The first step in solving any problem is to defining what you plan to achieve and how to get there. (Plan you work, work your plan - Les Brown) Several ideas on the way to reform health care in the past have been mired with potholes even before the plan was enacted. Sometime the administration knew about these potholes and attempted to cover them up, in order "just to look good", while their opponent (in an effort to do the right thing) pointed out these potential potholes ahead of time, but were put down as being "hateful opponents". It turns out, the opponents were RIGHT! When planning an action or reform, you must be CLEAR(Precise) and transparent about what you are proposing. Don't use political double speak and smoke\mirrors in order to pass something that doesn't work before it starts. This goes for building a new city park, buying out a competitor, expanding your office, bringing a new hospital, bringing a new sports team to your city, etc. Talk about ONLY what you plan to achieve. Don't change the subject to confuse or distract others, while pushing your agenda through, whether it be a board of directors, group of investors, concerned local citizens, or the American public. Sometimes groups are so lost in their discussion via tangents, that they end up pursuing the wrong goal, or spend too many resources on a project that is a waste of money, or not wanted by the public. …show more content…
During the study of various reforms that were proposed and denied, both the GOP and Democrats attempted to find a balance that would guarantee the success of their proposals. Years of research, growing ideologies, political views and disregard for the country's constitution sparked an array of alternatives to solve the country's healthcare spending. The expenditure of US healthcare dollars was mostly due to hospital reimbursements, which constitute to 30% (Longest & Darr, 2008). During the research for alternatives, the gr...
Politics or politicking is a game that is more ostensible and reserved for the political arena; however, metaphorically, much of the political discourse can also be found within organizations. Politics in organizations, then, is design for groups to reconcile differences between interests, conflicts, and power (Morgan, 2006). The case study to be analyze (Cutting Back at City Hall) is one that illustrates all three aspects of interests, conflicts, and power as the City of Smithville, the Fraternal Order of Police (FOP), the International Association of Firefighters (IAF), and the American Federation of State, County, and Municipal Employees (AFSCME) deliberate the city’s proposed budget.
For the last five years of my life I have worked in the healthcare industry. One of the biggest issues plaguing our nation today has been the ever rising cost of health care. If we don't get costs under control, we risk losing the entire system, as well as potentially crippling our economy. For the sake of our future, we must find a way to lower the cost of health care in this nation.
Agenda setting is the process that determines appropriate solutions to a certain problem of a given field (Kingdon, 3). The process itself consists of three streams: problems, policies, and politics (Kingdon, 16). These separate streams interact when windows of opportunity are open – solutions are fitted with problems, and the impetus for this relationship is amenable political forces (Kingdon, 20). Prominent agendas are determined by the problem or political streams, while solutions are crafted in in the policy stream (Kingdon, 20). In the field of health care, the agenda setting is based upon the high number of uninsured citizens, the rising cost of medical care, the development of Patient Protection and Affordable Care Act (PPACA) in response to this issue, and the key players that debate whether governmental involvement is the correct approach in the issue of universal healthcare.
ACO is an organization that consists of doctors, suppliers of health care e.g hospitals, clinics, all health care services, and anyone involved in patient care to provide the best possible care for all Medicare patients. This model was adopted by the Affordable Care ACT with the number one goal of providing timely, accessible and appropriate care for all Medicare patients. Not only was the ACO supposed to provide the best care, but a very important aim was to reduce unnecessary hospitalization of patients, unnecessary medical emergency visits, and any other duplicated medical service. This was supposed to bring about big changes in the health care system as it number one aim was to reduce the health care cost for the government and everyone
Overall, the increase within health care costs is effecting our nation significantly. Not only does it affect consumers but also organization. As it continues to increase everyone is finding themselves unable to pay for such changes. Reducing such growth within the health care costs requires a collaborative, inclusive, and dual-party approach. Strategies for reducing the costs include but not limited to: promoting prevention and healthy living, improving patient safety, and promoting transparency on medical costs and quality. If the nation works on such improvements, hopefully we will be able to turn the health care system into something we can all afford once again.
Cataloging and empowering external stakeholders who can champion reform is an essential undertaking. Their support is critical to convincing the American public and detractors throughout government that the time is right for reorganization.
Health Care workers are constantly faced with legal and ethical issues every day during the course of their work. It is important that the health care workers have a clear understanding of these legal and ethical issues that they will face (1). In the case study analysed key legal and ethical issues arise during the initial decision-making of the incident, when the second ambulance crew arrived, throughout the treatment and during the transfer of patient to the hospital. The ethical issues in this case can be described as what the paramedic believes is the right thing to do for the patient and the legal issues control what the law describes that the paramedic should do in this situation (2, 3). It is therefore important that paramedics also
One of the problems today is that America’s distrust for their leaders because they view them as ineffectual and removed. There is a need in America to democratize the public planning process and decision-making process. Many times projects, developments, and policy decisions are made without significant public input and participation. This often leads to m...
The United States health care is structured badly. The insurance companies only look out for themselves; they think of ways they can save money not spend it. When you file for health insurance, companies will look through your application and medical records as if it were a murder investigation. They will try to find any flaw possible in your application just so they would not have to pay for your medical bill. The health insurance companies have an extremely long list of medical conditions you may have that they will deny you for. They will reject you if the surgery is considered experimental,...
It seems like everyone hates the Patient Protection and Affordable Care Act (PPACA, also known as Obamacare). As a healthcare system aiming at improving health insurance coverage, holding insurance companies accountable, lowering individual healthcare expense, ensuring health choices and improving quality of healthcare (Corbett, & Kappagoda, 2013; Manchikanti, & Hirsch, 2012), Obamacare requires that everyone is mandated to have a health plan, while for the poor it is federal subsidized, children under 19 with pre-existing conditions must not be excluded from health plans, young adults under 26 can be covered under their parents’ health plan, and employers to cover their employees (National Conference of State Legislatures, 2011; Huntington,
This concept was a hard one to grasp. For my interview summary papers, I decided to interview my preceptor over the health care and different insurance policies. One thing that was brought up was the requirements on the insurance policies constantly changing. It could be one way the first day but then they add more information that will eliminate several people from getting that insurance. There are medical insurance companies that provide help for people who are do not make enough money but they often will deny people service due to making too much money.
There are several factors that contribute to the complexity of the revenue cycle. Frequent changes in contracts with payers, legislative mandates, and managed care are just a few examples of reasons why revenue cycle in the healthcare industry is so complex. Furthermore, the problems that arise in the steps of the revenue cycle further complicate the whole process. For example, going through the steps of the revenue cycle efficiently is extremely difficult when it is managed by poorly trained personnel. Furthermore, if a healthcare provider does not have the proper information system to track patient records and billing, receiving reimbursement can become difficult. In addition, one of the main factors that delay payments is denial from the insurance companies. The reason for Denial includes incorrect coding, the certain sequence of care and medical necessity or even delay in submitting claims. Lastly, inefficient patient correspondence can not only hinder the process of revenue cycle but also result in many patient complaints (Wolper, 2004).
It is likely that providers will take measures to avoid treating high-risk patients whose health care needs are more complicated than the average patient. Easier treatment means more efficient care, and more efficient care means full financial reimbursement. This is a major concern because the poverty rate in Allegheny County has been steadily increasing since 2000. High-risk patients are overwhelming represented in low-income
This quote is from the first paragraph of the article by Pierre Fillion. As a matter of fact, it is the first sentence he uses. It is a very strong sentence that sets up his article beautifully. While after reading his article, I do not agree with all of his statements or points, but this one, his main one, I do agree with strongly. Pierre lays out why he believes that planning discourse is becoming increasingly disconnected from implementation. He states that the public is becoming more involved in the planning aspect, many different ways, including advocacy groups, community based groups, and public general meetings. He also states that it is becoming harder to implement the plans that they do come up with. I believe that this is happening for a multitude of reasons. First and foremost, the main reason that the implementation aspect is lacking is because almost all areas of the western world have become obsessed with financial stability as well as have become quite fiscally conscious. Therefore getting the financing for these plans has become increasingly difficult over the past so many years. Cities, individuals, businesses, provinces, states and governments cannot freely spend on items just because someone or a group wants something planned. People are becoming more conservative, and therefore less is being accomplished now, than once was. Another reason, that I believe that things are not always accomplished is because of the planning that goes into them. I feel that people have become more conscientious of the advocacy groups and public groups that want things planning and accomplished a certain way. With the rise in public input, it is possible that the planned projects lose some credibility, and therefore when it gets to the implementation stage, those involved are less open to proceeding with the project. These two things, the publics’ opinion and the financial timidness, have led to a gap to be created between the two, and with each passing year, that gap seems to be widening.