Medicare spending began taking up more and more of the federal budget, threatening the continuation of the entire program and the ability of the government to help provide access to help for the elderly and disabled.2 These higher healthcare costs do not
To keep costs down, President Richard Nixon signs into law the Health Maintenance Organization Act to support health maintenance organizations (HMO). HMO is responsible for the financing and delivery of comprehensive health services for a prepaid, fixed fee for those who are enrolled (Shultz & Young, 2014). During this time, we also see the establishment of health insurance for federal workers and health insurance for the dependents of the Armed
Major Healthcare reforms have been established in the past half a century despite the above-list challenging factors. The reform focused on coverage on millions of American citizens through Children Health Insurance Programs, Medicare and Medicaid. Between 1934 and 1939, there was the National Health Insurance New Deal. This period was characterized with growing income inequality with unemployment standing at 25% of the total population (Starr, 2013). There prevailed increased levels of unpaid medical bills with the poor being assisted by welfare agencies to sort out their medical bills.
Now that vaccines, procedures and medicine are available for all these diseases that once took the lives of the young and old population, the American people are living longer with a new challenge. Elderly are now living with multi-morbidities and are experiencing debilitating physical decline that often requires an immense amount of care and is more than the American healthcare system projected. The real problem that is at stake is that fewer caregivers are available to provide the care necessary
Health care cost has seen to increase gradually as years go by. This has been influenced by major factors such as political influence, emerging chronic diseases, new procedures that are coming up including the technologies being invented for treating illnesses, pricing of medicines and treatment is not regulated and when treating ailment their may arise repetition of tests or a patient gets over treated for a particular ailment. The cost of healthcare has increased due to chronic diseases such as cancer and diabetes etc. The lifestyle people are living in this generation has led to the development of diseases that are expensive to treat or has led to there being over treatment in such for a cure of a particular ailment.
Medicare was initially formed as a health insurance program to provide aid in medical expenses for the elderly. President Lyndon B. Johnson influenced the path of these Medicare and Medicaid programs during his term as president in 1965. During the time that Ronald Reagan was president, new Medicare cost control approaches for health care providers emerged, which aided determining reasonable charges for the services provided and payment options. Medicare and Medicaid were the establishment of a mainstream model of federal medical assistance to people who are unable to secure it for themselves. Over time, many different policies have been endorsed to provide access to health care for specific groups who may be unable to pay for their own medical
Patient Readmission Patient/hospital readmission has always been a major issue facing the healthcare system but recently in my unit, many patients are being readmitted as early the same day. In 2012, Social Security Act establish the Hospital Readmissions Reduction Program, which requires CMS to reduce payments to IPPS hospitals with excess readmissions, effective for discharges. (Center for Medicare and Medicaid) Readmission is defined as admission to a hospital within 30 days of discharge. I will use John Hopkins Nursing Evidence Based Practice Model to help decrease the rate of readmission.
Since 1948-2010, the NHS experienced significant changes to its core structure, which brought decentralisation and the way funding and purchasing decision are made, which led the introduction of service commissioning (NHS 2010). This is due to the current financial burden on the NHS related to the government financial constraint and spending cuts (Appleby 2012). Thus, contribute for the NHS under considerable funding and budgetary constraint for the next five years to achieve productivity saving of £22 billion by 2020/21 (Parliament UK 2015). The NHS biggest spending is allocated to the ever increasing elderly population especially those with long term conditions and purchasing of clinical equipment etc (NHS Confederation 2014). The National
According to David Blumenthal M.D. and M.P.P. and Sara R. Collins Ph.D. “As proponents and many experts predicted, however, a late surge pushed the number of enrollees through individual marketplaces to 8 million, which exceeded the much cited predictions by the Congressional Budget Office (CBO).” Eight million people can now see a doctor or get medical treatment. These people consist of various reason of why they got the Affordable Care Act such as enrolling into different parts, first time getting insurance, or switching insurance. An example of this would be someone of the age sixty-five or older could enroll into Medicare.
Healthcare has changed dramatically over the past few years. With the development of the Patient Protection and Affordable Care Act (PPACA), 2010 and the expansion of Medicaid in 2012, many Americans are to afford health insurance. Since it is a requirement that everyone has health insurance, the issue lies with which plan should one choose or how much they are willing to pay for it. There were many reasons as to why Health Maintenance Organizations (HMOs) were formed in the first place. First, physicians wanted to maintain and increase patient revenues.
Though the average life expectancies have continued to increase since the creation of the baby boom generation, those who live longer lives will most likely be burdened with the constantly increasing cost of healthcare in the United States. More money required to be paid to healthcare for the betterment of older life means less money that can be dedicated to lifestyle choices like foods, living arrangements, etc.. With the baby boomers reaching retirement age, the social security fund will most likely decrease and may be expected to go bankrupt by the sheer amount of people to retire in upcoming
That means the insurance company 's denials were either partially or completely overturned. In the case of mental health treatment, the percentage went up to 70 percent. The IRO reviews found that healthcare insurers had large gaps in their coverage and their guidelines for determining which treatments were acceptable or not. This helped the state enhance its requirements for basic healthcare coverage for
During the extended hospital stay, the cost of treatment also increases, sometimes by about 61 percent of the normal charges for treatment (Guse et al., 2015). Evidence based practice has shown evidence that hourly rounding can decrease the general hospital stay significant while at the same time cutting down the cost of treatment through reduction of falls. Nurses against this change complain of increased commitment on other duties, making it difficult for them to attend to their patients within the hour (Marquis & Huston, 2015). It should, however, be understood that hourly rounding may never be successful without teamwork. The absence of one nurse during the hourly rounding should be substituted by another nurse without regular complaints about personal patients.
Healthcare Administrator Positive Outlook on Overcoming Debt Millions of Americans are uninsured from the very young to the elderly leaving them more vulnerable to sickness and disease that may have been prevented if they had regular health screenings covered by insurance. Uninsured Americans are not going into clinics or hospitals until it is to late and their symptoms have become acute, because of their fear of having to pay medical bills that they are unable to afford. These individuals do not have the means to go and seek preventative care as insured individuals would be seen for leaving them more vulnerable to emergency room visits to address their health concerns. Under the Emergency Medical Treatment and Labor Act (EMTALA) patients who come into a healthcare facility have the right to receive medical attention for acute symptoms without being turned away due to their inability to pay for treatment. This epidemic of healthcare facilities treating uninsured patients has financially burdened hospitals and left them with increasing financial debt.
Health care has gone through a great evolution through the years. Before 1965, individuals older than 65 years old received inadequate healthcare and more than half of this population did not have coverage (Reinhard, 2012). Due to this predicament, the need to identify issues and implement health policy was imperative to improve health care. Consequently, Medicare was introduced with the goal to mitigate the health issues during the 1960’s and to improve the healthcare availability for individuals 65 years and older. Since then, Medicare has gone through numerous changes in order to incorporate other population needs.