The patchy U.S. healthcare mechanism

Janice, a 70 an elderly lady aged 70, suffering from dementia and is living with her husband is close to a point where she needs special care. She is living on social security benefits and with less amount of saving faced the shortage of beds in her local nursing home that’s why she was moved to a care center which was 40 miles away from her house. This is an unwanted thing by an elderly individual. This case raises so many questions on the overall healthcare system of the U.S.
The Caring needs of an elderly individual like Janice

Catering healthcare needs of an aging America like Janice who was suffering from dementia requires the considerable amount of changes to our current system and approach ranging from treatment and quality delivery of services. For this purpose, authorities and policymakers should determine their line of action of now, aging Americans and their relatives will soon face significantly increased costs for healthcare needs as well as a sharp decline in the access of quality and integrated services. Care needs of the U.S. elderly population like Janice are changing at rapid pace. Janice needed an improved level of service near her house but unfortunately, they placed her 40 miles away, and it also took time. An elderly American will go through relatively intense and complex scenario which could be worse than the case of Janice. Almost 50% of U.S. population is likely to suffer from one life-threatening disease by the year 2020.

Also, By 2030, more than 40 percent of the population above 65 years of age may have diabetes; almost 80 percent can suffer from hypertension. The total number of cases of the elderly population with two or more long-term conditions have also risen considerably during the last decade or so, and this is likely to go up to 1/3rd among the 65+population by the year 2030. Confounding the job of curing the number of long-term conditions is the growing dominance of age-related functional deficiencies. It will sudden rise in the total number of people who need special care to carry out daily activities like Janice to keep quality in life and maintain self-independence. Also, by the year 2050, the size of Americans requiring services for long-term and supports (LTSS) will increase double to 27 million.

2 The patchy U.S. healthcare mechanism is not appropriate to address a rising aging population’s various healthcare needs like Janice, an elderly lady who couldn’t get quality service near her home instead had to move 40 miles away from her house. Whereas different long-term conditions can be effectively addressed with the help of integrated approach of treatment, providers hardly interact with each other and usually lack proper incentives and initiative for enhancing the overall health condition of the patient. This leaves people with various long-term conditions at a reasonably greater risk for adverse drug side effects and avoiding hospitalization. Disassociated service delivery also creates more difficulties for aging population as we have seen in the case of Janice who needed adequate and integrated health service.

A look at the financial situation and forecast of health care system that can impact the population of U.S at large in next decade considering the past and current status.

The healthcare industry in the United States is worth $ 3 trillion. However, Health finance involves the allocation of funds for healthcare services mainly for the patients like Janice who needed specialized care at a caring center. In this regard, giving funds to a specific population group, a particular region or any healthcare and or systems to afford healthcare (Adler et al.). Increasing healthcare costs continue to affect the overall American health policy and its agenda. So many professionals across the country are debating about the healthcare health sector financing, and administration, care management, private health coverage, and government programs and reforms impact the cost, quality, experience, and outcomes of care and delivery. According to an estimate by topline, health spending will grow at the rate of 5.5% each year till 2026, but the question is will this system be able to cater the needs of elderly individuals like Janice?.

This rate is in the mid of the pre-recession period and significantly low rate of 3.8 percent which was witnessed during recession period and its immediate repercussion. This forecast about spending growth is 1% more than the gross domestic product (GDP). These unbiased, comprehensive forecasts are the essential benchmark for all the concerned expecting the fiscal impact of the healthcare policies on the overall economy, but there are various other important matters for consideration. It all requires an exercise of prediction as to how the system would change such as will the low fee mechanism demanded by the Medicare Access and CHIP Reauthorization Act (MACRA) and the affordable care act (ACA) be practical? The thinkers don’t try to integrate the answers to such questions. They are under an assumption that the existing law will stand. The budget legislation two months ago included the retract of the Medicare independent payment advisory and other changes in healthcare, indicates this point but it got late to become the part of these forecasts. This shows how rapidly and unexpectedly policy and law may change (Almgren, G, 2017).

Secondly, as the authors identify, there is uncertainty around such forecasts. In the recession, we witnessed a sudden slowdown in the level of growth concerning “use and intensity” in care, a phrase “catch-all” getting more lab tests, physician visits, etc. With the implementation of ACA, use and intensity recovered, achieving a typical rate of growth and an enhanced expansion of coverage. The one thing is certain that more extensive coverage produces greater utility.

The statement is moving ahead that use and intensity will return to traditional procedures. The effect of improvements in payment in public and private sector do not reflect in these forecasts. That statement certainly makes sense assuming the usual impact of these changes to the current scenario, but the payment systems keep varying, and their effects can multiply, indicating that probably forecasted growth would be higher than the use and intensity growth (Osborn et al.). Obviously, uncertainty is not single sided. Other theories like launching new technologies or losing commitment to take control of utilization, would produce higher spending projection (Dickman et al.).

More importantly the third, the real rate of growth in spending concerning health in next decade and beyond highly depends on our actions. Healthcare spending is not a particular pattern that can be predicted. In this regard, efforts indeed matter. We should not demand the acceleration in spending growth instead we should consider if we would allow it accelerate or not. The choice are complicated. It also largely depends upon the concept that in future healthcare will spend 20% of the economy in next ten years or so which is a matter of concern because of the impact of taxation on future borrowing to maintain the future health care programs (Lewis et al.).
Challenges and Recommendations

The purpose of healthcare spending is to improve healthcare services. Therefore, acts to confine resources dedicated to health including limited access to healthcare or health insurance form the riks of slowing or rolling back reforms in health. Further, irrespective of the apparent advantages linked to accessing healthcare services, many people count on the healthcare sector for jobs. However, creating jobs is not a justification for lower spending growth as the low spending in healthcare services will create further problems that would also create political issues in the country.

Moreover, authorities should ensure the proper utility of the resources if they are not appropriately utilized they should be used on the other facilities as we have seen the case of Janice, a 70-year-old lady who has dementia, she needed extra care and later she was shifted to the place which was away from her house. This is not the preferred practice as at such age patients must be provided with adequate care near their home. The government should analyze this scenario, and they should work to collect the data of seniors and considering their healthcare needs they should build more nursing cares so that they don’t have to go away from their houses. After the age of 60, the patients need special care which sometimes is not provided by their relatives. Therefore, priority should be given to the elderly patients so they can spend rest of their lives peacefully. No one would like to move miles away from the house after getting retired.

The case of Janice is a clear indication that there is an urgent need for finance and proper infrastructure concerning the healthcare needs of elderly patients. Also, the waiting time should be reduced for such patients as the quick process would make things easier for them. Authorities should lay their focus on remote areas as these are the places where healthcare structure need to be reformed. Old age healthcare benefits should be introduced to cater the care needs of older adults (Owens, C, 2016). A through long-term planning is required in this regard so that patients do not feel isolated in their old age. Authorities should work closely with other departments to estimate the old aged population in next decade and should plan it accordingly. This service requires full dedication and allocation of resources.

Also, there is a need for integrated healthcare financing and delivery system to support elderly patients and rest of their family members. However, the Department of Defense and the Department of Veteran Affairs perform their duties of health care to the active service members, but their families, those who have retired, veterans are under different legal authority. As both, the departments deliver high-quality services but still proper coordination, much better communication, and improved collaboration with Department of Health and Human Services will be much more useful (Jackonis et al.) Those who have served the nation throughout their life need a better treatment in old age. Roles of nurses is very vital in this regard. Nurses who deal with the health issues of such veterans are in a better position to understand these needs very well.

Therefore, if they come up with the proposal of better integrated financial support and delivery system for healthcare purposes of elderly as they need better social network support and rehabilitation to come out of their psychological disorders as was the case with Janice, then it will be a great effort on the part of nurses. A good nurse always tries to provide patients and victims with the best possible healthcare system. Also, they identify the areas of improvement in healthcare system and services. In this regard, nurses can be good healthcare advocate for needs of elderly patients so that they can receive quality services in their town. In this way, patients with the likes of Janice a 70 years old lady who was living on social security benefits with a small amount left in their account, will receive improved healthcare services near their home. There are so many cases like Janice who need special care, but maybe there are neglected as a result of inadequate care centers of probably the lack of integrated financial services that should be provided to such patients.
References

Adler, N. E., Cutler, D. M., Fielding, J. E., Galea, S., Glymour, M. M., Koh, H. K., & Satcher, D. (2016). Addressing social determinants of health and health disparities. National Academy of Medicine. Perspectives: Vital Directions for Health and Health Care Initiative.

Almgren, G. (2017). Health care politics, policy, and services: a social justice analysis. Springer publishing company.

Posted in Uncategorized