Change is a hassle for many people, and the changes in this nation’s healthcare are continuous. Computerization, recession issues, the digital divide and even the price of gas all affect people and their health care. This list of seventeen healthcare trends and why they might be bad for us shows that some issues might be debatable, depending upon where you stand on the issues and how much money you have — the less wealthy you are, the more you may hurt from rising gas costs and computerization, for instance.
The people who are hurt from these trends are on both sides of the fence in many cases. Healthcare workers might be affected by downsizing; but, patients may be affected by this change as well. Computerize health records may be lauded as the next best thing to living next door to your doctor, but both the healthcare system and patients may suffer from issues in this area as well. Take a look at the list below to see how you feel about some of the most pressing health care trends today…
- Uninsured and Underinsured: With political infighting and rising insurance costs, the insured and the healthcare system will continue to shoulder the burden of the uninsured and underinsured. According to this CNNMoney report, “The problem, according to health care industry experts, is that the government and those with employer-based plans will have to pick up the tab as more Americans are unable to pay their entire medical bill.” Many of the uninsured are the working poor or are unemployed. Others are healthy and choose to go without it. Some have been rejected by insurance companies and are considered “uninsurable”. Some are without health insurance only temporarily. Some choose faith-based alternatives to health insurance.
- Health Care Worker Shortage: Health care workers at all levels are in short supply. While this is good news for those seeking a health care job (in those instances when the health care facility is not downsizing — see below), the bad news for citizens is that medical help may be in short supply. While this is a national issue, it also is a global problem. The World Health Organization (WHO) states that, “There is a direct relationship between the ratio of health workers to population and survival of women during childbirth and children in early infancy. As the number of health workers declines, survival declines proportionately.”
- Downsizing: Despite the need for health care workers in some areas, the trend among healthcare facilities often reflects the “do more with less” attitude because of rising expenses. While this frugality is good in many instances, when it comes to healthcare, the patient might wonder whether this ‘do more with less’ is affecting personal health care. Additionally, the effects of downsizing, no matter the industry, costs the U.S. more than $300 billion each year in health care, missed work and stress reduction efforts.
- Unions and Healthcare: In December three large RN unions merged to form the 150,000-member National Nurses United and a recent deal made with the White House and union leaders leads to supposedly help drive down health care costs, largely by encouraging companies to seek out less expensive plans. While this trend toward middle-class working class solutions may help workers, anti-union advocates state that 90 percent of Americans do not belong to unions and won’t benifit from this trend.
- Mandatory Staffing Ratios: This debate is ongoing, and mainly affects the nursing community. While some believe that mandatory ratios are the only way to ensure consistent, high-quality care, the opposition believes that mandating ratios goes too far and stifles the flexibility that makes this nation’s healthcare system work. Additionally, many believe that mandatory ratios, if imposed nationally, may result in increased overall costs of care with no guarantees for improvement in quality or positive outcomes of hospitalization
- Insurance Consolidations: A growing trend is for insurance companies to try consolidation, which — as shown by the story that is linked here — may be disapproved or may not, depending upon the situation. Mergers among insurance companies, it is believed, would further restrict — if not completely eliminate — smaller competitors and could drive up consumer insurance costs. The Federal Trade Commission and the Justice Dept. announced Sept. 22, 2009, that they will solicit public comments and hold joint public workshops to explore the possible update of the horizontal merger guidelines, which cover acquisitions between firms operating in the same market.
- Telemedicine on Rise: Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred via telephone, the Internet or other networks, and legal issues continue to generate regarding this practice. While consumers benefit from long-distance prescriptions and medical help and advice, telemedicine also raises a number of legal concerns regarding licensure and professional accountability — especially related to cross-state practice. The purpose of licensing health care professionals is to protect the public from incompetent or impaired practitioners.
- Electronic Health Records: Electronic medical records (EMR or EHR) are becoming realities, and the upside is that it may help to smooth the work flow in healthcare facilities. But, some patient issues can be problematic and bad for healthy reputations when it comes to obtaining insurance. This linked story shows just one example, where a patient discovered false diagnoses when his records began to reflect imprecise information plugged into codes required by insurers.
- “Hold Harmless” Clauses: As Health Care Information Technology (HIT) increases, more and more vendors are pushing for a contractual and legal structure that renders the vendors liability-free when it comes to patient mistakes in billing or in electronic health records, even if their proprietary products might be implicated in adverse effects. This “hold harmless” clause shifts liability and remedial burdens to physicians, nurses and health care facilities, even when those users follow vendor instructions. These costs may be passed on to patients. You can read more about this issue in this Wall Street Journal Health Blog article.
- Digital Divide: While the health care industry is trending toward online records and accounting, many U.S. citizens still cannot gain access to the Internet. Slow connections or no connections or the inability to pay for broadband or even for dial-up, let alone the cost of a computer. The problem here is that the individuals who are in the lower-income levels may miss out on some health developments with a trend toward online health care upkeep.
- Cost Accounting: Cost accounting is essential to many businesses, but health care industries are lagging behind. The trend is toward cost accounting in health care, because this approach would allow a quantitative component to be added to reviews of new and existing programs and services as managed care trends upward. As health care facilities seek to adopt cost accounting systems, the patient may watch his or her billing, as shortening collection times may affect the accuracy of record keeping.
- Reimbursement Rates: Medicaid is the issue here, as these programs cut reimbursement rates and benefits in 2009, putting pressure on health care providers nationwide. Additionally, state Medicaid directors worry about what will happen when federal stimulus dollars end in 2011. As healthcare costs continue to increase, driven by medical inflation and volume growth, policymakers may consider limits on reimbursement rates for doctors and hospitals as well as technologies to reduce costs in the long term. Administrators will again be asked to do “more with less.” In this case, see #3 above.
- Pay for Performance: The increasing trend in health care is to consider “pay for performance” models. This action is an incentive to reward physicians and hospitals for care, modeled after the Centers for Medicare and Medicaid Services’ voluntary quality-indicator reporting system. While some advocates for the ‘pay for performance’ believe that health care quality will increase, others have shown that pay for performance produces no financial incentives and “in some cases, produces disincentives for quality. Increasing numbers of programs link payment to performance.”
- Corporate Compliance: While the pressure is on for more corporate cooperation with government authorities, the habit of non-transparency remains strong. In a recent incident, Johnson and Johnson neglected to inform the Food and Drug Administration (FDA) about its delay in recalling Tylenol this year. It appears that the company sat on its products as complaints continued to pour into the Johnson and Johnson offices. Consumers may depend upon the FDA to notify them about problem foods, drugs and medical devices (see below), but the FDA only is as good as the corporations that inform it.
- Food, Drug and Medical Device Recalls: The Food and Drug Administration (FDA) lists recalls, but their list depends upon corporate compliance (see above). Additionally, while this list is available, many people do not know it exists, and many news publishers may not have room or incentive to print this information for their readers. Add the digital divide issue (see #10 above), and some citizens may not have access to this information. The consumer can only hope that retailers will know this information and remove products from the shelves before more people can purchase recalled items. Stay on top of recalls and more through the link for this listing and at Recall.gov.
- Buying Medications Online: While the digital divide does exist, more computer owners are seeking medical supplies — including drugs — online. While this trend toward online medical purchases is increasing, problems exist such as the legitimacy of the druggist or pharmacist, the increased possibility of medical errors and another possibility of tainted medicines. Many physicians may not recommend purchasing medicines online, so the consumer is left responsible for any online purchases. If you follow the link for this listing, you’ll learn more about online medicine purchases, including information about medication errors.
- Rising Gas Costs: While rising gas costs are not a healthcare trend, it is a trend that does affect many patients. According to this linked article, patients in need of frequent care are canceling appointments or prolonging the time between appointments because these patients cannot afford the gasoline. Fortunately, some agencies have offered help for these individuals in the form of grants to help patients continue their care.
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