“Better is Possible”: On the Cost of Healthcare {Process Reflection 3}

Prior to this class, I wore rose-colored glasses: my perspective of the healthcare system was naive and microscopic. As a student and young adult, I never had to seriously think about buying my own insurance or getting treatment for a particular life-threatening disease. This class has filled a gap in my knowledge that I believe will fare me well in my future years as a healthcare professional, patient, and advocate. I hope to follow in Dr. Atul Gawande’s footsteps, someone that I tremendously admire for taking a critical stance of his own profession, which is, to say the least, not an easy feat.

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There were so many new concepts presented throughout this course that shocked me, particularly, the soaring costs of healthcare. Recently, one of my  friends visited the doctor’s office and was charged with $160 ($320 total, half was covered by insurance) for two spritzes of freeze spray for treating a wart on his skin. My friend was in disbelief, but I nonchalantly told him, “That’s the American healthcare system for ya.” Like Dr. Guseva did with her boot, I decided to follow the money and investigate. I checked that the retail price of a medical freeze spray on Amazon was $19.99. My friend’s experience completely confirmed just how different healthcare services are from other markets: no true cost, no buying power, and no prices are known in advance.

I wholeheartedly agree with Dr. Atul Gawande: all it takes is a willingness to try to make this system better. We won’t know what works best unless we try. Without my rose-colored glasses, I feel like my life has just begun.

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Quality of Care in Nursing Homes

In the public health article, “Does Investor Ownership of Nursing Homes Compromise the Quality of Care?” Harrington and his co-authors looked to examine whether or not investor ownership of nursing homes affects the quality of care distributed at that home. Their study analyzed nearly 14,000 nursing home facilities across America, and measured the institutions’ quality based on a range of measures. These included the evaluation of  health outcomes, physician services, patients’ rights, and others, which all add to determine quality of care and in turn the quality of life for the institutions’ residents. The investigation revealed that investor-owned nursing homes had nearly 40% more deficiencies in all categories of quality-of-care than did non-profit and public facilities. The study concluded that investor-owned nursing homes provide lower quality care than non-profit or public facilities.

Continue reading “Quality of Care in Nursing Homes”

Social Media’s Role in Healthcare

After learning about the history of health care and a little bit of why the health care system is the way it is today, the title “Social Media For Health Care, Who’s Doing It Right” on Forbes.com immediately grabbed my attention. Social media, while it is such a major part of everyday life today, is a relatively new aspect of society. For the first time companies can reach out to customers in ways that previously would have been impossible. The internet has undeniably changed the way people learn and access information. These days information about healthcare is at everyone’s fingertips. Continue reading “Social Media’s Role in Healthcare”

Quantifing Quality of Life and Overcoming Social Death

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?

Occupational Groups and Autonomy

In recent years, many professions in addition to being classified as a medical doctor have moved classifications, such as osteopaths moving from being marginal to parallel, chiropractors from being marginal to limited practitioners, and acupuncturists beginning to move towards the mainstream. Many of these occupational groups are able to gain popularity and higher status because they have appropriate timing, large support from high status supporters, not working directly against doctors, or they aren’t subject to harsh licensing laws. My question is, what do you think is the next major occupational group that will be able to gain autonomy? Furthermore, what would an explanation as to why it was able to gain autonomy?

Hospital Code = Zip Code?

More often than not, the ZIP code health paradigm seems to be defining healthcare outcomes – and hospital codes – in cities across the United States. I found one of the most striking aspects of this unit to be this extreme correlation between zip code and health. It appears as if zip codes act as very simple, very prominent way of measuring social determinants of health in a specific geographical area via highly readily accessible data. The question is, in what way can this paradigm be effectively tackled in order to reduce this zip code inequality?

Continue reading “Hospital Code = Zip Code?”

Is America Actively Diminishing Access to Healthcare?

During the summer of 2015, controversy about Planned Parenthood took over the media. It stemmed from the Center of Medical Progress releasing “selectively edited videos” of PP staff members discussing a fetal tissue donation program. Anti-abortion advocates immediately started accusing the company of profiting from the sale of fetal tissue (which is illegal and morally questionable). Public outrage built as people took to social media and spread the accusations. Continue reading “Is America Actively Diminishing Access to Healthcare?”

The Social Construct of Illness

In Conrad and Baker’s article, they claim that illness is socially constructed. They state that the social construct of illness is “rooted in the widely recognized conceptual distinction between disease (the biological condition) and illness (the social meaning of the condition).” Social constructionists emphasize how the meaning and experience of illness is shaped by cultural and social systems. This suggests that individuals and groups not only suffer from the illness physically, but that there is also a social/societal stigmatism that comes with illness/disease that brings an added burden to any sufferers. Conrad and Baker state that a stigmatized illness can make an illness much more difficult to treat and manage. The stigma that comes with disease is often brought about because of widespread publicity about the disease and/or a widespread negative view to people with the particular condition. The two claim that effective policies for these stigmatized illness have a large barrier to overcome because of the added stigma. Should policy be focussed on overcoming the barrier, or should it be focussed on educating the people so that the stigma is generally removed from a particular condition? Should limits be placed on care publicity (i.e: drug/treatment ads) so that the stigma is lessened, or should the marketing of treatment be changed so that the stigma associated with a particular illness is one that encourages early treatment and proactivity?

Discussion Question Kunal Khurana

In discussion, we briefly alluded to this but didn’t discuss in detail, and it could be a great followup in the next discussion.

If a man who is below the poverty line regularly purchases cigarettes despite knowing the risks, does he still deserve health-related aid from the federal government? This can be in the context of both health insurance and broader social policy.