Paying A High Price For Health Care

What is one of the biggest issues facing the United State? The first issue that come to my mind is health care. This issue affects millions of American every year even with the so called “Affordable Care Act”. Some factors that contribute to poor health care are cost, unnecessary tests, and increasing paper work. The US needs to reevaluate how our health care is being processed and offered.

Health care has risen in price tremendously since 1960 and 2016. In 1960 an average cost for a person per year was $151 and in 2016 it rose to $10,320 per year. ( Agresti, J. D. & Bukovec, S 2018) The numbers are astonishing, that is a huge difference and looks like the price will continue to rise. A main reason health care is so expensive is because providers get paid by exam or test they perform on a patient. I strongly believe a medical facility should get paid by providing hire quality care. I have worked in the medical field for over 11 years and in my experience medical facilities are forced to see as many patients as possible in the 8 hours they are open. What do I mean by forced? Well for example, a medical facility that treats the under served population which is normally Medicaid and Medicare patients do not get paid very well. The only way for a medical facility to remain open and continue caring for patients is by seeing a lot of patients. This is a very common practice for solo practitioners.

Our health care system has focused on making it very difficult for facilities to operate at its fullest potential. Now there is something called meaningful use, this is a program for providers to gather data of the care that they are providing and at the end of the year the report to Centers for Medicare & Medicaid Services (CMS). ( L. 2017)  One of the biggest issues that I have seen with this is that if a provider does not meet the set requirement they are penalized by reducing a certain percentage of each payment they receive for the following year. I find this to be unnecessary and it seems like CMS is just trying to find a way not to pay the providers. Another example of unnecessary changes was the implementation of ICD 10 codes. ICD 10 increased the coding from 14,000 to 68,000 making it more difficult to code because everything had to be relearned by providers and staff which held claims and held payments. (L. 2017)

17.7 % of the economy is being spent on healthcare. (8 facts that explain what’s wrong with American health care) Pharmaceutical companies are not helping with the rise in cost either. For the medication Nexium here in the US it cost $215 but in places like Switzerland, Spain, England and Netherlands it varies between $23-$60. (8 facts that explain what’s wrong with American health care) How can a medication that cost over $200 dollars be bought in a different county at very reduced price compared to the US.

The health care we are receiving is very one sided. It is not catered to its citizens and the people are the ones feeling the effects of a flawed system. We need to reorganize the healthcare system and make it more affordable. We need to let the doctors treat patients without worrying about coding or meeting a number to keep the doors open.

 

8 facts that explain what’s wrong with American health care. (n.d.). Retrieved September 21, 2018, from http://www.pnhp.org/news/2014/september/8-facts-that-explain-what’s-wrong-with-american-health-care

Agresti, J. D. & Bukovec, S. (2018, September 21). Healthcare Facts. Just Facts. Retrieved September 21, 2018 from www.justfacts.com/healthcare.asp

L. (2017, January 10). The Top Healthcare Industry Challenges in 2017 – Healthcare in America. Retrieved September 21, 2018, from https://healthcareinamerica.us/the-top-healthcare-industry-challenges-in-2017-7b4799b8b540

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2 comments

  1. I think your post is great and you make some very good points. I too have worked in the healthcare industry (more so on the health insurance side) for over 12 years and I agree there should be some changes. I agree, health care affects millions of Americans and I think it is important for every American to have access to it. However, I think some of the points you are making are not issues with health care but are targeted to individuals. It is not the healthcare industry that necessarily orders these “unnecessary” tests so much as it is the practicing provider. That individual should be held accountable for wasting money, also this boarding on an ethical issue. As with everything that elsewhere prices rise (i.e. gas, food, auto insurance, rent, interest rates, etc.) why is it so far-fetched that health care costs rise too? This is not an anomaly, everything is going up, not going down.
    I do have a question about the “meaningful use” program. This is the first time I’ve heard about that. You indicated that one of the biggest issues that you have is the provider being penalized for not meeting the requirements. What are some of these set requirements? Are the requirements beyond the capability of being met? Are the requirements in place to ensure the provider is operating within legal limits? To your point about changes in the ICD codes, healthcare is evolving, health conditions are evolving, with science we are now able to diagnose conditions that we were not able to in the past. Today, we have different sicknesses and symptoms than before, why should the codes not evolve to keep up with this changing time? There are more codes for more diagnosis, would you prefer the codes not change (how would you code for something that previously didn’t have one..)? As with any field of work, things constantly change, and it is the responsibility of the interested party to keep up with the change in times.
    You have some great points, yes, the industry is flawed, but this is not the only one. This is an industry that runs just like any other business. The point of operating a company is to make a profit, which is the bottom line. I think this opens up talks for other issues like the economy, we cannot solely blame it on just one industry.
    Good Post!

  2. You certainly have raised a good point in your blog about health care and how much it has jumped in price from the 1960’s to now. As in Chapter 8 has discussed we as a society are living longer which means, “yet people are free from diseases and dysfunction, a person’s own roll in their life may affect their visits to the doctor and how much prescriptions they may or may not have to take.” (Schneider, Gruman, & Coutts, pg. 168, 2012) Even though we as a society have the ability to treat and diagnosis with all the “high-tech diagnostic and treatment actions such as CT (Computed Tomography scans, radiation treatments but they all come with a price. (2012) One thing that we can do as a society, is to promote healthy lifestyle choices and do what we can to decrease illness which then will decrease our own health care cost.
    On the other hand, even if we do practice good health choices, we do get sick but the severity of our illness and symptoms may be decreased compared to someone who does not take care of themselves. For example, my family and I get the flu shot every year. Yes, we have gotten the flu even after the flu shot, but it seems from our experience, the flu and symptoms did not last as long. Because I work in an elementary school, for some reason, the flu was rampant last year and it pretty much took hold not only kids but adults as well. A few of us noticed that whoever got the flu shot was out less with decreased flu systems than the ones who did not get the flu shot. It was very eye-opening. We also did not reference or catalog anything else and we only went with the flu shot and no flu shot and we were only speculating.

    References:
    Schneider, F.W., Gruman, J.A., & Coutts, L.A. (2012). Applied Social Psychology: Understanding and Addressing Social and Practical Problems-2nd ed. Thousand Oaks, CA: Sage.

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