Health policy issue

• Select a “news report” on a health policy issue.
• You may use traditional print media sources such as quality newspapers and news journals (for example: Newsweek, Time, Business Week).
• You may also use web sources including print and video.
• You will need to post a copy of your article or provide a link to the source for your instructor and peers.
• The article can be about any health policy topic and may be at the local, state or federal level.
• The article must be recent; this semester is preferred by since last semester is acceptable.
• You may duplicate subject matter but YOU MAY NOT DUPLICATE ARTICLES. For example, more than one person can post about federal health care reform initiatives, as long as the articles come from different sources.
• In your posting, include the source in APA format, provide a brief overview of the issue and a summary of the article.
• Identify elements in the article that you feel are biased and the suspected source of the bias.
• Based on what you have learned from this course, formulate questions you would pose to the author, addressing information you feel should have been included to provide a balanced perspective on the issue, if appropriate.
• Attach a copy of the article to your posting or include a link to the article in your posting. You are expected to read and respond to the postings of other members in your group.

"That means you might see your vision or dental coverage or perks like seeing a specialist without preapproval from your primary-care physician disappear." While the author of this article has done an overall good job of not reflecting bias, there are the occasional interjections from her like the one I placed in quotes. These seem to be her own personal opinion, and feelings.  Also, she states "you won't be stuck without insurance", if the employer offers COBRA then it is a choice. If the person chooses not to take COBRA then they are not stuck, they simply chose not to pay for it. If as the author points out there will be another alternative after leaving an employer then why would COBRA continue to be in existence? No-one would choose to pay the higher premium if there is even another plan to choose from.

Questions I might ask: 1. Why does Mr. Goodman say that many feel the penalty fine is too small? In your article you mentioned that there is a penalty for not obtaining health insurance coverage. You stated that for individuals it would be $95 or up to 1% of income whichever is greater. For someone making $60,000 per year this would be $600, then increase to 2.5% which for the same $60K is $1,500. You also mentioned that for families the fine is $2,085 or 2.5% of income whichever is greater. For a family with an income of $100,000 per year combined this fine would end up being $2,500 per year.

2. Who are these people who think the fine is too small, and what do they think would be a fair amount to penalize people with?

3. Aside from the breastfeeding issues, I thought many employer health plans actually cover maternity care? I had my children 7, and 9 years ago and this benefit was 100%.

4. Now, let's talk about the breastfeeding break. If an employer already allows 2-15 minute breaks not including lunch, would this break be extra? If, yes why is that? Why can't this type of thing be done on a regular break? (I breast fed both my children for more than 6 months each, and pumped while on my allotted breaks).

5. Since there is and will be a greater need for medical providers due to every single person being required to have health insurance, why was there not a fund allotted to recruit more individuals into the field and an increase in financial aid assistance? I know there are grants available for those who choose to work in poor communities, however what if the area in which you live does not qualify under the description of needy given by the government? 

Reference used:

Kotz, D., (2011, Jan.).  What Health Reform Means for You, U.S. News& World Report.  Retrieved from                 http://health.usnews.com/health-news/health-plans/articles/2011/01/14/what-health-reform-          means-for-you

Reflection:

I have lived all over the country and have seen how the media can portray even the mundane in glamorized ways in order to capitalize the coverage they receive. I have seen how celebrities, as well as, the news media can sensationalize and dramatize just to get what they are talking about more notoriety. Reporters can state that they are not biased; however this would mean they are not human. Humans are by their very nature biased.  We the public are biased in our opinions, likes and dislikes. We the public are enablers to this sensationalism. If the information is more dramatic and shocking we eat it up like it is our favorite food. We as the listeners, readers and buyers of the information are the ones who have to let the media know when they are out of line; however the question remains if we can recognize the media's bias through our own rose colored or tainted glasses. In order to recognize bias in others would mean we would have to look deep into our own psyche to know and understand what our own biases are.  It is my express opinion that it takes time to get to know yourself and understand how you view the world. Everyone has their own reality. 

Reference used: 

Sultz, H.A. & Young, K.M. (2011). Health care USA: Understanding its organization and delivery (7th ed.). Sudbury, MA: Jones and Bartlett Learning.

Quality of healthcare discussions

Post your thoughts on the following:

• What are some attempts that have been made to improve the quality of health care?
• Please share your own experiences and thoughts from your readings in this course and in other courses in this program pertaining to efforts made to improve the quality of health care.
• Refer to some of the key initiatives described in your text (i.e., physician report cards).
• Comment on your fellow students' postings.

According to Health Leaders magazine March, 2011 issue volume 14 number 3, "Hospital stays for the diagnosis of septicemia cost a total of $14.6 billion and accounted for 791,000 discharges. The average cost per discharge was $18,400, about twice as much as the average cost for all discharges ($9,100). Fifth on the list, liveborn infant, was just $2,700 per stay, but the large volume of stays, more than 4.2 million, boosted the overall cost to $11.5 billion." Even diagnoses of coronary atherosclerosis, and acute MI overall did not cost as much.

One of the things being done to decrease bloodstream infections is by Medicare and Medicaid requiring those hospitals who accept them to report any central-line associated bloodstream infections to the CDC. Some hospitals are changing the LOS (length of stay). It is thought that those hospitals who cut LOS even by 10% could free up almost 80 beds yearly. This type of change has the potential to increase the hospitals ability to deliver more procedures. (Health Leaders, 2011).

My own experiences, and thoughts regarding improvement of quality: I believe that everyone (medical staff, administration, patients and families) have to work together in order to achieve any sort of quality. This collaborative, and trusting kind of relationship will also, help in reducing medical malpractice claims. If we all work to eliminate claims of malpractice then naturally costs of care will and can decrease. It is frivolous lawsuits that cost everybody. Of course then we have those in the judicial system that also need to buy into this concept.

Patient satisfaction is key in determining how a patient feels not only about their physician, but the facility in which they were cared for. (Sultz & Young, p.105) Without this kind of quality check how would anyone know the areas in which improvement is needed, or what they are doing well.  Of course if patients are happy then they will feel they received great care. If they are not then everyone knows about it. As they should. Everyone has to work together to try making the patients and their family happy. If this was retail or another service type of atmosphere we would think nothing of providing a quality survey, but even those of us in this industry are struck odd by it when a survey is done for our work. But, physicians need to also be subject to quality survey's. They are under the employ of the patient and the patient as the customer is always right. Isn't that the adage?

Cantlupe, J., (2011, Mar.). The Quest For Quality, As healthcare reform sharpens the focus on    quality outcomes, the ability to achieve and demonstrate success becomes increasingly     important, Health Leaders, 14(3), pp. 14-26.

Sultz, H.A. & Young, K.M. (2011). Health Care USA: Understanding Its Organization and Delivery                (7th ed.). Sudbury, MA: Jones and Bartlett Publishers.

Response to classmates:

I am going to climb into the same boat and agree that the media can manipulate the publics way of thinking. It happens with every election, as well as, many other issues. The media used to ask tough questions of anyone they would interview, now they seem to be more like cheerleaders who are afraid to get messy or go off the beaten path of political correctness. I grew up all over the country and have seen the media bias. What the media wants us to know is not actually the facts, but what they deem to believe are the facts, or their version of the truth. Why is it that celebrities and those from Hollywood seem to grasp more news than actual news? Who really cares what dress so and so wore to her movie premiere? Is it really important? More important than knowing about Iran making nuclear bombs and missiles? Did they all get exhausted and too tired after 9/11/01 to actually report the real issues? But, then we have our nations politicians who refuse to come to work because of the collective bargaining issues, etc. These are elected officials folks, they don't have the right to not show up for work unless we the people say it is ok! If one of us refused to come into work because we couldn't take 'the heat', what do you think would happen? No more job!

Discussion 2:

Visit the Center for Responsive Politics at OpenSecrets.org. This organization tracks and analyzes campaign contributions to national Republican or Democratic candidates, and the contributions' sources. Then:

• Get familiar with the site by trying some of the many links available. Then look at areas such as, "Top overall donors," "Top PACs," "Top industries," "Most partisan industries," and "Totals by sector."
• Do some searches on the Health Sector, entering the names of various donors, such as "pharmaceuticals," "health professionals," "physicians," and "nurses."
• Consider party affiliations, including recipients according to party.
• Discuss what you find on the discussion page below, and identify what your findings may suggest in terms of money buying political influence.

$1,039,895 came from AstraZeneca PLC, and this was not even the largest contribution by a pharmaceutical company. I was well aware that large contributions came from pharmaceutical companies, however I think I was most astounded by the largest amounts coming from American Hospital Assn, and American Dental Assn. Granted some of these contributors tried to split their funds down the middle or as close to for equal contribution, however when you are giving this kind of money a 1-2% difference is huge! In 2010 cycle:

         Total             Democrats   Republicans   % to Dems% to Repubs   Individuals   PACs

        $1,674,734   $890,545     $765,689         53%                      46%       $228,120      $1,446,614

was contributed by Pfizer. Granted they contributed to both political parties, but they contributed 7% more to the democratic party. It seems that large associations, or companies seem to contribute more one way or another. There is no true bi-partisan on anyone's part. One would think that most of these large corporations and associations would want to contribute more to the republican party considering the history is they are for less regulations. It appears to me that these contributors are actually in favor of regulation just in the way and amounts of their contribution .

Healthcare expenditures discussion

Post your thoughts on the following:

• What are some of the contributing factors to the growth of health care expenditures?
• What are some measures being taken to reduce health care expenditures?

There are several contributing factors in the growth of health care expenditures. One of the largest factors is the overuse and inappropriate use of types of care, such as using the ED as a doctor's office.  Over the years people have wanted selective, specialized care rather than utilizing family physicians, or primary care physicians. This has in effect caused more of our medical school students to choose a specialty rather than in becoming a general practitioner. Specialists charge more per visit, thus driving up the overall costs of routine care. It is harder to get into these specialists, who as for referrals on new patients. This decreases the access for patients to obtain preventive and primary care that can potentially prevent ED use, and/or hospital admissions. Because of the expense of these higher priced specialists patients are more reluctant to be seen faster, and will wait until their symptoms worsen. Thus, these patients who cannot afford the routine visit are at a higher risk for complications of any illness not just chronic. Older patients with insurance such as Medicare, possibly see several doctors who do not coordinate the care of the patient. This is not safe, can be conflicting, and some may even duplicate tests, etc. There are physicians who receive payment incentives for delivery of more services. Some of these doctors provide these services without thought to cost effectiveness, or the overall necessity. Unnecessary services or tests drives up the cost for everyone. Then of course there is the cost of new and innovative technology. Not to mention that providers are having to turn to electronic medical records. Switching over paper records into electronic ones is expensive. This does not even cover all the increases in health problems like obesity, which alone can cause several problems.

Along with there being several contributing factors, there has to be several measure taken to reduce the health care expenditures. One of the measures can be in those physicians who do receive incentives to only get paid if they provide effective care. A focus of the new health care reform is for patients to have a primary care physician. In order to do this it would be necessary to promote and invest into having a patient-centered primary care system. One of the measures being done is in information technology. The change from paper records into electronic records makes it easier and medical records more accessible to several providers at a click of a button. Physicians and hospitals will be held more accountable for the treatment they provide. One of a major measures will be in price competiveness. Insurance companies are seeking treatments for patients even in other countries for things like major surgeries. They even pay for the patient's trip expenses. Planet Hospital is one of the companies that aids patients in finding treatments in other countries. The name of this type of care Planet Hospital calls "medical tourism".

Planet Hospital, (2011). Medical Tourism. Retrieved from http://www.planethospital.com/2009_v2/aboutmedicaltourism.php

Reflection:

I think the overall consensus is that big business, etc has been the brunt of the misconception of causing all of the increased costs. I am also seeing that the costs of medications in this country is out of proportion compared with other countries, even on the same drugs. In my own medications for migraines I have seen the location of Imitrex being moved from England to the Philippines for manufacturing. Did the cost of this medication go down? No, it actually went up, and is does not seem to be as effective as it once was. I am not sure why the effectiveness of this medication changed. I continue to read articles by the public media, in Health Leaders magazine, and in industry Insurance magazines regarding the ever increasing pharmaceutical costs. In the US we spend 30-50% more on medications than other countries. (OECD, 2009) Are the ever increasing costs of our nation's health care due to aging? ( OECD, 2009). I am inclined to say no, not by itself. It may be a contributing cause, but not any one thing by itself caused the increase.

OECD, (2009). Disparities in health expenditure across OECD countries: Why does the United States spend so much more than other countries? Retrieved from http://www.oecdwash.org/PDFILES/Pearson_Testimony_30Sept2009.pdf

Government branches discussion for nurses

Post your thoughts on the following:

• What are the three branches of the government?
• Provide examples of each at the federal, state, and local levels.
• How do they work together? Avoid duplicating what other members of your group have posted.
• List the names, office (Senate, Congress/House), and party affiliation of the individuals who represent you at the Federal level of government. Include the link to the webpage containing the information. Use official “.gov” websites to find this information.
• List the names, office, and party affiliation of the individuals who represent you at the State level of government. Include the link to the webpage containing this information. Use official “.gov” websites to find this information.

The three branches of government are legislative, judicial, and executive.

 Examples of the executive federal level are: The President, Vice President and all the cabinet members. Examples of the legislative federal level are: House of Representatives, and Senate. Examples of the judicial federal level is the court system. There are three different kinds of courts in the federal judicial system. The lowest level is the district courts. The second level is the court of appeals. The top level is the Supreme Court.

Examples of the state legislative level are: The House of Representatives who are elected to represent the people and make laws that meet their needs. The Senate who are elected to represent the people and make laws that meet their needs. Examples of the state executive level are: Governor who is elected by the people to enforce state laws and act as the state's leader. Under the Governor in this branch are the following: State Treasurer who is responsible for the state's money, State Auditor who writes checks for the state, Commissioner of schools and public lands who manages state lands for schools, Lieutenant Governor who is the Governor's partner and President of the Senate, Secretary of State who is the state's official record keeper, Attorney General who is the chief legal officer of the state. Examples of the state judicial level are: The state Supreme Court who are appointed by the Governor and approved by the legislature, Circuit Courts are the trial courts of the state, Magistrates hear cases that are less important.

Examples of the local government have to be granted power by the state and consist of elected individuals such as the mayor, and city council. Local government is two levels which are county, and municipal. Municipals are usually responsible for parks, recreation, fire departments, police, housing services and emergency medical just to name a few.

Jim Jordan represents me in the House of Representatives. He is a Republican.  The link to him is http://www.house.gov/house/MemberWWW_by_State.shtml#oh

Sherrod Brown (D-OH), and Rob Portman (R-OH) are my Senators.  The link for them is http://senate.gov/general/contact_information/senators_cfm.cfm?State=OH

Ohio State's Governor is John Kasich. His political affiliation is Republican.  The Lieutenant Governor is Mary Taylor. Her political affiliation is Republican.  The Ohio State Attorney General is Mike DeWine. His political affiliation is Republican.  The state Auditor is Dave Yost. His political affiliation is Republican.                         Secretary of State for Ohio is Jon Husted. His political affiliation is Republican.  The State Treasurer for Ohio is Josh Mandel. His political affiliation is Republican.  The link to find out more about the Ohio State government is http://www.ohio.gov/government/#tog using this link provides a direct link to each area, department, or office.

References:

House of Representatives, (2011). Retrieved from           http://www.house.gov/house/MemberWWW_by_State.shtml#oh

Ohio Government, (2011).  Retrieved from http://www.ohio.gov/government/#tog

Senate, (2011). Retrieved from                 http://senate.gov/general/contact_information/senators_cfm.cfm?State=OH

The Three Branches of Government, (2011). Retrieved from http://library.thinkquest.org/J0110221/