This reading inspires and suggests a different way of looking at ones health. The author proposes that by regarding oneself as a being of energy, one can enhance ones well-being over the whole of life. While this approach may present challenges to embracing it right now, it certainly opens up many avenues for thought and action.
My philosophy of health has not been clearly articulated in the past. In this, I am probably like many people. I have taken for granted that I will have good health while young, and probably experience health problems when older. I have also taken for granted that medicine will help me to some extent as my health issues multiply.
This attitude probably arises from seeing relatives and family friends showing different degrees of health and robustness in different decades of life. Siblings are just as vigorous and healthy as I am. Uncles and aunts are healthy, but take fewer risks with their bodies. Grandparents health concerns may interfere with their productivity and enjoyment of life. Great-grandparents are more frail or dead of the diseases of old age. For a child, this is just the way the world is, and few children question it. This, nonetheless, was my first introduction to the idea that health was not unvarying, and was, thus my first, immature philosophy of health.
As I have grown older myself, I have also watched as my relations and neighbors showed signs of aging. They show decreased vigor and increasingly complain of health concerns. This recognition of changes in people over time has occurred only since adolescence. Before then, such changes were simply not noticeable to me, partly because I was less aware of my growth and development. Adolescence showed me that I was a creature that passes through phases and stages of life. This realization made it easier to notice the stages of life and health that others experience as well. I now notice aging very clearly everyone that I interact with over time.
For example, an uncle who played football with his nephews in his 20s safeguards his knees in his 40s. The grandparent or great-uncle who once chased me as a toddler is now glad to sit down. The beloved great-grandparent who once participated in all family events needs help with daily chores. I have assumed, I think, that this decreasing mobility and freedom of action would happen to me as well, without having thought about it very carefully or specifically.
This was my more recent philosophy of health still very unsophisticated, but with the addition of a perspective of time. I certainly did not delve into the three aspects of health as described in this course. My family cared for my physical health and warned me away from risky behaviors. My mind was to be improved with as much education as I could manage financially and intellectually. Spirit was taken care of by my attending to religious obligations to the degree demanded by my family and community. This was the extent of explicit attention paid to what I now learn are three aspects of health
This is very much like what the author of the reading describes. We take for granted that we will live a certain number of years, then experience a disease that disables and kills us, or, if we are lucky, kills us so fast that we are not aware of having had a disease (OBrien and Jaidev 14). I have certainly inferred this from the experience in my family and community. Many people, myself included, also tend to focus on physical well being without reference to spiritual and mental well being.
The particular reading promises a great deal but offers little practical guidance on behaving like an energy being. However, this segment suggests a novel way to consider the human life cycle. The reading inspires me to aim for being the best I can be at each age. This requires being more in charge of the way that I feel.
My goal for this course is to take better charge of my health. This will have to begin with awareness. I need to be conscious of my health more of the time.
I know that smoking and obesity are two major health factors, and I can control both, to some extent at least. I can change the way that I eat, exercise, sleep, monitor screen time, and allow time for mental rest and recuperation. I can do this myself, without medical intervention.
My intellectual life is very fulfilling right now. It is also all-consuming. However, I now realize that a dull or otherwise awful job could negatively affect my health. This should shape my job hunt.
My spiritual health is the area where I have the fewest specific ideas. I think that if I remain aware that my spiritual health is important, I will be on the lookout for ways to optimize it. The religious practices of my family may be comforting, and I will try to reconnect with them to see whether they build me up, or have no impact. Meanwhile, I will be listening and trying to observe what works for the people around me whom I admire.
The assigned reading is a reminder that we are more than skin and bones, organs, and blood, that will inevitably malfunction. We have the potential to be healthier and more productive at each stage of life, according to the authors (OBrien and Jaidev 16). This is an empowering notion. If I can manage even a few goals eliminating some sources of health stress and adding positive behaviors, I will have taken good advantage of this course.
Works Cited
OBrien, Justin and Swami Jaidev. The Wellness Tree. St. Paul: Yes International, 2000. Print.
Health data is used in many countries to allocate scarce resources, distribute funds to health care organizations, regulate patient flow, as well as inform and enhance decision making and patient care outcomes (Lucyk, Lu, Sajobi, & Quan, 2015). As such, it is important to collect high-quality data using valid and reliable techniques to ensure that the decisions made reflect the true picture on the ground (Deering, 2013; Schoenman, Sulton, Kintala, Love, & Maw, 2005). This paper uses two real life events to not only discuss how health data is collected and submitted to relevant authorities, but also to make several recommendations on how the status quo could be improved to achieve better outcomes.
Description of the Events
The first event relates to data that was collected to show disparities in health insurance after Obamacare was signed into law. The news article demonstrates that most of uninsured Americans reside in the South and the Southwest (Republican-leaning states), and are generally poor as demonstrated by the socioeconomic indicators used. The news article also shows that obtaining health insurance is still seen as a major hurdle for many Americans due to low incomes and decisions made by local politicians to abstain from Medicaid expansion (Bui & Sanger-Katz, 2015).
In the second event, an independent global health research organization known as the Institute for Health Metrics and Evaluation (IHME) used data from two studies to report how child and maternal deaths have declined in most counties after the implementation of United Nations Millennium Development Goals (Murray, Wang, & Kassebaum, 2016).
How Information was Gathered and Submitted
In the first event, the newspaper enrolled the services of two organizations to collect self-report data from participants through the use of questionnaires administered in the form of a survey. Information in the second event was gathered through synthesizing the findings of two studies that were published in the Lancet scholarly journal. It not clear how the information from the two events was submitted to relevant authorities, though it is apparent that data from the two events could be used by federal health agencies to inform policies on health insurance and child and maternal health. However, due to their presence as news items that can be accessed through online protocols, it is argued that the information was reported through electronic means.
Proposals for Improving the Status Quo
Although available literature shows that self-report is one of the mostly used techniques of collecting health data (Pyone et al., 2015), it is often faced with problems of validation and variation in the timeliness of data. In the first event, for example, it is evident that one organization used census data that was not current to project uninsured patterns. This problem can be solved by using up-to-date measures and tools in collecting health information from the field. It is however difficult to use contemporary measures as most organizations prefer to use census reports due to their high validity (Lucyk et al., 2015).
Another proposal relating to the second event is to ensure that primary health data is corrected from the field so that the findings of the two studies used can be compared against objective data. However, it is often difficult for organizations to collect new health data from the field due to financial constraints, time considerations, and lack of capacity (Lucyk et al., 2015). The last proposal relates to ensuring that proper reporting mechanisms are implemented to ensure that such information and data become useful to relevant agencies and stakeholders. However, it is clear that most organizations do not invest in proper reporting mechanisms for health data due to lack of awareness on the importance of such data.
References
Bui, Q., & Sanger-Katz, M. (2015). We mapped the uninsured. Youll notice a pattern. New York Times. Web.
Lucyk, K., Lu, M., Sajobi, T., & Quan, H. (2015). Administrative health data in Canada: Lessons from History. BMC Medical Informatics & Decision Making, 15(1), 1-6.
Murray, C.J.L., Wang, H., & Kassebaum, N. (2016). Sharp decline in maternal and child death globally, new data show. Web.
Pyone, T., Dickinson, F., Kerr, R., Baschi-Pinto, C., Mathai, M., & van den Broek, N. (2015). Data collection tools for maternal and child health in humanitarian emergencies: A systematic review. Bulletin of the World Health Organization, 93(9), 648-658.
Assume you are part of a team charged with leading the implementation of CPOE within Health Matters. How would you approach the task? What would you do rst? Next? Who should be involved in the team? Lead the team?
Health Matters is a large health system involving Cooper Memorial Hospital, Ashley Valley Hospital, nine outpatient care clinics, and three imaging centers. Implementing the computerized provider order entry (CPOE) system within Health Matters would require identification of the needs of the personnel in the different settings within the healthcare organization. The implementation process of the information system should be approached with a view to making the system implementation succeed. It would be important to learn the factors which made a section of personnel to reject the previous CPOE system. By understanding the factors, they would be evaluated to determine whether they would influence the personnel to reject the proposed new system. It would also be known whether the person who rejected the implementation of the health information system was influenced by internal or external factors.
I would act as a team leader to help Health Matters implement CPOE by guiding the implementation team through five (5) stages. The first stage would involve strategic planning. At this stage, a team would be formed to be involved in the implementation process. The team would have representatives from all departments within Health Matters. All matters concerning the proposed CPOE system would be reported to the project team. The team would examine the current information processes and information flow within Health Matters. The project objectives would be formulated at this stage. In addition, an elaborate project plan would be drawn to contain all matters of the proposed CPOE system. It would be essential to involve personnel from all departments within Health Matters. The second stage would involve reviewing procedures.
Software capabilities would be reviewed, manual processes would be identified, and standard operating procedures would be developed. The third stage would involve data collection and re-organization. The stage would also involve converting data to the required form and reviewing all data input within Health Matters. The fourth stage would involve training of personnel and testing of the CPOE system. It would be essential to train all personnel within Health Matters so that they would understand how to use the various components of the system with minimal errors. They would also be taught basic troubleshooting skills. System testing would involve pre-testing the database, verifying test results, and performing final testing. The last stage would be the CPOE system implementation and evaluation. The evaluation would provide hints on the success level of the system implementation. Changes in the implemented system would be done based on the evaluation.
The CIO hasnt been hired yet. Do you see that as a problem? Why or why not? What role, if any, might the CIO have in the CPOE implementation project?
A chief information officer (CIO) has not been hired yet within Health Matters. It is clear that the information systems department does not have personnel with excellent skills in project management. Therefore, it could be concluded that the previous efforts to implement the CPOE system could have failed because the implementation team lacked guidance from a specialist in information systems analysis and project management. The fact that a CIO has not been hired yet presents a threat to the successful implementation of the proposed CPOE system. This would be due to the fact that the implementation team would lack personnel with adequate technical skills and knowledge in systems analysis and information management. A CIO plays a crucial role in the successful implementation of information systems within many organizations across the world. A CIO would provide crucial guidance to the senior information management team. He or she would report information related issues to the senior management for specific actions.
On the other hand, an organization that does not have a CIO does not have the professional guidance of implementing health information systems. In most cases, the implementation of such systems fails due to a lack of technical leadership. A CIO would be essential in the development and maintenance of information technology organizational structure that would be essential in implementing the proposed system. For example, a CIO would ensure that the right personnel is hired to maintain the implemented system. Another role of a CIO in the CPOE implementation project would be establishing the goals and objectives of the information systems department in line with the requirements of all users within the organization. Therefore, the goals and objectives would be geared towards fulfilling the needs of the system users. A CIO would ensure that the proposed CPOE system meets all the legal requirements set by relevant bodies. This would be important because a system that contravenes legal requirements would be stopped until it fulfills the regulations. Finally, a CIO would be essential in the CPOE system project monitoring and evaluation. Regular system monitoring would be essential in detecting possible threats and preventing them from occurring within the system in the future. Evaluation of the CPOE system would be necessary for determining the usefulness of the implemented CPOE system.
To what extent does the fact that Health Matters is a relatively new health system simplify or complicate the CPOE implementation project? How do other health systems typically implement CPOE or other clinical information system projects of this magnitude?
Health Matters was formed in the recent past by merging the two hospitals, two imaging centers, and nine outpatient clinics. Before the merger, the different systems within Health Matters had different information needs. In addition, they had different leadership which could have contributed to the choices of the information systems they were using. The merger would present challenges in the implementation of the project. For example, the two hospitals within the health system selected different health information systems based on user needs. The relatively new merger presents organizational challenges that would impede the adoption of the proposed CPOE project. Several approaches are adopted by other healthcare institutions to implement information systems of this magnitude. Firstly, organizations ensure that they have hired personnel with experience in implementing large information systems in other organizations.
They might hire the personnel on permanent or temporary terms to oversee the implementation of information systems. Secondly, organizations ensure that thorough training of personnel is conducted. Training on the different applications of information systems is essential because personnel is imparted with the knowledge and skills on the usage of the different components of new systems. It has been shown that proper training increases the chances of successful implementation of information systems within many organizations. Personnel who are not well trained on how to use new information systems make many errors that could make the systems to be ineffective. If there are many errors that are made by personnel associated with the usage of a new information system, it could be an indication that the personnel is not comfortable with the new system. Thirdly, organizations have been able to implement large information systems by dividing the implementation process into several phases. They implement different components of new information systems at different times. Successful implementation of one component would lead to the implementation of another component. This would continue until all the components within the system are implemented. This approach has been shown to be effective because problems encountered when implementing one component are addressed to prevent similar problems in the future. By adopting the approaches, healthcare organizations are able to implement large health information systems with a view to improving patient care outcomes.
Scenario analysis is a tool that is used to address what-if question, by this we mean that it is a tool that is used to predict the probability of an anticipated eventuality and how to solve them, in case they occur. Scenario analysis is of vital importance to many different organizations because it is not always what has been planned by the relevant authorities is realized. If they rely only on a fixed result and a fixed strategy of attaining the expected results, then they might encounter major problems such as experiencing huge losses in the respective organizations. The relevant authorities of an organization develop ways in which various eventualities that may occur in the long run can be assessed and solved. This stance puts the respective organization in a very secure position to ensure its continuity in the future. The question that scenario analysis answers are what if this happens? Then what suitable strategy can be used to address it. Mainly scenario analyses are developed as a plan B if plan A fails to happen as planned by the relevant authorities. Many organizations apply scenario analysis to assess a variety of risks, but the core reason for scenario analysis is to analyze interest rate risk. This is a risk that is very crucial to many organizations, and any possibility of the rates of interest increasing or decreasing in future should be addressed promptly.
In the essay above, we shall discuss how scenario analysis can be used to access the eventualities that may occur to www.trover health system organization by identifying the key drivers and how they will impact and shape the future environment of the trove health system. We shall use the scenario analysis to answer three main questions that include; what can be learned from the website? What can be done to access the website easily? Lastly, what can be done to improve the website and three areas that stood out about the website? The trove health system is a health provider organization and is located in western Kentucky. It is a renowned health centre that has specialist physicians and has various subsections that have professionals who work hand in hand with one another to achieve the corporate goal of the trove health system. Some of these subsections that are found within the trove health system include trove clinic, research divisions and many others that are going to be mentioned later in the essay. Trove health system values its employees very much because they believe the health systems that they have must be operated by humans in order to function. Many organizations in the world that care for the welfare of their employees happen to be the best performing organizations in the entire world. Trove health system happens to be one of these organizations.
The government of the United States has really benefited from the trove health system because of the high standard health services that it has offered to the United States republic in general. The trove health system has developed a website that is referred to as www.trover health system org, which aims at providing more information on the trove health system to the entire world. This website has really contributed to the high standards of health services offered by the trove health system. Lets start answering the questions that we earlier mentioned at the beginning of this essay. We can learn that the website has been posting its employment vacancies on its page so that anyone in the world can access it and apply if he or she feels capable and qualified. This is because the trove health system does not just limit itself when recruiting its employees but rather offers it worldwide so as to get the best of the staff. The other things that we can learn from the website are that it has been posting its subunits on the website page.
This is to show the world the diversity of their health services. The trove health system should have a domain that is memorable, not have bulky images which may cause the website not to be accessible to those computers with low processing speed. Lastly, the website should have a Cathy introduction, specific and clear information and effective domain that is memorable to the people. The trove website has stood to be effective so far because it gives the world a clear picture of what the trove health system is, what it is doing and how you can access them. If the future of trove health system will have to remain bright, there are key drivers that have to be identified and implemented. This includes keeping at par with technological advancement, stick to their vision, mission and core values of offering high standard health services always, consistent diversity of health services and so on. By so doing, they will be in a secure position to any changes that may occur in the future of trove health system. This is a type of scenario analysis at the health centres.
Obesity is regarded as one of the most dangerous pandemics of the modern world. The USA has been one of the leading countries regarding the rate of people with excessive weight. The problem is associated with such serious health issues as cardiovascular diseases, type 2 diabetes mellitus, and even cancer (Malik, Willett, & Hu, 2013). Malik et al. (2013) claim that obesity leads to considerable financial losses for the American economy, as medical costs attributable to obesity reached the US $147 billion in 2008 (p. 13). This is a heavy burden on the countrys economy as well as its healthcare system. Obesity among adolescents is of specific concern, as the lifestyles developed at early ages persist and define peoples behaviors in adulthood (Ahluwalia et al., 2015). Ahluwalia et al. (2015) note that adolescent obesity tends to have long-term effects irrespective of peoples weight in adulthood.
It has been acknowledged that the rate of overweight adolescents in the USA has stabilized, which is a positive trend. Researchers note that there is quite a small increase in the number of obese adolescents in the USA, which is a positive change given that the rate of overweight adolescents had been increasing in past decades at a significant pace (Ahluwalia et al., 2015). Vereecken et al. (2015) note that there is a certain growth in fruit and vegetable consumption among US adolescents (during the 2000s). It is noteworthy that the physical activity of US youth has also increased considerably. These findings show that there is a certain positive shift in health-related behaviors as American adolescents tend to have healthier diets and lifestyles as compared to older generations.
Nonetheless, these seemingly promising trends conceal one of the major issues persistent in US society. Social disparities contribute to a substantial difference between the lifestyles of minorities and economically disadvantaged groups and middle-class and rich adolescents (Frederick, Snellman, & Putnam, 2014). Frederick et al. (2014) emphasize that recent research shows that the obesity rate among high-socioeconomic status adolescents decreased while the same index for economically disadvantaged groups increased considerably.
It has been found that major factors contributing to the prevalence of obesity among teenagers coming from low-income families are population density, distance to parks, affordability of fruit and vegetables, and the availability of high-quality healthcare and educational services. Rossen and Talih (2014) note that demographic and geographical factors are major contributors to the prevalence of unhealthy behaviors among American adolescents. Young people coming from low-income and ethnic minority groups have few opportunities to be physically active and consume healthy food, which increases the rate of obesity.
It is noteworthy that the US government has tried to address this issue in many ways. Thomson and Foster (2013) note that educational establishments have become the primary platform for promoting healthy lifestyles. Young people are taught what to eat and that they must be physically active to be healthy. Moreover, both the government and non-governmental organizations have introduced various programs promoting healthy lifestyles. At the same time, research shows that these measures have proved to be ineffective as a considerable (and growing) part of American adolescents are still overweight and leading unhealthy lifestyles.
Potential Positive and Negative Impacts
It is possible to consider the impact of the trend in question on the healthcare system with the use of the complex adaptive systems theory. The focus of this paper is on overweight adolescents. Importantly, their socioeconomic status is disregarded as the number of teenagers with excessive weight is considerable in both groups, underprivileged and middle-class or rich people. It is difficult to identify any positive outcomes of the trend mentioned above, but it could potentially lead to major shifts in American society. Excessive weight is a noticeable feature, which will make people see the persistence of social disparity in society (Rossen & Talih, 2014). It is necessary to add that the obvious presence of the problem has made it more acceptable, and many people do not pay a lot of attention to it.
Nevertheless, the number of middle-class overweight adolescents is likely to reduce while the number of poor overweight people will increase, which can make all people see this shift in society. The excessive number of overweight youth will make it a norm for poor people. New stereotypes may appear. Just like people still think that a person of color is likely to be less well-off than a white person, an average person will regard an overweight person as a representative of lower classes. The concepts of emergence and self-organization can be applied when analyzing this positive outcome. There is a certain shift to more sustainable practices as people try to help those in need. Various non-profit organizations appear, and people become more active in their communities. New patterns of helping disadvantaged groups emerge, which can result in the development of various community-based programs encouraging and providing opportunities for disadvantaged groups to lead have healthier lifestyles. People will self-organize to create groups and communities of like-minded individuals who want to help or to seek needed help.
Apart from the potential positive effect on social justice, the trend in question can have a positive impact on the patient/client experience. Healthcare professionals start using inclusive strategies that imply engagement of the client/patients relatives, friends, community, and so on. Therefore, when treating disadvantaged groups, healthcare professionals might educate them and, more importantly, help them find opportunities to have healthier lifestyles. Instead of treating symptoms associated with obesity, healthcare practitioners will be able to address the root cause of the trend. Emerging patterns may involve the collaboration of diverse agents that will provide resources to disadvantaged families.
These resources may include training, facilities or areas for physical activity, food (affordable vegetables and fruit), jobs, and so on. Self-organization can also be a characteristic feature of this positive outcome. As has been mentioned above, the major stakeholders can form new systems. Healthcare professionals, low-socioeconomic status groups, high-socioeconomic status individuals focusing on the sustainable growth of the society, and officials can create platforms (non-profit organizations, governmental organizations, groups including digital communities) to contribute to a more proportionate distribution of resources. These agents will be united by such values as empathy, justice, sustainable growth. Americans develop numerous projects aimed at helping different groups of people including disadvantaged populations. Therefore, the chances of middle-class Americans involvement in addressing the issue are quite high.
One of the major and the most obvious negative outcomes of this trend is associated with financial issues. Excessive weight is likely to remain a heavy burden on the US healthcare system, as significant funds will be spent to address health issues associated with adolescent and adult obesity. Malik et al. (2013) note that over US$80 billion in economic production could be lost if the epidemic persists (p. 14). The concepts of non-linear interdependencies and diverse agents can help explain this outcome. The major agents involved in this situation are disadvantaged groups, middle-class and rich groups, the healthcare system, and the US government. The interaction of these agents will shape the development of their systems as well as the system as a whole (the American society). For instance, privileged and disadvantaged groups shape their lifestyles within the scope of the resources available. High-socioeconomic groups can afford a healthy diet and a lot of training (going to a gym, water pool, doing sports, and so on).
Disadvantaged groups have money to pay for their dwelling, food (often convenience food), some sort of education, but they do not have funds to invest in healthier lifestyles. The government has to address the needs of all groups within American society, which means that they should allocate certain resources needed to address the health issues of disadvantaged groups. Healthcare providers operations are shaped by the interactions of the three systems mentioned above as they follow the regulations developed. At the same time, the media can play a central role in the process. The rate of overweight adolescents is high in all socioeconomic groups, so the media will be able to focus on common values such as health and wellness, development, longer and better lives, and so on. Media should promote healthy lifestyles appealing to peoples desire to live better and to become successful. Many modern teenagers want to look like celebrities who are beautiful and successful. Media can continue revealing some secrets of the life of famous people.
The trend in question could also exacerbate social inequity as socioeconomically disadvantaged groups will still have limited access to health care and healthier lifestyles while high-socioeconomic status groups will be able to have healthy diets and lifestyles (Frederick et al., 2014). The concepts of co-evolution and diverse agents can be applied to better understand this effect. The major agents involved have been mentioned above. These agents will behave in a way to fit in their system as well as the larger system (US society). Ethnic minorities, low-income families, immigrants, and so on will try to survive and focus on meeting their families basic needs (accommodation, food, education, health care, and so on).
Limited resources will prevent them from having healthy lifestyles, and younger generations are likely to remain in their parents class, as they have fewer opportunities compared to privileged groups. The latter will try to improve their life by having healthier lifestyles and obtaining better educational and healthcare services. Privileged groups will see the negative health outcomes of obesity since the health condition will be well researched (minority groups will constitute the largest part of those affected). In other words, disadvantaged groups are prone to the development of this health issue, and their lifestyles have been analyzed and described. There are various educational incentives for teaching young people to have healthy lifestyles. Therefore, people will learn about numerous facts and scientific evidence, and they will see real-life examples in the streets of their cities that will show actual what obesity can be.
The healthcare system will also evolve in response to the development of the systems mentioned above. It is possible to come up with an example of nonlinear interdependence. Healthcare professionals will promote healthy lifestyles, but their strategies will be more successful with privileged groups. As for disadvantaged groups, healthcare practitioners will have to treat various symptoms associated with excessive weight and within the limits of the resources available to these groups. The government will continue investing in preventive measures, but when addressing the needs of disadvantaged groups, it is likely to allocate some funds to treat the symptoms rather than address the cause (social inequality) of the epidemic.
Recommendations
Healthcare managers can become the most active agents of change regarding the problem of excessive weight in American adolescents. The first recommendation to be given to these healthcare professionals involves the focus on the healthcare facilitys employees. The manager should launch a wide discussion of the major factors leading to obesity among adolescents as well as the strategies used by the employees to address the issue. It is crucial to discuss all the methods used with the focus on their benefits and shortcomings. This stage will help employees understand that a change is needed. The second stage will involve the implementation of research and discussions of numerous methods as well as particular procedures used in different states and different countries.
Healthcare professionals should understand that adolescents obesity and associated social disparity can and should be addressed at different levels (including the individual level). They should feel empowered to implement the change. It is noteworthy that modern healthcare professionals already pay a lot of attention to dietary habits and lifestyles. They provide information concerning possible outdoor activities, the benefits of healthy lifestyles, and so on. The discussion of excessive weight, its impact has become a part of many nurses daily routines (Thomson & Foster, 2013). Nevertheless, many healthcare professionals do not provide any training as they are reluctant to invest their time, which reveals an existing gap. Monetary awards have a positive impact as healthcare professionals enter a certain kind of competition.
The second recommendation to consider is associated with educating patients. Thomson and Foster (2013) argue that educational programs concerning healthy diets and lifestyles are quite ineffective. Healthcare professionals also educate patients/clients and their relatives concerning the most appropriate diets and lifestyles. However, this is not enough, as people having limited resources tend to ignore these recommendations. Moreover, they may feel depressed or even become angry, as they cannot afford the food and lifestyles recommended. It is essential to make this part of communication between the healthcare professional and client/patient more effective. Healthcare professionals should consult patients on the appropriate lifestyle and opportunities available for low-socioeconomic status groups when communicating with the corresponding individuals.
Healthcare professionals will have to implement quite extensive research on the matter, but the healthcare manager can inspire them to do so, stressing that they will become agents of the change that is needed for the development of the US society. The information provided can include data on local markets and groceries where prices are affordable, public parks or other public areas appropriate for physical activity, and so on. Since people often have quite different values, the changes can be hard to implement. The healthcare administration can be the necessary agents of change as they can motivate employees to train patients more effectively. Those who train patients effectively can receive monetary rewards, extra days off, more flexible hours, and so on. The administration should also pay the necessary attention to the development of proper culture involving the focus on such values as empathy, justice, growth, and so on,
The third recommendation to follow is related to the use of an inclusive approach. The healthcare manager should develop several strategies to get the community and different stakeholders involved in the process of addressing this trend. One of the easiest ways to do this is to address local churches and educational establishments as well as non-profit organizations. These agents can help low-socioeconomic status adolescents be more active through participation in various sports or different activities (dancing, manual labor, traveling with the focus on walking tours, and so on). More importantly, the healthcare manager can and should try to change the dietary habits of some groups making them healthier. The distribution of flyers including the information on affordable dietary options can be carried out with the help of educational establishments and local churches.
The healthcare manager can also address local business people (focusing on farmers and retailers) and high-socioeconomic status people who can create more opportunities for disadvantaged groups. The involvement of officials can be the most difficult and the most effective strategy. The healthcare manager can encourage local officials to launch programs involving tours to camps where healthy lifestyles are promoted. Officials can introduce some benefits for entrepreneurs providing more opportunities to disadvantaged groups. The educational sphere can be regarded as an example of the successful use of various projects aimed at changing childrens dietary habits (Malik et al., 2013). The use of certain menus has helped students understand that healthy food can be delicious and affordable. Again, it is necessary to stress that different agents values can differ significantly, and it is essential to focus on some values they can share. These may include sustainable development, collaboration, making a difference, and so on. The agents mentioned above have a common value associated with the development of society. Evolution and justice are values cherished in American society.
References
Ahluwalia, N., Dalmasso, P., Rasmussen, M., Lipsky, L., Currie, C., & Haug, E.,& Cavallo, F. (2015). Trends in overweight prevalence among 11-, 13- and 15-year-olds in 25 countries in Europe, Canada and USA from 2002 to 2010. The European Journal of Public Health, 25(suppl. 2), 28-32.
Frederick, C. B., Snellman, K., & Putnam, R. D. (2014). Increasing socioeconomic disparities in adolescent obesity. Proceedings of the National Academy of Sciences, 111(4), 1338-1342.
Malik, V. S., Willett, W. C., & Hu, F. B. (2013). Global obesity: Trends, risk factors and policy implications. Nature Reviews Endocrinology, 9(1), 13-27.
Rossen, L. M., & Talih, M. (2014). Social determinants of disparities in weight among US children and adolescents. Annals of Epidemiology, 24(10), 705-713.
Thomson, C. A., & Foster, G. D. (2013). Dietary behaviors: Promoting healthy eating. In K. A. Riekert, J. K. Ockene, & L. Pbert (Eds.), The handbook of health behavior change (pp. 139-155). New York, NY: Springer Publishing Company.
Vereecken, C., Pedersen, T., Ojala, K., Krolner, R., Dzielska, A., & Ahluwalia, N.,& Kelly, C. (2015). Fruit and vegetable consumption trends among adolescents from 2002 to 2010 in 33 countries. The European Journal of Public Health, 25(suppl. 2), 16-19.
Health care reform has remained to be an issue in the United States for the first time since 1994, when President Clinton proposed major reforms, there is provable consideration in reforming health care in America.
Research reported some constant challenges where unions of all influences are providing their own positions on the issue. Political activists and leaders are presenting concerns and solutions about these issues surrounding health care system. Some states have implemented different health care reforms and other states are on their way doing the same.
Interest in health care reforms is determined by three major issues, such as medical cover, cost, spending, and quality of health care services. With reference to coverage, it is estimated that above 50 million people were uninsured in 2007 and this makes up above one-seventh of the total population (Garber & Skinner 28).
The figure of uninsured population may have been increased by recession. Proposed reform favors private insurance and coverage under government medical plans to help people receive essential care and reduce difficulties paying for health care they obtain. In June 2012, the Supreme Court greatly legalized the President Obamas extensive health care service, the Affordable care Act, in varied decisions that Court viewers were speeding up to analyze.
Another issue is cost and spending since the costs increase for almost everybody in unanticipated and irregular change. The affected people are employees, taxpayers, health care providers, retirees, and employers. Costs are major basis of concern for families that are preparing for retirement or where somebody is severely sick.
National health care expenditure currently surpasses $2.5 trillion and this makes up around 18% of the GDP (Gross Domestic product) and expenditure has increased from around 13% of GDP in 1990 (Groszkruger 25).
The third concern addresses quality of health care. Even though the United States allocates significantly more on health issues per individual than any other developed country, it is considered average or relatively worse on different qualities of care measures. Medication and medical issues hurt several people yearly and they can lead to death.
Although the above issues raise major challenges, the proposed reforms are considered effective in solving the current issues in health care sector. Some critics argue that the solution for the three issues may contradict one another. For example, giving coverage for 50 million uninsured may probably increase costs since more people look for care and the demand for the services would be high.
However, 50 million insurance covers enlarge national expenditure since public subsidies may be needed to give support when obtaining insurance. Efforts to limit costs can hinder efforts to improve quality since new projects always need extra, not less, resources.
This paper discusses the current health care conditions in the United States and importance of health care reforms that are expected to be implemented in the country. Health care reforms presented by President Obama are expected to solve health care challenges through different ways, including solution to obesity, rationing of care, insurance reforms, and shortage of medical professionals to provide quality and reliable services.
President Obamas Health Care Reforms
Before discussing the main concerns that determine health care reforms, we will look at the reforms proposed by President Obamas administration. PPACA (Patient Protection and Affordable Care Act) is among the proposals that are intended to be enacted by American Congress, which was initiated by the Senate and afterward approved by the House of Representatives.
This proposal obtained a vote of 219 out of 431 in 2010 (Groszkruger 25). Later, President Obama signed the Act into law and made it among the first healthcare laws to be implemented in the United States.
Health care reforms address major issues such as chronic conditions, intervention opposed to hospice, unnecessary payment structure, and insurance policies governing employers and employees. Other health care reforms also cover areas such as incentives that address more health care rather than better health care and concentrate on the attributes of chronic health conditions.
Different strategies have been included in health care reforms to extend and improve the current health care system in the United States and these strategies include advance application of telemedicine technology, controlling health insurance agents, rationing of care, and tort reform. Various general strategies have also been proposed as well.
In 2009, President Obama provided his strategy for reforms and outlined electronic record-keeping, reduction of defensive medicine, and better classification and communication of the highest affordable treatments (Schmidt, Shelley, & Bardes 294). Health care reforms have covered the provision of medical insurance and coverage to most people in the United States as well as reducing obesity conditions and prevention of costly health conditions.
President Obama also expressed is purpose to a joint session of Congress in the end of 2009, which included the elimination of discrimination by insurance agents based on preexisting conditions, and self-governing commission to establish abuse, misuse, and fraud. The proposal also included formation of an insurance exchange for minor enterprises, individuals, deficit, neutrality, and other major reforms in health care system.
Latest Health Care Law
The High Courts ruling was a remarkable success for the President Obama and Congressional Democrats, where most of the people considered that it served as a key legislative support of President Obamas term. The Supreme Court ruled that a massive extension of Medicaid envisaged in the health care reform was an option, not an order, for all states in America.
The Medicaid expansion is a key section of the health care reform, making up around 50% of all uninsured Americans likely to gain health coverage, as stated by the Congressional Budget Office. It provided that around 17 million uninsured Americans will gain medical coverage via Medicaid that is financed by the federal government, which will allocate $930 billion from 2014 to 2022 (Andrews).
While maintaining Medicaid expansion, the ruling of the court narrowed the strength of the federal government to secure agreement through punishing states that decline to adhere to. Chief Justice Roberts stated that the federal government possibly will not force states to obey by cutting off the entire federal finances they obtain for active Medicaid plans or projects.
The endangered loss of too much federal money (above 10% of state budgets) is economic dragooning that leaves the states with no real option, but to acquiesce in the Medicaid expansion, the chief justice said (Andrews). A state could hardly anticipate that Congresss reservation of the right to alter or amend the Medicaid program included the power to transform it so dramatically, according to the Chief Justice (Andrews).
The Chief Justice Roberts stated that Congress has placed a gun to the head (Andrews) of states through instructing them to comply with the Medicaid expansion or they will not receive the entire Medicaid finances. Chief Justice said that states must have a genuine choice (Andrews).
The court case had depended on the alleged individual mandate, a condition that every American should receive medical insurance or will obtain a penalty. Republicans are planning to appeal this court decision since they stated that it is unconstitutional extension of federal authority.
President Obamas administration stated that it was required to mend fundamental faults and unfairness in the companies that provide or supply insurance to the people of the country and that it was vital to conditions like the necessity that insurers maintain every person requesting for the medical coverage without relating to the pre-existing health situations.
The courts ruling did considerably limit one key section of the law. The courts decision provides all states some elasticity not to develop Medicaid plans, without compensating equal financial fines that the law ordered.
Even with the ruling provided by the court, the discussions over health care reforms become more intense, with Republicans declaring to continue their fight the Obamas health care reform. Just on July 11, not more than 14 days after the Supreme Court ruling, the bill was passed by the House to repeal health care law proposed by President Obama and was accepted by a vote of 244 to 185. Five democrats were among the people who voted to repeal the health care law.
Some critics started preparing a challenge to President Obamas explanation of a different vital provision, where the federal government will subsidize medical coverage for most low and middle income Americans.
Commencing in 2014, the law directs most people to possess medical coverage and provides the subsidies to support Americans pay for insurance bought through markets that are called insurance exchanges. The debate arises whether the subsidies will be accessible in exchange program and managed by the federal authority in states that are not successful or decline to implement their own exchanges.
Critics state that the law enables subsidies just for Americans who receive medical insurance through state-managed exchanges. The White House states that the law may be interpreted to enable subsidies for Americans who also obtain coverage in federal exchanges.
Health care law aspires to enlarge medical coverage to accommodate above 30 million Americans, mainly by enlarging Medicaid and offering federal subsidies to support people receiving low-income and middle-income to purchase private medical coverage, which offers better opportunity to the people with lower income.
It will generate insurance exchanges for insurers to bundle services instead of charging based on personal or individual process. However, several states executives are afraid that Congress will decrease the federal share and transfer more expenses to the states as it looks for approaches to decrease the federal budget deficit.
Cost and Efficiency
Greater percentage of GDP (around 19%) in the United States is allocated to health care system and this makes it the biggest spender in the world, excluding East Timor. The number of workers who get medical cover is reducing and the expenses for health coverage from employers are increasing speedily. Since 2000, premiums for domestic insurance have moved up by 78%, wages have increased by 20%, and costs have increased by 18% relative to 2008 research by Mayes (61).
Private insurance in the United States differs highly in its health coverage and some studies projected that 16 million American adults were underinsured in 2004.
The underinsured adults were considerably more probable than Americans with sufficient insurance to decline medical care, Americans undergoing coverage caps for these substances such as medicine, and people reporting financial pressures due to health costs. Some have asserted that this process of involving greatly the participation of the government in the health care setting will eventually cause unnecessary expenses that come from the government.
Lowering Obesity
Prevention of overweight and obesity offers a major chance to decrease expenses. Different studies on obesity and overweight have reported that around 10% of healthcare expenses in 2000 were brought about by obesity and overweight.
About $92.5 billion were allocated to obesity-related problems in 2001 and this makes obesity to be among the expensive causes of health problems. Almost 50% of these expenses were provided by the government through plans of Medicaid or Medicare and a study by CDC approximated these expenses had almost doubled to $145 billion by 2007 (Schmidt, Shelley, & Bardes 294).
The study presented by CDC established a chain of costly conditions that are more probably to happen because of obesity and released some strategies to solve the issue of overweight and obesity. These include promoting children to be active, encouraging healthy diet, creating healthy diet more accessible, and promoting safe society to maintain physical activity.
Proposed health care reforms would allow promotions and policies that make noticeable decrease in obesity and overweight and this will reduce health care expenses. Almost 25.5% of American adults in 2006 were obese and around 23.6% in 2004. However, state obesity rates are estimated to be between 18.5% and 30% (Welch and Gruhl 551).
Obesity rates were nearly similar among both genders and some people have suggested an alleged fat tax to give incentives for safe practices through increasing the tax on foods such as soft drinks. These foods are believed to cause overweight and different studies have suggested individuals based on body measures that are very similar to the practice performed in Japan.
Insurance Reforms
Americans who are not able to get employer-sponsored insurance might purchase insurance through the exchange that would contain competing plans that provide a range of premiums, provider networks, payments and deductible alternatives.
Consumers who choose more expensive programs would pay the related greater premiums according to their choices of insurance or services. Minor firms and other companies would have an alternative to provide coverage to their employees through the exchange, but every firm would select its own program that favors them.
The political discussions concerning health care reforms have entailed the greater degree of co-pays for important services (for example preventive processes), and particular insurance industry functions (for example putting of caps on coverage). The debate has also involved the denial of several insurance companies to provide coverage to pre-existing conditions or providing extra premium charges for such pre-existing conditions (Garber & Skinner 28).
Supporters for proposed health care reforms claimed that moving the United States to a single-payers health care structure would offer universal coverage. They also argued that health care reforms assure all-inclusive coverage and mutual access to every medically essential process.
These reforms also provide clients free selection of providers and hospitals, without raising the entire expenditure. Moreover, moving to a single-payer structure would abolish errors or omissions by managed care assessors, which reinstate common doctor-patient relation.
Several legislative proposals that are being critically reviewed suggest penalizing major firms that do not offer a lowest standard of health care coverage. The legislation would also tax highly certain insurance plans to finance subsidies for low income Americans and provide coverage for the poor Americans as well. These will be provided on a descending scale to Americans receiving less than three times the federal poverty level to allow low income earners purchase health coverage if they are not insured by their firms.
Legislation that would offer an option of non-profit insurer formed on Medicare, but financing through insurance premium has been a debatable concern.
Some strategies have been created within health care reforms to the Medicare Advantage program that will decrease public subsidies provided to private insurance programs trading these programs through demanding insurers to compete. It is approximated that this process has raised the productivity of private insurance firms trading such programs to the people across the country.
Warren Buffett, famous entrepreneur and supporter of health care reforms, stated that the greater costs paid by firms in America for their workers medical coverage put them at a competitive difficulty.
He evaluated almost 19% of GDP allocated by American government on health care system with the 10% of GDP allocated by most countries in the world and pointed out that America has less nurses and doctors per patient (Welch and Gruhl 551). Billionaire Warren Buffett stated that the type of expenditure, matched up to most countries in the world, is the same as a tapeworm eating at the economy unit in the United States.
Rationing of Care
Healthcare rationing can be described as the control of medical care service delivery according to any measure of subjective or objective procedures, and rationing of care is among the issues that have brought debates and studies within the health care cycle.
Some people reported that health care reform programs, provided by President Obama, lengthen the management of American government over health care assessments and this is considered a kind of healthcare rationing. President Obama stated that most people in the United States are not insured or do not have access to medical coverage since they are denied these services by insurance companies or undergo greater premiums due to health pre-existing conditions.
Peter Singer argued that health care system in America is under rationing and suggested for advanced rationing procedures. He stated that health care is a limited resource and every limited resource is rationed directly or indirectly. In the United States, almost all medical facilities are privately owned and this brings about rationing based on price. Rationing of care means obtaining value of money that the country allocates to health care providers through establishing limits where treatments must be financed from the peoples money.
If health care is rationed, Americans will be providing blank checks to pharmaceutical firms for their unapproved drugs, nor paying for whatsoever processes that health care professions select to prescribe (Welch and Gruhl 551). When public supports subsidized health care or give it openly, it is wrong or unwise not to attempt to obtain value for money.
Health care discussion on these reforms in the United States must begin from the basis that different kinds of health care rationing are both unavoidable and enviable. Rationing of care across the country would greatly provide equal and fair care to the people of the United States and can reduce the cost of health insurance and general expenditures that are allocated to the health care system.
Shortage of Doctors and Nurses
The United States is experiencing high shortage of medical practitioners and most analysts predict that these shortages would become even worse in the future and can evidently bring about an increase in prices for these services that are provided in health care centers. Some studies have reported that the United States is undergoing a serious shortage of doctors and around 1,400 general surgeons were available in 2009.
The American Academy of Family Physicians (AAFP) estimated a shortage of around 35,000 health care practitioners by 2025 and the proposed health care reforms have addressed the issues of primary care doctors to provide quality and accessible care for all people across the United States (Feldman 187).
Health care reforms have an intention to allocate more funds to finance medical schools to provide more graduates that would increase the number of doctors and nurses. Therefore, this will accommodate the required standard in health care system.
Among the issues that are addressed in health care reforms are the shortages of medical practitioners, particularly doctors and nurses. In 2002, the United States had 2.3 doctors for every 1000 patients and this made the U.S. positioned 52nd, whereas France and Germany had around 3.5 and three respectively, and were listed among the top 20 countries worldwide (Feldman 187).
The United States had an average 2.4 doctors per 1000 people in all hospitals around the country compared to the average figures of OECD that had around three doctors per 1000 patients in 2008 (Feldman 187).
Some studies also approximated that shortage of nurses would be around 220,000 nurses by 2030 and around 130,000 vacancies available in 2030. More than 35% nurses should graduate every year to maintain the demands for the nurses in the country. A research by Garber and Skinner (28) provided various strategies needed in the health care reforms to address the issue of shortage of nurses and doctor.
These included application of advanced technology in training sessions, providing healthy work environments, and funds from federal and state-level for nursing trainees and instructors. Health care reforms also provided that public-private relationships should be developed and arrange more flexible duties for higher practice doctors and nurses.
Health care reforms have also addressed the issue of shortage of acute care hospital beds per capita, where the United States has fewer acute care hospital beds compared with most OECD countries (Mayes 25).
Health care reforms have proposed that the government should allocate more funds to increase the average acute care hospital beds in the country to accommodate the demands since the population is increasing rapidly in the country. More funds should be allocated to health care to solve the issue of shortage of nurses, doctors, and hospital facilities as stated in health care reforms.
Most studies have reported that the proposed health care reforms would solve different problems surrounding the shortage of doctors, nurses, and hospital facilities to bring about better and reliable health care to the people of the United States. Despite the costs that will be allocated to these initiatives, the outcome will be desirable and unavoidable. The results are expected to be more positive than what some critics predict to be negative.
Conclusion
Health care reforms started decades ago, but some reforms were unsuccessful during the presidency of Clinton. Some health care reforms were enacted, but more reforms are required due to various needs in the country.
There are shortages of medical professionals, low standard of acute care hospital facilities, higher percentage of uninsured people, discrimination contained in insurance companies, costly health care insurance for employers, and other critical issues surrounding health care system in the United States. President Obama has proposed some changes on health care system to solve critical issues surrounding health care system.
Although the latest health care law that President Obama proposed has been favored by the Supreme Court, it has received different critics from the Republicans. Republicans and other critics stated that this law will provide more expenses to the states and provides the federal government more privileges that are against the constitution. They also stated that it will reduce the people who will receive medical coverage.
Some critics have argued that some health care reforms will cause more taxpayers money to be allocated to the health care system. For example, giving coverage for 50 million uninsured may probably increase costs since more people look for care.
Health care reforms also enlarge national expenditure since public subsidies may be needed to support people obtain insurance. However, if the government limits the funds to address these reforms, improved and better services would not be achieved since new projects often require extra, not less, resources.
Feldman, Arthur. Understanding Health Care Reform: Bridging the Gap Between Myth and Reality. Burlington, MA: CRC Press, 2011. Print.
Garber, Alan and Jonathan Skinner. Is American Health Care Uniquely Inefficient? Journal of Economic Perspectives 22.4 (2008): 2750. Print.
Groszkruger, Dan. Perspectives on healthcare reform: A year later, what more do we know? Journal Of Healthcare Risk Management 31.1 (2011): 24-30. Print.
Mayes, R. National Health Insurance: A Brief History of Reform Efforts in the U.S. American Journal of Public 3.1 (2009): 56-67. Print.
Schmidt, Steffen, Mack Shelley and Barbara Bardes. American Government and Politics Today. Bolton, MA: Cengage Learning, 2012. Print.
Welch, Susan and John Gruhl. Understanding American Government. New York: Cengage Learning, 2011. Print.
The conventional meaning of human health is shifting from an emphasis on physical health to a more holistic model that incorporates the psychosocial and emotional well-being of persons as well.
This paradigm shift has broadened the reaches of health studies to include environmental health and environmental psychology; disciplines that study how the natural and built environment influence the health of populations (Jackson and Kotchitzky, 2001). This paper addresses simple and cost-effective measures to alter the built environment in a city in a way that improves human health.
One of the major health concerns in North America is the prevalence of obesity and cardiovascular diseases both of which have been positively correlated to sedentary living and lack of physical exercise (Pruss-Ustun and Corvalan, 2006).
Adopting measures that encourage physical activity like walking and cycling can lead to a healthier population and this can be achieved by building safe sidewalks and bicycle lanes on roads. Demarcating areas for parks and playing fields within a city and developing recreational areas are likely to increase physical exercise in the population; reducing the prevalence of obesity and cardiovascular diseases.
An area that city administration is directly involved in is transport and changes in transport can alleviate some health problems in a citys populace. Injury and fatalities caused by motor vehicle collisions and pedestrian accidents is easily reduced by putting in simple road safety measures such as road signs, crosswalks, speed bumps and rumble strips.
The motor vehicle causes a considerable amount of air pollution and congestion which are major factors for respiratory and stress respectively. To lower air pollution and congestion, a city ought to cut its reliance on personal motor vehicle transport and one way of achieving this is by constructing bus lanes to improve public transport. Constructing an efficient transport system can also decrease mental health problems related to commuting such as aggressive behavior, stress and depression.
City planning and zoning highly affect land use in a city. Some social problems that are associated with zoning are social exclusion and low density living due to urban sprawl. Urban sprawl is a form of land use typified by single-use zoning of land and this usually results in city expansion, low density living and low density land use (Fox and Barodness, 2003).
Zoning the city into residential, commercial and industrial areas means that city residents travel more to get to work and access services; increasing commuting and reliance on motor vehicles both of which have been shown to negatively affect human health.
Another adverse effect of zoning is social exclusion which results from minimal interaction among people. To reduce the negative effects of zoning, a city can advocate for mixed use of land which encourages interaction and social inclusion which in turn promote psychological and emotional health.
Low density living and high density living both have negative effects on psychosocial health. High density living has been linked to increased crime, stress, anxiety, attention deficit, substance abuse and aggressive behavior (Fox and Barodness, 2003).
Low density living on the other hand leads to social exclusion (Jackson and Kotchitzky, 2001) which adversely affects emotional and psychological health. For a healthy populace, it is important to factor in population density control when planning land use (Knox, 2003). Encouraging mixed land use and improving housing should cut urban sprawl and increase population density in low population density cities as urban sprawl is usually caused by residents seeking better housing in city outskirts (Adams, 1992).
Simple and cost-effective measures like improving planning and transport can greatly improve the health of a citys residents. Increasing green spaces in a city not only beautifies the city but also provides recreational space for such activities as sports and jogging; promoting mental and physical health. A city can adopt these rudimentary measures to improve the health of its population.
References
Adams, R.E. (1992). Is Happiness a Home in the Suburbs? The Influence of Urban Versus Suburban Neighborhoods on Psychological Health. Journal of Community Psychology, 20, 353372.
Fox, D. M., Jackson, R. & Barondess, J. A. (2003). Health and the Built Environment. Journal of Urban Health: Bulletin of the New York Academy of Medicine,80(4):534-535.
Jackson, R.J. & Kochtitzky, C. (2001). Creating a Healthy Environment: The Impact of the Built Environment on Public Health. Washington, DC: Sprawl Watch Clearinghouse.
Knox, S. (2003). Planning as a Public Health Issue. Urban Policy and Research, 21(4), 317-319.
Pruss-Ustun, A. P. & Corvalan, C. (2006). Preventing Disease through Healthy Environments: Towards an Estimate of the Environmental Burden of Disease. Geneva: World Health Organization
Good health is very important for human beings. This is because any health complication denies people a chance to live comfortably and perform crucial duties in their lives. Most of their resources are spent on expensive medical services. Access to affordable health care has always remained a big challenge to many people.
One of the most important factors that prevent most of them from accessing health services is poverty. This implies that it is important for governments to take the responsibility of providing health services to the poor through medical insurances.
Providing medical insurance for the poor is an effective method that can be used to ensure that individuals who do not have adequate financial resources gain access to quality health services. There are numerous advantages that are associated with provision of medical insurance for the poor.
For instance, it enables them to find regular doctors and visit them more frequently. Most people find it difficult to have regular doctors because of limited financial resources. This is usually detrimental to their health since it is easy for them to develop health problems unknowingly. In addition, medical insurance for the poor enables people to visit doctors regularly. Regular visits to doctors are very beneficial because they make it possible for early diagnosis of diseases that are deadly if not treated early.
The other benefit of providing medical insurance for the poor is that it enhances their financial stability. This enables them to feel better and also reduces depression. The financial stability is achieved when money that is supposed to be spent seeking medical attention is utilized on other needs. Poor health among the poor causes them to undergo depression. This is justified by the fact that in addition to physically struggling with their health conditions, they constantly think about how to access medical facilities and cater for other needs.
Another important concern with regard to provision of medical insurance for the poor is prevention of diseases. This is an important strategy that can be used to eliminate diseases in the society. People are able to use their money in catering for other needs other than looking for medical attention. Preventive care is particularly very important for women from poor backgrounds. Medical insurance enables them to access preventive services such as mammograms, cervical cancer screening and other services that enhance their health.
Women are regarded as high consumers of health care services hence the services should be made affordable. In addition, they are highly exposed to chronic diseases such as diabetes, stroke and heart diseases. This issue becomes complicated where most of the women do not have the ability to pay for health services. Their problems can only be solved by ensuring that they are provided with medical insurance.
Although some scholars have pointed out the disadvantages of providing medical insurance for the poor, there are many benefits associated with the plan. It relieves them of the stressful moments that are associated with sicknesses. For instance, when people are sick, they experience psychological, physical and financial instability.
However, when they are provided with medical insurance, they do not have to worry about these issues on a daily basis. This gives them the ability to meet other important needs in their lives. As a result, they are able to live more settled and comfortable lives. The poor should therefore be provided with medical insurance because it is very useful.
In what circumstances might you use this cost-benefit analysis method or design in a program for chronic kidney disease? What would be the benefits and disadvantages of this approach in those circumstances?
This cost-benefit analysis method can be used in situations where resources are limited. The Chronic Kidney Disease (CKD) is one of the calamities listed by the Department of Health and Human Services (DHHS). It requires response, regardless of the limited resources. It is always the hope of everyone to have a good health care. The less fortunate in societies also deserve good healthcare. Offering health services to millions of people require well laid strategies and resources. The cost-benefit analysis can offer solutions to CKD. The revenues that are raised through this program are critical for the program in terms of administrative and logistics mobilization to beneficiaries. The large portions of these revenues come from the ministries of health.
Identify the evaluation method the cost-benefit analysis, and describe a scenario in which you might use this. Explain why this would be an appropriate choice. Discuss the pros and cons of this method or design
Quantitative evaluation methods are the most suitable for Cost-benefit analysis (Garbarino, 2009). The program is designed to benefit a large number of beneficiaries. The relevance, efficiency and effectiveness of the program can be retrieved from these evaluation methods. Quantitative evaluation methods are effective in getting large scale data, as in this case. Quantitative methods that can be used may include surveys, questionnaires, and observation checklist. An example where this approach may come in handy is when the program needs to get the actual number of beneficiaries. A survey will help determine the actual number.
The numbers obtained from the survey will represent that of beneficiaries. Qualitative methods are the best, in the sense that they are easy to conduct within the shortest time possible. They are also suitable because they obtain large samples compared to qualitative methods. The pros and cons of this method are simple. It is important to choose samples correctly. The sample should be manageable and well balanced. Understanding all the risks involved before evaluation is advisable. However, it is important to note that in-depth data calculations should be avoided because the main objective is to find out the effectiveness of the program. The sample selection should not be specific but generalized.
Explain in two pages how you would evaluate your hypothetical program, addressing the following from attachment: Measurable objectives you already identified. Revise them if you can improve on them. Explain how you will measure the objectives to determine if you have reached your goals. Include a description of how you will get the data with which to evaluate your objectives
The first step in evaluating this program will be to develop relevant questions for the process. The hypothesis of this program is based on its goals and objectives. The solutions that this program seeks to offer societies include increasing the supply of kidneys for transplantation, prolonging the lives of CKD patients, reducing cost of treating ESRDs, and reducing the mortality rate of ESRD patients on dialysis.
From these four objectives, the questions that can be used to evaluate the effectiveness, relevance and efficiency of the program will be developed. The programs objectives are realistic. To measure the objectives to see the programs success proper resource organization will be required. The program core goal is to help in averting CKD crises. Survey evaluation method will be used to determine success of the program. To ensure accuracy of the program, it is important to work hand in hand with relevant authorities. These include the ministry of health, hospitals and clinics, and health based non-governmental organizations.
A successful survey requires accuracy of data for the analysis. The data used in survey will come primarily from beneficiaries, hospitals, ministries, and any other relevant agency that can provide important data. Clinical tests data and observational checklists from hospitals will be utilized in the whole process. The survey will obtain these data and add to the information from beneficiaries. Data from beneficiaries will be obtained through interviews and questionnaires. The information from the ministry of health will also be important in the sense that, it will provide statistics about the cases of CKD. The Ministry will also provide health records of the affected. All this information will help determine achievement of this program.
To measure the objectives, data collected will indicate whether the program has: reduced cost of treatment; increased kidney supply; prolonged lives of patient; reduced mortality rate of patients. If not, the data will help in establishing what could have gone wrong during the process. For instance, the increase in kidney supply can be obtained from hospital records and interviews with the beneficiaries. The increased number of beneficiaries would mean an increase in kidney donations. Beneficiaries can also provide information about treatment cost if they are compared with the initial rates.
Discuss some of the obstacles you can foresee in this process and how you would try to overcome them
The major obstacle will be obtaining health records from relevant agencies with respect to the health information privacy rule. To overcome this, it will be wise to follow the due process.
Indicate whether the evaluative measures are process (activities) or outcomes. Review the budget you created
This programs evaluative measure is the outcomes, which is the increased kidney supply. They seek to measure the achievement rather than the activities. The programs goals are not activities but outcomes of a process, aimed at averting CKD crises.
A big chunk of the budget will be to improve health services. That is improving equipment, infrastructure and most importantly, the medical supplies. By doing this, the budget will create an environment where CKD healthcare will be available to many people. The budget is well spread and will sustain the program because it caters for all essential costs.
Does your budget reflect the costs for evaluation? If so, do you think it is sufficient? If not, how would you amend to cover the costs of evaluation?
A portion of the budget allocation for administration will be used for evaluation. Seven percent ($7766.75) of the cost of administration will be dedicated to evaluation. It will be sufficient and enough to conduct the whole process. The allocation will be sufficient, owing to the fact that most data will come from other sources.
The presented budget has a number of strengths that qualify it to meet the Generally Acceptable Accounting Principles (GAAP). According to GAAP, a budget should be prepared in a manner that will reflect the true and fair position of the organization (Sensining, 2007).
One of its strengths is that the appropriation amount is not less than the budgeted amount. The general rule of thumb regarding budgeting is that one cannot budget with what they do not have, thus this budget complies with this rule (Sensining, 2007).
Similarly, the approved amount in the budget is larger than the actual amount. This implies that all the expenditures will be within the required range. The variance that exists between the actual and the budgeted amount creates flexibility in the event that the cost of products, labor and other variables increase or decrease.
Further, its arrangement in terms of expenditure and revenue items facilitates ease of record analysis and provides a proper means of monitoring expenditures. This aspect gives room for transparency and accountability that may arise during the audit of the financial books.
The methods used in its preparation are in tandem with the accounting and recording guidelines espoused by the International Accounting Standards (IAS). Such guidelines play an important role in ensuring that the approved standards of accounting are universally applied in analysis of the books of accounts.
Alongside the above complements, this budget has a few shortfalls as well. One of its most obvious weaknesses is that the budgeted revenue and expenditure are equal. This attribute portrays inflexibility despite the budgeted amount exceeding the actual amount. Thus, in the event that there is an increase in expenditure, the organization may find itself in financial woes due to lack of funds to handle such emergencies.
Additionally, the variance margin of this budget is exaggerated on certain items like the wage expenses, fringe benefits and Admin OH Salaries and Fringes. The funds should be allocated reasonably and appropriately, in line with the preceding budgets that had been prepared. Due to this excess variance margin, the entire amount has been budgeted for without any savings or allocations for miscellaneous expenses.
It is surprising to note that with the exaggerated variance margin, the budget places emphasis on the required inputs and resources rather than the expected results. This attribute prompts one to think that there was mischief in the motives of those who prepared this budget. Since it concerns county health, its priority should be health matters rather than the additional indirect expenses that prominently feature. These expenses only serve to make it inflexible and prone to irregularities and misappropriation of funds.
Based on the weaknesses identified in this budget, there are certain items that should either be reduced or removed. These include the excess variance in wage expenses and fringe benefits as well as the Admin OH Salaries and Fringes. The allocation for marketing should be increased since it helps in the creation of awareness regarding the program in the society.
As it is, it fails to meet the average expectations of a good budget. Its overs and the unders should be reasonable. The prudence concept ought to have been applied in the allocation of funds to ensure that right allocations are assigned to the items (Sensining, 2007). Such a move would have ensured truth and fairness in the development of the document.
In conclusion, a good budget should comply with all the accounting guidelines provided by the Generally Acceptable Accounting Practices in order to reflect a true and fair position of an institution. This should be in terms of budget allocations and the items that have been prioritized in the budget. This budget complies with some of these requirements but largely fails to rise above the threshold for a good budget.
Reference
Sensining, A. (2007). Refining estimates of public health spending as measured in national health expenditure accounts: The United States experience. Journal of Public Health Management and Practice, 13(2), 103114.