The modern American healthcare system is more complex and significantly different from “what it was” in 1988. The observed changes can be traced to the transformation of the system from a customized indemnity plan to a managed care system. Indeed, the system continues to evolve today with variation of costs being the most recognizable source of change. It seems that the American healthcare system is deeply rooted within the economic realities existing in the country. As evidenced by reports from analysts and firsthand observations of per capita expenditures, the cost of care has spiraled since 1988. This increase can be attributed to a range of factors, which include increase in healthcare technologies, growth of the population, increase in percentage of elderly populations, rising costs of insurance, increased reliance on drugs, higher malpractice insurance, and growth of allied healthcare professions.
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On assessing the status of the US healthcare system in the 1980s, I noted three major defining features. First, autonomous physicians played the role of an agent for many patients. Second, a larger percentage of patients received intricate care from autonomous non-profit hospitals. Third, insurers did not interfere with decision-making and reimbursed healthcare institutions based on a fee-for-service footing. As regards hospital admissions, the number of hospitals and beds have decreased from 1988, although much of this has been traded with quality.
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Nowadays, a larger percentage of patients return to their homes one the same day after treatment, even from surgeries. Prevention has also become more effective for individuals and families who have attempted to change their health behaviors and lifestyles. Even so, the incidence of insurance as a form of funding for healthcare related costs and the increasing costs have translated to less healthcare coverage and more and more people have been left without care.
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From a broad perspective, the modern American healthcare system involves numerous patient handoffs and interfaces among multiple practitioners with varying levels of occupational and educational training. During the course of a week hospital stay, patients can interact with dozens of employees, including nurses, physicians, nurses, and others. Thus, modern clinical practice revolves around collaboration and many instances that require exchange of information between different parties in the hospital setting. Healthcare reforms now seem to be concentrating on collaboration as it has been shown to improve outcomes like reducing preventable adverse reactions to drugs and declining mortality and morbidity.
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In general, the US healthcare system is experiencing improvement in numerous facets, especially as regards the adoption of technology and espousal of collaboration. As a result, the healthcare system is now characterized by role clarity, trust, confidence, as well as the ability to overcome diversity. Seemingly, the success of the US healthcare system has resulted from increased collaboration and teamwork. The system highlights the importance of inter-professional teamwork and the need of maintaining connections between various healthcare occupations, which is why all future practitioners, including myself, are learning the concept of teamwork more deeply in preparation for a more unified national healthcare of the future.