Category Archives: Health Care

Death & Dying Prompt 1

On the morning of December 23, 2010 I went into labor with my first child. I arrived at our local birthing center in more pain than I anticipated for this event. It was a busy night, and I felt neglected by the different nurse mid-wives coming in and out of the room. My daughter was in a funny side-ways position, which was causing ‘back labor’ and the pain I mentioned that I wasn’t anticipating. Early the next morning our daughter’s heartbeat had dropped to 40 bpm, and she had passed her first stool. We rushed to the hospital where I had an emergency c-section. They cut my bladder. I wore a catheter for the first month of motherhood. I was filled with anger toward every practitioner involved, as well as the shame that my body had failed me. I became depressed.

Later, I was able to see past the anger and realize this was nobody’s fault, not even my own. What occurred was not negligent, rather it was an adverse unintentional outcome of a very difficult birth. “It is important to understand one fundamental concept – there is a difference between adverse events and negligence. An adverse event is an injury occurring during the course of medical management” (Sohn, 2013). The doctors and midwives did everything they could to manage a difficult situation, and to keep my daughter alive. And in that regard, they succeed. Managing post-partum OCD and depression, they did not. “Negligence is the failure to provide a standard level of care or, in other words, the delivery of substandard care”(Sohn, 2013). At this point I would highly encourage anyone who reads this to please read this following link, and consider which of these scenarios are negligent or adverse: https://www.propublica.org/article/lost-mothers-maternal-health-died-childbirth-pregnancy. I think many of these maternal deaths are adverse, some are uniformed on the part of patients themselves, and I believe others are truly negligent.“According to researchers in Georgia, Michigan and other states, mental health disorders have become a leading contributor to maternal deaths among white women in the months after childbirth” (Cillekens, Freitas, Martin, 2017) are therefore, preventable deaths, and negligent on the part of all health care providers involved. When mental health disorders are the leading contributor of death, there is negligence occurring without a doubt. Again, “negligence is the failure to provide a standard level of care…” (Sohn, 2013).

I don’t know if it’s immediately helpful to know how many women suffer pregnancy related health complications, or that I am one of many women who lives with a mental health disorder. I certainly feel less alone, but I also wonder why, why is this all so commonplace? It was, however, helpful to find the definitions and differences between negligence, and adverse. The high occurrences of adverse health effects does lead to more questions. Why aren’t consumers being educated more on the signs and signals of their possible adverse health outcomes due to medical treatments and conditions? I am again (for the second time so far) reminded of something our professor said in the first week, “ in order to have autonomy, you need to have more information, and in order to have more information, you need more consumer regulation.” I think more than anything I would encourage people to look into the adverse health effects of their medical conditions, and treatments. I would encourage them to ask their doctors in detail about the signs and signals of life threatening conditions related to their conditions and treatments.

Martin, N., Cillekens, E., & Frietas, A. (2017, July 17). Lost Mothers. Retrieved July 17, 2017, from https://www.propublica.org/article/lost-mothers-maternal-health-died-childbirth-pregnancy

Sohn, D. (2013, February 15). Negligence, genuine error, and litigation. Retrieved June 23, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576054/

Death and Dying Prompt: Medical Malpractice

Malpractice is clearly a huge issue in the medical field, and after reading the NPR article in the prompt, I now see it is far more prevalent than I believed it to be. The older sister of a close friend of mine survived serious malpractice which caused very heavy blood loss during surgery. She is still dealing with the consequences of that doctor’s mistake. I hoped that this was not a common occurrence, but the estimates range from 98,000 to 440,000 a year according to the article.

The first step to fixing this issue should be to get the numbers recorded properly. The second should be working for better accountability measures or more strict hiring/screening processes. The doctor which made a mistake in my example above had left a previous hospital for similar reasons, these types of things should not be allowed to happen. One would expect hospitals to avoid doctors like this at all costs, but he must’ve slipped through the cracks somehow.

Challenge:

Around a year ago, my mom was given legal control of my grandfather’s medical choices. He ended up passing because he refused to be treated at first, but he wasn’t coherent enough to make choices himself. He didn’t have any of the preemptive paperwork done, so my grandmother was making the decisions. She was too busy trying to take care of herself, because she lives in a very rural area, so my mom took over the medical and financial decisions. I know too many people who have had loved ones make bad decisions for them because they were scared of what could happen, or too unwilling to listen to the doctors. With this in mind, the family that know how I would like to be treated aren’t necessarily going to follow that plan. I’ve spoke to my sister about how if I lose my mental capacity, i should be let go. I’m not quite sure my parents would let that happen, so I’ll probably get an advance directive filled out myself.

Glossary Building Post One

In my first “Glossary Building Post I chose to write a discussion on the different definitions of words such as resourcefulness, integrity, and dependability. It is my belief that in learning and applying consumer health practices one must be able to meet certain requirements or capabilities. Organizations can benefit from such qualities and can help improve both the consumer and the supplier. These three qualities are important because it gives individuals the empowerment to be positive.

The first term that I believe to be important in consumer health is that of resourcefulness. According to the article “The Importance of Resourcefulness” by Baldoni (2010) “resourcefulness is not a means of coping with deprivation; it can be a virtue that opens the door to greater accomplishment” (Baldoni, 2010, para. 2). This quality or term is important in many aspects. In being resourceful individuals are able to apply methods in which help improve consumers and an individual’s health. Also, Baldoni (2010) states “resourcefulness is about optimizing what you have to work with. Innovation is not just about creating something new; it also applies to making old things work better” (Baldoni, 2010, para. 4).

The second term that I chose was integrity. It is my belief that every person should have a level of integrity when dealing with consumer health. It is important due to the fact that the very decision that a person makes can have an adverse effect on an individual. According to the article “Success Will Come and Go, But Integrity is Forever” by Anderson (2012) “We live in a world where integrity isn’t talked about nearly enough. We live in a world where “the end justifies the means” has become an acceptable school of thought for far too many. Sales people overpromise and under deliver, all in the name of making their quota for the month” (Anderson, 2012, para. 2). This article was a great read and it offers explanations how being successful is not as important as your integrity.

Dependability has many definitions within itself and it is of great importance as well. Consumer health needs this type of quality because a company and its employees must be dependable. According to Ylisela (2017) “Dependability is a valuable quality in the workplace, whether it comes from your employees or vendors. Having a staff of dependable employees and managers helps your business run more smoothly and ensures that tasks are seen through to completion” (Ylisela, 2017, para. 1).

References

Anderson, A. R. (2015, July 31). Success Will Come and Go, But Integrity Is Forever. Retrieved July 08, 2017, from https://www.forbes.com/sites/amyanderson/2012/11/28/success-will-come-and-go-but-integrity-is-forever/#6953cf1c470f

Baldoni, John. “The Importance of Resourcefulness.” Harvard Business Review. N.p., 23 July 2014. Web. 08 July 2017. <https://hbr.org/2010/01/leaders-can-learn-to-make-do-a&gt;.

Ylisela, M. (2017). (“Example of Dependability in the Workplace.” (n.d.). Retrieved July 08, 2017, from http://smallbusiness.chron.com/example-dependability-workplace-34899.html

Healthcare Prompt 2

I believe most consumers don’t understand why people would lose insurance from the implementation of the BCRA. Many assume that this bill would be taking away peoples insurance by force, partially because they do not understand the healthcare industry at a base level, and partially because they do not understand Obamacare and the BCRA.

Obamacare legislated that insurers could not discriminate against prospective customers for pre-existing conditions, this alone is not feasible for insurance companies. In order for this to work, the american people must forcefully be signed up for insurance, so the insurance companies can maintain profitability. So this is actually allowing those who wish to not bother spending money on insurance to do exactly that.

Although I’m glad to think that people might no longer be forced to purchase something they don’t want, I’m not so sure about the economic effects that could have. We may see insurance companies going out of business due to the insurance pools having larger portions of risky customers. I’d like to know how that could play out in more depth. My Mom is in the healthcare industry, so I might ask her what she thinks.

Health Care Prompt 1

I do have a close friend who is against a number of things that I am not. She is completely against vaccines, and GMO’s—so at least she’s consistent. She actually voted for Trump—and doesn’t think we should pay for other people’s healthcare, and education. This all makes me feel disappointed in her, because I know she is a kind, and intelligent person. And I suppose that sounds like I’m saying people who are against vaccines, and for Trump are cruel, and the opposite of intelligent. But, I don’t think that’s the case at all, and that is not what I meant to imply. I think in both circumstances, my friend has made her decisions based off a lack of information, and of a fear of losing something or someone. She has not vaccinated her children for fear that they will be harmed in any way by vaccines, and the information she has is only from one side of the debate. Her beliefs that people should fend for themselves when it comes to healthcare and education are there because she’s afraid she will be taxed more than she and her family already are, and again because the information she has is from one side of this debate. And I feel as though I am partly to blame. I don’t have enough facts on my side—on the opposite side—to give to her. I don’t know enough about my side, as she does for hers. When it comes to the best aspect of the ACA, I would tell my friend that it covers our vulnerable populations with federally mandated provisions, where as the AHCA does not cover these—pre-existing conditions, mental health conditions, and there’s no lifetime or annual limit on coverage (Kodjak, 2017). And I think mandating people to have coverage, is how we can keep premiums down, but the best chance we have at improving how the ACA works, is by implementing it.

If my friend were so concerned about her tax dollars, I would ask her to consider how much it costs to imprison a person compared to how much it does to insure them. We imprison people with mental health issues, and addiction instead of medically treating them. And I would also ask how much welfare are we giving in the forms of corporate subsidies and homeowner tax breaks, compared to food, housing, and medicaid to those in need. What is most important to me, would be to point out that we are helping the wrong groups of people, and I would suggest that instead of “improving the average,” we need to reduce the populations who are known as “high-risk” (Reigelman & Kirkwood, p. 10-11). I think she may have a hard time considering how helping others, would in fact be helping the health of her family. And when her children caught whooping cough, and were sick for months, they could have gotten another child who has cancer sick. And what if my friend’s sick un-vaccinated children put another child in the hospital, where the family couldn’t afford the care because my friend didn’t want her taxes raised?! I do realize this may seem excessive, and far too hypothetical—but I also think it is very likely. I think something else to consider, is if you believe in the right to bear arms, but you want mass shootings (or even domestic, and accidental shootings) to end, then you must also encourage accessible, affordable, and subsidized mental health care. Mental health care is excluded from the AHCA as previously mentioned.

Facts for my Friend;

  • Average cost of California state prison per year; $75,000 (Thompson, 2017), other prisons can be as low as $24,000
  • Average cost of Methadone treatment for a year; $4,700 (NIH, 2012)
  • Average cost of psychiatric therapy for a year; $5000, if you go once a week, every week for a year.
  • Average cost of college tuition here at Central it’s about 12-15k for myself.
  • “Welfare policies are any government subsidy to a particular group of people to provide term with certain kinds of material advantages that they would not have, if things were just left to the market” (Wright & Rodgers, p. 253).
  • Included under the Welfare umbrella are; direct targeted government spending, and tax subsides. “The main recipients of welfare are middle-class and wealthy people, not the poor” (Wright & Rodgers, p. 235).
  • It is clear that when we provide education, and medical care, it is actually saving our tax dollars, and improving our communities, making them safer for all. So, dear friend, if your biggest issue is you paying more in tax dollars if you support Obamacare, I hope I’ve showed you that you are actually paying more now when you neglect those in need.

Citations;

Wright, E. O., & Rogers, J. (2011). American society: how it really works. New York: W.W. Norton & Co.

Thompson, D. (2017, June 15). California Prison Tuition: $75,560 . US News Associated Press. Retrieved from https://www.usnews.com/news/best-states/new-york/articles/2017-06-05/correction-california-prisons-costs-story

Is drug addiction treatment worth its cost? [Abstract]. (2012). National Institute on Drug Abuse. Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/drug-addiction-treatment-worth-its-cost.

Kodjak, A. (2017, May 5). Obamacare Vs. American Health Care Act: Here’s Where They Differ. Retrieved July 2, 2017, from http://www.npr.org/2017/05/05/527092478/obamacare-vs-american-health-care-act-heres-where-they-differ

Health Care Prompt Two

There are so many issues today, due to social media and other sources, that expose the public to “fake news” and it is truly difficult for any American citizen to decipher what is real and what is not. Fox News says one thing about the future of our health care and CNN says another, so reports such as this CBO report are crucial in understanding the reality of our situation; unbiasedly.

I had already learned in previous courses how much the U.S. spends on health care and yet has some of the worst health disparities in the world, and this CBO report taught me that under this new legislation would reduce direct-spending by $1,022 billion. This seems like a great thing right? Spend less on tertiary care, put the resources into primary care and watch the country’s health flourish. But when I read on, I learned that reducing this spending is in direct relation to the fact that this legislation would cut costs in Medicaid. Medicaid helps low-incomes families all across the country receive long-term health care, and cutting budgets here would hurt many people. What I would like to know is, if spending in Medicaid is cut and this new legislation would raise insurance premiums, how are low-income and even middle-class families going to be able to afford insurance for health care? I would assume that reading the new legislation bill itself would give me the answers I am looking for. Reports such as this CBO report are quite eye-opening. I don’t often think about federal budgets, yet it affects the people of this country, especially in regards to health care; it is definitely important to consider when learning about new legislation such as this.

Health Care Prompt Two

In reading this resource I learned that by passing the H.R. 1628, Better Care Reconciliation Act of 2017 was going to save approximately $321 billion through the years 2017-2026. The only negative impact that it would have on the people is that the individuals that cannot afford insurance will not have it. The Better Care Reconciliation Act would remove the penalties and make it more expensive for individuals to pay for medical attention. According to the H.R. 1628, Better Care Reconciliation Act of 2017 states that “by 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law” (H.R. 1628, Better Care Reconciliation Act of 2017, 2017). This information provided by the Congressional Budget Office and the staff of the Joint Committee on Taxation have estimated the effects of the Better Care Reconciliation Act of 2017.

In this case Obamacare provided all a means to be insured and if you were not insured you had to pay a penalty. This in my opinion was beneficial for both the insured and the individuals that do not have it. One of the main things that I would like to know is how much of an impact will it has to those that cannot afford health insurance. The increase of premiums will also negatively impact those that cannot afford it. In conducting further research I found that the affordable care act website had very informational sources to help those looking into becoming more informed in the types of insurances available. The current site that I found is the http://www.medicaid.gov/affordable-care-act/index.html.

Healthcare Act Prompt 2

There are two things I got from the CBO report.  One thing I already knew about but hadn’t realized yet, and the other one I learned from re-reading the report. The first one is that there are subsidies or that premium adjustments are made based on income.  In saying that, and as the CBO report points out, in some regions the ACA functions well enough that people can afford payed group health plans (CBO report H.R. 1628, 2017). Of course, those regions are only successful because of the state that they are located in. Therefore, it makes sense to remove insurance trade barriers between states. This would allow for a better distribution of cost sharing under the current law. However, there shouldn’t be trade barriers between states or cost sharing. It really doesn’t make sense in the first place to have cost sharing but no market sharing. Which is part of the laws failures, such an oversight or intention socialistic implication is what led to an increase in government spending and regionally increasing premiums (CBO report H.R. 1628, 2017). As for the subsidies, not enough people know about them or they were not accessible for enough people to offset healthcare cost (CBO report H.R. 1628, 2017), meaning that either there was not enough funding, possible waste and corruption of funds or that the government failed to inform the public of a service that they helped to pay for.

The second thing I learned was that despite significant reductions in government spending on healthcare, that there would be increases in other areas that would be appropriated for reducing premiums and easing the financial burden on healthcare consumers (CBO report H.R. 1628, 2017). A lot of what went wrong with the ACA was the burden of noncontributing consumers and the lack of employer supplied health insurance. Because of the lack of jobs in the job market, employers weren’t required to provide insurance per the ACA, or employers could not provide adequate insurance plans under the ACA. Abstractly speaking, at least the government will be in some way attempting to fix the issues that now exist because of the ACA.

Now that I’ve reconsidered the question, the CBO report overall generally is not known of by most consumers. In fact, most consumers do not know what the CBO is, much less what it does, and therefore it is very unlikely that the average consumer has ever even read a Congressional Budget Office report. This is probably should be something that is taught in high schools, along with things like the constitutional law and how the American political system works, and at the very least how voting works.

What I would like to know more about is how the market will change under the new healthcare law if it does pass. For instance, the CBO report says that an estimated 22 million people will be uninsured by 2026 because of the removal of the mandated insurance under the ACA (CBO report H.R. 1628, 2017). However, it will be interesting to see what the actual number will be, especially since the government will attempt to encourage the number of low care (healthier consumers) buyers with lower premiums and better insurance coverage (CBO report H.R. 1628, 2017). I would guess that the number will be lower if not for any other reason than because of the ACA mandating that everyone buys insurance and altering societal thinking. With things as they are now, it seems like more people feel the need for health insurance or understand the issues with not having a healthcare plan. As well, one of the success of the ACA was the better regulation of insurance companies, such as eliminating the preexisting condition discrimination and standardizing the level of preventative care for healthcare consumers. All of which has become expectations for consumers and an implicit encouragement for individuals to purchase insurance. I reached this conclusion because consumers will know the general level of care that they will receive and at what cost. Only future CBO reports will tell if this analysis reigns true or not… if the new healthcare law is ever implemented, that is.

Health Care Prompt 2

When I first learned about the Affordable Care Act I wasn’t outraged and neither were my parents. We know many people who fall below the poverty line who has had children that needed to be hospitalized and placed on medication. If it wasn’t for the ACA, they would not have been able to afford it. Many of them work at the warehouse my family runs. They are hardworking people and yet they still don’t make enough. With the ACA they got the help that they needed and removed some of the stress that they have to carry every day.

By 2018 it is estimated that 15 million more people would be uninsured under the new legislation because the penalty of not having insurance would be eliminated. By 2026, 49 million would be uninsured (Congressional Budget Office, 2017). Millions of people will be uninsured causing them to owe thousands of dollars if they have to seek medical attention. Many of them will not be able to afford to pay the cost of the medical bills due to the high cost. Just with an ambulance ride, it cost about 500-700 to take a ride. It’s going to lead people to be more in debt and many won’t pay the bills because they have families to take care of first. I think that the penalty for not having insurance should stay but reduce the cost of the penalty. A site that is reliable to look up more information would be on the http://www.medicaid.gov/affordable-care-act/index.html it’s one of the only few sites you can trust due to it being a governmental site and not a commercial or organization.

Health Care Prompt One up

Hi all – take a peek here. That second prompt is up now, as an option for “extra learning.” Remember that “Perfect World” (Friday, 10pm) and “Last Chance” (Sunday, 10pm) deadlines apply, for all posts you choose to complete. Remember that you must do a total of five. You must ALSO choose one post per week. (Meaning that you can NOT skip a week or two, and then rush out five posts in the last two weeks, covering only two topics.)

Just a reminder that the course rubric is also up – with an explanation of how it works and why. View that here at the Guidelines and Deadlines page! Please do let me know if you have questions. I’m on email and available by office phone almost all day, most days.