Importation of Non-US Health Care Concept

Unique health care needs of special populationsPoor access to health care is a problem for many special populations, and the reasons spans across the global community. According to Anderson, Rice and Kominski (2001) access to care is often assessed by existence of regular medical care and coverage of services, as well as by an absence of delays and barriers to care. Having a regular source of medical care is recognize as important for the general population, as well as for those with various chronic diseases (Anderson, Rice & Kominski, 2001 p.236). The poor, elderly, women, children and HIV/AIDS group are the most vulnerable groups in the world. The World Health Organization (WHO) indicate the next two decades will see dramatic changes in the health needs of the world’s populations with non-communicable diseases, mental illness, infectious diseases and chronic illness as leading causes of disability. Increases in the older population by up to 300% are expected in many developing countries; in addition, HIV/AIDS will continue to be a major cause of disability and death. These changes require a very different approach to health sector policy and health care services among the special populations of the world (WHO, 2006)Special population needsAccording to WHO, there were 390 million people aged over 65 years recorded in 1998, and this figure is estimated to double in 2025. With advances in medicine and prolonged life expectancy, the proportion of older people will continue to rise worldwide (WHO, 2006). Unfortunately fragile health and mobility, neglect and abuse are factors that increase the vulnerability of elder women and men. Al-Nasir and Al-Haddad (1999) suggest as the overall number of elderly people increase there is a corresponding rise in the number of older persons with disabilities. Such disabilities may be social, physical, mental or psychological. Data from the U.S. have estimated that 9.5 million, non-institutionalized individuals, experience difficulty in performing basic activities, such as walking, self-care and home management activities (Al-Nasir & AL-Haddad, 1999).The elderly population and there needs has an enormous implications for health care system across the global. The financial infrastructure of nations must be prepared to accommodate the coming influx of elderly patient. According to Fried and Gaydos (2002) the aging population, has put enormous pressure on the Japanese health care system. The Japan’s has a unique fund for the elderly know as the Roken system. The Roken system is a pooling fund which attempts to distribute the burden of paying for geriatric care for all Japanese. Established in 1983, the pooling fund covers those who are more than 70 years old and bedridden people over 65 years old. The fund pools contributions from all insurance schemes. Seventy percent of medical costs for the elderly are covered by contributions from health insurance societies for company employees and national health insurance schemes and the government shoulders the remaining 30 percent (Fried and Gaydos, 2002 p. 251). One draw back to the Roken system is when the number of workers paying into the pooling fund is lower than the proportion of elderly people seeking assistance the system may not be sustainable.In the U.S. the rapid growth of the elderly will put new stains on the financial resources of Medicare. Many older people who on fix incomes or limited financial resources may need a system as the Japanese Roken system, where health care is covered by contributions from health insurance companies or a universal social insurance scheme. The Medicare program has broad public support because it offers health security to many older and disabled people. Longest, Rakich and Darr (2000) suggest the need for a long-term approach to program financing, improved benefits and protections for people with low incomes remains an important issue to address. Medicare is facing the challenge of financing and managing health care for the growing number of Americans who will rely on this program for health insurance protection (Longest, Rakich and Darr, 2000). In the future the increasing growth of the elderly may pressure the government to set policies that resemble a cost sharing between private insurance and Medicare.HIV/AIDS GroupAccording to Kates, Jennifer, Dorian, Richard, Crowely, Jeffers, Summers and Todd (2002) more than 60 million people have been infected with HIV worldwide, 20 million have died. HIV is now the leading cause of death in Africa and the fourth leading cause of death worldwide. Most of the impact has been felt in the developing world. Children and women are increasingly at risk. In addition, it is estimated that more than 40 million children will have lost one or both parents to HIV/AIDS by 2010 and these children will also be at increased risk for HIV (Kates, et. al, 2002). Access to treatment and available drugs are some of the unique health care needs facing the world HIV/AIDS population.Fried and Gaydos (2002) indicate Cuba incidence of HIV/AIDS cases remains very low, although it is increasing as Cuba opens more to tourism and external contracts. Cuba once had a policy of quarantining for all HIV-positive cases. Pressures from international bodies such as the United Nations and many large nongovernmental agencies, Cuba now has a voluntary quarantine after medically recommended stay in a residency for eighth weeks. All newly identified people with HIV are also expected to spend at least eight weeks in a sanatorium (Fried & Gaydos, 2002). Cuba’s health system is funded primarily by the national budget through indirect taxation and duties. Cubans are expected to pay for all drugs for outpatient treatment. Access to health care treatment and services for HIV/AIDS patient therefore is very limited.In the U.S. even a voluntary quarantine of newly HIV diagnosed patient would be a social injustice. As HIV progress in the U.S. individuals experience disability and unemployment due to the illness. Many HIV/AIDS patients rely on public entitlements and private disability programs for income maintenance and health care benefits. Medicaid and Medicare are the primary payers for individuals who are disabled. Anderson, Rice and Kominski (2001) suggest the lack of insurance and underinsure can represent formidable financial barriers to treatment for HIV/AIDS. Persons with HIV/AIDS are more likely than the general population to be uninsured or to have Medicaid insurance. Unlike Cuba in the U.S. AIDS medication is available to HIV/AIDS patient however not all medications are covered by insurance (Anderson, Rice & Kominski, 2001).The financial burden of HIV infection increasing in communities is a financial burden on health care providers and public payers. The reliance on an infinite source of public funds for people with HIV/AIDS is in dout. Cuba is a communist country which developed a process of governmental quarantine for the HIV/AIDS population. The U.S. method of moving the HIV/AIDS patients into managed Medicaid health plans is a better process in which patient care is managed for the purpose of reducing the cost of treatment.While gender affects the health of both men and women, WHO places special emphasis on the health consequences of discrimination against women that exist in nearly every culture. Powerful barriers including poverty, unequal power relationships between men and women, and lack of education prevent millions of women around the world from having access to health care and from attaining and maintaining the best possible health (WHO, 2006).Anderson, Rice and Kominski (2001) indicate in Israel the waves of immigration in the early twentieth century sparked the establishment of networks of community welfare and health organizations. The sick fund model of health provision has persisted in Israel to this day. Although the 1994 National Health Insurance (NHI) Law made all sick funds regulated subcontractors of the state, thereby providing health care services to the country’s residents under government regulation (Anderson, Rice & Kominski, 2001). The system has been developed through voluntary sick funds, not for profit institutions, and the state. Israeli health system stem from organized social arrangements in which the government is responsible for the health of its citizens. The state has an active role in the development and financing of health care services that extend into the private sectors.In the U.S the entrepreneurial system is more concern with the cost and the profit involve in providing health care for individuals. The Israel NHI is a system of collaborative efforts on subcontractors of the government. The process of subcontracting allows the government to oversea the implementation of health care activities through out the country. In the U.S. entrepreneurial system subcontracting by the government would give too much control over the health care system. The Israel system can not be applied readily to the U.S. health care system because there are no true national mandates that can be applied to an entrepreneurial system. Anderson, Rice and Kominski (2001) indicate in the U.S. individuals or employers may purchase private health insurance. Approximately 63 percent of Americans had private health insurance between 1977 and 1999. Of those with private insurance, 58 percent obtained health insurance through their employer, and 5 percent purchased insurance individually. Private health insurance companies may operate as for profit or not for profit organizations (Anderson, Rice & Kominski, 2001). Private health insurance organization with in the U.S. would fight against a system such as Israel NIH. The NIH is a allows Israel to regulate the health care system by subcontracting this type of system would cut the profit margin of private health insurance companies in the U.S.ConclusionRising health insurance costs and high numbers of uninsured citizens has generated a public interest in national laws that would provide access to care for special populations. When evaluating Non-US health care concepts there is no one systems that guarantee universal access to health care for all. The national health care policy in the U.S. has evolved incrementally over the decade. Access to care has generally depended on insurance coverage that is implemented privately or publicly. With the increase needs of special populations the U.S. will have to establish policies that allow the collaboration between private as well as public entities to secure access for those in need.ReferencesAl-Nasir, F. & Al-Haddad, M. K. (1999). Levels of disability among the elderly in
Institutionalized and home-based care in Bahrain: Eastern Mediterranean Health Journal (5) p. 247-254 Retrieved March 3, 2006 from [http://www.emro.who.int/publications/emhi/0502/05.htm]Anderson, R. M., Rice, T. H., & Kominski, G. F. (Eds.). (2001). Changing the U.S. health care
system: Key issues in health services Policy and management (2nd ed.). San Francisco:
Jossey-Bass.Fried, B. J., & Gaydos, L. M. (Eds.). (2002). World health systems: challenges and perspectives.
Chicago: Health Administration Press.Kates, Jennifer, Sorian, Richard, Crowely, Jeffrey S., Summers & Todd, A. (2002). Critical
policy challenges in the third decade of the HIV/AIDS epidemic. American Journal of Public Health (92) Issue 7 Retrieved March 3, 2006 from [http://web14.epnet.com/citation.asp?tb=]Longest, B. B., Rakich, J. S. and Darr, K. (2000) Managing health services organizations and
systems (4th ed.). Baltimore, MD: Health Professions Press, Inc.World Health Organization (2006). Important target groups Retrieved March 2, 2006 from
http://www.who.int/oral_health/action/groups/en/print.html

Some Myths About Federal Health Care Reform or “Obamacare”

When the Patient Protection and Affordable Care Act (PPACA, aka ACA) became federal law in March of 2010, there were many assumptions about what the law would and would not do. As everyone knows, it has become known simply as “Obamacare,” because President Obama was the one who wanted health care reform. Here are some misconceptions about health care reform.One of the first statements made was that the new law was tantamount to “a government takeover of healthcare.” For this to be true, the government would need to inform every citizen that they were being enrolled in a federal healthcare program, sort of like Medicare, which is a federal health care program for any qualifying citizen or permanent resident over the age of 65. In fact, there is no federal alternative to private health insurance today. Since most if not all health insurance companies that were doing business in 2010 are still insuring millions of policyholders today, it is safe to say that there has not been a government takeover of healthcare. It is also true however, that many people would like to see that happen. They would love to see Medicare expanded to include everyone; but that is very unlikely for many years to come, if ever.”Medicare benefits will be reduced.” Actually the opposite has happened. Medicare now covers annual physical exams and colonoscopies in addition to the quite comprehensive benefits they have long provided. It is true that premium costs to Medicare beneficiaries will go up in future years, but medical costs and premiums have been rising steadily for decades, and seniors do use more medical services than people under 65.There will be government “death panels” that will make end-of-life decisions for people on Medicare. This idea was borne out of a well-intended provision in the health care bill that would have helped pay for the end-of-life planning discussion cost that the elderly already have with their physicians and caregivers. So a good thing became a bad thing. Now there can be no provisions in Medicare for this benefit which, ironically, hurts seniors and can actually adds to the cost of health care.Illegal immigrants will now be covered. The ACA specifically prohibits undocumented immigrants from receiving coverage.What is not known is the true long-term cost of this legislation. There are many people on both sides of the argument, time will tell what the real cost will be, and there are many components of this program still to be implemented. The truth about health care is that it is expensive no matter where you are. Canada, England, France, Switzerland, Italy, China.All of these countries have some form of government provided health care and while it is less expensive per-capita than in the United States, it is expensive nonetheless. The common element of all health care programs is that every citizen or legal permanent resident is covered. The cost of care per person is far lower when everyone is covered. What needs to be understood about health care is that every person at some point will seek it out when they need it. Whether or not they have health insurance is not a factor when there is a need for treatment. If a person cannot afford car insurance they have the option of not driving, and few people drive without car insurance. Not so with health insurance, and the situation is made worse by the fact that uninsured people often ignore minor medical issues because of the cost. Unfortunately those minor medical issues have a way of becoming serious, and that is when the uninsured seek care. And where do they go to get treatment then? The emergency room, which happens to be the most expensive entry point into the entire health care system in the U.S. They go there because federal law prohibits hospitals from turning away anyone during a medical emergency.This is a huge factor in the cost of health insurance, and a major reason why health insurance premiums have risen far in excess of the CPI over the past 30 years. Until that part of the health insurance equation is resolved the cost of insurance will continue to be out of reach for millions of Americans.In summary, the cost of delivering health care in the U.S. is not going to go away as an issue. The debate over the number of uninsured and whether or not they should be covered, public vs. private insurance, and who pays for all of this will go on until our politicians realize that there is no one best solution. All sides will have to agree that there will always be some elements of a common health care system that not everyone will like. There are many elements of the Affordable Care Act which work, and those elements need to be preserved. Many insurers who initially opposed the Act have since re-tooled their benefit and pricing models to reflect the major objectives of the program. The irony here is that abolishing the ACA would actually increase the cost of coverage as insurers once again had to redesign their policies and coverage. What is needed most of all is a system that works reasonably well and covers everyone or nearly everyone. In the long run, the cost of excluding millions of uninsured will cost more than covering them.

RN Nurses Make Up the Largest Group of Health Care Professionals

The largest group of health care professionals…and growingRN Nurses belong to the largest group of health care professionals in the US today. In 2008 there existed 2.6 million nursing jobs in the US. 60 % of this number was employed in hospitals while various smaller health care and health education facilities accounted for the rest. The nursing profession is divided into many specializations, each classified according to the branch of medicine to which they belong and the type of service that is required of the nurse.Types of Nursing CareYou may for instance have RN nurses trained especially to care for the elderly. Within this capacity, a nurse may give primary health care, nursing care, drug administration care and specialty care.Primary health care refers to the advice and services given for initial check-ups and health problems. While this form of health care is usually associated with doctors, RN nurses may also dispose of these functions within their scope of competence.Nursing care refers to overseeing the implementation of the physician’s directives. In this capacity, RN nurses may provide psychiatric care for mentally disturbed people. This category also includes caring for women in their pre-natal stage and after they give birth.RN nurses may also take care of administering drugs to patients in accordance with the prescription of the attending physician.Specialty care denotes the services rendered by nurses within their field of specialization. As such we have nurses who provide geriatric care for old people, cardiac care for people affected with heart ailments, and so on.What are the prospects for RN nurses?Because of the many areas of medical concern that nurses serve and the above-mentioned types of nursing services, the number of possible jobs for a nurse will be the number of fields of Medical Science multiplied by the number of service types. Obviously, the opportunities are ideally inexhaustible, considering that world population is growing in numbers, if not in terms of birth rate.Facts about US populationToday, the batch of people in the US between age of 46 to 65 belong to that special group called “boom babies” who were born between 1947 and 1964, immediately after World War II. This period is characterized by a high birth rate percentage, peaking at 2 % in 1950 and fluctuating down to 1.4 in 1964. Since then the birth rate has dropped to below 1 %.The “boom babies” represent a dramatic rise in the population. It is anticipated that as the people belonging to this batch age, the need for geriatric nursing care will constantly rise. If we were to consider the youngest individuals in the group (aged 45), we would expect the need for geriatric nursing care to up for the next 35 or 40 years. And considering that elderly patients may have other problems besides their old age to contend with, we should anticipate the over-all need for nurses to rise within that period.What about the Recession?The nursing profession has not remained unaffected by the economic crisis in the sense that a great number of lay-offs have been witnessed since 2007. But as a result, the number of RN nurses who are employed in hospitals is far below the population of patients that have to be attended to. Because of this current shortage, hospitals are hiring once more.Besides openings in health care institutions, RN nurses should not have difficulty finding jobs with the private sector. There are millions of people needing health care of one kind or another who would prefer to stay at home. An RN with initiative should never find himself/herself without practice.