University of Phoenix
June 24, 2013
Significant Health Care Event
Health care in the past was a humane calling, people went into health care to help those in need A sick patient had a choice of doctor or hospital he or she wanted to use, when visiting the doctor, the patient was allotted time to discuss concerns he or she may have. Today the visit is limited to 15 minutes, and has limited availability on hospitals depending on which organization the physician works under. The health care system of the United States has emerged from a nonprofit to a for-profit business with focus on revenue. Over the last century those who want health care to remain humane struggle with corporations and those who view health care as a lucrative business (Lown & Fagin, 1997). Health care has become a lucrative business for those in managed care and corporations.
Changes in Health Care
Physicians and hospitals once upon a time dominated the medical marketplace, until the mid 1980s, at this time a new force emerged known as managed care. Managed care becomes the driving force to provide health care to the majority of American’s. To survive this change physician’s and hospitals merged forming larger health organizations. Reimbursement for services is determined by managed care, in place of fee for service, and reimbursement for hospital inpatient acute care services was cut at this time. To compensate for the lost revenue Hospitals developed multiple types of outpatient services. Hospitals are involved with primary care, outpatient surgery facilities, home health care, and expanded into other health services, like long-term care and rehabilitation services. “Together, managed care and integrated delivery organizations have, in reality, corporatized the delivery of health care in the united states” (Shi & Singh, p108, 2012).
As health care is increasingly dominated by corporations, the independent physician struggles to maintain autonomy. Many physicians have consolidated into large clinics, formed partnerships with hospitals, or opened their own specialty hospital. Another option is for the physician to become an employee of large Medical Corporation. “Eighty-eight percent of physicians contract with managed care companies, these physicians receive forty-one percent of their revenue from these corporations” (Casalino, p. 3 2004).
As health care shifts to corporatization, there is a shift from nonprofit and government organizations to for-profit corporations, how much revenue can a corporation build. Revenue is seen in the millions with citizens having increased difficulty purchasing health insurance. Health insurance premiums rise with limited coverage for the consumer. The participant is limited to coverage on doctors, medications, and depending on the plan procedures, the consumer requires a prior authorization for certain procedures, which is obtained from the physician’s office. From the consumer’s standpoint managed care and corporatization have made health care system extremely complex to maneuver (Shi &Singh, 2012).
Cultural Beliefs and Values
Beliefs and values of the Americans influence reactions to health care reform, these values, and beliefs lead the American people to oppose any health reform. Values and beliefs also affect other countries health care systems. Canadians prefer increased spending for health care rather than receiving a tax break. Americans would prefer a tax break (Shi & Sing, 2012). Some of the beliefs and values of the American culture include the strong advancement of science and technology, resulting in the United States leading the race on medical breakthroughs.
Americans expect the best and newest medical care available. Consumers believe doctors focus on symptom treatment not disease management. With the