Rising Health Care and Poverty Rising Health Care and Poverty in the U.S.A Introduction Rising health care costs and poverty have been on the rise since the early, 1990’s. Medical costs have more than doubled over the last decade, and health insurance premiums have risen nearly five times faster than wages. Americans are spending far more on health care than residents of any other industrialized county while receiving lower quality care overall. Clemmitt, Marcia (2006, April 7) Rising health cost (vol.16, Issue 13). The census data for 2006 shows that 36.5 million Americans or about one in eight lived below the federal poverty like of $20,614 in income for a family of four.
Compared with other developed nations, America lags behind in the provision of quality and affordable healthcare to its citizens. This research paper will discuss some of the challenges facing the industry and solutions that can be applied to rectify them. Rising costs of medical care Healthcare is the leading socio-economic challenge affecting Americans. The ever increasing cost of medical care and insurance in affecting the American way of life in many aspects. Having problems paying for primary healthcare is no longer the preserve of the poor or the unemployed, but is affecting even those with medical insurance (Shea, 2005).
At MGH the decline was 87.6% in 1988 to 78.4% in 1993 as well. Because of their high medical cost and lack of primary care physicians, 30% of the hospitals revenues were at risk, giving the opportunity to other hospitals to provide these services and create price competition based on Chapter 495. The reduction of gross patient service revenue at MGH and BWH were affected by the changes in government programs such as Medicare, Medicaid and the enactment of chapter 495. These programs along with many insurance companies adopted the Prospective Payment System (PPS) which began monitoring hospital charges and refusing payment for unnecessary services. The hospitals were receiving a standardized payment for each service
In a healthcare organization, risk management manages risks in a manner in which each department works independently to resolve its own issues. Purpose of quality and risk management in healthcare Risk management in health care organizations did not begin until the malpractice crisis in the mid-1970s when hospitals and other health care entities experienced an increased rise in claims costs and insurance premiums in which several medical liability insurers left from the market (Carroll, 2009). Healthcare organizations were then faced with the malpractice verdicts that resulted in higher insurance rates. The purpose of quality management in healthcare systems is to deliver products and services that meet the expectations of customers. The basis of quality management can be identified by three principles: quality control, quality process, quality development.
It can be quite prevailing for individuals to have financial problems towards health coverage. Based on the Health Affairs reference, “In the last decade, health insurance premiums costs have increased by 80%... whereas 58% of Americans report they are not able to seek medical attention due to high costs” (Gary Claxton, Matthew Rae, and Nirmita Panchal, et al). Statistics also present many factors exhibiting millions of individuals facing the risk of losing their insurance. Above all, health insurance is a basic health necessity. Medical services being available to everyone will benefit the public health not only with quality, but along with quantity.
This part works with private insurance companies. This part covers the prescription – drug plan; Medicare covers up to 75 % of drug cost if they exceed a certain amount. Medicaid is a Federal and State funded program each state may have different qualification standards for who is eligible ; this program covers the poor and penniless , pregnant women on public assistance , low income seniors and young adults that are SSI recipients who are blind and or disabled. This plan also cover beneficiaries who
According to Shi & Singh (2012), reports showed that 1 in 3 or 87.6 million Americans were uninsured between 2008 and 2009 under the age of 65. This has contributed to the raise in health care costs. In order to reduce costs, the U.S. health care delivery system needs to have a plan in place to ensure that all of America’s population is insured such as the creation of the Obama Care Plan. The term delivery refers to the provision of health care services by various providers (Shi & Singh, 2012). Providers include physicians, hospitals, clinics, private doctor offices, and other entities.
The nation’s economy has been affected, because of poorer health, with a 65 to 130 billion estimated annual cost. Some estimate that nearly nine million children are uninsured in the country. The lack of insurance for children causes their caretakers to seek less medical care for them, leaving conditions untreated and resulting in improper development. Adults are at a higher risk of developing chronic conditions like diabetes or heart disease. The article has considered four possible solutions to the health care dilemma.
Health behavior such as overconsumption of food, lack of exercise, smoking, and stress accounts for approximately 40-50 percent of morbidity and mortality.  Thus, a reliance solely on the consumer-driven model is not likely to solve the problem, since it would do little to address the key factors that underlie the rise in health care spending. Indeed, missing from the list of solutions for slow-ing health spending growth are public health and preventive interventions at the population level that target the rise in treated disease prevalence.  Moreover, given the important role that medical innovations have assumed in expanding treatment, options for discouraging the diffusion of high-cost/low-benefit technologies also need exploration. To date, U.S. cost containment policy has focused too narrowly on demand-side interventions such as changing the design of insurance benefits and increasing cost sharing.