Survey Health Care Systems Final Review

Question

As of Tuesday April 12, 2016 UnitedHealth Insurance stated that they will be pulling out of the Affordable Care Act – ACA, (aka = Obamacare) in Arkansas and Georgia in 2017. UnitedHealth Insurance in 2015 in Georgia had a market share of 4.47% of the ACA business. What potential effects will this have on the membership of other companies (Anthem BCBS and Aetna insurance) in the ACA and the people they insure? What impact will this have on the overall state of healthcare in Georgia?

Answer

The AFA is expensive for United Heath and they are losing money, costs are going up to pay for these losses. There are losses related to attracting too many sick customers and too few healthy ones with the AFA.“If one of the largest and presumably, by reputation and experience, the most sophisticated of the health plans out there can’t make money on the exchanges, then one has to question whether the exchange as an institution is a viable enterprise,” The rest of the story is well-known and has been covered here extensively in the past: the inability of businesses to turn a profit from Obamacare has meant that about a dozen non-profit “co-op” plans created under the Affordable Care Act have failed, after charging too little to cover the cost of patients’ medical care, and because an Obama administration fund designed to stabilize the market paid out just 12.6 percent of what insurers requested. And Anthem last month said some rivals were offering premiums too low to provide the coverage patients require and book a profit. At the end of the day, the worst news is not for the corporations, since Obamacare is not going away any time soon. It simply means that what until now were supposedly Affordable plans under Obamacare, will soon become (even more) Unaffordable as insurer after insurer hikes premiums dramatically in order to make the biggest US governmental intrusion into the private sector in recent decades profitable to shareholders

Question:

You have a patient who wants your opinion on which ACA plan to choose based upon coverage. The comparison is between the Gold and Silver plan. Use the information from the charts on the attached pages to support your choice of either the Gold or Silver plan.

Question

With the recent release of 2 new prices for medication, each over $7,000.00/month and both used to treat very debilitating conditions, the need for relief is a necessity for these patients. In conjunction with this we see that enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month. Although most of these pills were prescribed for a medical purpose, many ended up in the hands of people who misused or abused them. What impact will both of these scenarios have on the healthcare system? Provide and explain a minimum of 3 examples that can arise from the above information.

Answer

(All they need to do is drink tap water, its polluted with all the medications from recycled urine water) Painkillers are likely to be abused and are addictive in nature. There are people who find acupuncture beneficial with no side effects that drugs have. People who have debilitating conditions, who are bed ridden, unable to pass a bowel movement, are pretty much in dire need for relief, it is possible with the love and kindness of the heart and power of spirit to transform all miseries, to have victory over all suffering.  Because of the high cost of living, and health care,  it is imperative to avoid the hospital at all costs. The drugs they give people create a slew of other health problems! This is the sad but true truth. I haven’t watched television in 10 years, but I have heard the disclosures and side effects on these drugs, I have heard of the demise that these drugs have on people, I have seen with my eyes the addictions and side effects of such pain killing medications, they are all too prevalent in the population, across all age groups. I do not think such drugs are misused in nations where there is a holy presence, such as India, where meditation teachings, connection to spirit supersede all other areas of health care.

I can see why there would be legal issues with access to opiods, and making health care rules more strict with receiving such pain meds. The health care system needs more filtering for individuals receiving such substances. Maybe the people can receive less pills at a time, to avoid the pills getting into the hands of the wrong people.  Examples of pain killer abuse: Grandpa has a bottle of pills in the bathroom, grand daughter comes over for the holidays and takes a handful of pills, or the whole bottle with her home to share with her other friends. Someone breaks their arm to get more pain meds from the doctor. Rush Limbaugh has a habit of taking medications to get high, innocent but guilty crime in the eyes of the public.

Question

Describe the four principles of medical ethics (beneficience, nanmalficience, autonomy, and justice) and give at least one example of how one of these may actually be in conflict with another of these. How should such conflicts be dealt with?

Answer

“Respect for Persons/Autonomy: Acknowledge a person’s right to make choices, to hold views, and to take actions based on personal values and beliefs

Justice: Treat others equitably, distribute benefits/burdens fairly.

Non-maleficence (do no harm): Obligation not to inflict harm intentionally; In medical ethics, the physician’s guiding maxim is “First, do no harm.”

Beneficence (do good): Provide benefits to persons and contribute to their welfare. Refers to an action done for the benefit of others” 

The conflict: Lacks a unifying moral theory that ties the principles together to provide guidelines.  Principles can conflict and the theory provides no decision-making procedure to resolve these conflicts. Difficult to weigh and balance various principles.  Autonomy in some cultures refers to individual autonomy, while in others refers to group/family/community autonomy.

Question

It is commonly accepted that preventing illness is easier and more cost effective than treating disease. That being said, it seems to be very hard to focus on preventative medicine in the United States. Give at least three reasons why this might be true (you can only blame pharmaceuticals in one of your three reasons).

Answer

Firstly, I disagree with this question, because from my observations holistic care is integrating nicely and I see a lot of preventative medicine going on. Furthermore, I will answer the questions to the best of my ability. I do see the doldrums of modern day society on a regular basis, especially in the clinic. Obese people whom have been injured by the medical system, overburden bodies with toxins, bad diets, no exercise, and sedentary lifestyle overall. Had people used Yoga, walking, strict diet, and acupuncture all along, we could prevent the effects that a non preventative lifestyle procure.

1. Passivity. People would rather have surgery than exercise in many instances, says Megan the PT in our class, which is verifiable and true. Many people are passive (massive) and don’t want to do the work. People’s priorities are not on the right things, such as Yoga, veganism, nature hikes, camping, etc. People would rather drive to work than walk to the bus, or bike ride. People are segregated by their cubicles, cars, homes. We have an individualistic society. Had the medicine and herbalist people, the healers, the folk medicine, the preventative and naturopathic medicines of our times, been utilized, there would be lot less need for the big insurance and hospital network. The E.R and ambulance should be used a last resort, but often times are misused and overused. The health club is underused as is the nourishing foods that Earth provide, with the high nutrition, are underused. Organic foods are readily available, especially around Minneapolis area. People take vitamins is a joke! Food is medicine.

2. Dependency. Because Pharmaceuticals are easy and accessible, insurance covers the costs of pills, and there is little work involved. Clinics give out medications like candy. Over the counter drugs to alleviate pain and headaches, rather  than get to the cause/root of the problem has been an issue. Its more of a collective consciousness problem, a mind conditioning problem. People are raised to think that its ok to be dependent on the health care system. People can be lazy and over reliant on others to provide for them what they can provide for themselves. The answer to all the worlds problems is meditation, breath work, and mindfulness. When we are taught a new way of being, we can take charge of our lives, and find true emotional and physical freedom!

3. Timely. Preventative medicine is costly and time consuming, people are subjected to a overloaded work schedule. People don’t have enough free time, with families that demand their time, school schedules, work schedules, pets, errands, there just is a decline in time and time management becomes too much to handle.

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