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Models and Their Role in Healthcare Essay Paper

Models and Their Role in Healthcare Essay Paper

The study of healthcare is founded upon a few basic ideas like the cell or the concept of disease. Informatics is similarly built upon the concepts of data, models, systems and information. Unlike health, where the core ideas are usually grounded in observations of the physical world, these informatics concepts are abstract ideas. As a consequence, they can be difficult to grasp, and for those used to the study of healthcare, often seem detached from the physical realities of the clinical workplace .Models and Their Role in Healthcare Essay Paper

According to Martocchio (2014), health insurance covers the costs of a variety of services that promote sound physical and mental health, including physical examinations, diagnostic testing, surgery, dental treatments, and corrective prescription lenses for vision deficiencies. More than two centuries ago, the presence of the health care system emerged when mining and railroad companies hired doctors to provide medical services to their employees. As a result of the catastrophic World War I, many health providers were left providing services with the prospect of not receiving payments for the services being rendered and many Americans faced with the financial burdens of these escalating health care costs. The essential for the development of a health care system was not established for no apparent reason. The health care system was developed due to the staggering number of Americans whom where unable to pay soaring medical bills. With no government intervention, the private sector of health insurance was established as a means for Americans to pay medical expenses. “In 1927, the American Medical Association (AMA) formed a Committee on the Costs of Medical Care to report on options for helping Americans pay for their medical services.





Care for All: A Case for Universal Healthcare Without our health, we have nothing. Money, friends and family, happiness–all are afterthoughts without our health. As such, both as individuals and as a society, maintaining our health must be an indispensable priority. Despite the many faults of our healthcare system, Americans realize this. Healthcare is undoubtedly a major concern in the United States. The recent implementation of the Affordable Care Act, more commonly known as “Obamacare,” the heated debates on healthcare across the nation, and the over one trillion dollars spent per year by the government on healthcare, all show our prioritization of health (“Federal Spending: Where Does the Money Go”). Furthermore, a strong majority of…show more content…
The United States has a very unique healthcare system. Does this mean that we are simply leagues ahead of the rest of the world in healthcare? Unfortunately, not at all. The ideal of American exceptionalism is apt to describe our healthcare system. That is, our current system is exceptionally bad. Per capita, the United States spends “twice the average of other developed countries” on healthcare (“United States Per Capita Healthcare Spending Is More Than Twice The Average Of Other Developed Countries”). Yet, in the World Health Organization’s ranking of healthcare systems by nation, the U.S. comes in at a dismal 37th place, despite spending the most per person of any country on Earth on healthcare (“World Health Organization’s Ranking of the World’s Health Systems”).
For everyone around the world, health is shown to be the most important thing but difficult to obtain. In trying to give healthcare everyone in a country, an idea which I saw a lot of countries thought about was Universal Healthcare. A system in which the government in a country provides healthcare to every individual. From this system what I notice the government does is provide assistance to its citizens insuring they do not need to think about insuring themselves with a private or public healthcare, however, the same one everyone in the country is using. The great thing about universal healthcare is it can ensure every citizen ‘s of a country can get helped. In today ‘s world as money is what everyone needs to have, a situation gets shown. A threat gets shown whether people could be treated or not upon what they have. Seeing this problem as many countries try to form affordable way to assist people where the idea of money gets not seen as a problem it gets illustrated how due to how many people there are countries still face the struggle of dealing with money.Models and Their Role in Healthcare Essay Paper

Imagine what your life would be like if you were one of millions of Americans without medical coverage. Universal health care is a system that will provide for all of citizens for health care and financial protection. Over millions of Americans are currently without health care coverage for themselves and also their families. Universal health care refers to any system of health care managed by the governments. This universal health care is a system that may cover different programs such as government run hospital, health organizations, and programs targeted that provides health care. Many developed countries such as Canada and United Kingdom have embraced universal health care with United States being the only exception that has not embraced universal health care to its citizens. One of the reasons is that universal health care will ensured that all Americans citizens to have the right to health care and will decrease health care costs by allowing people to receive regular and prevent medical care. And not have to wait until they are chronically ill to seek treatment when medical costs is way much higher.Health is a state of complete physical, social and mental well being and not merely the absence of disease or infirmity. Health is thus a level of functional efficiency of living beings and a general condition of a persons mind, body and spirit, meaning it is free from illness, injury and pain. It is a resource of everyday life and a positive concept emphasizing physical capabilities.Health Insurance is one of the nations top problems, the cost is rising for premiums, and many businesses just cannot afford it. As Americans many of us have the luxury of health insurance, but far too many of us have to go without it. This is something that always seems to brought up at congressional debates, but little is done about it. “In 2013 there were 41 million people reported with out health insurance coverage, this is too many considering those people probably were sick at some point through out the year, and they couldn’t afford treatment.” We need to find someway to make sure that every citizen of the United States is able to have affordable healthcare for themselves, and their families.

Healthcare is a hot button issue in politics today. Since Obama’s first term as President, the country has been debating how best to provide medical coverage for the population of the United States and how best to keep the costs of this coverage down.

If you want to teach your kids how to write – especially how to write persuasively – then you need engaging, interesting topics for them to write about. Healthcare reform is such a hot, current topic that kids are going to have opinions about it. It’s a great basis for a persuasive essay writing task.Models and Their Role in Healthcare Essay Paper

A sensitive topic in the United States today revolves around the issue of healthcare. Is health care a basic human right or is it just a privilege to those who are able to afford it? Health care in the United States is in desperate need of reform. The Affordable Care Act takes that stance that health care is in fact a basic human right and that everyone should have health insurance. When the term “basic human rights” is used, most people think of the right to life, liberty, and the pursuit of happiness. This doesn’t necessarily mean that people should be forced to sustain others’ lives, or that they have the responsibility to make others happy because they have a “right” to pursue happiness. You are born with these basics rights that no…show more content…
A sensitive topic in the United States today revolves around the issue of healthcare. Is health care a basic human right or is it just a privilege to those who are able to afford it? Health care in the United States is in desperate need of reform. The Affordable Care Act takes that stance that health care is in fact a basic human right and that everyone should have health insurance. When the term “basic human rights” is used, most people think of the right to life, liberty, and the pursuit of happiness. This doesn’t necessarily mean that people should be forced to sustain others’ lives, or that they have the responsibility to make others happy because they have a “right” to pursue happiness. You are born with these basics rights that no one can take away. On the other hand, healthcare is something that is given to you; it costs money and is a basic need of life. We have a right to pursue and acquire healthcare, but it is not a right.
EXECUTIVE SUMMARY The U.S. Department of Health and Human Services (HHS) stated that “The health of the individual is almost inseparable from the health of the larger community and that the health of every community in every state and territory determines the overall health status of the nation.” It has now become clear that our economy in terms of healthcare insurance is not healthy; the healthcare system in the United States spends 1 cent of every healthcare dollar in the prevention of diseases and 99 cents on the cure. Our healthcare system is the most expensive and yet arguably among the least cost effective in the developed world. Despite the highest per person health care spending among the Organization for Economic Cooperation…show more content…
It is a patchwork of loosely connected financing mechanisms varying in terms of sponsorship and provider type. It also reflects the age, health and economic status of the specific patient groups that are being served. Considering the growing number of Americans who are uninsured for health care and the low ranking of the United States among a variety of health indicators, one may say that it is a disappointing financing system. These observations provide a basis for supporting our position for a national health care system. Where possible, comparisons will be drawn between the United States and other countries. Special focus will be paid to similarities in the public and private financing components of the system, reimbursement of various provider categories and trends that we may expect to see in the future. Overall, the role of health insurance as a financial channel will be mentioned. Monetary business objectives will be contrasted with the altruistic goals of health care as a humanitarian service.

Healthcare is becoming more and more expensive and under such conditions it is difficult to poor people to manage their health. Many arguments rise on this topic and that is why graduates are assigned with argumentative essay on various topics of healthcare. Sample essay on should government provide healthcare is given here for such types of assignments to the students here by Students Assignment Help. The best quality essay assignments on healthcare issues can be written easily by grabbing the essay writing tips for college assignments from the Example Essay given here.Models and Their Role in Healthcare Essay Paper

This is a very serious question that is associated with the health of people who cannot afford to spend on their healthcare. People who belong to marginal sections of the society have to depend upon the government services which cater their health. But there are many governments which find it unimportant to provide healthcare services for free of cost to the citizens so that no crises can occur on the nation’s economic growth. The revenue that is collected in the form of cess should be utilized in the welfare of the state rather than giving healthcare help according to these governments. The debate is going over long period of time and several conclusions have been given by the intellectual regarding this topic so far.

If we observe the situation meticulously then there are people who can contribute well in the growth of a country but their health hinders them to do so. Human assets of a nation are very important and that must be preserved to an utmost level. Giving healthcare services to those who are under privileged societies should be confirmed at the least what government can do for its citizens. This is because other people can manage the things related to their health easily who are having their source of livelihood and earning but poor who fail to secure two squares of meals per day cannot afford to finance their routine check up and die without treatment.

A massive breakdown in the growth of the countries is experienced where government is not giving funds for the healthcare services to poor people. Such people become the cause of spreading several viral and bacterial diseases from one person to another. But at the same time if we consider the case on contrary scale then the situation is somewhat inverted where people have free healthcare and capable of becoming a part in the growth of their own nation on Economic scale in the world. Thus the importance of free healthcare can be seen in relation to the development of a nation in every way and we cannot ignore this truth.

The conclusion of the argumentative essay reaches to a point where we cannot say that every government of the nation should give free healthcare to its citizens especially those who are in deep financial crises. But at the same time at least those people must be provided with these facilities which are having the issues in grave concern. Developed nations can do well in this field by giving the free health care support to their citizens irrespective of their status and identity on the base of money they have.

We cannot say that health is not important as there are several diseases which are communicable and can spread from one person to another destroying the entire stability through endemic and other such situation. This brings lot of anarchy and instability which is not in the favour of economic growth of a nation. That is why it is the supreme most duty of any government to take care of its citizens if they are not able to help out with their diseases owing to the lack of money required for the treatment of the diseases they are going through.Models and Their Role in Healthcare Essay Paper

Argumentative Essay Writing Services to the graduates and school goers are given here by the Students Assignment Help. With the help of these quality services best score can be fetched at low price by those who have no idea about how to start writing an essay on healthcare. Not only essay writing help but at the same time Free Essay Editing Help to college students is also given for the plagiarism free assignments which are having zero plagiarism and errors of grammar. Online Essay Writing Help can be availed by asking the essay helpers to make my assignments in essay anytime. So do not find anything wrong in completing your assignments of essay writing on time by having this support of the professional writers.

The issue of health care is one of the most important aspects of an election campaign of any political party, which certainly reflects the extent to what the society depends on a good healthcare service. A well-organized, efficient health care system is not that easy to provide and one of the key problems on the way to the ideal hospitals and medical help is proper funding. Nowadays, there are three basic types of funding: private, insurance and state. Nevertheless, many people believe that the government must bear full responsibility for providing the money our health care service needs. However, I do not completely agree with the idea.

The government will not be able to provide enough money to guarantee the use of the most innovative methods of treatment. It is not a secret that medicine and medical equipment are outrageously expensive. Moreover, government has several branches of the social sector, such as education and culture, which also do not produce anything, but need funding. Providing enough money for all these spheres will sooner or later result in the budget deficit and, as a result, in the increase of taxes, which means that the main financial burden is on an average citizen again.

In my opinion, an ideal variant will be a combination of all the existing sources of finance. Some rich people may prefer to pay for medical treatment, while the government must necessarily subsidize the health care for children, senior citizens, the unemployed and the homeless, as these social groups cannot provide for themselves and, thus, are extremely financially vulnerable. However, working adults can use the benefits of the medical insurance, which will give them an opportunity for a decent medical service and reduce the general taxation burden.Models and Their Role in Healthcare Essay Paper

If you read these tips on persuasive writing prompts, you’ll know that it’s important for students to have some facts on which to base their arguments. When it comes to civics education, divisive political issues, like healthcare reform, can spur arguments based more on passion and opinion than facts, so it helps to assign some reading before your students write. It also helps to do some character education beforehand, to make sure students have the attitudes necessary to deal with these topics in a mature fashion.

Time Magazine published an excellent article in February by Steven Brill – “Bitter Pill: Why Medical Bills Are Killing Us.” In the article, Brill does some good old fashioned journalism to attack one of the root problems in healthcare – why are the bills so high? The article is a bit long, and you may not want to assign the entire thing to your students. It would, however, be an excellent idea to excerpt a couple of pages to accompany each of the prompts that you give to your students.

Five Topics for Students to Write Persuasive Essays About

Each of the topics and tasks below were inspired by the Steven Brill article above. I highly suggest that you, the teacher, read the article so that you’ve got a firm grasp on the issues and some of the facts. Then, you can decide what (if anything) you want your students to read to inform their own opinions.

Should there be limits on the prices drugmakers and hospitals charge for certain drugs?New, sophisticated drugs are necessary to treat diseases like cancer. These drugs often cost several thousand dollars per treatment straight from the manufacturer, and hospitals will often mark the price of these drugs up even further when they bill patients. The patient usually has little to no choice in the matter, and there’s no competition to help drive down prices as would happen in a normal market.

Drug makers, on the other hand, argue that high prices are necessary to fund research and development. Brill has some interesting numbers to challenge that assertion, and you’ll want to read his findings before you make up your mind. However, there’s a fundamental question about free market economics, liberty, and fairness involved in this question.

Should there be limits on the salaries of hospital administrators?

One of Brill’s findings is that hospital CEOs and other administrators are paid outsized salaries – often in the high six figures or even seven figures. In the case of hospitals attached to research universities, the hospital administrator is often paid more than the university president. This is similar in some ways to the salary arms race going on in college sports, where head football coaches are paid exorbitant salaries.

In the scheme of things, reducing administrative salaries probably won’t bring costs down much. But it just seems like a good idea. It’s also interesting to note that many of these hospitals are not-for-profit organizations.

Should hospital fees be tied directly to the cost of providing a particular service?

A constant theme of Brill’s article is the “chargemaster” list. It’s a list of prices for particular services and items administered at a hospital, and it’s the basis for all prices charged to individuals and to insurance companies. These lists have no logical connection to the actual cost of services, and they often produce extremely high mark-ups (1000% to 2000%) over the actual cost.

There’s an alternative method, which Medicare uses. When the government reimburses hospitals for treating medicare patients, it draws on a calculated list of what it actually costs to provide a service. These prices are drastically lower than the ones on the chargemaster. An interesting reform might be to tie the prices of all fees to this Medicare reimbursement list, and then allow a certain mark-up for the hospitals to make a profit.Models and Their Role in Healthcare Essay Paper

Should uninsured individuals pay more for the same services?A peculiar problem of the American healthcare system is that uninsured (or underinsured) people face steep charges if they go to the hospital. These fees are based on the previously mentioned, outrageously over-priced chargemaster. Insurance companies negotiate lower prices, and the government insists on a particular schedule of fees when it pays for Medicare and Medicaid patients.

Yet individuals who have no insurance are at the mercy of the hospital, and they must pay whatever the hospital charges them. To make matters worse, people often don’t know how much they’re going to be charged until after they’ve been treated. This begs the question of whether it’s fair for some people to pay far more for healthcare than those who are covered by insurance.

Should there be limits on malpractice lawsuits (i.e. tort reform)?

On the conservative side, one argument about healthcare is that prices are so high because hospitals and doctors have to be concerned with malpractice lawsuits. One wrong step and they’re on the line for millions of dollars of liability. If they don’t exhaust every option, then they might even be on the hook for that. Brill suggests that this leads to massive over-testing, and doctors are ordering all kinds of tests (like CT Scans) that aren’t really necessary.

By tightening the rules for proving malpractice – i.e. requiring true negligence on the part of the doctor – you free hospitals from the need to run excessive tests to simply cover their butts. This could help bring down spending significantly, although the counter argument is that this could lead to inferior care.

Most people rely on their employers to provide them with health insurance, but with many health care is not available through the employers. Many small businesses can simply not afford the high cost of health care, or it may be available, but the employee needs to pay the entire premiums.  A lot of employers are utilizing part time employees, the part time employees are usually not qualified for benefits, like health insurance. This is very unfortunate for these part timer’s not only because they will not get benefits such as health insurance, but also they probably have a slim chance of going full time because of the health insurance dilemma. Business owner’s need to assess what is good for them financially, and having plenty of part time employees who do not require insurance is probably the most cost effective method to keep the Business up and running.

Health is Wealth’ is a famous saying that refers to the importance of health to us and reveals that health is wealth. If we are not healthy (do not feel in the state of physical, mental and social well being), wealth means nothing to us. So, our health is a real wealth; we should always try to be healthy.

There is a very common and true saying that Health is Wealth. We should always keep in mind that wealth is wealth however health is the greatest wealth in this world. We should also motivate our kids and children to know something about this common saying using such as simple and easy essay on Health is Wealth. You can make your kids aware about their health using such simply worded Health is Wealth essay.

It is very true that Health is Wealth. As, it is only our good health which stay with us in any bad or good circumstances. Nobody in this world can help us in bad times. So, if our health is good, we can bear any bad circumstances in our life. If one is not healthy, he/she would definitely suffer health related or other difficulties in life instead of enjoying the life. In order to maintain a good health we need to eat balanced food, daily mild exercises, fresh air, clean water, maintain good posture, enough sleep and rest, maintain cleanliness, regular medical check-ups, follow our elders, parents, and teachers etc.


The common saying Health is Wealth fits to everyone’s life. Good health is the real wealth means money which has capability to help us always. Good health is most important part of our life without which we are incomplete and living unhealthy life. Good health is really better than wealth and other things in this whole world.

For getting fit we need to maintain standard and healthy eating. We should follow the regime like “Early to bed and early to rise makes a man healthy wealthy and wise”, “Time and Tide waits for none”, etc. We should brush our teeth daily two times a day to keep our mouth clean and free of diseases. We should clean our hand with soap and water every time before eating food. We should maintain our good personal hygiene in order to get healthy. We should daily take bath with fresh water and go for morning walk to have some fresh air.Models and Their Role in Healthcare Essay Paper

As we all know about the popular and common saying that “Health is Wealth”. It is as true as our life. Good health keeps us always happy and gives us feeling of complete physical, mental, social and intellectual well-being. A good health keeps us away from the diseases and health disorders. The loss of good health causes loss of all the happiness. A great freedom fighter, Mahatma Gandhi (also called Bapu) has said that “It is health which is real wealth, and not pieces of gold and silver”.

A good health helps us to life a good, balanced and healthy life. Our good health needs several things to get done on daily basis. We need fresh air, clean water, proper sunlight, balanced diet, away from junk food, clean and healthy atmosphere, greenery environment, morning walk, personal hygiene, proper education, etc.

Healthy food at proper time is very necessary for the healthy body which is possible only through the well balanced diet. It promotes the proper growth and development of our body which keeps us mentally, physically and socially healthy. With the help of our good health we can fight any bad situations in the life. We should always remember that we need proper food, water, air, physical activity, sleep and rest on daily basis.

The meaning of most common saying “health is wealth” is very simple and easy. It means our good health is the real wealth of our life which gives us good physique and mind and enables us to enjoy whole life by managing its all challenges. Good health promotes a good mental, physical and social health. I completely agree with this saying that health is actually a true wealth as it helps us at all. A good health keeps us away from the metal and physical disabilities as well as other medical conditions including cancer, diabetes, heart disease, fatal diseases, etc.

A physically or internally unfit person has to face lot of challenges in the whole life even she/he has to be depend on someone else for performing daily basic needs. This situation is quite embarrassing for one who faces it. So, it is good at all to maintain a good health forever to be happy forever without anyone’s help. It is true that to maintain a good health we need money and to earn money we need good health. But it is also true that without money we can live life and without a good health we cannot live life happily. Because our good health helps us all the time and encourages us to do something better in our life, instead of earning money only.

In such a busy life and polluted environment, it is very hard for everyone to maintain a good health and live healthy life. It needs a careful watch and regular medical check-up to get healthy.Models and Their Role in Healthcare Essay Paper

Now-a-days, a good health is just like a boon given by the God. It is very fact that good health is real money of life. Good health is considered as the precious earning of a human throughout his/her life. If one has losses his health, he has lost all the charms of life. A good wealth can be earned anytime using a good health however; a good health can never be earned again in the life if once destroyed. In order to maintain a good health we need to do regular physical exercises, yoga, meditation, balanced food, good thoughts, cleanliness, personal hygiene, regular health check-ups, proper sleep, rest, etc. If one is healthy, he/she does not need spend money on his/her health in buying medicines or visiting doctors. A healthy person just needs to spend some money only on his health on regular basis. However, on the other hand a lazy, diseased or sluggish person needs to spend more money throughout his life.

People generally become fail in their life to maintain a good health just because of their lazy and idle habits. They think that what they are doing is right but time has already gone whenever they understand their mistakes. A good health is one which keeps us healthy in all aspects like mentally, physically, socially and intellectually. A good health provides us freedom from all the sickness and diseases. A good health is the feeling of mental, physical and social well being. It is a costly and most precious gift of the life and necessary for living a purposeful life.

A good health allows us to work for more time without getting tired. A good health is the real pleasures and charm of life. An unhealthy person always worries about his/her physical or physiological complications. So, it is good to maintain the good health to get rid of all the complications of body as well as successfully face all the challenges of life.

As we all live in super-fast, crowded and busy time period. We have to perform multiple tasks throughout the day in order to earn more money however we forget that good health is as necessary for our healthy life as air and water for the body. We forget to take proper food in timely manner, daily exercises, proper rest, etc to just earn some false wealth. We should never forget that our health is a real wealth of the life. It is true for all that Health is Wealth.

A good health reduces the stress level and promotes healthy life without any sufferings. We should always be aware of our health and go for regular health check-up. We should eat balanced food having fresh fruits, salad, green leafy vegetables, milk, egg, dahi, etc in timely manner in order to maintain the good health. A good health also need some daily physical activities, proper rest and sleep, cleanliness, healthy environment, fresh air and water, personal hygiene, etc. In order to reduce our rush between hospital and home, maintain a good health is better idea. Maintaining a good health is a good habit which should be practiced from childhood with the help of parents.

In earlier days, life was not so hectic. It was quite simple and free of too many challenges with healthy environment in comparison to these days. People were healthy as they had to perform all the daily routine activities by their own hand and body. But now, life in the technological world has become easy and comfortable but hectic because of the competitions. Now-a-days, easy life is not possible as everyone wants to earn more money to get better life than others. Now-a-days, living life has become costly and tough as well as unhealthy as everything like air, water, environment, food, etc has become contaminated, infected and polluted.Models and Their Role in Healthcare Essay Paper

People have to work for at least 9 to 10 hours in the offices by just sitting on the chair without any physical movement. They come to home in the late evening or night and become too tired to perform any household work or exercise. Again in the morning they get up late from bed and do some necessary works like bath, brush, breakfast, etc and go to their office. In this way, they live their daily routine only to earn money and not their life for themselves. It is very necessary to earn money for fulfilling some basic needs however, it is also necessary to live a healthy and peaceful life which needs a good health.

Health is related deeply to life-style. Ideal health will however, always remains a mirage, because everything in our life is subject to change. Health may be described as a potentiality—the ability of an individual or a social group to modify himself or itself continually, in the face of chang­ing conditions of life not only, in order to function better in the present but also to prepare for the future.

Personal Life:

The importance of health in personal life cannot be minimized. It has come to be regarded as a prerequisite for optimum socio-economic development of man. Health care as a right of every individual has been recognized in many countries.

In the “Universal Declaration of the Human Rights”, there are 30 articles. The Right to better living conditions and the Right to Health and Medical service are vital. Though the health is now recognized as a fundamental right of every human being, it is essentially an individual responsibility. It is the individual who has to accept certain responsibilities in order to attain good health, i.e.- responsibility about diet, personal hygiene, cultivation of healthful habits, carrying out specific disease prevention measures. It is also desirable that in the personal life every individual should be acquainted with the essential health skills to stay healthy.

Family Life:

The family is a primary social group. It is a group of biologically related individuals. The family is like a ‘shock absorber’ to the stress and strains of life. At the time of emotional upsets, worry, anxiety, economic insecurity, the family provides an opportunity for release of tension.

The family therefore plays an important part both in health and disease in the prevention and treatment of individual illnesses, in the care of children and dependent adults, and in the stabilization of the personality of both adults and chil­dren In most societies the family is the fulcrum of health services Medical schools are developing teaching programmers in family medicine; because, as Florence Night­ingale had said, “the secret of national health lies in the homes of the people”.

Social Life:

Society is a group of individuals drawn together by a common bond of nearness and who act together in general for the achievement of certain common goals. The society plays an important role in the health as well as in disease; public health is an integral part of the social system. It is influenced by society and society by public health. Many public health problems are social problems and vice-versa.Models and Their Role in Healthcare Essay Paper

Why should Mandatory Health Care be a necessity? Mandatory health insurance is important to improve the well being and the health of our citizens. Study show that the United States health system are well below other countries when comparing life expectancies of our citizens to those of China, Europe and even Canada with our health system. There are many aspects that play a roll in improving our health system, but the three major factors are preventive care, accessibility and health care reform. Studies show that preventive medicine can decrease cost and have a better treatment outcome. Better access presumably improves health outcomes. Each community should have some form of health clinic that patients can go for care. …show more content…

In the movie Sicko by Michael Moore shows that there are 50 million Americans without health insurance. The United States is ranked number 37 in health care in the world with China and France leading. Canadians life expectancy is three years longer than Americans (Michael Moore 2008). Another factor that affects the US health is our obesity rates. Adults in the United States have one of the highest obesity rates in the world. Nearly a third of U.S. adults 20 years and older are obese, while about two-thirds are overweight, according to the National Center for Health Statistics.

Good health is a secret of every happy man. There is an old saying, ‘Health is Wealth’. Staying healthy for children is vital for proper growth and development of mind and body as they need to focus in the class and fully participate in the activities on the field. Parents must take their children for medical check-up and learn from experts about their development in terms of height and weight, as it has a huge impact on their overall performance and efficiency. If you are strong and healthy, you can be a shining example to others and teach them how to achieve vibrant health.

Good health is a matter of great concern, to maintain it, healthy living and a disciplined life is a must. One of the best ways is to drink plenty of water as it reduces the risk of infection, keeps your skin healthy, reduces the risk of heart attack, burns body fat and regulates our body temperature. We should sleep well as it relaxes our body and reduces stress. We need to have a balanced diet and go for long, brisk walks. Our motto should be to keep our body clean in order to remain healthy. We must laugh more as laughing is a therapy and a secret of good health. The government should include integrated health programs into their public policies and control specific health problems. Models and Their Role in Healthcare Essay Paper

The Six Benefits of a Healthy Lifestyle

Eat healthy. Sleep well. Exercise. This seems to be the mantra of the current generation. Admittedly, a lot of it is born out of body image issues, and the need to look their best at all times.  But, maintaining good health is not just about looking good, it is about being a healthy person overall. If you live a healthy life with lots of good food, exercise, sleep, and ample fluids, it will have an overreaching effect on your physical appearance, mental health, and even emotional condition. In this article, let us take a look at the many benefits of living a healthy life

You can stay energetic: Yes, that is true. By living an even moderately healthy life, you will be a lot more energetic, living life with a lot of vigor. Everyone has gone through phases make by long hours of work, erratic eating schedule, and little sleep to top it off. It makes you feel drowsy throughout the day, fatigued all the time, and, worst of all, has seriously negative effects on your emotional and rational capabilities. It is important for an adult to get about 8 hours of sleep every day, with balanced food and at least 30 minutes of exercise of any kind to be at the peak of their abilities during the day.





You have a clean bill of health: Studies have shown that people who eat healthy and exercise often are at lower risk of contracting deadly illnesses such as diabetes, cardiovascular problems, arthritis, and so on. Exercise helps in regulating blood flow in the body, balancing metabolism and boosting overall health. Lots of exercise, coupled with a balanced, healthy diet, translate to low cholesterol, a leaner body, and improved immunity.

You are more confident: The most confident of us feel a tad bit of our confidence ebb on days when we are not feeling our best. When we have been living a healthy life for a long time, we feel good about ourselves. We know that we look good, thanks to the fitness and glow that good food and exercise gives us. We are energetic and clear minded, which means that we are ready to take challenges head on, and we are aware that we will perform well in whatever we are entrusted with. Positive self-awareness of this sort makes us a lot more confident, and we consequently do better on a daily basis.

You are more emotionally stable: Surprising as that may sound, mood is a lot psychosomatic. When was the last time you came down with a cold and stayed in terrific mood all along the sneezing and retching?  The answer is probably never. That is because when the body doesn’t feel good, the mind does nor either. Mood swings are inevitable with hormonal ups and downs, but you can certainly limit them to certain periods. Healthy eating, lots of fluids, and plenty of exercise and sleep boost the release of serotonin, or the happy hormone. Although ice cream and alcohol will give you a temporary spike in those hormones, healthy habits will guarantee that high for the long term.

You look better: Carbonated drinks, fatty foods, and inordinate amounts of sugar feel great on the taste buds, and definitely give you the glow of happiness. But that is not all. But they also give you wrinkles, extra padding around the waist and elsewhere, and the sluggish gait that comes with carrying around excess weight. A healthy diet with vegetables, grains, and fruits, lots of liquid intake, with ample sleep and a good amount of exercise gets rid of dangerous belly fat, and keeps your skin glowing and your hair shiny and voluminous. A healthy system is reflected on your body and movements, leaving you more supple and attractive.Models and Their Role in Healthcare Essay Paper

You are more productive: As mentioned in the very beginning of the article, a healthy lifestyle keeps you more active. By getting enough sleep, you are not fatigued during the day, and cutting down on your alcohol intake means that you don’t have to risk a hangover. Tobacco and caffeine gives you a momentary spike in energy, but in the long run, they make you tired, thanks to dwindling oxygen in the blood. A balanced lifestyle keeps your mind clear and your body fit; you are not sleepy, you don’t feel sick, and are generally ready to take on the day’s work with alacrity.

Bad habits may be hard to quit, but it is not impossible. It is never too late to start a healthy lifestyle. Include lots of greens and fiber in your diet, along with fruits and water, and cut down on the salt and cigarettes. As far as your health is concerned, a small step goes a long way.

Many people do not realize, and often underestimate, the importance of good health. Health, as they say, is wealth. Good health is necessary to carry out daily tasks. When discussing healthy, many people would consider the condition of their bodies and forget about the condition of their minds. However, health is not only about alleviating and being free from physical aspects of health. It also means being healthy in mind too.An unhealthy mind results in an unhealthy body. Good mental health helps you to make the most of life and enjoy it. Good mental health offers you a feeling of well-being and the inner strength needed in times of trouble or unrest. Everyone knows how to care for their bodies. This is done almost every day by the majority of people. Exercise and eating the proper foods are the best ways of keeping the body healthy. But, how does one keep the mind healthy? A healthy mind requires a lot of work, as well as, a combination of the right foods and exercise.Most often, the food consumed has a pivotal effect on the body, as well as, the mind.

In this paper, I will discuss the reasons why America should convert to a universal healthcare system, and reveal the pros and cons behind the problems that America faces without a universal plan. My argument is based on these major issues: the people involved and their experiences, a variety of groups’ opinions, the political background, issues of cost, and comparisons. After taking into account these arguments, the reader should have a full understanding of why we should adopt the universal healthcare system in America.

             The healthcare system in the United States is unlike any other because the government has never provided universal coverage for everyone in the country. The World Health Organization reported that “among the world’s 29 industrialized nations, only the US does not have a form of universal healthcare coverage for its citizens”(qtd. in Scott 53: 32). We currently have a system called “managed care” where some citizens have private insurers and can choose which physician they wish to go to. The problem with this system is that not enough people in the country can afford insurance. The majority of the people affected by this issue are anyone falling in or above the lower middle class population. Americans in the lower middle class make just enough money to live, but unfortunately cannot afford basic healthcare. Citizens with insurance are affected because they must pay overpriced hospital fees to compensate for the uninsured. CQ researcher revealed that hospitals run at about 114 percent of costs – so the excess can subsidize the uninsured. (10) The government provides basic health coverage called Medicaid to select citizens exceptionally below the poverty level.


The patient protection and affordable care act (PPACA) is a federal statute that was signed into law by president barrack Obama in 2010. The act is also colloquially known as the Obama care. This act was passed into law with the aim of overhauling the entire health care system of the United States of America. The act does not act in isolation. The act works in conjunction with the Health Care and Education Reconciliation Act.

The act was made into law with the main goal being increasing the quality and the ability of all the people to afford health care through cheaper insurance option  (Atlas, 2010). The act seeks to attain this by lowering the rate of the people that are uninsured through a conscious expansion of the public and private means of accessing insurance. By the increase in coverage of the insurance to most of the people in the United States, the act aimed at reducing the number of people that would be uninsured.

The act seeks to attain the goal of increased medical coverage by use of various mechanisms such as the mandates and insurance exchanges (Pipes, 2010). The law is also more accommodative to the people that would previously not qualify for the insurance cover award. The act also aims at reducing the costs while improving the quality of medical care through the enacting and the consequent enforcing of the regulation, increase in the level of competition and offering of various forms incentives in order to streamline the insurance sector  (Graham, 2010).Models and Their Role in Healthcare Essay Paper

Obamacare also had the hopes of reducing the budget deficits that the government was facing at the time while reducing the government expenditure on health. In as much as the law has been the target of various opinions from the states government and small business groups, the act has had significant impact on the healthcare sector in the United States. This paper will focus on the real issues that face the act and the stride that is has been able to bring to the nation’s healthcare system. The paper will evaluate the merits and demerits of the care act from the time of the enactment to date while offering the possible solution to the issues that face the act.

Prior to the enacting of the Obamacare, many pertinent issues faced the government. Various governmental players had previously tried to counter the problem by the introduction of new way of dealing with the issue of the healthcare that would encompass all the people and not the selected members of the public that could afford to pay for insurance or who were in the formal employment (Pipes, 2013).

The act was a means that the government would use to come up with the ultimate means to handling the issue of the healthcare  (Graham, 2010). Even in the old care system, many issues were still in the balance even for the people that had the average insurance cover (Pipes, 2010). The act may be seen as a cash mill for the biotech and pharmaceutical companies. However, the issue of the biotech companies and what they stand to gain from the enactment of the act is still not clear. The focus of the media on the potential gains that the companies will make tends to overshadow some of the real motivations behind the enactment that focus on the average person in the united states of America that needs to have medical cover.

The first issue that the act addresses is the lack of the surgery option for the people that were suffering from cancer and other terminal diseases (Pipes, 2013). The initial policies were cut out to disadvantage the poor such that they would not have the access to the surgical options when they were suffering from the terminal illnesses such as cancer  (Atlas, 2010). The only people that could be allowed to have the option of surgery were the rich and the ones that had adequate insurance cover  (Graham, 2010). However, in the real sense, other people deserved the surgical treatment even when they did not have the finances.

The thousands that could not afford the insurance packages that covered the cancer patients ended up dying or suffering from conditions that could have been alleviated or corrected using surgical means. The patients in an attempt to stay alive would end up seeking other modes of treatment that were not authorised in order to alleviate their suffering. One of the common approaches that the patients resorted to was smoking of marijuana (Pipes, 2013). The smoking of medical marijuana is not accepted in all the states in the United States. However, the act was not practiced in the states that allow it. On the contrary, the people that came from the other states that prohibit the use of marijuana even for the medical purposes still used the drug (Manchikanti & Hirsch, 2012).

This meant that the failure of one public policy was making the people resort to breaking the law in the name of reducing the effects of their illness. In worse scenarios, the people used to resort to other approaches to the issue that were uncalled for. The inadequacy of the healthcare system had proved to be the main impetus behind the unwitting willingness of the people to break the law  (Graham, 2010).

The other issue that Obamacare seeks to correct is the inability of the masses to afford healthcare. The poverty indicators in the United States point out that the United States has over 15 percent of its populace living in poverty. This can be translated to the fact that over 15 percent of the people earn between 11000-23000. The people that earn this kind of money are unable to afford the health policy cover that often costs an average of 800 dollars per month. However, with the introduction of Obamacare, there is hope for the people in this class since the policy aims at providing the people with the insurance cover in an indiscriminate manner.Models and Their Role in Healthcare Essay Paper

The poor people may also be suffering from the aggravated conditions due to lack of medical attention that is accorded to the rich  (Atlas, 2010). The Obamacare seeks to rewrite the health cover with the introduction of covers that can touch on the needs of all the people. This approach is also consistent with the public policy requirements that have to cover all the people regardless of the influence and the past of the person. The Obamacare does not discriminate the care to the people according to their ability or inability to pay the premiums (Moncrieff, 2012). The care seeks to include all the people such that their treatment is not a determined by their ability to afford the care.

The Obamacare package was also enacted to deal with the trend that was pervasive in the United States. Prior to the act, the treatment of the old people was dependent on the relatives that the patient has and the financial stability of the patient. However, not all the old people have any relatives that care about their health or progress in life (Manchikanti & Hirsch, 2012). This means that the old people are often victims of neglect from the people that are supposed to help them during their ailing years. The trend was neglecting whereby the patients would be tucked in an old people home and forgotten.

In most of the old people homes, the care accorded to the patient was dependent on the follow up of the other relatives of the patient. With the above predicament affecting the old patients, it was of extreme importance that the healthcare system covers all the people. The Obamacare seeks to correct the trend of neglecting the old people and providing them with the substandard care that they were accorded in the old people homes. With the advent of the healthcare system, the people were capable of attaining the desired healthcare such that they would not be treated as liabilities to the society (Moncrieff, 2012). On the contrary, the Obamacare seeks to include the old people in all the medical attention in the same manner as the young people (Pipes, 2010).

The other public consideration that is behind the Obamacare is the provision of contraception treatment to the women. The consideration was arrived at after the realization that not all the women have the required access to birth control that they would need in order for them to lead a healthy lifestyle that covers all the aspects of their health care (Oberl & Er, 2012). The Obamacare ensures that all the women have the same access to birth control.

The act accords the women the power to take charge of their life and protect themselves from being pregnant. The other package that comes alongside the contraceptive access is the increased access to the treatment procedures for the sexually transmitted infections  (Graham, 2010). The women can also access the preventive services such as pap smears and mammograms in order to check if they have cancer.

This way the Obamacare seeks to remove the disparities between the wealthy and the poor when it comes to the access of medical care (Moncrieff, 2012). This is what makes the Obamacare act an essential act in the society that will be instrumental in the according it or at least close treatment to all the people. The act also looks at the possibilities of providing the people with the requisite medical attention regardless of their ability to afford the medical care.

The failure of the Obamacare could lead to serious repercussions for the people whereby they will end up suffering from the severe medical conditions that the nation’s poor has been exposed to throughout the years under oppressive and often segregating medical care. The chances of the people are better with the Obamacare than with the traditional care. The care act provides the individual with the ability to access the medical care that they need with little hustle (Manchikanti & Hirsch, 2012).

The treatment that the people deserve can be easily accessed with the Obama care. The people have the power to take up preventive measures with the Obama care by undergoing affordable tests that will in the end turn the cost of medical care into minimal spending by the government. It will also increase the access that all the people have to the health care  (Atlas, 2010).

However, in as much as the Obamacare received the praise for the innovations that it proposes in the provision of medical care, there are some issues that face the act that ought to be rectified if the care is going to survive. This part of the paper will look at the timeline of the care act since the time that it was enacted to date  (Graham, 2010).

The professional in the medical care sector had advanced the argument that the care system that runs mainly based on the free market mechanisms in the market had severe impact on the quality (Moncrieff, 2012). Compared to the other countries that sought to guide the healthcare system in their nations, the healthcare system of the United States of America was wanting (Pipes, 2010). The government was supposed to be involved in the care provisions in order to increase the quality of care accorded to the people and reduce the mortality rates associated with the free medical care system (Yelowitz, 2009).

The nations that involve themselves with the provisions of medical care in the direct manner have fewer costs compared to the ones that have to rely on the free market system. The lack of proper health insurance cover has often led to the deaths of the people involved. However, with the introduction of the Obama care the people have more access to the medical care (Manchikanti & Hirsch, 2012). The treatment that the people receive is not purely dependent on the ability of the patients to pay for the care. On the flipside, the care that the people are accorded is standard and all the people can be covered.

The cost and efficiency outlook of the government spending has reduced in a significant manner. The United States was the largest spender of a major proportion of the GDP on the world compared to other major nations of the world. The predicament made the government spend most of its money on the healthcare system that could be availed in an effective manner by the attainment of the requisite public private collaboration. The onset of the economic downturn made it hard for the employers to provide their employees with the required access to medical care  (Graham, 2010). This means that the government had to bear more burdens or reducing the suffering of the people that did not have the required medical cover that would deal with the issue.

The Obama care could also be viewed as a policy that was precipitated by the current economic conditions in the area that were making it hard for the people to have the required access to medical care (Pipes, 2010). The loss of employer initiated medical cover means that the people that are unable to buy the needed medical care would be left out when it came to the access of the four types of medical services mentioned above  (Atlas, 2010).Models and Their Role in Healthcare Essay Paper

However, with the advent of the Obamacare, the affordability of the people has increased over the years to cover all the people. The inclusive nature of the Obamacare is the main force that determines the success of the healthcare provisions to all the people (Manchikanti & Hirsch, 2012). The employers could only offer the medical cover up to a certain limit and the people that were on the lower cadres could on rare occasions be covered by the medical insurance.

In addition to this, the medical care providers that the people could access were limited to the ones that the employer had selected for the people (Moncrieff, 2012). The lack of choice is maybe on other major issues that made the employer backed insurance covers to be less attractive to most of the people (Ross & Ross, 2013)7. The Harvard study that made the government to come up with the medical care placed the number of deaths of the people that arose from the lack or insufficiency of the medical cover to over 100000 deaths per year  (Graham, 2010). The enactment of the Obamacare may not have abolished the deaths but it has led to the reduction of the deaths by significant margins.

The people that had the private insurance were mainly underinsured. The event of a major health condition, the people that were underinsured would have to find other sources of funding that would reduce their potential of attaining the affordable medical care. Compared to that time, the current enactment of the Obamacare has led to significant reduction in the instances of the people that are gravely underinsured (Manchikanti & Hirsch, 2012). The underinsurance incidences were mainly manifested in the people that had low incomes (Feldstein, 2009).

However, with the introduction of the Obamacare, the people that have low incomes have access to medical care that is relatively decent compared to what they would have in the even that they had been covered under a private plan (Moncrieff, 2012). This means that the Obamacare act has helped in the alleviation of the medical care stress that affected most of the people. Therefore, it is correct to state that the Obamacare is a success as far as the medical care provision is concerned (Pipes, 2013).

As it is a common phenomenon, many controversies surround the Obamacare. One of the main issues that have faced the law was the fact that most of the people opined that the enactment of the law would eventually lead to the increase in the number of abortions that are procured in the United States (Feldstein, 2009). Some of the people feel that the Obamacare will lead to the creation of situations that would deny the deserving the right to medical care.

Some people feel that the Obamacare will make every federal taxpayer to contribute to a plan that will cover the elective abortions  (Graham, 2010). This is the case since the government and the state government agreed to federal state health exchanges. Therefore, the fact that the taxpayer is not from the states that advocate for the abortion or the state has actively voted against the direction of the taxpayer’s money towards the abortion agenda  (Atlas, 2010). This outlook has been the major issue that has made the Obamacare act unpopular among the people.

The other cause of controversy in the Obamacare is that it allows the federal legal bureaucrats to come up with the rationing standards that allow the health providers to deny access to medical care to some people that deserve the lifesaving treatments even if the people are willing and capable of affording the care (Moncrieff, 2012). This means that it is possible for a person to die even if he or she has the ability to pay for the medical care. This rationing means that the government will have too much control over the lives of the people even if the people have the access to the medical care (Ross & Ross, 2013). It also beats the logic why the government would deny its people the access to medical care even when the act proposes that it is meant to increase the access (Oberl & Er, 2012).

The other issue that causes a lot of controversy in the mode of operation witnessed in the government is the increased violation of the rights of the conscience of the patients. The people that have conscience issues will have to fund the abortion causes regardless of their innate objections to the plan (Manchikanti & Hirsch, 2012). The faith issues is not well taken into consideration since most of the people that will be making contributions to the Obamacare will have to do so regardless of their reservations on the use of their taxpayer dollars.Models and Their Role in Healthcare Essay Paper

This also means that the government will have the ability to dictate what the people will do with their money and they cannot have any objections to the proposed use of the money that the government will be proposing (Feldstein, 2009). Which this issue being a reality it is proper to reconsider the impacts of the healthcare act using a bigger scope apart from the affordability of the medical care. The people that are going to suffer because of the medical care act are also important for the making of the most effective decisions (Moncrieff, 2012). The law ought to be amended in order for it to have the right impact to the people. The areas of controversy mentioned above should be removed or some exceptions ought to be made in matters that touch on the conscience and the faith.

The other issue is the imposition of the Obamacare to all the people. The care does not allow the people to have a choice of the nature and quality of the medical care that they would need for themselves. It seems that the act was made as a rule to be followed by all the people regardless of their inhibitions (Feldstein, 2009). This is manifested in the outright imposition of the law on the state that have actively worked against the imposition of the abortion on them. In this case, the sovereignty of the people that have voted against the act has been largely reduced. The people do not have the requisite choice that makes a nation democratic. In this case, the care act is a mere imposition of the ideas to the public (Pipes, 2010).

The above aspect of the Obamacare can be largely viewed as the main sources of failure for the system (Ross & Ross, 2013). The imposition or rather the perspective among the people that the ideals that the plan holds are imposed on to the people is a major threat to the success of the plan. The public inclusion could have been the main way that the care could have attained the acceptance. However, with the increased rejection of the people against the Obamacare, there are major issues that may lead to the failure of the plan in the future (Feldstein, 2009).

However, the complaints made by the people could be the main sources of future competitiveness for the program (Pipes, 2013). The policy makers can revise the program such that it includes all the people. This way, the care will have the relevance that it deserves in order for it to survive  (Atlas, 2010). The strengths of the plan have been its ability to reduce the cost of medical care to all the people. The major weakness of the plan has been the failure to include all the people (Pipes, 2010).

Obamacare is a law that is under siege for the wrong reasons. Some of the people against the law cite unfounded reasons for taking their stand. However a deep look into the law manifests that there are some benefits for the people that were absent in the proceeding laws. The stipulations of the law have led to the provision of a level-playing platform for the people regardless of the gender. In the previous laws, the women were at a disadvantage and they had to pay more than their male counterparts did for insurance. Obamacare came to correct the unfair treatment of the women. This paper will a look at the benefits of the Obamacare law while dispelling the notions that those that are anti-law state.

Women have some reason to celebrate after the historic ruling made by the Supreme Court upholding the affordable care act. The basis of the celebration is the fact that the law is a leeway to the end of gender discrimination in the insurance market. Otherwise put, it is imperative that the women will not have to pay up to 150 per cent more compared to the man for the same benefits. In the previous practice known as gender rating, insurers had the right to charge the women high insurance premiums compared to the men. Gender rating was built on the premise that women have higher needs than men do. The rating makes women pay over one billion dollars per year for the same benefits as men. However, when the plan comes into full effect in 2014, the rationale of gender rating in insurance will be illegal. This provision translates to billions of savings over the years by the women.

Another benefit that the law brings the women is on the maternity benefits. In the conventional plans, the coverage is routinely excluded since there is high incidence of childbirth per a pool of the insured. The lack of the business sense in covering women during their childbirth is so widespread that only 12 per cent of the plans sold have the maternity provision. Even in the event that the plan has a provision for maternity, the plan is inadequate since there is long waiting periods. The deductibles applied can also be as high as the actual cost incurred in childbirth.Models and Their Role in Healthcare Essay Paper

However, after the affordable care act comes into full play, there will be a guarantee to the women that they will access cover for their maternity benefits in small plans and group plans. Another conventional approach that the common day insurers take in covering women is that of discriminating women based on a gender based preexisting condition. The conditions that they cite include the fact that an applicant may have been a victim of gender violence, had undergone Cesarean section or breast cancer. This will no longer happen in the Obamacare. In addition to the scrapping of the discriminatory practice, the Obamacare will also ensure that the people that have never been covered in any plan access affordable insurance.

The other big advantage that women get from the plan is that it guarantees the recommended preventive health services whereby there will be no cost sharing. The provision will reduce the instances where the women fail to seek insurance owing to the costs associated with the plans. The situation is worse since some of the women forego necessities so as they can pay for their health care. However, under the new plan, the insurers have the obligation of covering all the preventive care services such as the pap smears and mammograms.

These preventive cares will be covered without the case of cost sharing, as it was the norm in the previous arrangements. The act also provides a provision for the addition of more care plans to the preventive plans. Most of the preventive plans will benefit the women more than men. The preventive plans will cover contraception, breastfeeding counseling, screening, and counseling for the victims of domestic violence. The plan also provides that women should access private space while breastfeeding at their work places. Women can also benefit from home visiting programs. These programs target the high-risk new mothers.

There are other provisions in Obamacare that affect all the people but will also help in improving the access to medical care for the women. Most of the provisions are in place already but will be fully functional after the care comes into place fully in 2014. As the name implies, the plan makes the access to medical care more affordable to all the people. From 2014, families and small businesses will be receiving tax credits on a sliding income scale so as they can afford to purchase insurance plans. The act seeks to make the affordability of insurance cover a reality to all the people (Moncrieff, pg. 288).

The other provision that will benefit all the people is the fact that people will be able to access insurance cover even if they are below the poverty level set by the federal government. This cover will include the families of four earning less than 31,809 dollars or individuals earning less than 15000 dollars per year. The plan will enable the women that are below the poverty levels to acquire the plan even if they are unmarried or are not pregnant.

The other provision in the law that will benefit most of the people is the fact that the plan eliminated the lifetime caps. The plan is also in the process of phasing out the annual caps. The ban on the lifetime limits has been beneficial to millions of women (Oberl & Jonathan, pg. 2165). The copay and deductibles will also be subject to limits. With the introduction of the new limits, the plan will make insurance affordable to all the people and by extension access to medical care will improve.Models and Their Role in Healthcare Essay Paper

The other benefit of the plan is that it will include the children and the mothers alike. This is a source of peace of mind to the women since they will know that the cover also includes their children. The provision will reverse the current status quo whereby insurers deny over 17 million children with preexisting conditions access to cover. This plan allows the young adults to stay on the insurance plans of their parents until the age of 26. In short, the new plan will provide insurance cover to the women while lowering the health care costs that they incur. This will be the end of the abuse that women undergo in the current insurance industry.

This makes the debate on whether the plan will win or not a matter of political affiliation (Feldstein par 5). The people that are against the plan are doing so based on their party stands and they do not pose to evaluate the merits of the paper. An honest evaluation will bring out the benefits of the plan to the public that would be absent in the event that the status quo was upheld. This brings the debate to the question of whether the plan is meant to protect a person or the industry practice

In conclusion, the Obamacare plan is a good creation. The merits of the plan can come out clearly in the period that the plan has been working. The main beneficiaries of the plan are the women and children with preexisting conditions (Graham pg. 10). Old people are also beneficiaries. Poor women can access medical care under the new plan. Poor families and small companies can but insurance plans that are not as costly as they were in the previous plan. Passing of the act is a good and not a bad as people would like to make it look.

Medicare has had many legislative changes to modernize the program since it was first signed into law. Medicare has assisted many retirees from a financial disaster by providing benefits during a healthcare crisis. The prescription drug program has ensured seniors have access to the medications they require. Medicare has also provided care to the disabled that are under age 65. This national social healthcare program has also come under fire politically because of the extremely high cost of the program. The baby-boomer generation is aging and adding more beneficiaries’ at an increasing rate than ever before and is estimated to impact the federal deficit by over 17% by 2020. Many other countries have National Healthcare that provides better care at a much lower cost. Medicare was the motivation for a universal healthcare plan and a program for the U.S. could have a positive impact. (Starr, 2011). The Medicare program is being perceived that it will go bankrupt in about 10 years unless there is major reform. There are six recommendations that should be reformed for the protection of the program for future generations. The program must protect retirees from an economic healthcare disaster.

Today’s health care system is very different from how it used to be. There have been many changes that have taken place which represent the major shifts involved in moving from a plan which was based mainly on what the patient wanted, to a managed care system. The American health care system has evolved immensely over the past years and it continues to evolve to this day. As health care costs continue to rise, as treatments become even more costly, and as the population continues to age, it is essential to understand how health care is different from in the past and how changes in the future will impact families across the nation. By addressing past modifications, awareness is brought upon individuals and families regarding the progression of the current health care system. There are abundant key factors that contribute to the ever-changing health care system. Cultural beliefs and values play an important role as well as situational and economic factors. Ultimately, the changes which have led to a managed care system have been influenced by economic realities.

A health care system is a framework of interrelated, interacting, and interdependent descriptions of human development in a given country, region, or community. This system of human development functions as an organized measure to promote and provide treatment in which individuals reach their highest attainable level of physical, mental, and social well-being. All health care systems are grounded in the concept that genetic and biological factors must be taken into account to understand the problems and behaviors of a specific population. The interconnected factors that determine an individual’s health status includes personal features, social status, culture, environment, educational attainment, health behaviors, childhood development, access to care, and government policy. International collaboration of ideas on the progression of transnational health is greatly endorsed for the benefit of complete global health care. Health care has social, governmental, and financial implications that affect all members of the health care system and in countries within the Central American region specially, citizens have fallen victim to health disparities that have resulted from long-term neglect of the underlying factors that perpetuate this issue.Models and Their Role in Healthcare Essay Paper




Health care will always be a topic of discussion. Every health care system has its pros and its cons, due to the fact that healthcare in itself will never be perfect. Even in other countries around the world, although their healthcare system works are much better than America’s, it is still a work in progress. In the videos from Sick Around the World and Kaiser Family Foundation’s video on describing how our healthcare system was before the Affordable Care and how it was after the Affordable Healthcare act was passed, we get a glance of our own health care system here in the United States. We also get a glance at the healthcare system in five distinct countries: Great Britain, Japan, Germany, Taiwan, and Switzerland. The one thing I…show more content…
A negative charistic about Switzerland’s healthcare system is that the average monthly premium for a family is seven hundred-fifty dollars, which is the second most expensive healthcare in the world (Palfreman & Reid, 2008). One of our biggest problems with our healthcare system is cost, it’s way too expensive. For a family in the United States, the average cost of a premium is almost fourteen thousand dollars a year. The premiums have also doubled over the past nine years. Our population is also aging and living much longer, this means more people have health problems which raises healthcare prices even more. Another big problem in our healthcare system is that it’s filled with holes. People that buy health care on their own can be turned down if they have a preexisting condition. Small businesses can also be charged if their workers are sick, which makes insurance unaffordable. Some of the healthcare policies also have a lifetime limit on benefits, which means people least likely to have coverage are the ones who need it the most (Kaiser Family Foundation, 2013).

Models are abstractions of the real world .

What is a model and what does it do? Models are commonplace in our everyday lives. People are familiar with the idea of building model aeroplanes , or looking at a small-scale model of a building to imagine what it will look like when built. In health, models underlie all our clinical activities .

The Health Care Delivery System

For Americans to enjoy optimal health—as individuals and as a population—they must have the benefit of high-quality health care services that are effectively coordinated within a strong public health system. In considering the role of the health care sector in assuring the nation’s health, the committee took as its starting point one of the recommendations of the Institute of Medicine (IOM) report Crossing the Quality Chasm (2001b: 6): “All health care organizations, professional groups, and private and public purchasers should adopt as their explicit purpose to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States.”

This chapter addresses the issues of access, managing chronic disease, neglected health care services (i.e., clinical preventive services, oral, and mental health care and substance abuse services), and the capacity of the health care delivery system to better serve the population in terms of cultural competence, quality, the workforce, financing, information technology, and emergency preparedness. In addition, the chapter discusses the responsibility of the health care system to recognize and play its appropriate role within the intersectoral public health system, particularly as it collaborates with the governmental public health agencies.Models and Their Role in Healthcare Essay Paper

The health care sector in the United States consists of an array of clinicians, hospitals and other health care facilities, insurance plans, and purchasers of health care services, all operating in various configurations of groups, networks, and independent practices. Some are based in the public sector; others operate in the private sector as either for-profit or not-for-

profit entities. The health care sector also includes regulators, some voluntary and others governmental. Although these various individuals and organizations are generally referred to collectively as “the health care delivery system,” the phrase suggests an order, integration, and accountability that do not exist. Communication, collaboration, or systems planning among these various entities is limited and is almost incidental to their operations. For convenience, however, the committee uses the common terminology of health care delivery system.

As described in Crossing the Quality Chasm (IOM, 2001b) and other literature, this health care system is faced with serious quality and cost challenges. To support the system, the United States spends more per capita on health care than any other country ($4,637 in 2000) (Reinhardt et al., 2002). In the aggregate, these per capita expenditures account for 13.2 percent of the U.S. gross domestic product, about $1.3 trillion (Levit et al., 2002). As the committee observed in Chapter 1, American medicine and the basic and clinical research that inform its practice are generally acknowledged as the best in the world. Yet the nation’s substantial health-related spending has not produced superlative health outcomes for its people. Fundamental flaws in the systems that finance, organize, and deliver health care work to undermine the organizational structure necessary to ensure the effective translation of scientific discoveries into routine patient care, and many parts of the health care delivery system are economically vulnerable. Insurance plans and providers scramble to adapt and survive in a rapidly evolving and highly competitive market; and the variations among health insurance plans—whether public or private—in eligibility, benefits, cost sharing, plan restrictions, reimbursement policies, and other attributes create confusion, inequity, and excessive administrative burdens for both providers of care and consumers.

Because of its history, structure, and particularly the highly competitive market in health services that has evolved since the collapse of health care reform efforts in the early 1990s, the health care delivery system often does not interact effectively with other components of the public health system described in this report, in particular, the governmental public health agencies. Health care’s structure and incentives are technology and procedure driven and do not support time for the inquiry and reflection, communication, and external relationship building typically needed for effective disease prevention and health promotion. State health departments often have legal authority to regulate the entry of providers and purchasers of health care into the market and to set insurance reimbursement rates for public and, less often, private providers and purchasers. They may control the ability of providers to acquire desired technology and perform complex, costly procedures that are important to the hospital but increase demands on state revenues. Finally, virtually all states have the legal responsibility to  Models and Their Role in Healthcare Essay Paper

monitor the quality of health services provided in the public and private sectors. Many health care providers argue that such regulation adds to their costs, and high-profile problems can create additional tensions that impede collaboration between the state public health agency and the health care delivery system.

Furthermore, when the delivery of health care through the private sector falters, the responsibility for providing some level of basic health care services to the poor and other special populations falls to governmental public health agencies as one of their essential public health services, as discussed in Chapter 1. In many jurisdictions, this default is already occurring, consuming resources and impairing the ability of governmental public health agencies to perform other essential tasks.

Although this committee was not constituted to investigate or make recommendations regarding the serious economic and structural problems confronting the health care system in the United States, it concluded that it must examine certain issues having serious implications for the public health system’s effectiveness in promoting the nation’s health. Drawing heavily on the work of other IOM committees, this chapter examines the influence that health insurance exerts on access to health care and on the range of care available, as well as the shortcomings in the quality of services provided, some of the constraints on the capacity of the health care system to provide high-quality care, and the need for better collaboration within the public health system, especially among governmental public health agencies and the organizations in the personal health care delivery system.


Health care is not the only, or even the strongest, determinant of health, but it is very important. For most Americans, having health insurance— under a private plan or through a publicly financed program—is a threshold requirement for routine access to health care. “Health insurance coverage is associated with better health outcomes for adults. It is also associated with having a regular source of care and with greater and more appropriate use of health services. These factors, in turn, improve the likelihood of disease screening and early detection, the management of chronic illness, and the effective treatment of acute conditions,” IOM notes in a recent report (IOM, 2002a: 6).

Private insurance is predominantly purchased through employment-based groups and to a lesser extent through individual policies (Mills, 2002). Publicly funded insurance is provided primarily through seven government programs (see Table 5–1). Medicare provides coverage to 13.5 percent of the population, whereas Medicaid covers 11.2 percent of the population (Mills, 2002). Additionally, public funding supports directly

delivered health care (through community health centers and other health centers qualified for Medicaid reimbursement) accessed by 11 percent of the nation’s uninsured, who constitute 41 percent of patients at such health centers (Markus et al., 2002). Because the largest public programs are directed to the aged, disabled, and low-income populations, they cover a disproportionate share of the chronically ill and disabled. However, they are also enormously important for children. In early 2001, Medicaid and the State Children’s Health Insurance Program (SCHIP) provided health care coverage to 23.1 percent of the children in the United States, and this figure had risen to 27.7 percent according to data from the first-quarter estimates in the National Health Interview Survey (NCHS, 2002).

Being uninsured, although not the only barrier to obtaining health care, is by all indications the most significant one. The fact that more than 41 million people—more than 80 percent of whom are members of working families—are uninsured is the strongest possible indictment of the nation’s health care delivery system. Those without health insurance or without insurance for particular types of services face serious, sometimes insurmountable barriers to necessary and appropriate care.

Adults without health insurance are far more likely to go without health care that they believe they need than are adults with health insurance of any kind (Lurie et al., 1984, 1986; Berk and Schur, 1998; Burstin et al., 1998; Baker et al., 2000; Kasper et al., 2000; Schoen and DesRoches, 2000). Children without health insurance may be compromised in ways that will diminish their health and productivity throughout their lives.

When individuals cannot access mainstream health care services, they often seek care from the so-called safety-net providers. These providers include institutions and professionals that by mandate or mission deliver a large amount of care to uninsured and other vulnerable populations. People turn to safety-net providers for a variety of reasons: some because they lack health insurance and others because there are no other providers in the area where they live or because language and cultural differences make them uncomfortable with mainstream care. Safety-net providers are also more likely to offer outreach and enabling services (e.g., transportation and child care) to help overcome barriers that may not be directly related to the health care system itself.

In this section, the committee reviews concerns about the barriers to health care that are raised by the lack of health insurance and by threats to the nation’s safety-net providers.

The Uninsured and the Underinsured

The persistently large proportion of the American population that is uninsured—about one in five working-age adults and one in seven children— is the most visible and troubling sign of the nation’s failure to assure access to health care. Yet the public and many elected officials seem almost willfully ignorant of the magnitude, persistence, and implications of this problem. Surveys conducted over the past two decades show a consistent underestimation of the number of uninsured and of trends in insurance coverage over time (Blendon et al., 2001). The facts about uninsurance in America are sobering (see Box 5–1). By almost any metric, uninsured adults suffer worse health status and live shorter lives than insured adults (IOM, 2002a).

Because insurance status affects access to secure and continuous care, it also affects health, leading to an estimated 18,000 premature deaths annually (IOM, 2002a). Having a regular source of care improves chances of receiving personal preventive care and screening services and improves the management of chronic disease. When risk factors, such as high blood pressure, can be identified and treated, the chances of developing conditions such as heart disease can be reduced. Similarly, if diseases can be detected and treated when they are still in their early stages, subsequent rates of morbidity and mortality can often be reduced. Without insurance, the chances of early detection and treatment of risk factors or disease are low.

However, even when the uninsured receive care, they fare less well than the insured. The IOM Committee on the Consequences of Uninsurance found that “[u]ninsured adults receive health services that are less adequate and appropriate than those received by patients who have either public or private health insurance, and they have poorer clinical outcomes and poorer overall health than do adults with private health insurance” (IOM, 2002a: 87). For example, Hadley and colleagues (1991) found that uninsured adult hospital inpatients had a significantly higher risk of dying in the hospital than their privately insured counterparts. Emergency and trauma care were also found to vary for insured and uninsured patients. Uninsured persons with traumatic injuries were less likely to be admitted to the hospital,
received fewer services when admitted, and were more likely to die than insured trauma victims (Hadley et al., 1991).

For children, too, being uninsured tends to reduce access to health care and is associated with poorer health. The 1998 IOM report America’s Children: Health Insurance and Access to Care found that uninsured children “are more likely to be sick as newborns, less likely to be immunized as preschoolers, less likely to receive medical treatment when they are injured, and less likely to receive treatment for illness such as acute or recurrent ear infections, asthma and tooth decay” (IOM, 1998:3). That report emphasized that untreated health problems can affect children’s physical and emotional growth, development, and overall health and well-being. Untreated ear infections, for example, can have permanent consequences of hearing loss or deafness.

Even when insured, limitations on coverage may still impede people’s access to care. Many people who are counted as insured have very limited benefits and are exposed to high out-of-pocket expenses or service restrictions. Three areas in which benefits are frequently circumscribed under both public and private insurance plans are preventive services, behavioral health care (treatment of mental illness and addictive disorders), and oral health care. When offered, coverage for these services often carries limits that are unrelated to treatment needs and are stricter than those for other types of care (King, 2000). Cost-sharing requirements for these services may also be higher than those for other commonly covered services. (Additional discussion of these and other “neglected” forms of care appears later in this chapter.)

Access to care for the insured can also be affected by requirements for cost sharing and copayments. Cost sharing is an effective means to reduce the use of health care for trivial or self-limited conditions. Numerous studies, starting with the RAND Health Insurance Experiment, show that copayments also reduce the use of preventive and primary care services by the poor, although not by higher-income groups (Solanki et al., 2000). The same effects have been shown for the use of behavioral health care services (Wells et al., 2000).

As a result of the nation’s increased awareness of bioterrorist threats, there are concerns about the implications of copayments and other financial barriers to health care. Cost sharing may discourage early care seeking, impeding infectious disease surveillance, delaying timely diagnosis and treatment, and posing a threat to the health of the public. The committee encourages health care policy makers in the public and private sectors to reexamine these issues in light of the concerns about bioterrorism.

This committee was not constituted to make specific recommendations about health insurance. The issues are complex, and the failures of health

care reform efforts over the past 30 years testify to the difficulty of crafting a solution. However, the committee finds that both the scale of the problem and the strong evidence of adverse health effects from being uninsured or underinsured make a compelling case that the health of the American people as a whole is compromised by the absence of insurance coverage for so many. Assuring the health of the population in the twenty-first century requires finding a means to guarantee insurance coverage for every person living in this country.

Adequate population health cannot be achieved without making comprehensive and affordable health care available to every person residing in the United States. It is the responsibility of the federal government to lead a national effort to examine the options available to achieve stable health care coverage of individuals and families and to assure the implementation of plans to achieve that result.

Safety-Net Providers

Absent the availability of health insurance, the role of the safety-net provider is critically important. Increasing their numbers and assuring their viability can, to some degree, improve the availability of care. The IOM Committee on the Changing Market, Managed Care and the Future Viability of Safety Net Providers defined safety-net providers as “[t]hose providers that organize and deliver a significant level of health care and other health-related services to uninsured, Medicaid, and other vulnerable patients” (IOM, 2000a: 21). That committee further identified core safety-net providers as having two distinguishing characteristics: “(1) by legal mandate or explicitly adopted mission they maintain an ‘open door,’ offering access to services to patients regardless of their ability to pay; and (2) a substantial share of their patient mix is uninsured, Medicaid, and other vulnerable patients” (IOM, 2000a: 3).Models and Their Role in Healthcare Essay Paper

The organization and delivery of safety-net services vary widely from state to state and community to community (Baxter and Mechanic, 1997). The safety net consists of public hospital systems; academic health centers; community health centers or clinics funded by federal, state, and local governmental public health agencies (see Chapter 3); and local health departments themselves (although systematic data on the extent of health department services are lacking) (IOM, 2000a). A recent study of changes in the capacities and roles of local health departments as safety-net providers found, however, that more than a quarter of the health departments surveyed were the sole safety-net providers in their jurisdictions and that this was more likely to be the case in smaller jurisdictions (Keane et al., 2001).

tal agencies, contribute to the public health system in multiple ways. Services provided by state and local governments often include mental health hospitals and outpatient clinics, substance abuse treatment programs, maternal and child health services, and clinics for the homeless. In addition, an estimated 1,300 public hospitals nationwide (Legnini et al., 1999) provide free care to those without insurance or resources to pay. A survey of 69 hospitals belonging to the National Association of Public Hospitals indicated that in 1997, public hospitals provided more than 23 percent of the nation’s uncompensated hospital care (measured as the sum of bad debt and charity care) (IOM, 2000a). These demands can overwhelm the traditional population-oriented mission of the governmental public health agencies. Furthermore, changes in the funding streams or reimbursement policies for any of these programs or increases in demand for free or subsidized care that inevitably occur in periods of economic downturn create crises for safety-net providers, including those operated by state and local governments (see the section Collaboration with Governmental Public Health Agencies later in this chapter for additional discussion).

The IOM committee that produced the report America’s Health Care Safety Net: Intact but Endangered (IOM, 2000a: 205–206) had the following findings:

Despite today’s robust economy, safety net providers—especially core safety net providers—are being buffeted by the cumulative and concurrent effects of major health policy and market changes. The convergence and potentially adverse consequences of these new and powerful dynamics lead the committee to be highly concerned about the future viability of the safety net. Although safety net providers have proven to be both resilient and resourceful, the committee believes that many providers may be unable to survive the current environment. Taken alone, the growth in Medicaid managed care enrollment; the retrenchment or elimination of key direct and indirect subsidies that providers have relied upon to help finance uncompensated care; and the continued growth in the number of uninsured people would make it difficult for many safety net providers to survive. Taken together, these trends are beginning to place unparalleled strain on the health care safety net in many parts of the country. . . . The committee believes that the effects of these combined forces and dynamics demand the immediate attention of public policy officials. (IOM, 2000a: 206)Models and Their Role in Healthcare Essay Paper

The committee fully endorses the recommendations from America’s Health Care Safety Net: Intact but Endangered (IOM, 2000a), aimed at ensuring the continued viability of the health care safety net

BOX 5–2 Recommendations Concerning Safety-Net Services

Federal and state policy makers should explicitly take into account and address the full impact (both intended and unintended) of changes in Medicaid policies on the viability of safety-net providers and the populations they serve.

All federal programs and policies targeted to support the safety net and the populations it serves should be reviewed for their effectiveness in meeting the needs of the uninsured.

Concerted efforts should be directed to improving this nation’s capacity and ability to monitor the changing structure, capacity, and financial stability of the safety net to meet the health care needs of the uninsured and other vulnerable populations.

Given the growing number of uninsured people, the adverse effects of Medicaid managed care on safety-net provider revenues, and the absence of concerted public policies directed at increasing the rate of insurance coverage, the committee believes that a new targeted federal initiative should be established to help support core safety-net providers that care for a disproportionate number of uninsured and other vulnerable people.

SOURCE: IOM (2000a).


The committee is concerned that the specific types of care that are important for population health—clinical preventive services, mental health care, treatment for substance abuse, and oral health care—are less available because of the current organization and financing of health care services. Many forms of publicly or privately purchased health insurance provide limited coverage, and sometimes no coverage, for these services.

Clinical Preventive Services

The evidence that insurance makes a difference in health outcomes is well documented for preventive, screening, and chronic disease care (IOM, 2002b). Clinical preventive services are the “medical procedures, tests or counseling that health professionals deliver in a clinical setting to prevent disease and promote health, as opposed to interventions that respond to patient symptoms or complaints” (Partnership for Prevention, 1999:3). Such services include immunizations and screening tests, as well as counseling aimed at changing the personal health behaviors of patients long before

clinical disease develops. The importance of counseling and behavioral interventions is evident, given the influence on health of factors such as tobacco, alcohol, and illicit drug use; unsafe sexual behavior; and lack of exercise and poor diets. These risk behaviors are estimated to account for more than half of all premature deaths; smoking alone contributes to one out of five deaths (McGinnis and Foege, 1993).

Coverage of clinical preventive services has increased steadily over the past decade. In 1988, about three-quarters of adults with employment-based health insurance had a benefit package that included adult physical examinations. Two years later, the proportion had risen to 90 percent (Rice et al., 1998; Kaiser Family Foundation and Health Research and Educational Trust, 2000). The type of health plan is the most important predictor of coverage (RWJF, 2001). The use of financial incentives and data-driven performance measurement strategies to improve physicians’ delivery of services such as immunizations (IOM, 2002c) may account for the fact that managed care plans tend to offer the most comprehensive coverage of clinical preventive services and traditional indemnity plans tend to offer the least comprehensive coverage.

Although the trend toward inclusion of clinical preventive services is positive, such benefits are still limited in scope and are not well correlated with evidence regarding the effectiveness of individual services. The U.S. Preventive Services Task Force (USPSTF), a panel of experts convened by the U.S. Public Health Service, has endorsed a core set of clinical preventive services for asymptomatic individuals with no known risk factors. In the committee’s view, this guidance to clinicians on the services that should be offered to specific patients should also inform the design of insurance plans for coverage of age-appropriate services. However, the USPSTF recommendations have had relatively little influence on the design of insurance benefits, and recommended counseling and screening services are often not covered and, consequently, not used (Partnership for Prevention, 2001) (see Box 5–3). As might be expected, though, adults without health insurance are the least likely to receive recommended preventive and screening services or to receive them at the recommended frequencies (Ayanian et al., 2000).

Having any health insurance, even without coverage for any preventive services, increases the probability that an individual will receive appropriate preventive care (Hayward et al., 1988; Woolhandler and Himmelstein, 1988; Hsia et al., 2000). Studies of the use of preventive services by Hispanics and African Americans find that health insurance is strongly associated with the increased receipt of preventive services (Solis et al., 1990; Mandelblatt et al., 1999; Zambrana et al., 1999; Wagner and Guendelman, 2000; Breen et al., 2001; O’Malley et al., 2001). However, the higher rates of uninsurance among racial and ethnic minorities contribute significantly  Models and Their Role in Healthcare Essay Paper

to their reduced overall likelihood of receiving clinical preventive services and to their poorer clinical outcomes (Haas and Adler, 2001). For example, African Americans and members of other minority groups who are diagnosed with cancer are more likely to be diagnosed at advanced stages of disease than are whites (Farley and Flannery, 1989; Mandelblatt et al., 1991, 1996; Wells and Horm, 1992).

Medicare Coverage of Preventive Services

Preventive services are important for older adults, for whom they can reduce premature morbidity and mortality, help preserve function, and enhance quality of life. Unfortunately, the Medicare program was not designed with a focus on prevention, and the process for adding preventive services to the Medicare benefit package is complex and difficult. Unlike forms of treatment that are incorporated into the payment system on a relatively routine basis as they come into general use, preventive services are subject to a greater degree of scrutiny and a demand for a higher level of effectiveness, and there is no routine process for making such assessments. Box 5–4 lists the preventive services currently covered by Medicare.

The level of use of preventive services among older adults has been relatively low (CDC, 1998). This may reflect the limited range of benefits covered by Medicare, as well as other barriers such as copayments, participants’ unfamiliarity with the services, or the failure of physicians to recommend them. Cardiovascular disease and diabetes exemplify the problem. Although cardiovascular disease is the leading cause of death and diabetes is one of the most significant chronic diseases affecting Medicare beneficiaries, physicians cannot screen for lipids disorders or diabetes unless the patient agrees to pay out-of-pocket for the tests.

Medicaid benefits vary by state in terms of both the individuals who are eligible for coverage and the actual services for which coverage is provided. The exception is preventive services for children. In 1976, the U.S. Congress added the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program to the federal Medicaid program. This entitled poor children to a comprehensive package of preventive health care and medically necessary diagnostic and treatment services. In 1996, 22.9 million children (20 percent of the nation’s children) were eligible for EPSDT benefits. Given its potential to reach such a high proportion of the nation’s neediest children, the program could have a very positive, widespread impact on children’s health. Unfortunately, data on the program’s progress are incomplete and inconsistent across the country, despite federal requirements for state reports (GAO, 2001a). However, some studies have demonstrated that EPSDT has never been fully implemented, and the percentage of children receiving preventive care through it remains low for reasons ranging from systemic state or local deficiencies (e.g., a lack of mechanisms for follow-up, issues related to managed care contracting, and confusing program requirements) to barriers at the personal level (e.g., transportation and language) (GAO, 2001a; Strasz et al., 2002). Of the 22.9 million children eligible for EPSDT in 1996, only 37 percent received a medical screening procedure through the program (Olson, 1998) (see Box 5–5). Additionally, data show that as many as 50 percent of children who have an EPSDT visit are identified as requiring medical attention, but if they are referred for follow-up care, only one-third to two-thirds go for their referral visit (Rosenbach and Gavin, 1998).Models and Their Role in Healthcare Essay Paper

Mental Health Care

The Surgeon General’s report on mental illness (DHHS, 1999) estimates that more than one in five adults are affected by mental disorders in any given year (see Box 5–6) and 5.4 percent of all adults have a serious mental illness. Data for children are less reliable, but the overall prevalence of mental disorders is also estimated to be about 20 percent (DHHS, 1999). Mental disorders are a major public health issue because they affect such a large proportion of the population, have implications for other health problems, and impose high costs, both financial and emotional, on affected individuals and their families. The cost to society is also high, with indirect costs from lost productivity for affected individuals and their caretakers estimated at $79 billion in 1990, the last year for which estimates are available (Rice and Miller, 1996).

For the most prevalent mental health disorders such as depression and anxiety, receipt of appropriate care is associated with improved functional outcomes at 2 years (Sturm et al., 1995), but the majority of individuals suffering from mental illness are not treated for their condition (DHHS, 1999). Access to care is constrained by limitations on insurance coverage that are greater than those imposed for other diseases. Annual and lifetime coverage limits are frequently less, and mental health coverage often has more hidden costs in the forms of copayments and higher deductibles (Zuvekas et al., 1998). Table 5–2 shows the distribution of sources of payment for treatment for mental health and addictive disorders in 1996. Additionally, those with no insurance all year paid nearly 60 percent of costs out-of-pocket, whereas those with some private insurance paid 40 percent of costs out-of-pocket in 1996 (Zuvekas, 2001).

Adults’ use of mental health services in both the general and the specialty mental health sectors correlates highly with health insurance coverage (Cooper-Patrick et al., 1999; Wang et al., 2000; Young et al., 2001), and health insurance coverage specifically for mental health services is associated with an increased likelihood of receiving such care (Wang et al.,

Models actually serve two quite distinct purposes, and both of these are of interest . artificial heart is based upon two kinds of model. Firstly, the cardiovascular system has to be modelled, and secondly, a mechanical blueprint is used to model the way the heart will be constructed.

When artefacts are created, it is assumed that they too will be used for a particular purpose. If the purpose changes, then a design becomes less effective. Thus, the physical design of the waiting room and treatment areas for a general practice clinic will assume a certain number of patients need to be seen during a day, and that certain kinds of therapy will be given. If the clinic was bought by radiologists, they would have to remodel the clinic’s design to incorporate imaging equipment, and to reflect a different throughput of patients . we can consider a particular treatment of a disease written in a textbook to be a template for what should be done to any given patient. If that treatment was based upon assumptions about the incidence of diseases in a given population, then it may not work well if attempted in a different one. Treating infant diarrhoea in a developed nation is not the same task in underdeveloped nations where poorer resources, malnutrition, and different infecting organisms change the context of treatment. Before a model is used, one therefore has to be clear about what has actually been modelled. This is because, when models are created, the circumstances at the time have a strong influence on the final value of the model. Similarly, a set of rules and procedures might be developed in one hospital, and be spectacularly successful at improving the way it handles its cases. One would have to be very cautious, given that these procedures implicitly model many aspects of that particular institution, before one imposed those procedures on other hospitals. Very small differences, for example in the level of resources, type of patients seen, or experience of the staff, may make what was successful in one context, unhelpful in another.Models and Their Role in Healthcare Essay Paper

More generally, any designed artefact, whether it is a car, a drug or a computer system, has to be designed with the world within which it will operate in mind. In other words, it has to contain in its design a model of the environment within which it will be used. These specifications constitute its design assumptions. Thus there is a connection between the process of model creation, the construction of artefacts based upon such models, and their eventual effectiveness in satisfying some purpose .

Models are the basis of the way we learn about, and interact with, the physical world.

Models can act either as copies of the world like maps, or as templates that serve as the blueprints for constructing physical objects, or processes.

Models that copy the world are abstractions of the real world:

Models are always less detailed than the real world they are drawn from.

Models ignore aspects of the world that are not considered essential. Thus abstraction imposes a point of view upon the observed world

Many models can be created of any given physical object, depending upon the level of detail and point of view selected.

The similarity between models and the physical objects they represent degrades over time.

There is no such thing as a truly general-purpose model. There is no such thing as the most ‘correct’ model. Models are simply better or worse suited to accomplishing a particular task.

4. Models can be used as templates and be instantiated to create objects or processes that are used in the world.

Templates are less detailed than the artefacts that are created from them.

An artefact is a distortion of the original template.

No two physical artefacts are similar even if they are instances of the same template.

The effect of an artefact may change while the original template stays the same.

The process of creating an instance has a variable outcome, and the impact of the instance of an artefact in the real world also varies. As a consequence, there is no such thing as a general purpose template. All we can have are templates or designs that are better or worse suited to our particular circumstances and task.

5. The assumptions used in a model’s creation, whether implicit or explicit, define the limits of a model’s usefulness.

When models are created, they assume that they are to accomplish a particular purpose.

When models are created they assume a context of use. When objects or processes are built from a model, this context forms a set of design assumptions.

6. We should never forget that the map is not the territory and the blueprint is not the building

A 50-year-old woman with a past history diabetes and alcohol and IV drug abuse, presents with symptoms of abdominal pain and vomiting and is diagnosed as having “acute chronic pancreatitis.” Her amylase and lipase levels are normal. She is admitted and treated with IV fluids and analgesics. On hospital day 2 she begins having spiking fevers and antibiotics are administered. The next day, blood cultures are growing gram negative organisms.

At this point, the service is clueless about the patient’s correct diagnosis. It only becomes evident the following day when (a) review of laboratory data over the past year shows that patient had four prior blood cultures, each positive with different gram negative organisms; (b) a nurse reports patient was “behaving suspiciously,” rummaging through the supply room where syringes were kept; and (c) a medical student looks up posthospital outpatient records from 4 months earlier and finds several notes stating that “the patient has probable Munchausen syndrome rather than pancreatitis.” Upon discovering these findings, the patient’s IVs are discontinued and sensitive, appropriate followup primary and psychiatric care are arranged.

A postscript to this admission: 3 months later, the patient was again readmitted to the same hospital for “pancreatitis” and an unusual “massive leg abscess.” The physicians caring for her were unaware of her past diagnoses and never suspected or discovered the likely etiology of her abscess (self-induced from unsterile injection Models and Their Role in Healthcare Essay Paper

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