Tag: Healthcare

Introduction

The following research paper will focus on the Long Term Care Sector which is part of the health care delivery system. It will look at the historical development of the sectors and the challenges and issues facing it prior to health care reform. It will also look at the specific challenges in the sector, and the benefits and risks it faces in the future associated with health care reform. Despite the US having one of the best medical care services in the world, it is only accessible to those who have health insurance plans or resources. It is has not been universally accessible to all American citizens. The Affordable Care Act ensures that all Americans have access to affordable health care.  Current health reform has focused on the key issues of those who are uninsured, and has not looked critically at long term care especially for the future.

Long term care users fall into two categories; the frailed elderly and the disabled. The long term care sector is a crisis in the horizon as the 77 million baby boomers enter retirement. The number of people requiring long term care in future will increase including the non-elderly persons with disabilities. Policy makers need to look at the key issues affecting the sector in order to come up with health reforms that will assist avert the crisis that will happen with long term care in the next 30-40 years. The costs of long term care are high and the existing systems do not have clear mechanisms for payment and delivery.

Historical Development and Current State of Long Term Care Health Care Delivery

In order to understand the historical development and current state of long term care in health care delivery one must look at the US Health Care Delivery system as a whole. The Health Care Delivery system consists of major components and processes that enable people to receive health care. Most developed countries have a National Health Insurance programs that enables all citizens to receive health care services. However, in the US not all citizens are entitled to routine and basic health care services. Despite the US Health Care Delivery System having evolved, there are concerns on access, cost, and quality as the system does not provide a universal basic health care package at an affordable cost. Organizations, individuals involved in health care include educational and research institutions, medical insurers, suppliers, claim processors, and health care providers.

The US health care delivery system has various subsystems that include managed care, military medical care system that caters for vulnerable populations, and the integrated system that consist of various forms of ownership between hospitals, physicians, and health insurers. Long term care is normally provided through managed care. Long term care is any arrangement where a Medicaid program contracts an organization to provide benefits which will include some level of long term care benefits.

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The following are the main characteristics of the US Health Care System. The system has no central governing agency, and has little integration and coordination. The health care costs under the system are high and there is unequal access. Legal risks influence practice behaviors, and there is conflict through the health care system in terms of market justice vs. social justice. The access to health care under this system is selectively based on insurance coverage. There is a quest for integration and accountability.  The US expenditure on primary health care is the highest in comparison with other developed countries and is almost 13% of the Gross Domestic Product.

The US has a unique Health Care system, but it lacks universal access to all American Citizens. Health care in the US is compromised by disintegration in delivery limited access and high costs. The two groups of patients that suffer under this system are those with complex long term care needs and those with low income or no health insurance. Access is restricted to those who have health insurance through their employer; those covered under a government health care program; those who can afford to buy health insurance using their own funds; and those who are able to pay for services with their own funds. In most developed countries the Government plays a central role in the provision of health care to its citizens. In the US this is different where the private sector plays a leading role.

In 2003, managed long term care market was expected to grow dramatically. However, only 2.3% of this market using public long term care is receiving these services. Managed long term care is provided mainly through large local non-profit plans or those that have progressed due to responses from particular states. The growth of long term care services has been very slow due to several factors. These include complex programs that take a relatively long time to plan, startup periods, and resistance of long term care providers, federal policies, and inadequate infrastructure. However, despite these challenges long term care is popular in the states where it is well established and has the potential to grow in the future (Fronstin, 2010).

In the 1970’s long term care services was mainly through nursing homes. This brought about large increases in nursing home expenditures and raised the issue of whether the long terms services system was sustainable. In the 1980’s there was the introduction of home and community based waiver (HSBC) so that states would create flexible community based services. The HSBC waiver program grew rapidly, however the nursing home expenditures continued to increase. This meant that the HSBC waiver could not control the growth of institutional care.

In the 1990’s several states planned initiatives on long term care based on Medicaid managed care. Different states had different legislation on long term care. In 2003, 3.1 million elderly persons and persons with disabilities received long term care through Medicaid financed long term care. Of these, over half a million were in nursing homes and half a million went through community based waiver services program. Examples of managed long term care programs include Arizona’s Long Term Care System, Florida’s Frail Older Option, and San Francisco’s On Lok Program. Minnesota, Colorado, and Wisconsin are among the leading states providing innovative models on long term care.

Types of Long Term Care

• Formal and informal caregivers – this refers to unpaid family members and unpaid persons such as friends, neighbors, family members and partners. The individuals can be primary or secondary care-givers, live with the aging individual or separately, and can work full time or part time. This category comprises of the largest number of caregivers in America.
• Home and Community Based Care – thevast majority or about 80 percent of people receiving aid include those with functional limitations and stay in private homes in the society and not in institutions. The ageing population aged 65 years and above with functionality impairment receives 9 hours of assistance daily while those who are aged more than 85 years have 11 hours of support daily. Hospice care can also be given at home for the terminally ill persons.
• Nursing Home Care – There are many old people that resides in institutions mostly those who are above 85 years of age. However, the price of a room in nursing home caresgrowing over time. This is due to the surge in the number of people who seeks a long-term solution in this home care while the facility does not expand with demand.However, the nursing homes provide a cost-efficient technique to permit patients with injuries to recuperate in an environment outside a sanatorium. The nursing homes attend to two types of clients. The first group is those that have been discharged from clinics for rehabilitative upkeep. The Medicare recompenses for a limited time for this type of nursing home care. Secondly, it also caters for those who suffer from mental disorders and chronic physical ailments that they are unable to move about, provide their own meals, and clean themselves by taking a bath. This kind of care is paid by Medicaid and the kind of people who suffers from chronic physical diseases and mental disorders are referred to as long term care residence.
• Supportive Housing programs – this kind of program offer low cost housing to the older people earning low to moderate incomes. The responsibility of developing such housing is under the state or local governments. They assist the client with tasks such as shopping, laundry, housekeeping, and meals. Further, they also assist with help such as eating, bathing, transportation, toileting, taking medicines, and dressing.
• Continuing Care Retirement Communities – This type of long-term care provides a full variety of services and care based on what every occupant requires over time. This kind of arrangement provides care in three key stages namely: skilled nursing, assisted living and independent living(Crocker, Forste, Young, Brown, Ozer, Smith & Greenwood, 2013).

Challenges and Issues In Long Term Care Sector Prior to Health Care Reform

The major challenges and issues facing long term care prior to health care reform relates to access, cost and quality. Prior to health care reform, states had showed interest in using managed care models to purchase Medicaid benefits for those populations that required long term care. In developing these programs, States needed businesses that had managed care plus expertise in clinical, social management of long term care populations. Traditional health plans prior to health care reform did not have this expertise. On the other hand, those that had expertise to provide services for long term care did not have any experience in managed care. For the long term care market to succeed, it required the merging of managed care expertise with experience in long term care populations. Due to this the managed care institutions expanded into long term care or long term care institutions expanded into managed care. The market before health care reform was dominated by long term care businesses expanding into managed care (Baer & O’Brien 2010).

The role of the aging network advocates was another challenge facing long term care. Advocacy from aging networks has a huge impact on various long term care programs. For example, the aging network advocates were opposed to long term care reforms based on partnership models that involved integration of acute and long term care. This was because such plans would be dominated by medical HMO’s thus reducing the role of the aging network.

The other challenge is that there are not many private long term care businesses to offer long term care to the aging populations.  Prior to health care reform law, there were two major for profit players in the long term care market; Amerigroup and Evercare which is the leading player. Evercare has long term investment plan and it targets frail elders and all persons with disabilities. The company is working across the country and is also active at federal and state levels. Amerigroup on the other hand is Evercare’s major competitor, but long term care is not its core business. Most providers of long term care have developed a managed care service (Fronstin, 2010).

Another challenge is whether managed long term care can offer more value in comparison to HCBS services. HCBS or fee for service programs depend on the case manager who coordinates the long term care. Managed long term care increase the use of home and community based services, and reduces the use of institutional services. They also have high customer satisfaction levels. In addition preventable admissions and high death rates are not a concern.

Policy issues and complex program designs are a challenge to managed long term care. The managed long term care programs that have been implemented are very diverse across different states. Differences exist in payment methods, managed care suppliers, competition, and whether enrollment is mandatory or voluntary. Most states do not have a clear picture of which program models they should replicate. However, Arizona stands out as one of the most successful long term care programs (Grabowski, 2006).

Legal authority over managed long term care has advanced positively, however difficult policy issues often emerge that complicate program development. Payment challenges will always remain controversial and technical for most managed long term care programs. These need to be refined in the future. Constituents are concerned about political resistance to managed long term care from the established fee for service systems. Infrastructure is a challenge which affects access, and it is does not exist in some states where the target population for long term care lives. Managed long term care was in its infant stages prior to health care reform, where only 3% of the potential market has enrolled in managed long term care plans.

Challenges in the Long Term Care Sector

The biggest challenge that the long term care sector will face in the future is that baby boomers are set to retire and the number of citizens seeking long term care will increase. In addition new technology and medical advances are increasing life longevity. It is estimated that there are about 77 million baby boomers. Most of this population prefers to receive medical care from home or their community and not in nursing home. Very few of them have prepared for long term care either through insurance or savings. Majority of the baby boomers have fewer children and will most likely be divorced. It is therefore unlikely that they can have family to informally take care of them (Johnson, & Wiener, 2006)

Currently health care reform laws and associated regulations are concerned with the populations that are uninsured and the rising health care costs. However, long term care need to be considered as it may soon become a crisis in the future. Many elderly people live in fear that chronic diseases will drain them financially. This aging population may have to depend on their children or welfare, and this will limit how they want to live at the end of their lives. Long term care will soon become the issue after the health reforms on acute health care systems.

Policy makers need to reform the health care system to ensure that this aging population can access affordable long term care in the future. The current system does not meet the demands of the frail and elderly who require assistance in normal daily life tasks such as bathing, toileting, dressing, cooking, transportation, housekeeping, and managing finances. Long term care is expensive and the cost will continue to rise in future. Long term care is currently funded through Medicaid and Medicare (63%), with out of pocket expenses covering 22%, and the remaining 15% from private sources. Medicaid covers long term care, but Medicare only covers some level of long term care for short durations after hospitalization. Most of the people approaching retirement are unaware of this fact (Johnson, & Wiener, 2006).

Private financing of long term care is through long term care insurance. Currently about 8 million Americans have some form of long term care insurance. These policies vary as long term care insurance is a relatively new product in the health insurance market. Cases of difficulty in getting long term care benefits under some of these policies have been reported. The market for long term insurance is small because families, who can afford to but it earlier in life, do not because they are in denial about ending up in a nursing home when they retire. Other families do not have the necessary information to make a decision and sometimes they do not understand the insurance technical language. High premiums is also another factor that deters families from purchasing long term care insurance (Baer & O’Brien 2010).

As the baby boom generation approach retirement, most of them do not have financial plans for their retirement. This leaves them with insufficient savings to take care of their expenses in retirement. The average nursing home costs about $ 80,000 a year, whereas some of this generation end up with about $70-75,000 in savings when they retire. Additional policy effort is required to deal with the challenges that the long term care sector will face in future. Medicaid and Medicare are already facing huge financial strains due to high health care costs and an increase in demand for services (Calmus, 2013).

Potential Risks and Benefits

As discussed earlier the number of people requiring long term care will increase as baby boomers grow older and the number of non-elderly persons with disabilities increase. The Patient Protection and Affordable Care Act also known as the ACA or Obama care makes long term care services more affordable and protects the rights of consumers. All citizens are entitled to health care until they retire.  The law ensures that people can receive long term care services and support in their homes or community. It provides existing tools, new options and financial incentives for States to provide home and community based services. The aging population will have increased access to health care and the law will ensure quality of service (Gruber, 2011).

The health care reform provides enhance federal funding to states for the provision of person centered and home and community based attendant services. This will increase the ability of individuals with disabilities to live within their community. The law increases access to non-institutional long term services support (LTSS). The Money Follows the Person (MFP) was extended under the law for a further five years. The MFP allows for individuals who are provided with long term care to move out of institutions into their homes and other community based environments. In the area of quality, the law provide for a grant program (TEFT), demo grant for testing experience and functional assessment to test quality measurement tools and ensure quality of long term care services (Gruber, 2011).

The possible risks to long term care associated with health care reform are that the current health reform laws have not critically looked at the future. Long-term care should be part of efforts to improve health care for all Americans. It is believed that long term care affects only a small percentage of the population. 70 percent of people turning age 65 will need long-term care as they age, and about 33% will spend some time in a nursing home  (Wiener, 2009)

There are four critical factors that need to be considered when looking at the possible risks for long term care associated with health care reform. The first one is that the aging population and people with disabilities is going to grow dramatically in the future. The financial burden for long term care will be much greater than before. Health reforms need to consider how this part of the population will access long term care. Reforms need to consider the demographics or characteristics of the people who will require long term are in future as this is very different from those receiving long term care today (Wiener, 2009).

Secondly, federal and state governments are spending huge amounts of money on long term care. Public spending on long term care will increase substantially in the next 20-30 years. Long term care is one of the health sectors that is dependent on public funding. Thirdly, most of the older people with disabilities also incur high acute care expenses as these are related to their underlying chronic diseases. Fourthly, the current health care system under the existing reform laws does not have a proper financing and delivery system. There are no proper mechanisms in place to help people plan and pay for long term care as they grow older (Calmus, 2013).

Conclusion

In conclusion long term care is an important sector of the health care delivery system. Policy makers need to develop health reform laws and regulations that can deal with the growing number of people that will require long term care in the future. This is especially because of the baby boomers that are soon to retire and live longer due to medical advances. The focus has been on acute care services and the uninsured, but the focus should now shift to long term care. The Affordable Care Act benefits long term care in certain aspects but it does not look at the future.

Healthcare Information Governance Assignment Instructions

Research health care organizations / providers that have recently had a significant information technology failure, and complete this assignment. Write a seven to eight (7-8) page paper in which you:

• Determine the key factors contributing to the failure in question. Next, analyze how the failure impacted both the organization’s operations and patient information protection and privacy.
• Analyze the leadership team’s reaction to the failure, and indicate whether the leadership took sufficient measures to deal with various stakeholder groups impacted by the failure. Provide support for the rationale.
• Take a position on whether the health care provider that you identified should either develop a custom application or select a proprietary system. Provide support for the rationale.
• Recommend at least three (3) best practices that any organization could adopt in order to avoid such a failure in the future.
• Provide support for the recommendation. Suggest how health care leaders can use project metrics and portfolio management to ensure operational efficiency and effectiveness. Provide specific examples to support the response. Analyze a government intervention into health care businesses, meant to ensure that health care and patient information is secure and thus to minimize information breaches and technology failures.

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Health Care Organizations That Had a Significant Information Technology Failure – Sample Paper

Information Governance

            Good information technology must enhance cognitive function, provide user experience, can be customized easily and effectively to the needs of the subspecialists and specialists, must effortlessly put the essential information to the hands of the physicians, should keep eHealth information securely, help facilitate better practice of medicine and outcomes and protect patient privacy. All these attributes point to the importance of maintaining an effective information technology in the healthcare setting. The information technology with no doubt has brought improvements in the healthcare setting and has improved the level of outcomes.

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However, a poorly designed information technology can bring huge loss of patient data and sometimes can cause patient data breaches as witnessed in the Health Net, which lost a hard drive that had information of close to 1.5 million members. Numerous healthcare providers have experienced information technology breakdowns in the United States.

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Health Care Organizations That Had a Significant Information Technology Failure

Network Glitch at Florida Health System

            In 2014, IT network failure at Florida Health system paralyzed health operations in its MHS facilities (Stuart, 2014). According to the hospital officials, the failure in the hospital hardware system paralyzed operations for about two days. A hardware failure in the three-hospital Martin Hospital in Stuart caused an unexpected downtime in the hospital’s Epic EMR and other applications. In fact, the breakdown affected thirteen of the hospital MHS facilities.

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            Although the breakdown occurred in the evening of Wednesday, the hospital officials reported that the IT department resolved the problem and restored the services by Friday (Stuart, 2014). The hospital officials asserted that although the problem affected the Epic EMR, the cause was attributed to the hardware breakdown. The hospital spokesperson, Scott Samples asserted that the hospital had to resort to manual patient documentation and charting system, as the patient care was their priority. In the same hospital during the launch of its Epic MRC in 2011, Samples had asserted the development of proper processes to ensure patient safety and proper documentation in such processes of downtime. He pointed that the health system would follow due processes in order to ascertain the causes of the glitch and prevent such events in future.

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Sutter-Health in Northern California

            As more hospitals ditch paper work for electronic record systems, more downtime glitches are reported in the United States. The other recent occurrence of a downtime on patient care is the Sutter Health in Northern California that occurred in August 2014, (Stuart, 2014). In an event similar to that of the Florida Health system, the hospital’s $1 billion Epic EMR experienced downtime that paralyzed hospital operations for a whole day. According to a press response from Sutter nurses, the glitch caused a compromise on the patient care.

            The problem extended to the hospital patient data backup system and when the hospital nurses resorted to printing the patient data using the hospital’s Pyxis system, the data print out was outdated by two to three days. According to a RN at Alta Sates Summit Medical Center and California Nurses Union representative for the hospital, the patients were concerned for failure to receive their medications for a whole day. Although the downtimes were from Citrix glitch, the hospital officials denied naming the vendor (Stuart, 2014). However, they issued a statement to regret the inconvenience that was caused to the patients.

How the Failures Impacted Both the Organization’s Operations and Patient Information Protection and Privacy

            The failure of the hardware in the Florida Health system paralyzed operations in its MHS. Although the hospital was able to resort to manual chart and documentation of patient data, there was likelihood that it caused many patient inconveniences due to time taken to offer medication. In addition, given that the glitch took two days to rectify, explains the extent of inconvenience and the risks it exposed the electronic medical data.

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            According to (Johnson & Willey, 2011), healthcare data loses can result in social stigma and privacy violations. The failures of the Epic EMR in Florida Health system opened an avenue for consequential changes in the patient medical information. For example, changes in information such as blood type or allergies can affect patient health. Therefore, the downtime in Florida Health system exposed patient data to possible privacy breaches and improper diagnosis.

            The Sutter Health in Northern California case caused a lot of patient inconvenience, although it just occurred for a day. The fact that the retrieval of patient data from hospital backup system produced data that was outdated by two to three days, meant the system failure exposed the patients to wrong diagnosis. In addition, the system opened up loopholes for data loss in the hospital electronic data storage. The reliance of the Sutter Health in Northern California in its Epic EMR meant that many of the patients were not able to receive their medications for most of the day and almost paralyzed the operations in the hospital.

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The Leadership Team’s Reaction to the Failures

            The reactions of the leadership in the failures that affected Florida Health system and Sutter Health in Northern California were almost similar. Both leaderships failed to own responsibility for the failures. In addition, the hospitals response failed to give comprehensive information regarding the steps the hospitals took in order to secure patient information during the time of the failures. The spokesperson for Sutter Health in Northern California just issued a statement expressing the regret for the inconvenience caused by the downtime in the hospital EMR. In addition, the hospital leadership declined to name the vendor of the Epic EMR, only for the medical representative to name it.

            However, the leadership of the Florida Health system reacted by ensuring the patient care experienced minimum inconvenience, when it resorted to the manual patient data documentation and charting. The numbers of the patients in both hospitals, whose data was exposed was huge and it could easily have led to a breach of the HIPAA regulations. According to (Gamble, 2012), a number of regulations govern the Electronic Medical Records. The first legal aspect covers the risks of medical malpractice. The Florida Health system in the case above was concerned with patient care and the hospital leadership worked to ensure that minimum inconvenience was caused and that patient care was not compromised due to the failure of its Epic EMR. Its use of the manual system worked and patient care experienced minimal inconveniences.

            However, the Sutter Health in Northern California use of the Pyxis system produced outdated data, which would have exposed the hospital to the breach of the HIPAA regulations governing EMR. The reactions of the Sutter Health in Northern California to resort to Pyxis system exposed the physicians against risks of medical malpractice claims, likelihood of medical errors and vulnerability to fraud claims.  In addition, the failure of the hospital leadership to provide detailed information of the cause of the downtime and the steps it took to secure patient data as well as ensure patient care was not compromised, was insufficient.

Position on Whether the Health Care Providers Should either Develop a Custom Application or Select a Proprietary System

            As the healthcare system in the United States adopts more electronic healthcare records (EHRs), the numbers of vendors have narrowed. In 2013, about ten EHRs vendors accounted about 90% of the HER market in the hospital sector in the country. These vendors include Epic, Cerner, Healthland, MEDITECH, Siemens, CPSI, McKesson, NextGen Healthcare, Allscripts and Healthcare Management Systems (Gregg, 2014). However, only three of the ten vendors expanded their market in 2013. These vendors include Epic, MEDITECH and Cerner. Although there are national efforts to improve safety, effectiveness and quality, there is need for the healthcare organizations to be prepared for the failures that occasionally come up with the adoption of the EHRs applications.

            In regard to the failures that occurred in the Epic EMRs in Sutter Health in Northern California and Florida Health system, there is need to adopt custom applications. When an organization adopts proprietary system, there is likelihood of the laxity from the supplier company and this poses great risk in the event of any system failure. Most of the proprietary applications are one company owned and once the companies sell the copies of its software to cover its development costs, every other unit sold generates pure profit and this reduces company emphasis on innovation or efficiency (Muir, 2011). As seen in the case of Sutter Health in Northern California, the presence of the Pyxis system would provide an alternative when the Epic system failed. Therefore, there is need for Sutter Health in Northern California and Florida Health system to integrate multiple disparate systems in order to have comprehensive custom applications for their EMRs (Vest & Gamm, 2010).

Recommendation of Best Practices That Any Organization Could Adopt In Order To Avoid Such a Failure In The Future

            The failures of hospital EHRs causes inconveniences to the patients and can hinder patient care (Terry, 2013). In order to avoid such occurrences as witnessed in the Sutter Health in Northern California and Florida Health system, there is need for healthcare organizations to adopt a number of strategies. The following are the recommendations, which when adopted, can help in avoiding such failures in future.

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            First, avoid proprietary and adopt custom applications in order to ensure the healthcare information system is interfaced with the available information technology infrastructure. As witnessed in the case of the Florida Health system, there was no backup for the healthcare records, due to dependence on the proprietary Epic application in its EMRs. The presence of backup system in Sutter Health in North California allowed an access of patient data. However, lack of interfacing with the existent hospital information technology, led to retrieval of out dated data. Therefore, there is need to interface the HIT with the existing hospital information technology in order to ensure continuity of patient care in case of a glitch.

            Second, identify and mitigate risks before they occur. The hospital information and technology department should conduct system updates and regular checks in order to troubleshoot and prevent major downtimes that can derail the operations in the hospitals. The regular checks should also take into consideration the security checks in order to ensure that appropriate measures are in place in order to prevent any data loss in case of any system failure. As noted in the case of the Sutter Health in North California, the hospital patient information is very vital and it goes a long way in enhancing the work of the physicians. Making such information available all the time is very important in ensuring the continuity of patient care.

            Third, exercise good governance, learn from others and past events in order to benchmark on the best practices. There is need for the senior management should ensure the organizational mission and vision are focused on efficiency, increasing quality and delivery of services in organized and cost effective way. It is with no doubt that EMRs play a critical role in enhancing vision and mission. However, there is need for the top management to support the EMR in order to realize successful implementation (Cellucci, Wiggins, & Trimmer, 2011). Most EMR failures result from its poor implementations.

How Health Care Leaders Can Use Project Metrics and Portfolio Management to Ensure Operational Efficiency and Effectiveness

            The project portfolio involves the maximization of use of the available resources and organizational capabilities in order to ensure the meeting of the desired outcomes, within the constraints of technology, finance, vision and mission (van Angeren, Blijleven, & Batenburg, 2014).  The project metrics are data that give a measurement of the projects. The healthcare organizations can use a combination of shrewd resource allocation and project metrics in ensuring that its operations are effective.

            An organization in analysis the costs of project, selecting the project that is cost effective and providing good control measures, it can ensure a project that is efficient and affordable. In addition, the evaluation and controls in portfolio management help in prevention of inconveniences caused by failures in projects. Besides, the use of metrics ensures that the right projects are selection and implemented.

Government Intervention into Health Care Businesses, Meant To Ensure That Health Care and Patient Information Is Secure and Thus To Minimize Information Breaches and Technology Failures

            The federal government through the HIPAA act has enacted a number of regulations that govern the safety of patient data (DesRoches & Miralles, 2010). The federal government through its federal stimulus package of 2009, the American Recovery and Reinvestment Act 2009 has a number of provisions as drafted in the Health Information Technology for Economic and Clinical Health Act provide an encouragement for the hospitals to adopt electronic medical records. It is evident that as much as the government provides framework for adoption of the EMR, it exercises also it other core responsibility of regulation.          

The most important aspect of the healthcare security is the security of the patient information, which includes the medical information. Any lose of the patient information is not like lose of a financial card, which can be re-issued and another one issued. When patient data is lost, it can be used for impersonation or to solicit for money. Therefore, the government through the HIPAA has provided a number of regulations that protects the patient against risks associated with loss of their medical information in case of security breaches or system failures.

“I will begin by welcoming all of you to today’s presentation. The topic of this presentation is “How the practice of nursing is expected to grow and change.” The mode of healthcare delivery today is very different from the one used in the past centuries. The healthcare delivery system is now changing to meet the health needs of the current and future generations. In the coming years, we as nurses are expected to contribute positively to the restructuring of the healthcare delivery system of the United States. For example, it is anticipated that very few nurses will be required to serve in acute care hospitals while a large percentage of them are expected to work in the community. This means that future nurses must be equipped with the knowledge and skills required for quality healthcare delivery in the community. In order to produce competent nurses who can offer both community-based and hospital-based healthcare services, the educational sector must make relevant changes that match the anticipated growth and changes in the health sector.

The community is faced with the challenge of dealing with new infections that are affecting society today. With close guidance and advice from nurses, the community will be able to know the right actions that they must take in order to avoid deaths that may occur from such infections. According to Kovner and Walani (2010), there is an increasing need for health education and prevention in the community. The best way through which the community can receive relevant health education is when healthcare delivery systems are brought close to them. This explains why nurse-managed clinics should be created out in the community. An advanced practice nurse must be deployed in every nurse-managed clinic to help provide health education and to deliver care to the community (Kovner and Walani, 2010). This clearly indicates that more nursing jobs will be available in the community in the near future following the creation of nurse-managed clinics.

Apart from the anticipated change in the role of nurses in the near future, another aspect of growth in nursing practice that is expected to change is the manner in which nurse performance is rewarded. In a few years to come, nurses will be rewarded on the basis of the quality of care delivered and their ability to manage costs. In nursing, this new system is known as Accountable Care Organizations (Deloitte, 2009). Various healthcare organizations will transform into accountable care organizations that compensate physicians and nurses based on health care quality delivered. Successful implementation of this new system will completely change the manner in which healthcare organizations reward nurse performance. This calls for an immediate realignment of the nursing sector such that nurses must be in a position to deliver quality care to their patients both in the hospital setting and the community (Deloitte, 2009).

We as nurses are charged with the responsibility of ensuring that rates of disease occurrence in the community remain low. In order to achieve this, the community should be given an opportunity to make medical consultations whenever they need to (Dardani and Lyles, 2010). Patient-Centered Medical Homes is a new health care delivery system that seeks to provide the community with constant access to their personal healthcare providers and to unlimited medical consultations. According to Dardani and Lyles (2010), it is anticipated that Patient-Centered Medical Homes will change nursing roles from the provision of indoor medical services to serving community-based roles in the medical homes.

We must also remember the fact that many deaths that occur in the community today are caused by chronic diseases such as high blood pressure, cancer, and diabetes. Many people succumb to these diseases because they lack adequate knowledge on how to effectively manage them back at home after they have left the hospital. Faster recovery from chronic diseases can be enhanced if the nurse continues to guide the patient even after acute care (Haggerty et al., 2003). This is known as Continuum of care and it is one of the new systems that are likely to change the face of healthcare delivery in the near future. Under Continuum of care, more nurses will be deployed in the community to offer continued care to community members who are suffering from chronic infections (Haggerty et al., 2003). Nurses who will offer a continuum of care and who will be required to serve in nurse-managed clinics, accountable care organizations, and patient-centered medical homes will be chosen at random. I, therefore, urge each and every one of us to acquire the necessary skills that will enable them to continue working as nurses in a sector characterized by rapid growth and change. Thank you!”

According to nurse 1, many people in the community acquire certain infections due to a lack of knowledge about how such diseases can be prevented. This compels the health sector to spend a lot of finances purchasing drugs that can be used to treat diseases that could have been avoided. For instance, a high percentage of the population is currently infected with HIV merely because they were not conversant with various preventative measures. Such infections can be avoided if only members of the community were taught in advance on how to avoid them. Nurse 1 supports the idea that the health care delivery system is likely to change in the near future where nurses will be required to deliver care in nurse-managed clinics and patient-centered medical homes (Kovner and Walani, 2010).

According to nurse 2, the nursing profession requires all workers to offer high quality of care to all patients. A system that assesses the quality of care can help nurses enhance their performance levels and to ensure that they offer quality care. Both modern and future hospitals are incorporating a new system that will assist them to reward nurses and physicians based on performance. Nurse 2 has an impression that in a few years to come, healthcare organizations will not reward nurses based on their academic qualifications but on the quality of care they deliver. She believes that accountable care organizations will not retain nurses who cannot meet their quality standards (Deloitte, 2009).

According to nurse 3, the healthcare conditions of people who are suffering from chronic infections normally worsen after they leave the hospital. This is attributed to either side effects of drugs or non-adherence to medication. In order to reduce rates of deaths that occur from chronic infections, nurses must be deployed in the community to deliver continuum care to patients who are suffering from such infections. This means that in the near future, the number of nurses working in the community will exceed those offering indoor services. Nurse 3 feels that the nursing sector is expected to grow and change at a rapid rate in the near future and nurses must be prepared for those changes in order to fit in the future job market (Haggerty et al., 2003).

Child mortality refers to the death of an infant before their first birthday. Notably, infant mortality is widely used to measure both population health and the quality of health care. According to World Health Organization (2020), infant mortality highlights a longstanding, growing concern of public health. Public health not only sees the factor as a measure of infant death risk but uses it more broadly as a crude indicator of availability and quality of medical care, community health status, and poverty and socioeconomic status level in a given community. Thus, the health and wellbeing of children and communities across the globe can be measured using child mortality rates.

Understanding child mortality is, therefore, essential to describing advancements in health care outcomes. Infant mortality comparison between time periods can help determine whether the quality and accessibility of health care in a particular area is improving or deteriorating. Increased infant mortality points out declining health care outcomes and vice versa (World Health Organization, 2020). Therefore, by analyzing infant mortality rates across time periods and regions, health care policymakers are able to determine which communities need improvements in their health care system as well as prioritize based on urgency.

To sum up, infant mortality comparison serves as a needs assessment to help public health evaluate the quality and accessibility of health care. The variable is also essential for assessing the impact of public health programs. The essentiality of infant mortality in describing advancements in health care outcomes stems from its ability to paint a picture of the availability and quality of medical care, community health status, poverty, and socioeconomic status level in a given community.

What are some of the ethical and social implications of predictive informatics in health care?

Over the past decade, predictive informatics has emerged as the potential future of healthcare globally. Yet, it still remains imperative to consider key ethical and social implications of this new reliance upon predictive informatics. A major ethical concern associated with this new development is the privacy and confidentiality of patient data. This typically includes issues surrounding the granular control over data provided to a specific healthcare provider, evaluation of the data, and social networking reliance (Meek, 2016). Similarly, decision support is also a key social implication of predictive informatics in healthcare. This is primary due to the fact patients have previously been known to access such data devoid of any qualified clinical intermediaries within a healthcare setting.

Is predictive informatics that uses genomics racist, sexist, or homophobic?

            Although predictive informatics using genomics has recently been criticized for being racist, sexist, or homophobic, I firmly contend that this assertion is erroneous and unfounded. Predictive informatics essentially seeks to address medical actualities of the day with the primary aim of introducing viable solutions through new developments in personalized medicine. This now involves identifying the susceptibility of a particular race, ethnic group, sex, or gender with the primary objective of bolstering disease prevention and reducing specific risks associated with a particular. For instance, susceptibility to cardiovascular disease and obesity varies starkly from one individual to the next based solely on biological and sociocultural factors (Srivastava et al., 2020). Thus, predictive informatics through genome-based knowledge is responsible for a deeper comprehension of distinctions within a given population and bound to ultimate result in positive outcomes for vulnerable individuals.      

How can genomics and data analytics change how healthcare and coverage could be approached?

Genomics and data analytics represent a revolution undoubtedly bound to have far-reaching impacts on healthcare and an alternative approach to coverage. This is mainly because their application increases the accuracy rate of diagnoses. The subsequent application of predictive algorithms will play a central role in informing a physician’s decision concerning whether a patient should be discharged as opposed to relying solely on their clinical judgment (Yoshihashi & Hoyt, 2017, p. 56). Furthermore, it will also bolster preventive medicine within the healthcare sector through early intervention and health promotion through well-living. Predictive analytics is also bound to transform coverage by according healthcare providers with accurate predictions of individual costs associated with insurance products. This may also go a long way in allowing employers to make accurate future predictions of healthcare costs likely to be incurred by employees covered by the organization.

The field of healthcare is undergoing a massive scientific change and revolution as a result of technology. One disruptive technology that is rewriting the delivery of care is virtual reality (VR) technology. VR is the use of computer simulation and modeling technologies that facilitate interaction with three dimensional virtual and sensory environments. VR technology was initially popularized in the 1990s. Since then, scientific research has produced a plethora of studies to present new discoveries and applications in various fields. The health healthcare sector has experienced a huge increase in the application of VR. Uses span from the creation of new life-saving techniques to medical training, patient treatment, surgery, medical marketing, and disease awareness. In essence, VR applications immerse users in computer-generated environments that simulate reality through special integrative devices that communicate with the user. Virtual Reality devices are becoming increasingly available to the average consumer, meaning that sooner or later, patients may also reap the benefits of VR technologies. Examples of VR devices comprise headsets, goggles, bodysuits, and gloves.

            A significant area in healthcare where VR is progressively transforming procedures and workflows is education (Fertleman et al., 2018). Notably, many healthcare operations require the utilization of expensive high tech equipment which may not be available to everyone. VR provides a cheaper alternative by providing simulations that mimic wards and operation rooms. Simulators are an advantageous way of training aspiring surgeons, medical professionals, and assisting nurses. Many healthcare educators have already implemented VR in training. For Example, Stanford University uses a surgery simulator that provides haptic feedback to the user.

Read also Design Concept for Haptic and Thermal Sensorial modalities in Virtual Reality Interactions Evaluation

            Despite its promising benefits, VR technology is plagued by several ethical limitations. Virtual Reality is a new technology, and as such, its implementation presents challenges that impact the user in various proportions. For instance, there is no evidence documenting prospected side effects since no one has utilized VR before in healthcare settings. Researchers have cited the significant concern that the application of VR could lead to the occurrence of unexpected side effects. Some have cited cybersickness as a potential outcome because of incongruous sensory cues that emerge when one uses VR. Incongruous sensory cues denote a conflict between casual, auditory, vestibular, and proprioceptive senses and the user’s expectations based on real-world experiences.

Read also Reflection Essay on the Use of Virtual Reality in Employee Training Programs

The use of VR may pose significant issues to children and elderly populations. Children are highly susceptible to information and can confuse what is real and what is virtual. Studies that have featured children in VR experiments have concluded that children are more likely to believe that virtual characters are real (Segovia & Bailenson, 2009). Additionally, since VR involves full immersion of the user into a virtual environment, elderly people and people with mental issues can have adverse reactions. Traditional moral responsibilities are not applicable in the virtual world since the latter may lack or include aspects that are not synonymous with those of the physical world. It is important to investigate environmental impacts, account social involvement, and other repercussions that Virtual Reality may bring when applied in healthcare settings.

Read also How Patient Education and Technology Impacts the Delivery of Healthcare and Nursing Care

In conclusion, virtual reality technologies offer healthcare communities a vast array of opportunities, but they also present an equal share of challenges that require further assessment and research. The future of VR in healthcare is seemingly boundless and the current range of applications is getting wider by the day.

One of the major concerns that currently impede the achievement of quality healthcare in the 21^st century is the resistance to change. Although scholars have identified a range of problems and barriers to attainment of excellence in care, literature shows that many organizations in the healthcare sector frequently try to maintain the status quo when efforts are made to alter it. Often healthcare professionals view change as a threat to their security, as change upsets established patterns of behavior. The change of established behavior is particularly challenging because of the complexity of relationships between various organizations, professionals, caregivers, and patients. It is important to note that change triggers several group emotions that pervade an entire healthcare team, causing a group counteraction in resistance to the proposed change. These effects exist in a majority of healthcare systems that use poorly planned implementation approaches that do not consider all significant variables in change management such as the emotions of those affected by the change, potential deleterious effects of such emotions, and the pragmatic approaches for managing negative sentiments. The process of implementing change also adds on to the challenge as some new policies can take a considerable amount of time to implement. Thus, healthcare professionals should acknowledge impediments to change and develop counteractive measures as well as explore various ways that can facilitate the attainment of quality healthcare in future.

Read also Toxic Handler Role In Organizational Change

            Factors that  promote resistance to change include habits, conservatism, complacency, fear of disorganization, perceived loss of power, insecurity, set patterns of response to change, perceived loss of current or meaningful personal relationships, ego involvement, and perceived lack of rewards. People are afraid of change because of lack of knowledge, prejudices resulting from a lifetime of personal experience and exposure to others, and fear of the need for greater effort or a higher degree of difficulty (Roussel, 2006). People have developed fears, biases, and social inhibitions from the cultural environment in which they live. Since they cannot be separated from these cultural factors, it is necessary to find ways of managing them within a system. Barriers to change include a perception of implied criticism. Most people hold a perception that the implementation of change is because the implementers do not like what the people in that system are doing (Roussel, 2006). Employees perceive that machines and systems are replacing them or making their jobs less interesting. For example, a programmed system could be used by patients to take their own nursing histories; Change may demand the investment of a great deal of time and effort in relearning. If nurses are to be independent practitioners, what happens to those who are not prepared? Probably the greatest single personal barrier is that individuals do not understand or refuse to accept the reasons for the change or the need for it (Roussel, 2006). Unfortunately, it is not always easy to equate the reasons and the needs and to communicate them in meaningful and compelling language. Healthcare professionals are part of a social system and will resists change if alters that social system. In fact, social changes invoke more resistance than technical changes (Roussel, 2006). Other causes of change include pace and time of implementation owing to the fact that different generations of healthcare providers have different rates of change.

Read also Appropriate Strategies for Administering the Quality Improvement and Risk-Management Processes within a Healthcare Delivery System

            In order to counter resistance to change and facilitate the attainment of quality, healthcare professionals and leaders need to comprehend how to handle the complexity of the process. They ought to evaluate, plan, and implement operations, strategies and tactics, as well as make sure that the change is relevant and worthwhile. The overall guiding principle is that change is a dynamic, complex, and challenging process and is never a choice between people or technology-oriented solutions, but rather a combination of all. Effective change involves unfreezing old behavioral patterns, introducing new behaviors, re-freezing them. As a rule, change can either be sporadic, occasional, continuous, or rare. Predictable change can allow healthcare systems to reserve enough time for preparation, while unpredictable change can subject systems to challenges, disabling them to respond effectively. Fortunately, many changes in the healthcare sector are predicable because they occur rapidly, and this means that facilities can prepare adequately before the implementation process.

Read also Process Mapping of a Quality Improvement Initiative – Improving Healthcare Delivery For HIV Patients

            Perhaps one of the superior and sustainable competitive advantages in the 21^st century is the ability to change, evolve, and adapt to quality techniques of providing care. In fact, academics continue to associate rates of failure to a range of factors that include limited integration with other processes and systems in the organizations, lack of commitment and vision from senior management, and ill-conceived implementation plans (Mariotti, 1998). If healthcare departments are to experience a greater level of success in providing care, leaders need to embrace better frameworks for deliberating about change as well as understanding the key things that accompany the management of change. For instance, employees will want to understand the motive behind change and how it will affect them. Layoffs will more often than not only lead to confusion, paranoia, insecurities, and anger under the auspices of change. Thus, the promotion of change tends to be fatiguing and demanding to managerial teams. Not only are managers are compelled to challenge the precedent but also to persevere against the norms and habits of established behaviors. They must appreciate that change takes time and that their commitment is key for the achievement of success (Weiss, 1998). A health manager who values the needs of both the patients and the nursing team should appreciate the values that matter and concentrate on altering them as opposed to countering every invitation for change. In addition, he ought to be clear on the importance of each motive for change and develop appropriate responses and proactive actions fittingly.

Read also Current Status of the United States Healthcare System

Read also Is The US Healthcare System Sick?

            Healthcare organizations that utilize a large group of professionals may not perform well if they are overly bureaucratic. According to Steiner (2001), bureaucratized and hierarchical organizations tend to be less flexible, less likely to empower staff, and therefore less amenable to change. If employees as used to doing what they are told, they will not give their organizations full value. Thus, it is indispensable for leaders to learn the best ways of implementing change in specific settings, rather than allowing change to come to power. Coram and Barnes Coram (2001) contend that there are no “best ways” to manage change in any unit and that the public sector needs to introduce a new approach to managing change that harmonizes well with their situational factors. Because change is inevitable in managerial structures, leaders should acknowledge the issues that go along with change in order to acquire a capability to manage change effectively. Additionally, they have a duty to establish a clear vision concerning the direction of the change process. The measurement and monitoring of outcomes of the change process is necessary for realizing whether or not the change has met the objectives. It is also important for those who are currently leading healthcare programs to painstakingly identify the current problems that arise as a result of change to help avoid them in future implementations.            

In conclusion, global changes in the healthcare sector drive healthcare organizations to alter their conventional systems or adopt fresh ones in order to attain quality of care. Nevertheless, such changes have created turbulence in the concerned organizations. It is necessary to critically review changes so as to identify the benefits they bring as well as the problems they draw. Leaders in regional and national heath should particularly concentrate their efforts on the identification of emerging changes and how to overcome them. Moreover, institutions should upgrade the skills and knowledge of managers and employee. This necessitates training on themes related to changes and the adoption of technology since it has become a common tool in the world of healthcare. Individuals who manage change should keep track of the emerging problems and design ultimate solutions for a secure future of the organization. All in all, the healthcare sector ought to tailor quality healthcare to the needs of the local population as well as create communication links between healthcare leadership and the society.

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.

Read also Is The US Healthcare System Sick?

             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.

Read also Evolution of US Healthcare System since Post Industrial Period

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.

Read also How My Current Worldview Effects Perception of Current Healthcare Debate

            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.

Read also Disparities in Access to Mental Health Care among Racial and Ethnic Minorities in the United States

 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.

The Great Marketing Debate: Quality vs. Quantity

Healthcare marketing describes the various highly-segmented channels which involve both offline and online techniques established to evaluate and obtain the right patients with the aim of nurturing them to create a strong bond in their recovery journey. In this regard, healthcare marketing seeks to gain and retain customer loyalty by establishing a connection with the patients using multiple channels (Kumar, Jacob & Thota, 2014). Nevertheless, healthcare marketing usually encounters several challenges in balancing quantity and quality in an attempt to create and distribute valuable, relevant, and consistent marketing content that can help healthcare facilities attract more patients.

Read also Healthcare Marketing : Premier Healthcare – Environmental Assessment

The aspects of quality and quantity in healthcare marketing are defined by two statements: “less is more” and “more is more” respectively. A “less is more” approach in healthcare marketing is more suitable in scenarios which a healthcare facility has gained loyal customers but wishes to retain them by providing marketing content that promotes quality healthcare. One of the main repercussions of this approach is that a healthcare facility will tend to retain its old patients and gain new ones through referrals. On the other hand, a “more is more” approach is ideal in scenarios in which healthcare marketing seeks to increase the number of patients visiting a healthcare facility. This approach would lead to outcomes such as a healthcare facility gaining new customers but without assurance of retention in the event their marketing content does not give assurance of quality healthcare to the patients.

Read also Marketing Concepts in Health Care

In my opinion, a “less is more” approach is more reliable compared to a “more is more” approach during healthcare marketing. This is because the “less is more” approach tends to provide patients with an assurance that the services offered by a healthcare facility are reliable. More so, a “less is more” healthcare marketing approach is more costly-friendly compared to the “more is more” approach. In this regard, healthcare facilities should seek to use the “less is more” approach when developing marketing contents that target both new and existing customers.

Read also Marketing in For-profit and Not-for-profit Health Care Organizations – A Matrix that Contrasts the Differences

In essence, the healthcare system in the United States is sick.  The high cost of care has increasingly created numerous barriers and resulted in poor patient outcomes. It is, therefore, fundamental for policymakers to transform the current American healthcare system, thus preventing it from collapsing due the existing economic burden. Key players should also lobby the government to benchmark with other developed nations known for the provision of affordable and high-quality healthcare.

Read also Evolution of US Healthcare System since Post Industrial Period

Compare how much the United States and Europe spend on healthcare every year

            The federal government has always reaffirmed its commitment to providing universal care and safeguarding its citizen’s well-being. It is for this reason that the United States channels considerable amounts of resources towards healthcare in its annual budget. On average, the United spends more money on healthcare compared to other developed countries in Europe. This prevailing state of affairs has been blamed on the high price of pharmaceutical goods and services in North America. Furthermore, the United States is ranked top among other members of the Organization for Economic Co-operation and Development (OECD) in its annual spending on healthcare and related activities. In 2019, the federal government allocated $3.6 trillion towards healthcare, which far exceeds the 3% to 14% of the national budget in which Switzerland remains (World Health Organization, 2019).  Also, policymakers are cognizant of this reality and have promoted the implementation of the Affordable Carte Act to remedy emerging challenges related to limited insurance coverage.

Read also Healthcare Utilization and Finance – UK vs USA

Metrics Used to Measure Health and Where the United States fall According to those Metrics

Health metrics are important measures in healthcare which aid nations in identifying the best strategies to employ when seeking to improve the general health and well-being of their populations. These parameters also track performance of programs and health initiatives employed to improve the system. Health metrics identify crucial areas of individual’s wellbeing and inform the aspiration of major states. They also foster an environment where evolving insights are encouraged and considered to introduce cumulative gains. Health metrics now guide the Department of Health and Human Services in its quest of improving multi-level health outcomes within all levels of society. This clear sense of direction enables government agencies to champion for the introduction of reforms to improve the current system and level of performance. Life expectancy, infant mortality rate, causes of premature death and personal healthcare access are the most common healthcare metrics in use today.  The United States has a life expectancy of 78 years, an infant mortality rate of 5.8 deaths per 1,000 live, poor lifestyle choices as the leading cause of premature death with only 91.5% of the population with health insurance (“Health System Metrics,” 2019). These metrics thus guide healthcare reform by identifying areas requiring immediate attention and focus.

Rationale for the Role of Government in Healthcare

            Government plays a major role in healthcare.  It is one of the major benefactors of the sector and seeks to promote early prevention to avert future healthcare challenges. The United States Constitution highlights this in its “general welfare” clause which underscores its commitment to safeguarding individuals from infectious diseases and related hazards. The federal government also actively seeks to improve the quality of care by establishing adequate public health infrastructure.  This is particularly important in maintaining a well-functioning system, public health and quality improvement. Elaborate campaigns also promote healthy behavior which also goes a long way in preventing the spread of communicable diseases.       

Read also The Patient Protection and Affordable Care Act (PPACA) And How It has Impacted American Government and Society

By so doing, the population is always assured of health services while facilitating collaboration between local governments and the U.S Department of Health and Human Services (Schulte, 2011). Poverty is also a salient factor in government intervention.  Low socio-economic levels often mean that individuals are unable to secure healthcare insurance which ultimately makes them ineligible to receive care from facilities across different states.  The federal government, therefore, seeks to increase access to care by reducing poverty through progressive tax, public assistance programs and managing the economy.

Read also Proposal for New Healthcare Legislation to be Presented by Political Party to United States Citizens

How Healthcare might be Reformed to Address High Costs and Limited Coverage

            The high cost of care and limited coverage in the United States can be addressed through elaborate healthcare reform initiatives. This can be done through the creation of a robust framework where providers are organized around patient’s needs. Through this policy, health facilities will implement patient-focused care which is cheaper and convenient. Consolidating the services provided in healthcare facilities is also capable of lowering the cost of care in the United States (Leatt & Mapa, 2016). Amalgamating crucial services such cardiovascular services in a single care facility will, therefore, improve the quality of care dramatically while reducing cost. Eradicating the free-for-service payment system is also capable of eliminating a perverse model which reimburses medical practitioners and care facilities based on volume of services as opposed to quality. Furthermore, embracing technology is also bound to improve the healthcare system through reliance on comprehensive electronic health records, incorporating telehealth services and using big data to predict trends within the industry.   

Read also Impact of The Growth of Health Care Cost on The Government and Employers

Prospective Advantages and Disadvantages of a Single-payer System

The single-payer health care system utilizes a single pool of funds for the payment of medical bills. This system has several pros and cons. One of the major advantages of the single-payer health care system is unlimited insurance coverage which enables individuals to gain access to physicians and treatment. Additionally, all providers within this healthcare system are paid at the same rate, allowing medical providers to always remain aware of the expected payment. It also fosters a spending leverage by relying on prescription medication and the application of technological advancements. Costs are also reduced while also minimizing the use of health insurance. Nevertheless, single-payer health care system has been criticized for creating a suitable environment for providers to opt for private-pay only. Additionally, it does not solve the doctor shortage problem and requires a steady pool of resources to be successful.