reason for higher prices, it is not true. Societies are known to spend more on marketing while still attaining exorbitant profits.
Physicians not only have a significant role in making sure that patients obtain ample health care, but also in ensuring the growing costs of health care are controlled. It is imperative that they balance their gatekeeper role for insurance companies and advocating for the patient. The intention behind assigning primary care physicians as gatekeeper was to lower the healthcare costs through reducing the tests and referrals. In the current health care setting insurance corporations offer inducements to doctors to order less referrals thus causing healthcare spending to increase.
It is the responsibility of patients to ensure their health is fine and control costs. The advance in technology has resulted in patients with insurance asking for the most expensive and advanced treatment that their insurance can cover. Although the most costly treatments are not essenti...