Showing posts with label Government Healthcare plan. Show all posts
Showing posts with label Government Healthcare plan. Show all posts

Tuesday, November 30, 2010

Death Panels Should Have Been Named Moral and Ethical Reasoning


  What Broke My Father’s Heart 

James Wise

Class: HCA300

 
                                                                       Introduction

            This week’s course study took us down the path of reading a true story written by Katy Butler, regarding the end of life experience of her Father who was put on a pacemaker.  The story was heart wrenching as may be expected considering the nature of our topic, death.  Her family was upper middle class, her father a retired professor.  They were known to be educated, even prepared for end of life experience with both having signed living wills.  Katy suggests that the healthcare system is profit focused and towards that end keeps a person alive as long as possible, disregarding value of life.  She explains that her father has dementia, and already he could not do all his ALD,s which was left up to her mother to perform on his behalf in changing diapers, giving baths and more.  Her research lead her to lobbyist from drug and medical equipment companies who that pay over 500 million to get policies that reward doctor as she terms it as overtreatment. 

She exclaimed that she is given more Government-mandated consumer information on a new car then medical procedure counseling, such is it a good idea to put a pacemaker in a man who barely has a mind.  Ironically, her father was not for it but because of his dementia it was left up to mom.  As well informed, as her mother was she was put in a life or death decision with the surgical team advising the pacemaker. Katy points out, that the new healthcare bill had a provision, called ”end of life counseling;” to determine value of life and if the procedure is worth the outcome of the patient.  However, this was to become known as “Death Panels” and removed from the bill, the very thing that would have stopped the pacemaker from being put in her father.  After years of grief, service in mom helping her estranged husband do to dementia, he passed away with the pacemaker still shooting electrical pulses to his now dead heart. 


All About The Money
   
         I am in complete agreement with Katy Butler concerning the money trail and underlining motivation.  She also point out that 30% of  elderly who are deathly ill wish for death or trade one good day then two more years of illness.  Comparably, she showed statistics that 30% of Medicaid/Medicare cost is from overtreatment.  Her rational is sound when she says, “if a patient says no to a procedure then there goes the money, no one is paid.”  In my support of Katy, I have, in many other courses shown that the worse disparities in health care are formed when profit is the motivating factor.    In her family’s case, it turned her joyful mother and their shared joy into a nightmare, resulting in thoughts that cause guilt because you want it all to end.
     
       We are called the sandwich generation because science has created longevity of life.  In today’s world many are raising their children and caring for their ageing mother or father as well.  The young parents are now sandwiched into taking care of two generations and often times the ailing parent is harder to care for. This puts so much more stress in life and strains family systems to point of even breaking.  Such was the case in my personal story when my mother in law moved in with our family.  She was both mentally ill and physically incapable and she stayed with us for three years.  Personally experiencing the downward spiral of my mother in law and the twenty so procedures to keep her going was the most depressing time of my life.  In the end, it was one of the factors that broke up my marriage; an experience I still shutter over to this day.   It was my first real glimpse in health care’s great machine, often playing on my ex-wife emotions they would get yet another procedure underway.  In my mother in laws case it was overtreatment with each procedure as she worsened from each and everyone. Not only were the doctors paid but also my family paid the price as well with heated discussions that our predicament created.      It was indeed a path into nightmarish madness watching a love one slowly and with no personal dignity left finely pass away. 

Common Sense or Policy

            I do not fault medical science, in fact I applaud each new breakthrough with much vigor.  Medical science continues to enhance life in many ways.  Policy drives market in the direction towards maximum profit and policy form from special interest groups or lobbyist.  Anytime a policy is not based in common sense thent I almost guarantee a lobbyist was behind its creation.  Who was behind the coinage of “Death Panels” when it was based in common sense not the automatic model that says maybe one more procedure will fix the problem.  Simply there must be transparency in our health system that does not compromise value of life when achieving longevity. 
   
         Concerning life-supporting equipment such as pacemakers they have great use and help people live, long lives that they would have been deprived of.  In contrast, I would highly question putting the device in a 81 year old man suffering from dementia in the story I summarized here.  In such decisions in life, perhaps the hardest concerning death, needs good counsel with all considerations on the table.  In my personal experience with my mother in law, it was always a hurried process when it came to a new procedure.  We should have called death panels’ moral and ethical reasoning.  In conclusion, I will order the Do Not Resuscitate bracelet and wear it from now on, because simply I do not want to trade quality of life for longevity. 


Reference:

Butler, Katy (2010)  What Broke My Father’s heart The New York Times

            Retrieved on November 27, 2010, from
                       

Friday, August 13, 2010

Theories of Government Intervention in Health Care

Theories of Government Intervention in Health Care
James Wise
Class: HCA205


Abstract

We will explore two conflicting theories concerning Government intervention in the health care market. The first theories we will explore are the special interest group theory (Becker, 1983) and second the public interest theory (Johnson-Lans, 2004). Once we introduce these two theories, we will contrast Government’s current intervention in the health care market. In conclusion we will share our view using fact-based rational.

Special Interest Group Theory

Entrenched in political survival, politicians create legislative programs that compliment a special interest groups’ agenda for the return for votes that keep political representatives in office. Lobbying for legislative changes is an expensive endeavor, including organizing a legitimate counter political movement, inform the public, gaining petitions, and finely engage in lobbying. With that considered it leaves the general public out of important decision making when it comes to the health care market. In this theory special interest groups receive wealth transfer in scarce resources causing the general public to pick-up the cost in inefficiencies created by this model. Furthermore the political negotiations process consumes large amount of money that would be better used in productive purposes.

Public Interest Theory

We introduce this model as the more perfect in theory when contrasting the special interest group model. The core of this theory is Government intervenes in the best interest of society. This means several interventions through encouraging competition, providing information, and reducing harmful externalities or the fatal phrase “redistributing income in society.” This encompasses addressing market failures, in imperfect information “lack of transparency”, and breaking up monopolistic behaviors. By now we can clearly see these two theories are in direct conflict with one another; both continuing to compete with each other for Government intervention. So our question is which theory is currently the prominent one in our health care market? We will explore this question in our next section Current Health Care Trends, with fact-based rational.

Current Health Care Trends

Let us take a look into mergers which is a reliable snapshot on which theory is dominate in our current health care system. Mergers and consolidations have been increasing in our health care system at an alarming rate and to a point where companies have formed to help companies in a merger. Woodard and Lindstrom assert that health care organizations are consolidating at an unprecedented rate. With the number of mergers and acquisitions not likely to abate, healthcare organizations will need to become involved in strategic planning to manage the effects of this transaction activity and exert more control over the direction it will take. In particular, healthcare organizations need to know how to respond when their organizations are approached about a consolidation opportunity and how to determine whether a consolidation transaction would be strategically advantageous.
Furthermore hospitals and long-term health care are becoming the largest mergers in our current health care system. Market Watch explains the trend in health care mergers and acquisitions for the last ten years. NORWALK, Conn., Apr 08, 2010 (BUSINESS WIRE). More than $7.5 billion was committed to fund 459 mergers and acquisitions of home health care companies announced during the 10-year period ended December 31, 2009, according to DealSearchOnline.com. The largest of these transactions, the acquisition of Apria Healthcare Group by The Blackstone Group for nearly $1.6 billion, was announced in 2008. The deal between Apria and Blackstone is almost twice the size of the next-largest home health transaction for the same 10-year period: the acquisition of Option Care, Inc. by Walgreen Co. for $850 million, which was announced in 2007. Option Care itself was on the buy-side in 27 of the home health care mergers and acquisitions announced during the same 10-year period, while Apria Healthcare Group was on the buy-side in 15 of the home health care mergers and acquisitions announced during the decade.
Clearly these fact based examples show the special interest groups is the theory most dominate in our current health care system. We will now contrast this to current Government intervention within the public interest theory in our conclusions.

Conclusions

So far we have only shown the dominate special interest theory; however our Government is making inroads to addressing public interest theory. The new health care reform has achieved greater access, eliminated penalties to pre-existing conditions, and continually informs the populist in a myriad of official government website that address every aspect of healthcare. Furthermore the Government is taking a hard look at antitrust laws under the rule of reason. Alonso-Zaldivar (2010) assert that Washington, in a blunt warning to the health insurance industry, the Obama administration said Monday it won't hesitate to block mergers that threaten to stifle competition. Justice Department antitrust chief Christine Varney told a lawyers' conference that vigorous enforcement of anti-monopoly laws is vital to the success of the new health care law, particularly in trying to control rising premiums. In conclusion we see these changes important in favor of public interest, but we are also seeing the price as it relates to special interest groups. Simply the Obama administration has acted upon public interest concerns rather than special interest groups causing perhaps political suicide in his acceptance rate. We admire his sacrifice in his attempt to make health care a more competitive market and closer to the perfectly competitive market.

Reference:

Sultz, Harry A.. Health Care USA, 6th Edition. Jones & Bartlett Publishers

Dewar, Diane, (2010). Essentials of Health Economics, Jones & Bartlett Publishers

Business Wire. (2010) Key Stats on Home Health Care Mergers and Acquisitions for 10-Year Period Ended
December 31, 2009 Generated by DealSearchOnline.com. Retrieved on June 5, 2010, from
http://www.marketwatch.com/story/key-stats-on-home-health-care-mergers-and-acquisitions-for-10-year-period-ended-december-31-2009-generated-by-dealsearchonlinecom-2010-04-08

Health Care Financial Management (1997) Analyzing and executing mergers and acquisitions –
managing healthcare mergers. Retrieved on June 5, 2010, from
http://findarticles.com/p/articles/mi_m3257/is_n5_v51/ai_19645353/

The Huffington Post (2010) Justice Department: Expect “Vigorous” Scrutiny of Health Insurance Mergers.
Retrieved on June 5, 2010, from http://www.huffingtonpost.com/2010/05/24/justice-department-health-
insurance-mergers_n_588150.html

Sunday, August 2, 2009

Goverment Healthcare Plan: Key Elements

Dear Professor, I own the movie sicko and was one of my assignments in a prior class. Although he paints a great picture of Universal Healthcare being the perfect answer it has its issues as seen in recent news. I must agree with him when he states that Pharmaceutical companies should be run like an utility company. One way to accomplish this indirectly would be global production lines and the Government can assure the best price; it would cause our monopolized pharmaceutical companies to have to compete. This tried to be accomplished in Bush's administration but failed although including myself and many others receive our medication through Canadian channels.

The only difference but a psychological one is with a CEO of an insurance company telling where you can get service verses the Government is you get to sign the contract making it your decision now I know this decision is often curtailed completely when you elect to join your companies insurance plan. But in the end psychologically you are still making the decision with the Government it looks as you have no choice when in reality in most cases it depends on who you work for that makes the decision concerning your insurance plan. But people do not seem to look at it this way unless it is pointed out to them. Ironically when this is pointed out that the idea of Government deciding for us my open up much less restrictive channels for availability and portability.

One comment on Fox News Channel address why insurance companies are not focused more on preventative care and the answer was an opening for much thought. The Doctor stated that with company based healthcare plans the employees are always changing, getting new jobs with new insurance plans. The only way a insurance company can insure preventative care is if their policy holders are lifetime. Entertaining that idea you would be able to keep the same plan for life and take it with you where ever you may move to and work for now that is potability at its finest and is in consideration on Capital Hill at present time.