Discuss the role of the hospital in the overall development of the health care system in the United States.
Discuss how hospitals have played a role in access of care in the United States
The hospital??™s role in the nation??™s health care system has changed dramatically over the years. The hospital originated as an institution for the poor. This evolved into the center of the system and the primary technology focus of health care. The hospital is a provider of highly specialized services and the hub of an assortment of other actives. Today the technology to manage hospitals has changed with an information systems focus and the application of complex parameters of performance measurement.
During the second half of the twentieth century, managed care developed in the United States as a mechanism for constraining the growth of health care costs by controlling the delivery system. This approach originated in the western United States in the form of staff model plans such as Kaiser Permanente which employed physicians and other caregivers directly. In the private health insurance industry, managed care plans controlled costs and the delivery of care by restricting hospital utilization, such as admissions and lengths of stay, by limiting access to specialists, and by encouraging healthful behaviors among subscribers
On an international basis, the development of health care policy is increasingly being influenced by cost considerations. Advances in health science and the delivery of care continue to expand the capabilities of treatments. The ability of nations and communities to pay for this care from available resources is a major subject of debate.
(Williams/Torrens, 2010, Pg. 183-184)
Today??™s United States, health care access is disproportionately afforded to the affluent, the employees of government and large corporations, the very poor, and many receiving adequate pensions plus Medicare. Forty-seven million Americans are uninsured, largely the self-employed, recently unemployed, middle income, and working poor. Lack of health care access affects minorities disparately, and the results of the devastating expense of a long-term or terminal illness, inadequate care in general, and the extraordinary cost of insurance all contribute to keeping many minorities in the poverty cycle, dependent on welfare and other forms of assistance, and imprisoned in struggling and dangerous communities. Disparities in access lead to disparities in treatment. The poor, the aging, women, children, people with disabilities, and persons of color are most at risk. The infant mortality rate in the United States is the worst among the ???developed??? countries. African-American women die from cervical cancer at three times the rate of Caucasian women. African-Americans have a significantly lower life span than Caucasians and Hispanics have the least access to the health care system of any group. Native Americans, besides suffering greatly from alcoholism, have a substantially higher diabetes and tuberculosis rate than average US rates. Recent immigrants who experience health problems find the health care system poorly equipped to meet their needs. It is believed it is unconscionable and abhorrent that any human being should ever be denied access to adequate health care due to economic, racial, or class barriers.
Discuss long-term care services and how they are financed. Provide examples.
Discuss one of the service areas in long-term care.
Long-term care services are to help people achieve functional independence, in contrast to the goal of acute care, which is to cure. The reason that a person will need long-term care is because they suffer from on or more functional disabilities. Numerous sources pay for long-term care. Medicaid is the largest single third party payer of long-term care. The other public programs that provide and/or pay for select long-term care services are Veterans Affairs, Title XX of the Social Security Act, The aging Network established by the Older Americans Act, state and local mental health services, Ryan White Act (AIDS/HIV), and there are numerous others. Many individuals pay out of pocket for long-term care.