That they have stopped listening to anybody in between. I am very passionate about healthcare politics and our current system. Otherwise, I will leave it to the professionals. I have decided that I will never vote for a "politician" again. I cannot stand the ones that are so politically correct they cannot have ideas of their own.
Our health care problem is complicated because we made it that way. The human body is complicated enough, adding administrative complications sets us up for failure. So we hire people to take care of those administrative complications. People that do not understand the “care” part of the system take these jobs. For instance, the urgent care that I work for has a terrible EMR that makes it very difficult to find the correct diagnoses. So I will put “leg pain, unsp.” then will type underneath “the correct diagnoses is osteoarthritis R knee.” I will get an email every once in a while that I need to change it and find the correct diagnosis myself. Another example is the pre-approval process. Thank goodness I do not deal with too many pre approvals but I have heard stories.
The people hired to take care of this task will email the provider and say that the pre-approval was denied. No explanation given and that the provider should call the insurance company. That is what our country is paying for. Without administrators, our healthcare system would be cheaper. With that said, medical administrators provide this country with a lot of jobs. I think a single payer system that has patient financial responsibilities would slowly allow for big healthcare companies to decrease non-essential personnel without causing the economy to collapse. The patient must have co-pays and monthly premiums so that they utilize health care preventative measures (like not smoking) and so that they do not come in for every little red bump that has been there for two hours.
I also support public and preventative health. I saw a community service announcement for ways to prevent identity theft last night on TV. Why not an announcement on the dangers of sugar in our communities? Why not more information on flu prevention or chronic illness prevention? Why not the dangers of too much screen time especially when it is a school night and you have tons of homework to do? I see at least one patient per week that does not understand how detrimental smoking is to health. They say, “It’s my only vice.” These patients will have no preventative care other than birth control until they turn 65. Then, they will be admitted to the hospital for COPD/pneumonia and die there 2 months later.
I believe our system is dangerous because healthcare is expensive. If a patient is paying $200 at the urgent care (no insurance), I am going to prescribe them antibiotics for a cold. It is a costumer service thing. That is not the only reason it is dangerous, but a reason I deal with on a weekly basis. Healthcare providers need to be involved in policy making or this system will continue to grow more and more dysfunctional.
Policy makers made a 2000 page legislation that would “help” people get access to care (Mason et al., 2016). Good job. Now lets hire 2000 more administrators to find loop holes to get more money. Providing healthcare is a profession but gaining profits from healthcare is not.
Politics for me is a touchy subject in my family because the political party alliances run so strong and discussions tend to get heated. I'll be the first to admit that I avoid conversations about politics with members of my family. I tend to be more interested in social policy, rather than focus on a particular political party's agenda. I suppose I would even go so far as to say I'm a disgruntled constituent...is that even a thing? I'm so disappointed in the entire political process because it's so cumbersome and heavily influenced by money and power. I think Mason et. al (2016) sums it up nicely when they say that evidence and scientific finding ought to play a key role in shaping policies, however, it "may not be sufficient to advance policies" due to the influence of values and politics trumping evidence.
As for health care reform it's definitely needed. Why is the US spending so much money per capita on health care, yet not reaping superior health care outcomes? I understand that Americans value independence, self-sufficiency, and autonomy--I'd go so far as to say these are some of the core values of our society; however, I personally would like to see a paradigm shift toward allocative health care coverage in the form of universal health care because health care is essential.
I'm a proponent for active involvement of nurse providers in policy. I think a lot of places have done a decent job of having nursing "at the table" for bedside nursing policy, but there still is room for improvement for APRNs to have a seat at the table. I'm hearing more situations where APRNs are considered medical staff with full voting privileges, which is awesome, but it seems there are still more places without this recognition for APRNs than with. More often than not the barrier comes down to opposition from one or two physician providers, or even indifference or apathy among APRNs. As the largest workforce in health care, nurses, especially highly-trained APRNs, should have a say in the decisions that affect their practice and should care about being active in making those decisions.
I have read your post and I have found the piece of information to be very interesting. I agree with your point of view in most of the places. I agree with the point that providing healthcare is a profession and it should not be converted into money making. I also agree with the point that people who are hired for the care management process within a hospital setting are not sufficiently trained. Additionally, the electronic medical records set up for the purpose are not able to give the correct and appropriate diagnosis making the medical procedures more cumbersome (Travaglia, Daly, Jackson & Speedy, 2015). Like the point which you have mentioned that EMRS are simply putting osteoarthritis as leg pain.
I have myself faced scenarios where the pre-approval process has made the process of support care delivery delayed. This particularly increases the risks when the patient is in need of urgent care. I think you are absolutely right in stating that most of the times sickness as simple as cough and cold are used by medical administrators to make profit. Thus, I think the focus should be upon health education to make the patients more health conscious, which will reduce the burden upon present healthcare system and allow for optimum utilization of the medical resources.
I agree with your point that allocative healthcare system need to be implemented where the health care benefits from reallocating resources between programmes are limited. In my opinion, it will check the sharp rise in healthcare costs, which makes it more accessible to each and every sections of the economy.
As mentioned by Hwang, Sharfsteinm & Koller (2015), inclusion of the nursing professional within the decision making can make the care and support services more appropriate. In this respect, opposition is received from within the healthcare channels (Gilson, 2016). In my opinion, inclusion of the nursing professionals within the care planning can also help in enchanting individual skills.
Gilson, L. (2016). Everyday politics and the leadership of health policy implementation. Health Systems & Reform, 2(3), 187-193.
Hwang, A., Sharfstein, J. M., & Koller, C. F. (2015). State leadership in health care transformation: red and blue. Jama, 314(4), 349-350.
Travaglia, J., Daly, J., Jackson, D., & Speedy, S. (2015). Leadership and health policy. Leadership and Nursing: Contemporary perspectives, 2013, 187.