This course has been eye-opening for me. The most interesting idea I have learned is the correlation between socioeconomic status and health outcomes. The Whitehall studies in England produced a result I did not expect. Prior to the course I would have expected wealth to correlate with health but I would not have expected race, education or stress to correlate with health as well.
Another topic I found very interesting was the need for the medical profession to focus on care and the quality of patient life as well as curing the affliction. This idea is one that I have seen in the past when dealing with family members in the hospital. However, I was not aware that the quality of life is not always the primary concern of doctors. This realization had a large impact on me.
A final topic was shown to me in the analytical postings, but I wish it was discussed more in class. Mental health infrastructure is a serious problem that has been around for far too long. A large percentage of the population experiences some form of mental health issue, and there is very little infrastructure to support these patients. Moreover, the majority of homeless people and a large portion of the prison population suffer from a mental illness. I feel that, in the context of a course that is teaching students to address societal medical issues, this would have been a great topic to study in depth.
An interesting article I read this month, published in The Wall Street Journal, discussed the financial implications of the Affordable Care Act and provided an interesting point that had been brushed upon but not examined in class. The article, entitled “Medicaid Expansion Is Proving to Be a Bad Bargain for States”, does show a bias which is usually not overly credible, however, its point is well supported. Continue reading “A Critical Review of the Fiscal Repercussions of the ACA”
In the article, “social Death as Self-Fulfiling Phophecy”, Timmermans makes a plethora of pertinent points to the effect of proving that there is “no equalizing potential of rationalization of resuscitation techniques and legal protections.” I find the last discussion about quality of life to be most personally resonant. The anecdote about the nightmare scenario is something that does present the personally worst case scenario for a medical procedure. It does bring into question the quality of life that is acceptable for ‘success’. Is it a common feeling that mentally disabled lives resulting from a medical procedure are “not worth living?” In what ways can the quality of life be quantitatively measured in order to weigh the risks of a procedure? How can the resuscitative efforts have a better outcome than the original expectations?
The paper “Managing Emotions in Medical School” by Smith and Kleinman discusses the desensitization of students to unwanted emotions on an individual basis. Continue reading “Desensitization of Doctors”
In the article “The Social Construction of Illness: Key Insights and Policy Implications” by Peter Conrad and Kristin Barker, the continued development of medicalization is examined. It is said that disease is the biological condition and that illness is the social meaning of the condition. Continue reading “Social Construction of Illness”
The mental health of the nation has been an issue for far too long. This past Thursday, 23 mental health groups submitted a letter to congress urging them to pass legislation to repair the nation’s fractured mental health system. In this article by Liz Szabo, the question is raised, “‘How many more reminders do we need that mental health has to be a high priority?”’ Mental illness is something that affects 13 million Americans, yet, most fail to receive proper psychiatric care and services. Continue reading “Attention Needed in Care for Mental Illness”
This first period of the semester has been very enlightening because it has opened my eyes to some of the inefficiencies in the American health care system. I had never previously thought of the healthcare system as a consumer market. That is, I had not realized the competition amongst providers, the business strategies in pricing insurance and services, and the consumer mentality of patients. This realization is tremendously useful in understanding how the system works. However, it has set the frame work for the rewarding knowledge that I have amassed. Continue reading “Reflection on Learning: Part 1”
In Sarah Wheaton’s article “ Why single payer died in Vermont,” the point is brought up that besides financial constraints, there is a good deal of political opposition to the single payer system including push back from existing insurance companies that will be kicked out of the market, and a general understanding that Americans inherently distrust government-run anything. The suggestion was made that there has to “be so much pressure that it’s like a volcano goes off and it happens.” Continue reading “Could a Single Payer System Exist in the United States?”
This article by Melinda Beck discusses an enormous expansion of the coding system used by doctors to classify and bill for specific ailments. The current system of coding, ICD-9, includes about 14,000 diagnostic codes that doctors must use to bill insurance agencies and about 4,000 codes for specific hospital use. These codes are an international system for recording diseases, injuries, and other conditions set by the World Health Organization. The new system, ICD-10, was developed by federal agencies for more elaborate diagnoses in the United States. This new system, to be implemented October 1st, will increase the diagnostic codes from 14,000 to 70,000 and hospital codes from 4,000 to 72,000. Continue reading “72,000 Ways to Classify Ailments”