As I look back on this semester, my thoughts toward our health care system have changed. To be honest, I enrolled in this class because I needed an elective for my public health minor. I did not have any expectations coming into this course as I thought it would be just like my previous healthcare course I took in Sargent. At the end of the day, I learned so much from this class and I hope to use this knowledge and understanding as I pursue my career in the health care industry. Continue reading “Hope for Our Nation? (Process Reflection)”
Before taking this course, I knew generalities about healthcare but never anything too specific. I knew, mainly, that everything involving an aspect of healthcare in the U.S. was overpriced. I was hoping that this high cost of healthcare was for a reason, better equipment, better doctors, better medicines, etc. Unfortunately, as I found out, this was not the case. This course has completely changed my perspective of healthcare and has influenced my decisions of re-evaluting a profession that I thought to be flawless. Continue reading “A New Understanding of Healthcare”
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.
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.
Within the article “Fight to Honor A Father’s Last Wish: To Die At Home,” it was mentioned that “most developed countries spend much less on medicare, but twice as much on social supports.” Thus, I wonder how end-of-life care is structured and regulated in other countries? Is nursing home abuse as rampant and overlooked? What checks and balance do they have in place to ensure the people’s best interests? Is the cost much higher in comparison to the US?
After reading Live Long and Pay for it: America’s Real Long-Term Cost Crisis, I saw strong overlap from previous lecture and discussion conversation. It is absurd how much nursing homes cost but it is not surprising being that a large percentage of them are privately owned. I am surprised,however, that people are willing to pay the upwards of $70,000 a year for a nursing home when the quality of living usually doesn’t reflect the price. As seen towards the end of the article, people don’t want to confine their parents or grandparents to these homes in the first place, let alone use all of their assets to pay for them to be in there. My questions are what is the $70,000 a year being spent on if the quality of care in private homes is so poor? Is the markup on nursing home prices just due to the fact that they can charge more, like the “charge masters”in hospitals and Big Pharma? Although Medicare can be used to pay for some of the stay in these homes, 100 days according to the article, are there alternatives the government can provide for a more lasting/realistic stay?
In theory, elderly people being placed in a nursing home seems like a fantastic solution for those who need extra care in their old age. It is a place grandparents and great grandparents can go to receive quality care. It can relieve stress felt by families because they are able to know for sure that their loved ones are not in a dangerous situation such as living by themselves could be. However, in practice nursing homes are not nearly as warm and inviting and they are imagined. In fact, as Weitz points out in Chapter 10, nursing homes are not a good solution at all. In fact 90% of nursing homes have been cited for health and safety regulations. Since the reality of nursing homes is so bleak, it makes me wonder what is being done to fix them. Is there a good solution while keeping the financing of nursing homes low? Or do we have to invest more money in elderly care in order to improve treatment?
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 ?
It’s no secret that the life in a nursing home isn’t what people imagine it to be. Most expect a warm and nurturing environment that comforts the elderly, but realistically speaking, nursing homes revolve around a “profit-driven system” (Weitz, pg.241). Chapter 10 in Weitz emphasizes the truth behind modern-day nursing homes, indicating that may nonprofit nursing homes and for-profit homes significantly lack both quality of life and quality of care. Nursing assistants are considered “budgeted expenses”, nursing home administrators and owners keep overall care to a minimum, and health and safety violations are at an all time high. In fact, “federal regulators in 2008 cited more than 90% of nursing homes for health and safety violations” (Weitz, pg.241). This overwhelmingly large percentage of nursing home violations places residents at risk of “bedsores, malnutrition, pneumonia, and other avoidable health problems” (Weitz, pg.241).
With all these federal health and safety violations, it makes one wonder what is being done to fix these problems. Weitz indicates many problems that come with nursing homes, as well as at-home care and hospices, but fails to provide solutions to this increasing problem. And so I ask – What are possible solutions to this failing, profit-driven system that so many people rely on? How do we stop the process of commodification – turning patients into commodities?
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.
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”