Priming for the Future

Looking back on this semester, I realize I have learned so much more than I ever thought I would. I came to this class knowing that the healthcare system was considerably flawed, but this class opened my eyes to the extent at which our healthcare system is flawed. Some politicians (more recently some presidential nominees) talk about fixing this country’s healthcare as if it could be accomplished overnight and suddenly everyone who should be covered, would be covered. However, the healthcare system is so much more intricate than that as its problems stem from a wide variety of sources, starting from the very birth of healthcare. Where most people think that its problems stem from doctors charging a lot for their services or insurance companies being unwilling to cover certain medical treatments or procedures, these people fail to see that it is also the fault of pharmaceutical companies, the way it is so difficult for people to attain a higher socioeconomic class, and so much more that influences the amount and level of care that is accessible and also importantly, affordable to everyone in this country.

It’s hard pill to swallow when one sees exactly how many people are without adequate healthcare or medical insurance in this country, more often than not through no fault of their own. We even went through stories in class of people who worked their entire lives, bought a house, and have retired, only to be pulled out of retirement and lose everything they had because of a medical issue that they have to pay out of pocket for. It’s an even harder pill to swallow when we see how people from other countries thrive under their country’s version of healthcare, other countries having universal healthcare. Politicians in the United States argue that our government cannot afford to provide universal healthcare for everyone in the country. How then, are other countries able to afford universal healthcare for their citizens? In addition, how then does US government have enough money to spend trillions of dollars on wars in the Middle East? Though many of these questions will take more research and taking related classes to answer, SO215 has primed me to begin questioning these aspects of healthcare not just through the length of the course, but for the rest of my life as an active and voting citizen of this country.

A plan to create change in the healthcare world

Before taking this class, I will admit that I had a very narrowed view of the healthcare industry, and was not familiar with all the intricate components that make up the healthcare sector. The beauty of becoming a doctor is all too glamorized, and many fail to realize that the healthcare industry is not solely about the doctor and their practice. Medicare, Medicaid, pharmaceutical companies, healthcare laws, the doctor-patient relationship, elderly care, overtreatment, overdiagnosis – these are just a few of the many things that this sociology class has introduced me too. As a future healthcare provider, I now realize the importance in understanding these individual components and how they shape the way patients receive care.

The most fulfilling thing this class has instilled in me is a desire to change all the negative aspects of healthcare. One of the major parts that we focused on in class is the lack of care millions of Americans receive, despite Medicare, Medicaid, and private insurance companies. I was baffled by the staggering numbers of Americans that find themselves unable to provide medically for themselves, and find themselves resorting to alternative methods, foreign country care, or simply avoiding medical care altogether. As I’ve discussed before in a previous reflection post, I believe the most impactful way to change the course of our current healthcare is to become educated, and vote. This upcoming presidential election is inching closer and closer, and educating myself of each party’s platform and ideals in the best way to see change in the healthcare world.

Although I initially took this class as a fulfillment for my Public Health Minor, the wealth of knowledge I have acquired will better me as a healthcare consumer, and a future healthcare provider. Even after finishing this class, I plan to keep educating myself on the persisting changes in the healthcare world.

“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.

Investor Ownership of Nursing Homes and Reform Issues

Within the article “Does Investor Ownership of Nursing Homes Compromise the Quality of Care,” written by Charles Harrington et al, noted that while non-profit and public nursing homes typically displayed higher quality in comparison to investor-owned nursing homes, the quality of care experienced at such facilities could not be considered average or above average. Such issues largely though not entirely stemmed from the acts of industrial lobbyists, whom blocked the passage of nursing home reform legislation since 1987. After reading of the long term hindrance posed by these groups, why has the government not enacted any means by which break the nursing monopolies? It is possible to do so using legislation, or must other means be used? How can the existence of these nursing homes be maintained for those who truly need them, while minimizing their costs and improving their quality of care ?

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”

How Do We Improve Elderly Care in Nursing Homes?

In the article, “Does Investor Ownership of Nursing Homes Compromise the Quality of Care?”, the authors notes that 2/3 of nursing homes are investor owned. They investigated whether or not investor ownership affected the quality of care in these nursing homes. After examining about 14000 nursing homes, they found that investor-owned nursing homes did in-fact provide worse care and less nursing care compared to non-profit and public homes. I wonder if there are any set regulations, rules or guidelines that these medical homes have to obey in order to remain running? If this study was known to more people, do you think other people will take this into consideration and send their loved ones into certain homes? Would they do further research in order to secure better care for their loved ones? Or would they just want to send them anywhere in the means to “get rid of them or let someone else take care of them”. If consumers do realize that for-profit homes provide worse care, do you think the owners of these homes would try to fix it and focus more on improving patient care? How do we ensure that the elderly get the best care possible? As mentioned before, do we need to set rules, regulations, and/or qualifications of care givers?

Investor Ownership of Nursing Homes

In a study of whether or not investor ownership of nursing homes affect quality of care, it was found that investor ownership of nursing homes does affect quality of care and, more importantly, for the worse. After reading this study, I was not surprised by what was found. The thing I was surprised about was how much worse investor owned nursing homes were in comparison to non-profit and public homes. Although this study did not prove that public and non-profit nursing homes were good to begin with, the results were extremely significant. My questions are why have restraints not been put on these “money making firms” by the government? Is it difficult to regulate how nursing homes are managed because they are considered a part of the free market system of healthcare? Are the issues with nursing homes the same in other countries? If not, are the problems avoided in other countries because they don’t pay for healthcare to begin with?

Rise in Early Cervical Cancer Detection Is Linked to Affordable Care Act

Earlier in the semester we watched a documentary about how health care coverage varied based on age. The highest rate of uninsured Americans were between the ages of 18 to 25. Most were unable to afford healthcare because they didn’t have access to employer-based health plan and were not covered by their parents’ health insurance. Health and finances of young Americans were at risk. In 2010, the provision of the Affordable Care Act allowed young adults to stay on their parents’ insurance until the age of 26. The number of uninsured adults in this age group declined significantly.

Continue reading “Rise in Early Cervical Cancer Detection Is Linked to Affordable Care Act”

Person-Centered Health Care

http://chicago.suntimes.com/news/7/71/1108320/university-of-chicago-part-push-person-centered-health-care

In the Chicago Sun-Times article, U. of C. part of push for ‘person-centered’ health care, the Associated Press addresses a major flaw in communication that exists in the current physician-patient relationship and in the overall system of care seen in hospitals as well as the steps that are being taken by the University of Chicago to eliminate such issues. A very prominent problem arises when complex diagnoses or diseases must be broken down for the patients to understand in order to know what exactly they have and what has to happen down the road. This problem is that the patients and family of those patients leave the hospital either not knowing what has to be done or feeling as if there is something wrong with them for not knowing all the necessary information. In an attempt to better inform patients and create better physician-patient communication and relationships, the University of Chicago has created the Comprehensive Care Program. This is a new model of care that aims to shift doctors’ from treating symptoms to treating people. This is an, “individualized model of care, called “person-centered care” or “patient-centered care,” [that] is based on the idea that costs can be reined in by preventing expensive emergency room visits.”

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Experimental Procedure

The study conducted by Dr. Harrington and his colleagues looked at various factors to assign the quality of nursing care between investor-owned homes and not-for-profit homes. However,  subjectivity and error could potentially eliminate the study as legitimate research. For example, surveyors were asked to judge nursing homes on a severity scale from A to L. The discrepancies between individual letters (ex. from E to F) could allow for inaccurate data. Also, asking surveyors to “judge” based on experience could potentially present a biased subset of data. Therefore, how could the researchers create a more objective, statistical study?