MARY JACOBS RNFERRIS STATE UNIVERSITY

Managed Care

Why is the United States Such a Slow Learner?

Managed Care only provides insurance for the employed, Medicare for the elderly, and Medicaid for the indigent. This leaves the working poor with out health coverage.

Universal Health Insurance can cover everyone.

Universal Health Care has worked well historically.

Universal Health Care should be finalized with in the United States.

The Question

Can US citizens provided Universal Health care coverage, yield improved economical and affordable health outcomes as compared to the present Managed Care system?

Why is this research Necessary?

The U.S. per person spending is $7,681 per resident, for health care spending

It is among the highest of all industrialized countriesWith the economic downturn in the U.S. less

companies can provide Managed Care insurance for their employers

Continued research needs to be conducted to shed light on ways to make health care more affordable or to show it is not feasible.

Change has to occur for justice for all citizensThe United States can not continue to exclude on

section of the population

National Health Care Expenditures, 2008

.

How We Care Less and it Costs More

The first hospitals took care of their own ethnic groups for free, and physicians volunteered their services to the hospital.

The first health insurance in the United States was sold for fifty cents to lumberman.

Today in Michigan “the average employee contribution for family health coverage is 1,741-3,474 (Michigan.gov, 2011).

The increased cost of Managed care is causing employers to stop providing health care coverage.

Presidential Attempts and Platforms

1935 President Franklin D. Roosevelt signed the Social Security Act.

1950’s Unions Collectively Bargained for health insurance through work.

1964 Campaigned for Medicare, and won1971 Again an attempt at National Health

Insurance1973 HMO Act instituted1980-90’s Rising costs make is a no go for

Clinton2010 Obama making a change?

Theory Base

Nursing Theory: Health as Expanding Consciousness, by Margaret A. Newman

A Theory of Justice by John Rawls: “All social primary goods - liberty and opportunity, income and wealth, and the bases of self-respect - are to be distributed equally unless an unequal distribution of any or all of these goods is to the advantage of the least favored."

Managed Care Joke

October 2001 Tweezer Pharmaceutical Company Memo To:     All Pharmaceutical Sales Representatives

From:  District Sales Manager Re:      Promotional Gifts 

It has come to my attention that pens and other promotional trinkets that we have been leaving for physicians’ office staff are no longer having the desired effect. 

This is a serious problem, since our ability to penetrate the market depends on advertising. The last thing that we, as a drug company, want to see is the spread of Silly-Pen-Resistant Staff!

Our Research and Development Departments are working feverishly on this serious advertising problem. We can't allow America's physicians to develop Sell-Mediated Immunity!

SICKO

Michael Moore had his reasons for becoming such a movie success

He gave the American people hope and made them mad

This movie showcases human beings with no health care and how it has impacted their lives

It shows the business of health care in comparative countries and how it is working.

It shows how prisoners are given better health care than the working poor.

Econmics

Assessment of the Health Care Environment

Consider PoliciesResourcesQualitySafetyA Root Cause Analysis

Rationing of health Care

Data Collection

At least one possible approach to exploring the research question is presented and potential study participants identified

A Case Study of at risk populations in countries with Universal health coverage in comparison at risk populations with the united states with managed care coverage.

How will the data be collected and who will be the study subjects. A questionaire could be used to gather data over a period of five years.

Potential Problems

Problems that could arise are explored Limitations subject drop out could be a

limitation of the study, or insurance changes which could change care plans for clients being observed.

Variables Patients being studied may die, become employed and receive health insurance, or a better paying job with better benefits.

Problems with study designCase stuidies are expensive and time

consuming, and there is also subject drop out rates.

Implications/Consequences

Assessment of the healthcare environment Thoughtful reflection on what the logical

interpretation of this information isMost likely outcome, based on view points

Nursing Importance

Implications of this research and importance to Nursing Practice are made clear to audience.

How could this research change practice.It could provide evidence showing the value

of Universal health care as a cost deterrent, and how preventative care saves money.

Recommendations for Quality and Safety

Based on the analysis of the previous sections research and literater reviewed, the student shares realistic interventions or strategies tht could improve quality and safety related to this issue.

QSEN competencies (patient centered care, teamwork and collaboration, evidence based practice, quality improvement, safety, and informatics) (Quality and Safety Education for Nurses, 2011).

Three ANA standards 1. “Stewardship and allocation of available resources supports

the maximum population health benefit gain” 2. “Public Health Nursing Practice includes an obligation to

actively reach out to all who might benefit from an intervention or service”

3. “Primary Prevention is given priority”

How Can You Make a Difference

Links to sites to promote Universal Health Care Coverage.

“Lets Get It Done!”Contact Congress (just Google it for your

state)Watch to Movie SickoRead: A Special Message from Govenor Rick

Synder: Health and WellnessStay involved or get involved with nursing

politics.

References

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