Changes In Health Care Essay Research Paper

Changes In Health Care Essay, Research Paper

In today’s society, public perception of the U.S. health care system is widespread. Many people are satisfied with the advancements that we have made in the medical community. Less than one hundred years ago, health care was non-existent. Today, it is one of the leading industries in our country and worldwide. However, many people criticize where health care is going. They believe that doctors are giving up quality care and replacing it with the quantity served. This paper will describe the changes that have occurred and are occurring in the US health care system. Beginning with the health care environment, we will see that although we are downsizing some subdivisions, at the same time we are increasing access to health care by providing a variety of different services. Next, the rapid increase in medical insurance since the mid-1900s will be discussed. Medicare and Medicaid were created under the Social Security Act. Since then, medical care to elderly and to the poor in our community has improved drastically. Finally we will discuss why the public perception of a growing medical community is sometimes negative. There are steps that need to be taken to keep the pace of change in our health care system to match the changing needs of our community.

Health Care Environment

Although the American public and Congress resisted the health care reforms proposed by President Clinton in the failed Health Security Act of 1993, market forces continue to alter the health care environment with remarkable rapidity. With consumers, employers, government, and commercial payers intensifying their demands for lower costs, higher quality, better access, and more information about outcomes, most hospitals have undertaken a series of competitive efforts to retain and, if possible, improve their market positions. Many have engaged in mergers and consolidations intended to effect economies of scale and place them in a better position to negotiate with managed care organizations and other payers. Others, in communities with excess hospital capacity, have either closed or been converted to other uses, such as ambulatory or long-term care facilities.

Between 1980 and 1993, approximately 1,000 hospitals closed in the United States, and hospital admissions declined by 11 percent. Although this may seem strange with an increasing population base, major hospitals are now being supplemented by smaller ambulatory and nursing facilities. The decline in hospital admissions is a blessing to many who have become accustomed to waiting long periods of time for medical care. Furthermore, with an increasing number of medical services occurring in ambulatory settings, hospitals are facing the need to reduce inpatient capacity and refocus their service efforts on intensive care and other inpatient essentials. The major reformation of the hospital industry has been a formidable challenge to traditionally conservative hospital executives, boards of trustees, and medical staffs steeped in their long-standing institutional cultures. Many find it difficult to comprehend the inevitability of health care system shifts and the magnitude of the organizational changes that will be required for institutional survival.

Health Insurance

The transformation of hospitals from simple, charitable institutions to complex, technical organizations was accompanied by a parallel growth of private hospital insurance. The percentage of the United States population with hospital insurance grew from 9 percent in 1940 to over 74 percent in 1986 (Stevens, 324). This change is outstanding. Medical insurance should be made available by most employers, and in today’s job market it is becoming a commonplace. By the 1960s, billions of dollars were flowing into hospitals from insurance companies, such as Blue Cross/Blue Shield, medical society plans, and others sponsored by unions, industry, physicians, and cooperatives. The availability of hospital insurance removed an important cost constraint from hospital charges. The availability of insurers to cope with ever-rising hospital costs by distributing relatively small premium increases over large numbers of subscribers opened the floodgates to hospital admissions. Expanding hospital services and relatively unrestrained reimbusrment rates created an inflationary spiral that was to persist for decades.

In addition, medical advances and medical specialization encouraged hospitalization, and the hospital industry expanded to meet the demand. Following World War II, the American Hospital Association convinced Senators Lister Hill and Harold Burtons to sponsor legislation that provided federal monies to the states to survey hospitals and other health care facilities and to plan and assist construction of additional facilities and to plan and assist construction of additional facilities. The Hill-Burton Act was signed as Public Law 79-75 in 1946 and became a major influence in the expansion of the hospital industry (Stevens, 399).

Medicare and Medicaid

In 1966, the hospital industry was the recipient of another major legislative contribution to its fiscal well-being by the passage of Medicare, Title VIII of the Social Security Act. The legislation provided the growing population of American over age 65 with significant hospital and medical benefits. In one decisive legislative action, the large