Saturday, 10 December 2011

A Flawed U.S. Healthcare System and Some Potential Solutions

Earlier this year, the Associated Press and other popular news agencies reported on the disturbing results of a study published in the March 16, 2006 issue of the New England Journal of Medicine that concluded that Americans receive, on average, only 55% of the care that they should receive at any given time 1,2. This study evaluated the care that individuals, from a wide variety of ethnic and economic backgrounds, receive in a variety of different healthcare settings (clinic, hospital, etc.) here in the U.S. The authors came to a conclusion that was, to me, very startling; but, as it turns out, this is not really new information.

With some minor variation across the boards, people were either under or over treated, for a variety of conditions ranging from alcohol dependence to urinary tract infection. This means that, although we have very well defined screening, diagnostic, and treatment protocols, nearly half of the time these protocols were not followed by physicians, other health care personnel, or the institutions in which they work.

While the Associated Press story decried this as "woefully mediocre... care," and the New England Journal authors concluded that the "problems with the quality of [health] care," are "widespread and systemic," I personally see this as an outright tragedy. Although we spend more money on health care than any other nation, and our massive research efforts have well defined the ideal mechanisms to prevent, diagnose, and treat disease, we are still unable to provide our mothers and fathers, sisters and brothers, husbands and wives, with the care that they all pay for, deserve, and that is available. I find the idea repellant that people's quality and duration of life is routinely compromised in this manner.

National Health Care System In Japan And Taiwan - Would It Be Possible For Us?

Every society is affected by any national changes or new movement introduced; therefore, an issue one may think is unrelated to his environment can very well affect him through chains of cause and effect.

Health care is an immediate issue that concerns all of us. We all experience it and need it. Let's serious ask ourselves if the current health care system is satisfactory and available to everyone. Should health, medicare and treatments be available to only selected groups? Many people are voting for the presidential candidate who can restore the present health care system or who can pioneer a better healthcare distribution for our country. Personally, I hope to see a change that health care is available and affordable to everyone.

Being able to receive basic health care is a fundamental need of all people. Fulfilling this fundamental need makes people feel secured, and it makes sense that people with better health can contribute more to the society. A realistic and reachable standard of health should be set for all people. This effort needs a non profit driving entity to establish and to maintain it. People's life and health should not be compromised for the profit of few organizations.

Before moving to Japan, I was covered under my parents' insurance policy in the United States. Their policy covered children of the family until the age of twenty-four. Upon graduating from university, I moved to Japan and started my first job there. I joined the Japanese national health insurance through the company I worked for. There are basically two types of health insurance in Japan: national health insurance and employer-sponsored health insurance. Usually, under employer sponsored insurance, the insurance premium is calculated according to income, number of dependents, and the company' subsidies. For someone who is self-employed or unemployed, the national health insurance costs a minimum of 13300 yen, or about $110 per month plus a small percentage of income for those who are self-employed. In other words, everyone can get insurance from around $100 dollars a month. Unlike the Medicaid program in the U.S. which is only available to certain low-income groups with specific requirements for eligibility, the Japanese health insurance is available to every citizen and legal residents. There is a ceiling to what the Japanese National insurance covers, but it covers all the basics and beyond.

In most cases in Japan, patients choose their doctor and hospital. There is no limitation to the doctors or hospital they can visit. This is a true competition among the clinics, hospitals, and medical practitioners, not for profit, but for quality. The same insurance that people have in Japan gives them the freedom to get second opinions and naturally eliminates those doctors whose practices are in question. The doctor visits, treatments, and medicine are not free; one is responsible for thirty percent of their medical bills. Japanese health costs are much lower than the costs in the United States. Thirty percent of the medical bill is still a reasonable amount one can afford. There are also special cases or categories of illness for which the insurance would give more coverage. If one is late on his payment, his insurance will not automatically be invalid. The insurance will still cover the person as long as he makes up the missed payments. After all, some people do run into difficulties in life at one point or another. Sounds to good to be true? Well, It's real.

Taiwan, a place with no world recognition politically, has one of the top public health care system in the world. After moving to Taiwan due to my husband's transfer a year a go, I learned and appreciated the system where universal or national health care is available to all more than ever. When speaking of universal, national, or pubic health insurance, people often turn their attention to the well-debated and discussed health care system in Canada. There are those whose views are negative, claiming that the medical service in a single-payer insurance system may not perform at its ultimate, and those whose views are positive, saying that they do not live in fear of ever having to face bankruptcy for outrageous medical bills. From my informal inquiries, more Canadian I came across favor their national health care system. Most of those who favor their national health care system commented that people of Canada are more secured in having their basic physical and psychological needs met.

In Taiwan, there is also government-sponsored universal health care for not only their citizens but also for foreign residents who live in Taiwan. Foreign residents can apply for the government-sponsored insurance after proving their legal status of residing in Taiwan. The insurance fee starts from the basic 600NT, or around $18 a month. For people in higher income brackets, their insurance is calculated based on a percentage of their income over the 600Nt. Fees are waived for retired soldiers, those who are physically challenged, and people who have economic disadvantages.

Interestingly, Taiwan's national health insurance has only been established for little more than two decades, since 1985. The government policy-makers studied health care system from different foreign countries and composes the first Taiwan national health care from the ideas and methods of the system of other countries. It was said that Taiwan's national insurance system is like a completed puzzle made from pieces of which fit its country and people. This insurance now covers the entire population, including foreign legal residents. According to research funded by Taiwan's National Health Research and Taiwan's Bureau of National Health Insurance, the cost of health care did not rise after the universal coverage was established (Jui-Fen & Hsiao, 2003.) What does that tell us?

A basic health care program can greatly reduce the consequences of illness left untreated. Basic health care does not mean free of charge or mindless spending without control. To build a healthy nation, we should take a closer look at the current U.S. health insurance. After all, a sound nation starts with the health of its people.

Writer's Information:
The writer is a Chinese-American. After graduating from Queens College, New York, she moved to Japan and started teaching English as second language. In the 15years of living in Japan, she became a wife, a mother and a university lecturer. She continued her education after giving birth to her daughter and is now pursuing her ph.d in education. She is a positive person who is always looking forward to challenging new things. In Japan, many friends and students were affected by her words and encouragement, especially women. Using herself as examples, she encourages women to be a life time learner, open minded and to have self confidence. Now she is temporarily residing in Taiwan with her family.

France Has the Best Healthcare System in the World

As the United States struggles toward a system of universal health care, many have looked at the Canadian health care system as a model. Only a few have looked toward France. That's a mistake for at least 2 reasons.

First, according to the World Health Organization (WHO), France has the best health care system in the world . It has been widely reported that the WHO found the French system to be number 1 while the Canadian system is number 30 and the U.S. number 37.

It should be noted here that the WHO rankings actually contain multiple rankings and the numbers generally quoted are the ranking based on the measure that the WHO calls the OP ranking. OP is said to measure "overall performance" adjusted to reflect a country's performance based on how well it theoretically could have performed. When reporting the rankings of 1 for France, 30 for Canada and 37 for the United States, it is the OP ranking being used.

Why did the French system do so well in the WHO rankings? The French system excels in 4 areas:

* It provides universal coverage
* It has responsive health care providers
* Patients have freedom of choice
* The health and longevity of the population

Second, we should be looking more closely at the French system because it has more similarities with the U.S. system than either the Canadian or British system. Many Americans assume that the French system is like the system in Britain. Nothing could be further from the truth or more insulting to the French.

Exactly like the United States, the French system relies on both private insurance and government insurance. Also, just like in America, people generally get their insurance through their employer. What is different is that everyone in France has health insurance. Every legal resident of France has access to health care under the law of universal coverage called la Couverture maladie universelle.

Under the French system, health insurance is a branch of Social Security or the Sécurité Sociale. The system is funded primarily by taxing the salaries of workers. An employee in France will pay about 20% of their salary to fund the Sécurité Sociale. These taxes represent about 60% of the cost of the health insurance plan.

The balance of the funding comes from the self employed, who pay more than salaried workers, and by indirect taxes on alcohol and tobacco. Finally, additional taxes are levied against other income, both direct and indirect.

The French share the same distaste for restrictions on patient choice as American do. The French system relies on autonomous private practitioners rather than a British-style national health service. The French are very dismissive of the British system which they call "socialized medicine." Virtually all physicians in France participate in the nation's public health insurance, Sécurité Sociale.

HealthCare Systems

This particular system is basically an institute that works towards the conveyance of appropriate fitness care. It differs greatly all around the globe. The people who work towards providing this service through the respective organizations are known as experts and professionals in their field. It is often argued if these systems oblige private rights of the public or amplify the regulation of these industries by the administration of the particular country.

The aim of these health care organizations according to a recent statement has been explained as the promotion of good health amongst the people around the globe and their reaction towards it. These organizations are mostly quality oriented, well-organized and resourceful.

The funding of these organizations is done via quite a few numbers of methods. Off these the top most are insurance (public or individual), funding it out of ones own budget or charities to name a few. A contemporary research has concluded that there is no proven relation between its cost efficiency and the method that is employed to fund it. It means that the quality of the service that the respective organizations are providing to their clients is independent of the financing method employed. We can take the example of India as a country that is financed by its administration in terms of the respective organizations. At times the private organizations and individuals also make contributions.

Amongst the top features of this system is the regard of the most fundamental therapies as a basic human right. It does not take into account the individual's ability or inability to pay, as many treatments are more pricey than the average family's financial reserves put together. Other than that the individuals who service people through these organizations are bound by both the law and a personal pledge that has to be undertaken at the time of recruitment in these systems.

Sunday, 4 December 2011

An American Universal Health Care System

Health Care System Needs Reform, Not a Government Takeover

Believe it or not, America boasts some of the world's best doctors, the most advanced health care system, and the most technically superior resources in the world, bar none. Those who travel globally and have gotten sick know that their first choice for treatment would be in the U.S. Though health care in America is, more expensive than any other country, many of the worlds wealthiest come to the U.S for surgical procedures and complex care, because it holds a worldwide reputation for the gold standard in health care.

To examine the complex health care issue, a small research study was conducted from randomly selected doctors in a best doctors database. We ask 50 top doctors, located in different states and who practice different specialty fields, " Is a universal health care plan good for America?" Forty-eight of these doctors essentially responded that it was a "bad idea" that would have negative impacts on the quality of our nation's health care.

Social Engineering Medicine

One of the greatest mis-conceptions some people have relied on with regard to the health care debate is that, given a universal health care system, every person in the U.S. would receive the highest quality health care - the kind our nation is renowned for and that we currently receive. However, unlike some public amenities, health care is not a collective public service like police and fire protection services, therefore the Government cannot provide the same quality of health care to everyone, because not all physicians are equally good orthopedic surgeons, internists, neurosurgeons, etc, in the same way that not all individuals in need of health care are equally good patients.

As an analogy - stay with me - when you design a software program, there are many elements that are coded on the back-end, and used to manipulate certain aspects of the software program, that your average "John Doe" who uses the software (the end user) does not understand or utilize, nor do they care about these elements. Certain aspects of the program are coded, so that when one uses that portion of the program, other elements of the program are manipulated and automatically follow the present or next command.

Likewise, once a universal care plan is implemented in America and its massive infrastructure is shaped, private insurance companies will slowly disappear, and as a result, eventually patients will automatically be forced to utilize the government's universal health care plan. As part of such a system, patients will be known as numbers rather than patients, because such a massive government program would provide compensation incentive based on care provided, patients would become "numbers," rather than "patients." In addition, for cost savings reasons, every bit of health information, including your own, will be analyzed, and stored by the Government. What are the consequences? If you're a senior citizen and need a knee replacement at the age of 70, the government may determine that you're to old and it's not worth the investment cost, therefore instead of surgery, you may be given medication for the rest of your life at a substantial cost savings to the government, and at a high quality of life price to you.


Fixing the current U.S. health care system might require that we;

1. Encourage prevention and early diagnosis of chronic conditions and management.
2. Completely reform existing government are programs, including Medicare and Medicaid.
3. Forgive medical school debt for those willing to practice primary care in under-served areas.
4. Improve access to care, provide small businesses and the self-employed with tax credits, not penalties for providing health care.
5. Encourage innovation in medical records management to reduce costs.
6. Require tort reform in medical malpractice judgments to lower the cost of providing care.
7. Keep what isn't broken-research shows 80% of Americans are happy with their current insurance, therefore, why completely dismantle it?
8. Reimburse physicians for their services.
9. Innovate a system in which Medicare fraud is dramatically decreased.

Devil In the Details

Socialized medicine means:

1. Loss of private practice options, reduced pay for physicians, overwhelming numbers of patients, and increasing burn-out may reduce the number of doctors pursuing the profession.

2. Patient confidentiality will need to be compromised, since centralized health information will be maintained by the government and it's databases.

3. Healthy people who take care of themselves will pay for the burden of those with unhealthy lifestyles, such as those who smoke, are obese, etc.

4. Patients lose the incentive to stay healthy or aren't likely to take efforts to curb their prescription drug costs because health care is free and the system can easily be abused.

5. The U.S. Government will need to call the shots about important health decisions dictating what procedures are best for you, rather than those decisions being made by your doctor(s), which will result in poor individualized patient care.

6. Tax rates will rise substantially-universal health care is not free since citizens are required to pay for it in the form of taxes.

7. Your freedom of choice will be restricted as to which doctor is best for you and your family.

8. Like all public programs, government bureaucracy, even in the form of health care, does not promote healthy competition that reduces costs based on demand. What's more, accountability is limited to the budgetary resources available to police such a system.

9. Medicare is subsidized by private insurers to the tune of billions of dollars, therefore if you take them out of the equation, add a trillion dollars or more to the current trillion dollar-plus cost estimates.

10. Currently, the government loses an estimated $ 30 billion a year due to Medicare fraud. Therefore, what makes anyone think that this same government will be able to run & operate a universal health care system that is resistant to fraud and save money while doing so?.

Thursday, 10 November 2011

Human Resource Management and Health Care Systems

Did you ever know that in the health care systems and services, the human resource management plays a great role? Yes, this is absolutely true especially in the global context because studies and researches have shown that their management techniques have largely helped to improve the health of the patient to a great extent. In fact, the health care and the management of the resources are very much linked to each other and there are several key factors that can help them to go with each other and work successfully. This in turn proves to be fruitful for the entire health care organization as well.

It is no doubt true that the human resource management is indeed essential and important part of any health care system. They work in such a way so that they can improve the overall model of the heal care. Though there are several challenges existing in the field of health care in the recent days yet these challenges are solved effectively by the management services to get overall success. The challenges faced might be of many different kinds and these challenges are examined and studied in various different ways by the organization to bring out an effective solution.

It is the proper implementation of the strategies of the human resource department that helps in finding out the right approach that should be taken to sort out the various different problems that might come in the way. Different places have different functioning in the health care systems and it is on the basis of these different functions that the effective solution is tried to be found out. The skill and the expertise of the different people involved in the department helps them to manage all the different resources effectively in any kind of situation.

Monday, 10 October 2011

Medical Device Technology That Saves Lives

Annual expenditure on medical device technology in the U.S. is around $150 billion. This is a large amount of money, but the devices save lives. Furthermore, thanks to medical device translation, the U.S. exports this vital technology around the world.

Glide Scope
Paramedics often attend patients who are having problems breathing. To provide help, they place breathing tubes down patients' throats. This is an awkward procedure. The risks include damage to the vocal chords.

The Glide Scope makes the procedure far easier and quicker. The device has a tiny video camera and monitor. As a paramedic inserts the breathing tube, he or she can see exactly where it is going. In this way, the paramedic can avoid harming the vocal chords and can ensure the tube is in position without delay. Paramedics who have used the technology report positive results.

Blood Pressure Management
Abdominal aortic aneurysms are a major cause of death in the U.S. High blood pressure can swell an artery in the abdomen. If the artery ruptures, it leads to uncontrolled internal bleeding. Because an increase in blood pressure can result in such a rupture, it's important to monitor the pressure, and therefore the size of an aneurysm, regularly.

The traditional way of doing this is with a costly CT scan. A cheaper and faster alternative is the Endo Sure Wireless A Pressure Management System. This takes a different approach to CT scans. Surgeons implant a tiny measuring device inside the patient. This device sends a wireless signal to a monitor. Doctors can then find out the level of blood pressure in the aneurysm sac. Knowing exactly what this pressure is can save lives.

The Endo Sure was initially tested in Argentina, Brazil and the U.S. Medical device translation helped ensure everyone involved understood the use of the Endo Sure and its potential.

Trauma Pod
A major issue facing troops in war zones is IEDs (improvised explosive devices). Soldiers wounded by an IED may bleed to death while their comrades transport them to the nearest field hospital. Although the trauma pod is still in development, it promises to be a remarkable piece of medical technology that helps solve this problem.

The trauma pod is a surgical field unit. Instead of human surgeons, it has robots. These treat soldiers immediately by staunching wounds and opening airways.

The robots in the pod also run CT scans. The scans provide information for diagnosis and further treatment. Surgeons in the field hospital control the trauma pod process remotely.