I am currently a junior at UW-Eau Claire. My experiences with outpatient care have been fairly good. My mom works for the Eau Claire school district and my dad works for the city, so both of my parents have pretty good health care coverage. Whenever I'm not feeling well, I simply set up an appointment with Urgent Care and get in pretty quickly.
I do wonder what changes will occur when the new health care reform takes place. I, personally, haven't been responsible for "paying" the bills, but I wonder if access will be limited with more patients in the system. I believe the new reform also permits children to remain on parents' insurance until they are 26 years of age. With the economy and how difficult it is to find a job now, I feel this is a benefit, not just to me but other students as well.
-SophieA.
Friday, April 16, 2010
Student Perspective
Today’s debates over health care and health insurance are analogous to the state of medicine. We spend too much time treating the symptoms, as opposed to finding a cure for the real sickness. Looking into the health industry over the past several years has led me to conclude that the solutions proposed to our problems are not truly aimed at the benefit of society.
Listening to the most recent national discussions on health insurance leaves most people, including members of Congress, scratching their heads. The Democrats seem to want to push whatever they can under the control of the Health & Human Services Department, former WI Governor Tommy Thompson’s former post. Whereas the Republicans, seem to be up in arms over pieces of the legislation that have been supported by Republican Presidents from Theodore Roosevelt to George W. Bush.
I, on the other hand, wish that the debates wouldn’t center on government controls and mandates, but patient choices and competition in the health care industry. To understand where we are, we must look from where we came.
The mid-19th century is where the foundation of today’s debate was laid. The 1860’s saw the removal of most regulations in health care which led to competition between the allopathic mainstream medicine with its eclectic and homeopathic counterparts. This was also a time when the schools of medicine were much more affordable, and much easier to access. The competition driven marketplace that existed kept prices low, and patients’ needs met. However, this was also the time that the American Medical Association(AMA), and Congress soon to follow, began to make its mark on the industry.
Health care providers were generally middle-income Americans, and had a more intimate relationship with patients that often led to working out prices that both parties could agree upon. This isn’t to say that doctors don’t deserve a high income, in fact, they deserve to make a killing, no pun intended. Also, to obtain an education in the medical field students didn’t have to invest an exorbitant amount of time and money, compared to the debt-ridden, over half-century long education necessary to enter the field today.
The 20th century saw the growth of power in organizations like the AMA and Health Management Organizations(HMO’s), and with insurance providers like Blue Cross and Blue Shield. The rise of these organizations was, unfortunately, not due to their positive impact on the patient, but rather on their support from unionized labor and legislation from Congress. The growth of accredited schools for medical practitioners was stymied, and entrance into practice became more and more difficult. This had the obvious impact of increasing the cost of education, and the limiting of growth in field. This shift pushed onto patients higher costs for care, and higher premiums for insurance.
Some ideas that I believe would push the industry in a positive direction for the patient is to reform insurance in several ways. Health insurance, like any other insurance, should not be linked to your employment, which could be accomplished by revising the tax code. The use of health insurance should also be examined. Most people have car insurance, but nobody uses it to get an oil change. This should apply to the outpatient when they receive minimal treatment, and/or purchase small amounts of pharmaceuticals. Leaving their health insurance to be used for the catastrophic events in life like cancer and heart attacks, similar to car crashes and flood damage to the house.
As a future member of the health care service industry I know that today’s problems don’t lie in the hands of providers, it lies in the foundation our industry is built on. The debates of today do not look to fix the sickness that is at the foundation of increased costs, but instead focuses on the symptoms of its superstructure.
When I ascend to the Presidency I will straighten it all out for us though, don’t you worry.
Bryce Chinault
University of Wisconsin School of Medicine and Public Health
Listening to the most recent national discussions on health insurance leaves most people, including members of Congress, scratching their heads. The Democrats seem to want to push whatever they can under the control of the Health & Human Services Department, former WI Governor Tommy Thompson’s former post. Whereas the Republicans, seem to be up in arms over pieces of the legislation that have been supported by Republican Presidents from Theodore Roosevelt to George W. Bush.
I, on the other hand, wish that the debates wouldn’t center on government controls and mandates, but patient choices and competition in the health care industry. To understand where we are, we must look from where we came.
The mid-19th century is where the foundation of today’s debate was laid. The 1860’s saw the removal of most regulations in health care which led to competition between the allopathic mainstream medicine with its eclectic and homeopathic counterparts. This was also a time when the schools of medicine were much more affordable, and much easier to access. The competition driven marketplace that existed kept prices low, and patients’ needs met. However, this was also the time that the American Medical Association(AMA), and Congress soon to follow, began to make its mark on the industry.
Health care providers were generally middle-income Americans, and had a more intimate relationship with patients that often led to working out prices that both parties could agree upon. This isn’t to say that doctors don’t deserve a high income, in fact, they deserve to make a killing, no pun intended. Also, to obtain an education in the medical field students didn’t have to invest an exorbitant amount of time and money, compared to the debt-ridden, over half-century long education necessary to enter the field today.
The 20th century saw the growth of power in organizations like the AMA and Health Management Organizations(HMO’s), and with insurance providers like Blue Cross and Blue Shield. The rise of these organizations was, unfortunately, not due to their positive impact on the patient, but rather on their support from unionized labor and legislation from Congress. The growth of accredited schools for medical practitioners was stymied, and entrance into practice became more and more difficult. This had the obvious impact of increasing the cost of education, and the limiting of growth in field. This shift pushed onto patients higher costs for care, and higher premiums for insurance.
Some ideas that I believe would push the industry in a positive direction for the patient is to reform insurance in several ways. Health insurance, like any other insurance, should not be linked to your employment, which could be accomplished by revising the tax code. The use of health insurance should also be examined. Most people have car insurance, but nobody uses it to get an oil change. This should apply to the outpatient when they receive minimal treatment, and/or purchase small amounts of pharmaceuticals. Leaving their health insurance to be used for the catastrophic events in life like cancer and heart attacks, similar to car crashes and flood damage to the house.
As a future member of the health care service industry I know that today’s problems don’t lie in the hands of providers, it lies in the foundation our industry is built on. The debates of today do not look to fix the sickness that is at the foundation of increased costs, but instead focuses on the symptoms of its superstructure.
When I ascend to the Presidency I will straighten it all out for us though, don’t you worry.
Bryce Chinault
University of Wisconsin School of Medicine and Public Health
Thursday, April 15, 2010
Patient Perspective
As a patient using our health care system, I was asked to comment on my experiences with outpatient or primary care. As a recent graduate, I have had very little experience with outpatient and primary care. This is primarily because I don't have full health coverage due to the cost. Not only that, but I am young and feel I have been fortunate and been fairly healthy.
However, I do feel that outpatient and primary care will greatly affect me in the near future. The health care reform touches on very important topics, but honestly, it's confusing and hard to follow in the news. In the past my outpatient care experiences have been time consuming. On one particular occasion, I was waiting to see a physician about a bad allergy reaction. I had waited so long in the ER that by the time I met with the physician my symptoms had subsided. Frustrated by having waited so long, I simply took the medication he prescribed and headed off to see the pharmacist. It surprises me still that in the Emergency Room I had waited hours.
There are many things that can be improved within our health care system. Particularly with outpatient care, I feel improvements can be made with staffing. If there would have been more primary care physicians, I may have been seen sooner. Also, I would appreciate more quality time with the physician when I do have a concern. I am hopeful the new health care reform will address some of these issues, lower costs, and improve access in the long run.
--S.Lee, a patient
However, I do feel that outpatient and primary care will greatly affect me in the near future. The health care reform touches on very important topics, but honestly, it's confusing and hard to follow in the news. In the past my outpatient care experiences have been time consuming. On one particular occasion, I was waiting to see a physician about a bad allergy reaction. I had waited so long in the ER that by the time I met with the physician my symptoms had subsided. Frustrated by having waited so long, I simply took the medication he prescribed and headed off to see the pharmacist. It surprises me still that in the Emergency Room I had waited hours.
There are many things that can be improved within our health care system. Particularly with outpatient care, I feel improvements can be made with staffing. If there would have been more primary care physicians, I may have been seen sooner. Also, I would appreciate more quality time with the physician when I do have a concern. I am hopeful the new health care reform will address some of these issues, lower costs, and improve access in the long run.
--S.Lee, a patient
Tuesday, April 13, 2010
Athletic Trainer Perspective
Hi,
I have been a licensed athletic trainer for 20 years and I have been asked to comment on this blog as a health care worker. As an athletic trainer it is my responsibility to manage and coordinate the care for injured athletes and work with healthy athletes to prevent injury and illness. Athletic training is an allied health profession that often works with primary care physicians as a physician extender.
As a physician extender, athletic trainers work under a licensed physician to help treat and educate patients who are in the "active population." For example, if a patient has an overuse injury from starting a new running program, the physician may ask me to teach the patient some exercises to alleviate the pain. He may also ask me to educate the patient on how the injury developed and how to prevent it in the future. This care model has many benefits.
One such benefit is the quality of service provided to the patient. Often, the patient spends very little time with the physician and is just given orders by the physician. These orders are sometimes confusing the patient and often leads to non-compliance. When an athletic trainer takes the time to discuss the treatment plan with the patient, not only do they better understand why a treatment is needed, but they are more likely to adhere to the care plan.
The second benefit is cost. If this same service were provided by the physician it would cost a lot more money. As you can imagine, it doesn't cost nearly as much to compensate an athletic trainer for 30 minutes as it does a physician.
The final benefit is access. By having an athletic trainer assist a physician with his duties, it allows the physician to increase his patient volume without harming the quality of care.
Thank you for giving me the opportunity to discuss the importance of my profession in the inpatient care model.
Denise, Licensed Athletic Trainer
Monday, March 15, 2010
Reform Proposal
Congress should pass legislation that imposes a tax on all services performed by a specialist. By imposing this tax, not only would it discourage citizens from receiving care from a specialist unless necessary, it would also create a large source of income that could be used to better fund Medicare and make it more accessible to those without health insurance. With the average cost per office visit to a specialist is roughly $81 as compared to $64 for a primary care physician (AAFP, 2010; Figure 3), a simple 2.5% tax could generate an extra $2 per office visit. In 2006 there were an estimated 66.6 Medical Specialty Office visits per 100 people and 59.8 Surgical Specialty office visits per 100 people (AAFP, 2010; Figure3). With the currently estimated population of the United States at 308,874,791 according to the US Census Bureau, that equates to 205,710,610 estimated Medical Specialty Office visits in the US in 2006 and 184,707,125 estimated Surgical Specialty office visits.
This tax would be applied by the government to all billings on services not considered primary care, which could then be passed on to the patient. This added funding would help the US ease the strain on the US budget and increase the money available for spending for Medicare. According to the Kaiser Family Foundation, spending for Medicare has grown at a slower rate than private insurance companies (KaiserEDU.org, 2010). If Medicare was more utilized, more Americans could have health insurance. The US government would be able to transfer that increased funding into either expansion for who is eligible for Medicare, which would in turn increase the number of Americans with insurance, public or private. This act would not only increase the amount of insured Americans, but by reducing the amount of uninsured Americans, costs would be reduced. Americans with insurance would not be forced to pay for uninsured Americans that still receive medical care. This would also reduce costs for insured Americans. This tax might also deter specialty care usage and promote primary care usage. If more Americas utilized primary care, more illness could be prevented, which would also reduced costs.
References
American Academy of Family Physicians (2010) www.afp.org. Accessed 3/14/2010.
US and world population clock. (n.d.). Retrieved from http://www.census.gov/main/www/popclock.html. Accessed 3/14/2010
US health care costs. (2010, March). Retrieved from http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358. Accessed 3/14/2010
Health insurance 2008 highlights. (2009, September 22). Retrieved from http://www.census.gov/hhes/www/hlthins/hlthin08/hlth08asc.html. Accessed 3/14/2010
Shi, L., & Singh, D. A. (2008). Delivering health care in America: a systems approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers, Inc.
Monday, March 1, 2010
Health Care Reform-Primary & Outpatient Care
As emphasized before, primary and outpatient care is extremely important, if not the most important aspect of healthcare. Primary care serves as the foundation for health care and any health care reform. As shown, an increase of just one primary care provider per 10,000 individuals has shown to decrease mortality by 5.3% (County Health Rankings, 2010). Primary care physicians are central to any health care reform. Currently, there is a 20% increase in specialization by internal medicine residents resulting in less primary care providers (Riselbach, et al). The following table shows the percentages of medical school graduates who contemplated careers in generalist specialties (Petersdorf & Goitein, 1999).
We feel primary care can be greatly improved if more emphasis is placed on the medical school environment. Our health care reform, then, addresses an underlying cause to the imbalance between primary and specialty care services, which has contributed to an imbalance in the ratio of generalists to specialists (Shi & Singh, 2008). Our reform proposes solutions to help influence the career choices of medical students and physicians already in residency programs (Monegain, 2009). We feel primary care physicians should have effective incentives and be eligible to receive additional funding and support (Monegain, 2009). We feel much can be done to make the medical school environment friendlier to primary care, thus improving all aspects of primary and outpatient care. We suggest the following proposals:
1. Medical schools should devote significant sections of the curriculum to general and ambulatory experiences.
2. Student should also be exposed to strong generalist role models and mentors. There should be an increased emphasis on teaching general internal medicine.
3. Generalists should also be offered prominent positions within academic medicine, as chairpersons, deans, and committee members.
4. Medical schools should strengthen their primary care departments by improving research and fellowship training programs.
5. Financial incentives such as loan forgiveness should be established to encourage medical students to choose generalist careers (AAFP, 2010; Annual Residency Completion Survey 2008).
6. There should be an increase in the number of primary care tracks.
7. Most importantly we feel the size of subspecialty programs should be downsized. This can be done by limiting the number of applicants into specialty fields (Petersdorf & Goitein, 1999).
(AAFP, 2010; Michael Munger, M.D., examines a patient at his medical office in Overland Park, Kan.)
We feel the medical school environment can act to reduce the disparities among primary care and specialty care physicians by implementing our seven proposals. Many factors will be changed, primarily the medical education programs themselves. However, we do feel these changes will be cost effective for patients considering the median expenses per office-based physician visit (AAFP, 2010; Figure 1). These seven suggestions also improve access for the estimated 45 million individuals who are uninsured bringing health care closer to where people live and work (Shi & Singh, 2008). Not only does our reform improve cost and access, it will also enhance quality as primary care focuses on the person as a whole, whereas specialty care centers on particular diseases or organ systems of the body (Shi & Singh, 2008).
References
We feel primary care can be greatly improved if more emphasis is placed on the medical school environment. Our health care reform, then, addresses an underlying cause to the imbalance between primary and specialty care services, which has contributed to an imbalance in the ratio of generalists to specialists (Shi & Singh, 2008). Our reform proposes solutions to help influence the career choices of medical students and physicians already in residency programs (Monegain, 2009). We feel primary care physicians should have effective incentives and be eligible to receive additional funding and support (Monegain, 2009). We feel much can be done to make the medical school environment friendlier to primary care, thus improving all aspects of primary and outpatient care. We suggest the following proposals:
1. Medical schools should devote significant sections of the curriculum to general and ambulatory experiences.
2. Student should also be exposed to strong generalist role models and mentors. There should be an increased emphasis on teaching general internal medicine.
3. Generalists should also be offered prominent positions within academic medicine, as chairpersons, deans, and committee members.
4. Medical schools should strengthen their primary care departments by improving research and fellowship training programs.
5. Financial incentives such as loan forgiveness should be established to encourage medical students to choose generalist careers (AAFP, 2010; Annual Residency Completion Survey 2008).
6. There should be an increase in the number of primary care tracks.
7. Most importantly we feel the size of subspecialty programs should be downsized. This can be done by limiting the number of applicants into specialty fields (Petersdorf & Goitein, 1999).
(AAFP, 2010; Michael Munger, M.D., examines a patient at his medical office in Overland Park, Kan.)
We feel the medical school environment can act to reduce the disparities among primary care and specialty care physicians by implementing our seven proposals. Many factors will be changed, primarily the medical education programs themselves. However, we do feel these changes will be cost effective for patients considering the median expenses per office-based physician visit (AAFP, 2010; Figure 1). These seven suggestions also improve access for the estimated 45 million individuals who are uninsured bringing health care closer to where people live and work (Shi & Singh, 2008). Not only does our reform improve cost and access, it will also enhance quality as primary care focuses on the person as a whole, whereas specialty care centers on particular diseases or organ systems of the body (Shi & Singh, 2008).
References
- American Academy of Family Physicians (2010) www.afp.org. Accessed 2/26/2010.
- County Health Rankings (2010) Access to Care. www.countyhealthrankings.org. Accessed 2/26/2010.
- Monegain, B. (2009, February 4). Docs say primary care physicians central to healthcare reform. Retrieved from http://www.healthcarefinancenews.com/news/docs-say-primary-care-physicians-central-healthcare-reform.
- Petersdorf, R.G., & Goitein, Lara. (1999). The Future of internal medicine. Annals of Internal Medicine, 119(11), 1130-1137.
- Rieselbach, R.E., Crouse, B.J., Frohna, J.G. (2009) Teaching Primary Care in Community Health Centers: Addressing the Workforce Crisis for the Underserved. Annals of Internal Medicine.
- Shi, L., & Singh, D. A. (2008). Delivering health care in America: a systems approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers, Inc.
Friday, February 19, 2010
History and Overview
Outpatient and primary care is arguably the most important facet of health care, but it hasn’t always been. In the early days of modern medicine, most physicians practiced alone in their community. The advent of technology and improved diagnostic and treatment capabilities caused a decrease in outpatient treatment options largely due to the need to aggregate technological resources in close proximity to a larger group of physicians. In the last several years however, we have seen a reversion to outpatient care and an increased importance in primary care (Shi & Singh, 2008). This is due to the need to decrease cost, increase access, and better the quality of care.
Primary care is vital to increasing access. In the United States there are an estimated 45 million individuals who are uninsured. Eighty percent of those individuals are employed or live with an employed adult. 18 million of these individuals have a family income over $50,000 per year (Kaiser, 2010). Because 75 – 85% of the United States population seeks primary care in a year, attention to this aspect of health care is crucial (Shi & Singh, 2008).
Primary care is central to decreasing cost. Because primary care appointments cost less on average, we can receive more with less money. For example, the average bill from a family practitioner is $62, a bill from a specialist can be upwards of $90 (AAFP, 2010; Figure 1). Primary care costs less because these physicians orders less tests and receives the same or better results than specialists. This decrease in tests is also correlated with a decreased iatrogenic complication (Shi & Singh, 2008). While an estimated 50% of emergency department visits would be better handled in the primary care setting, patients who lack insurance continue to overrun emergency departments to get their necessary care (Shi & Singh, 2008).
Primary care certainly betters the quality of care. This has been shown with epidemiological data. We see areas with a higher ratio of primary care physician yield better health results. Several studies have shown that an increase in primary care providers in a given region have yielded a decrease in cancer, heart disease, stroke and infant mortality, in addition to a decrease in low birth rate, and an increase in life expectancy. Furthermore, an increase of just one primary care provider per 10,000 individuals has shown to decrease mortality by 5.3% (County Health Rankings, 2010). In the U.S., about 43% or practicing physicians work in the primary care setting as opposed to 50% and 70 – 72% in Canada and Great Britain, respectively (Shi & Singh, 2008; Figure 2). Both of these countries are ranked higher than the U.S. on the World Health Organizations list (World Health Organization, 2010).
As the foundation of our country’s health care system, primary care is currently relatively weak. Over the previous eight years, we have seen a 20% increase in specialization by internal medicine residents resulting in less primary care providers and yet more specialists. Additionally we have seen 15% fewer residency spots filled in the U.S., while half of these positions are being filled by foreign graduates (Riselbach, et al).
Given the preceding information, it should be quite clear that consideration of primary care is essential to the success of health care reform. While this may be one of the most important pieces, we concede that without a system for providers to work in improvement will be negligible.
References
Shi, L., & Singh, D. A. (2008). Delivering health care in America: a systems approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers, Inc
Henry J. Kaiser Family Foundation. (2010) www.kff.org. Accessed 2/19/2010.
American Academy of Family Physicians (2010) www.afp.org. Accessed 2/19/2010.
County Health Rankings (2010) Access to Care. www.countyhealthrankings.org. Accessed 2/19/2010
World Health Organizations (2009). www.who.int. Accessed 2/19/2010.
Rieselbach, R.E., Crouse, B.J., Frohna, J.G. (2009) Teaching Primary Care in Community Health Centers: Addressing the Workforce Crisis for the Underserved. Annals of Internal Medicine.
Primary care is vital to increasing access. In the United States there are an estimated 45 million individuals who are uninsured. Eighty percent of those individuals are employed or live with an employed adult. 18 million of these individuals have a family income over $50,000 per year (Kaiser, 2010). Because 75 – 85% of the United States population seeks primary care in a year, attention to this aspect of health care is crucial (Shi & Singh, 2008).
Primary care is central to decreasing cost. Because primary care appointments cost less on average, we can receive more with less money. For example, the average bill from a family practitioner is $62, a bill from a specialist can be upwards of $90 (AAFP, 2010; Figure 1). Primary care costs less because these physicians orders less tests and receives the same or better results than specialists. This decrease in tests is also correlated with a decreased iatrogenic complication (Shi & Singh, 2008). While an estimated 50% of emergency department visits would be better handled in the primary care setting, patients who lack insurance continue to overrun emergency departments to get their necessary care (Shi & Singh, 2008).
Primary care certainly betters the quality of care. This has been shown with epidemiological data. We see areas with a higher ratio of primary care physician yield better health results. Several studies have shown that an increase in primary care providers in a given region have yielded a decrease in cancer, heart disease, stroke and infant mortality, in addition to a decrease in low birth rate, and an increase in life expectancy. Furthermore, an increase of just one primary care provider per 10,000 individuals has shown to decrease mortality by 5.3% (County Health Rankings, 2010). In the U.S., about 43% or practicing physicians work in the primary care setting as opposed to 50% and 70 – 72% in Canada and Great Britain, respectively (Shi & Singh, 2008; Figure 2). Both of these countries are ranked higher than the U.S. on the World Health Organizations list (World Health Organization, 2010).
As the foundation of our country’s health care system, primary care is currently relatively weak. Over the previous eight years, we have seen a 20% increase in specialization by internal medicine residents resulting in less primary care providers and yet more specialists. Additionally we have seen 15% fewer residency spots filled in the U.S., while half of these positions are being filled by foreign graduates (Riselbach, et al).
Given the preceding information, it should be quite clear that consideration of primary care is essential to the success of health care reform. While this may be one of the most important pieces, we concede that without a system for providers to work in improvement will be negligible.
References
Shi, L., & Singh, D. A. (2008). Delivering health care in America: a systems approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers, Inc
Henry J. Kaiser Family Foundation. (2010) www.kff.org. Accessed 2/19/2010.
American Academy of Family Physicians (2010) www.afp.org. Accessed 2/19/2010.
County Health Rankings (2010) Access to Care. www.countyhealthrankings.org. Accessed 2/19/2010
World Health Organizations (2009). www.who.int. Accessed 2/19/2010.
Rieselbach, R.E., Crouse, B.J., Frohna, J.G. (2009) Teaching Primary Care in Community Health Centers: Addressing the Workforce Crisis for the Underserved. Annals of Internal Medicine.
Sunday, February 14, 2010
Beliefs and Values
The World Health Organization (2010) defines primary health care as
Essential health care based on practical, scientifically
sound, and socially acceptable methods and technology made universally
accessible to individuals and families in the community by means acceptable to
them and at a cost that the community and the country can afford to maintain at
every stage of their development in a spirit of self-reliance and
self-determination. It forms an integral part of both the country's health
system of which it is the central function and the main focus of the overall
social and economic development of the community. It is the first level of
contact of individuals, the family, and the community with the national health
system, bringing health care as close as possible to where people live and work
and constitutes the first element of a continuing health care process.
Primary care plays a central role in a health care system. Traditionally, primary care has been the cornerstone and conceptual foundation for ambulatory health services, or outpatient care, as well (Shi & Singh, 2008, p. 247-248). Therefore, a strong primary care delivery system is essential to creating an efficient outpatient care delivery system in reforming the United States health care system.
We believe that primary care is a right that should be provided to all American citizens. The World Health Organization's definition of primary care includes the phrases, "Essential health care...made universally accessible." It has been estimated that 75-85 percent of people in a general population require only primary care services in a given year. Additionally, Americans, on average, make three visits per year to physician offices, with the most common reason being a general medical examination (Shi & Singh, 2008, p. 247). With the provision of properly provided primary care services, the United States health care system could become more cost-efficient, as prevention and primary care cost less than secondary or tertiary care and provide greater benefits. A continuum of health care is essential not only for individuals, but also for communities, to enable a country's social and economic development. A health care delivery system that lacks universal access is ill-equipped to meet that objective.
We also believe that primary care providers should act as gatekeepers. This practice is already used by managed care organizations in the United States, where many Americans view this as a threat to their freedom of choice. However, the intervention of primary care protects patients from unnecessary procedures and over-treatment because specialists tend to use additional medical tests and procedures more often than primary care providers. The additional procedures also increase the risk of iatrogenic complications. When a person's comprehensive health care needs are coordinated by a trained primary care professional, it leads to better health outcomes and cost-efficiency (Shi & Singh, 2008, p. 282).
Shi, L., & Singh, D. A. (2008). Delivering health care in America: a systems approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers, Inc.
World Health Organization. (2010). Primary health care. Retrieved February 14, 2010, from http://www.who.int/topics/primary_health_care/en/
Sunday, February 7, 2010
Welcome!
Welcome to our simulated healthcare reform blog! Stay tuned for some interesting discussions!
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