1Running Head: AMERICAN HEALTHCARE The Rise of Worldwide Healthcare Disparities and the fall of Americans Dollar Anthony Wallace, Master Candidate P.C.D.I Healthcare and Consultants of Texas, LLC
2 America Healthcare ForwardI want to dedicate this essay to God and the hard work and gifts that he has allowed me to sharewith my readers. I want all my experiences, education, and heart to exemplify my passion for thefield. I want to dedicate this essay to my mother and those professionals that are in the field whohas given me the encouragement that I needed to keep going instead of quitting. God Bless
3 American Healthcare AbstractThis article will express to the reader the different social models of medical coverage that areoffered around the globe. The article will have different philosophies that will emphasis theneed for governmental interventions in our American healthcare system to prevent waste. Wewill then explore other options regarding “hard and soft saves” within the insurance industry.The methods used in this article, will make my argument stronger for much needed attentiontoward our funding for organizations that render free healthcare to the poor and low-middleclass. The article will also compare other social insurance policies globally in comparison tothe United States. I am using social media such as Facebook, LinkedIn, and WHO, and paststudy materials to study foreign governmental healthcare policies and interventions to relievethe poor.Key Words: American healthcare, healthcare, social insurance, poor health, health
4 American healthcareIntroduction: This essay will inform the reader of the rise in healthcare disparities within the regional area of Texas and the global impact of America’s economy. I want my readers to understand that the impact of illness vs. prevention may save Americans more money then we spend. Americans spends trillions of dollars in healthcare expenses than any other country. According to a documentary, that I have seen on Netflicks “Sick around the World” follows a researcher who traveled the globe in search of which country has the best healthcare policy or coverage. The focus is to find out does social healthcare work. We will explore many options of comparative healthcare models but the number one thing is to look at the give and takes of each health policy. For example, the healthcare plan may have lower premiums but the catch may be employer favored based (EFB) politics causing “selective hiring.” Selective hiring is a term that has conditions such as diabetes, high cholesterol, etc that may pose a higher premium payment for the employer. This may prevent the prospective employee from getting hired. I hope that I can bring some insight to my readers and educate them on how others (globally) may feel about our healthcare system versus their healthcare system. The references that I have included in my paper will make my augment much stronger in defense to the marking of the American Healthcare System (AHS). Our healthcare market
5today, is a market that is quite vast in relieving the poor from immediate disparity. The fact thatAmericans want an instant healthcare system is quite demanding on the healthcare services. American healthcareThe global health care aspect of the paper will compare the United States systematic expensivehealthcare system vs. the National healthcare Insurance System in the foreign countries. Healthcare is vastly growing with new diseases and procedures that is used to treat them.We can brighten up our horizons by educating more people on preventive medicines vs.distributing extensive medication that most cannot afford. The references that I have includedin my paper will not only further educate the consumers but will enlighten the consumer toother forms of medical techniques, alternative procedures of wellness, and the financialdirection out of medical debt.Medical ComparisonsThe American Healthcare System is not only vast in its structure but it can become verycomplicated. I have talked to other providers that are practicing physicians and they all havesaid “Medicine doesn’t pay like it use too.” I wondered to myself what the use mean in thatstatement. I imagine that going to school so many years to learn an art that heals people andpays good money will cause a person to say “it doesn’t pay like it use too.” As a HomeHealthcare Administrator, I have to look at all options for reimbursement for services that isrendered to the patients. Our healthcare system is bleeding and I wanted to look at other optionsof finding out what works.
6 In the game of healthcare, it is just like chess. We must get all the patients beforesomeone else does or suffer the consequences. Most that are in the administration game mustfind creative ways on saving the agency money as well as the patients that they care for. It isvery impossible to care for patients that cannot pay the fees that the agency is charging. American healthcareMedicare is charging $99.00 (USD) for its premiums but who can pay that when you are livingon social security and government assistance. It is impossible for the patients to pay formedicine and eat and the same time. I run a small company that is vastly wide in the UnitedStates and the United Kingdom. I have seen firsthand how patients may suffer as a result ofcuts in Medicare and state medical funding. P.C.D.I Healthcare and Consultants of Texas is a global healthcare company that givesaid to patients that are in medical need. As the Administrator, I must look at the Americanhealthcare system as well as national insurance systems of reimbursements. In America, ourhealthcare system was built based on structures of payments, gatekeepers, reimbursements, andpayments made by the patients or co-pays. The National Insurance structures are governmentenforced to prevent over inflation of governmental healthcare debt. Most would call this socialhealthcare. The national insurance program will deduct payments from the employees checkjust as if they are the employer insurance premiums. Everyone must have a job in order to getthe national insurance full coverage. The opposite would be if the patient did not have a job.The patient will go the governmental clinics, which will treat them for a fee less than $100.00(local currency) for check up, surgery, and other services.
7 I have a student that I taught in Ghana, Africa. He was a young man without a job andnow according to his testimony he is now a Registered Nurse at Tamale General Hospital. Thehealthcare system in Africa is quite different from America. A patient in Ghana must present$100.00 (Ghanaian Dollars) for treatment to see the doctor that could be miles away. American HealthcareThis $100.00 (GD) only covers the doctor’s visits and the stay for a couple of days. This feedoes not include surgical interventions if needed. The family will have to hustle money quicklyin order to save their love ones. In America, it is a crime to deny a patient emergency treatmentdue to payment. The patient has to be stable enough before turning them away for treatment.Most county hospitals will care for many homeless, low-income, and uninsured patients. This isthe reason why the city taxes are fluctuating. Many governmental grants may be available torelieve cities hospitals from this burden. It is important that we find ways to help those that arein need because it does affect everybody. The licensed providers in America, provides care to all individuals with a care plan,tailored for the indigent poor, vulnerable communities, and the mental ill. It is a statemandatory requirement to have plans to care for the poor and vulnerable communities. Thevulnerable community category includes the elderly population, bed-fast patients, children, andlow-income patients. When writing policies and certificates of need (CON) to practice as ahospital, clinic, or home health care provider there must be policies regarding financial ability to care for thecommunities that are most affected by environmental influence of illness. Most of the
8healthcare facilities go under within a year because of the lack of planning for the patients thatcannot afford the services provided. We as healthcare professionals must lobby for change at the governmental level. Thechange must come from the patient’s testimonies of hardships, lack of harmony with wellnessvs. finances, etc. American HealthcareThese countless acts of greed on our government part of cutting Medicare funding must stop. Ifthere are significant cuts to the Medicare and Medicaid funding, there will be many agenciesclosing including free aid agencies. In many countries, social healthcare is viewed as the primary way of living. It is the mostreliable way of affordable healthcare. I spoke to a cab driver “Benny” about wages andhealthcare in Mexico. Benny informed me that the patient pays for all healthcare expenses andnot the Mexican government. The wages in Mexico are paid weekly in the form of pesos. Thewages are no more than average 100 pesos that is $7.75 a week minus the taxes taken from theemployee’s wages. This is not fair but big corporate companies do it every day. This is whymost jobs are outsourced. It will save millions to pay workers less than what they are worth forthe same job here in the United States. The decisions that United States makes regarding healthcare can make a lastingimpression on the Global aspect of financing healthcare. Other counties are affected byhealthcare change but one that I was told about was the Republic of the Philippines. I spoke totwo (2) of my colleagues that are Nurses in the Philippines and I was informed about their
9 National Insurance Programs (NIP). 1 The national insurance in the Philippines is expensive and can be costly to the poor. For example, there is a $15.00 (PHP) charge for services at the poor clinic for treatment and some medicines. American Healthcare The nurses on average are earning 13,000 a year as a professional (BSN) nurse. The cost to the patient for treatment and discharge medicine is around15.00 (PHP) that is 0.36 (USD) for treatment. This is ridicules for patients to suffer due to the lack of funds. This figure may seem cheap but limited employment opportunities, this can become a life or death situation. Most patients will not see a doctor or practitioner because of the lack of citizenship or funds (Xiung, 2012). Many patients are suffering with the agony of pain and anguish due to the lack of insurance in America. We are wasting healthcare dollars on many unnecessary treatments that may or may not work. Most of our healthcare dollars are coming into the hands of Administrators that commit fraud. The statues need to become tougher to catch acts of fraud and prevent Medicare waste. America is the home of the brave and the leaders of many positive causes such as foreign aid, ministry missions, and economic growth. Many people from other countries perceive that America is rich because of what is being described in the news media. Most of the news media perceive America to be wasteful and ungrateful. In some instance, we are because of the many unnecessary purchases that are made.1 The information that was taken to highlight the National Insurance coverage in the countries spokenabove are there to protect the identity. The sources are from Ghana (GD), Mexico, and the Philippines. I didnot get any signatures to use in the study. PHP is Philippines Pasco, BSN is bachelor science in nursing, andDOP is Dominican Republic Pasco.
10 The status quos of our time can manifest as greed, which in the end promotes disease. This is why most patients from other countries will not see healthcare insurance any other way but to have the government take over the responsibility of caring for its citizen’s healthcare. For example, in Santo Domingo, Dominican patients are responsible for their healthcare expenses with little help from governmental healthcare insurance but the practitioner/physician is paid a sum of $400.00 (DOP) a month that is about $10.18 (USD). American Healthcare In my opinion, low wages in these countries can contribute to the problem associated within the quality of healthcare services rendered. Methods The methods section of the study mainly focused on healthcare comparison between the United States and the other countries at random. I wanted to compare the information used by past studies as a formulation base for improving or discovering new information. The sources of information gathered from public social websites such as facebook, blog space, and twitter. P.C.D.I Healthcare and Consultants runs a blog page that practitioners from all areas of the globe can answer questions regarding healthcare in their countries. The population sample that were tested were 170 (in the entire group) people. The test only came back with 7 practitioners of different medical arts from Naturopathy (2), Nursing (2), Chiropractic (1), Layman (2)2. The questions range from healthcare impact on the poor to2 The population sample was small including 116 volunteers in the group of facebookers. The Layman werepeople that hold no degree or title in healthcare. Anthony Wallace is the facilitor of the research group.
11 major impact of disease. The majority of my population samples were from the United States (135), the Philippines (30), Africa (3), India (4), England/Europe (3), and Israel (1). The population majority were not healthcare professionals but were seeking alternative healthcare knowledge (USA). The foreign participates were either alternative therapist, doctors of the healing arts, or nurses. American healthcare The study lasted for 8 weeks during the first day of class starting in August 2012 to the last day of class ending in October of 2012. The questions were simple to read and the volunteers had up to a week to answer the questions that were displayed on the company facebook blog page. The practitioner then put questions on the board with percentages added for easy calculations. The practitioner added the background reasoning on comparing healthcare insurances to national insurance. One participant told me that the major disease that is plaguing the Philippine population is TB (tuberculosis)3. According to the participant, this can become a very expensive disease because there is a high influx of unemployed persons there in the Philippines. The government insurance will cover some of the expense but the rest of the expense can be costly to the patient that is unemployed. After the interview, I checked for more information of the diseases that cause so much money and no cure. I check the Philippines vital statistics website and found that TB is not the leading cause of sickness it is pneumonia. About 780,199 citizens were3 Tuberculosis is a highly contagious disease that can start from anywhere in the body and land in the lungs causingdecay of tissue by dangerous bacteria. This disease can transmitted by air droplets by the patients by coughing orsneezing. TB bacteria can be carried up to 3ft before dropping out of the air.
12 carriers of this dangerous virus/bacteria that causes pneumonia. This can spread through the village in matter of days4 (National Statistical Coordination Baord , 2012). This is also a startling fact that may plague other countries such as Africa with its HIV/AIDS outbreaks maybe due to limited medication and ignorance of disease transmission. This among all needs to be addressed within government prevention programs. American healthcare In my study, I wanted find ways of educating the public regarding the comparison of healthcare programs for the poor and treatment programs as well. According to the past study burden of the poor, it clearly states that the non-communicable diseases are less important than communicable diseases (Gwatkins DR, 1999). The communicable disease pose more of treat to the environment as a pandemic infection, it poses more spending of city charities healthcare dollars, and can have devastating effect on the city commerce. The study participants were somewhat hesitant to answer the questions due to who was watching the dialogue. I tried to make it clear that fact and opinions will not be taken as offensive. The participants from Africa and the Philippines were the first to answer. The questions are listed in the supporting documents of the paper. The main question was “how do you see National Insurance in your country?”All answers to the questions were quite interesting because most similar to all that participate in the National insurance program. Most of the answers lean toward feeling sorry for the poorest citizens. Mainly, the country is in need of money for the poor due to limited employment opportunities to support themselves.4 The website for the source of vital statistics for the Philippines http://nscb.gov.ph/secstat/d_vital.asp. It dates backto the year 2008.
13 After consideration, the national insurance is not the only opportunity out there for good healthcare. Some according the documentary will swear by it because American premiums are too high. It is always a catch 22 to any good healthcare program. Europe and also Canada, you may not go see a specialist until a certain amount of time. The period may be 2-3 weeks before the patients can receive any advanced specialty care. As Americans, we can go to the specialist the next day if need be. American healthcare The only bonus to the National Insurance Program is that it is completely paid in full for everything in such as hospital stays, medicines, regular doctors visits, etc.Summaries My audience answered majority of the questions (1,2,3,5). The totally percentage was not calculated because it was all open-ended questions. The focus of the questionnaire is to compare the similarities of the National Insurance and the American Healthcare system. My study was conclusive that national insurance works, it may not benefit most of the poor but with the money saved without high insurance premiums we can convert monies to help those citizens that are in most need of medical services. We need to lobby for more free clinics to treat the poor, more programs that give the poor independence by paying co-pays, and getting more direction from front line practitioners that really know what the patients need. There are always going to be many people on the opposite side of the table but we can all come to an agreement on proper preventive programs that reduce medical cost.
14 For example, progressing research in healthcare finance, interviewing and assessing patient’s needs, proper screening criteria for government benefits, proper field testing for data collection and non-bias processing, and lastly ensure program development and implementation of programs are done correctly. These are all ways of starting our healthcare reform in the right direction. American healthcare On all healthcare plans, there has to be limits and boundaries set to protect the vulnerable populations such as the poor, women, children, and uneducated (Martin, 2011) In some countries, NIP is considered a mandatory taxation and by not paying the taxes will land the citizen in jail. The participants that were interviewed, had no problem in paying the national insurances taxes. It is the practitioners that are going broke behind the reimbursement rates. The education maybe free but the life of a physician is 24 hours a day with $400.00 pesos a month5. That is again $10.18 a month (USD). We can do better with aid to other countries but before we can help anyone else, we must help ourselves. So many problems need to be worked out here in America first. Let us band together and let the congress know that funding programs that are not needed take them off and put plans to recover, provide low-cost healthcare coverage, and promote job security.5 This information came from an interviewee, that lives in Santo, Domingo, Dominican. The source is areliable source of information. All Conversions of money came from my converter app on the Samsungnetwork.
15RecommendationIn my recommendation, this is quite important when calculating the cost of soft to hard saveswithin the insurance industry. Most indigent poor persons cannot afford proper healthcare thusmaking it very hard for the agency to catch its “second wind.” We must come up with newagendas in addressing new healthcare reform. The difference within the industry is defined ashard saving are when insurance companies has taken a bad “hit” with millions spent but wasable to get the case manager to stop the bleeding. American HealthcareThe soft saves comes from having the patients take a less expensive road to recovery such asdischarging the patient home to finish out at a rehab or with the assistance of home healthcare.With this saying “The more you keep the patients out of the hospital the lower the cost andsavings.” The American Healthcare System and National Insurance philosophies are the same asmaking healthcare “affordable” but my study has concluded that it is not afford both ways. Asexplained before, every cut and gain has a consequence. We must have checks and balances toevery plan. We must set plans to recover in cases of emergency spending or deficit. The cutsare causing the facilities to bleed and business to go under. Let’s start by thinking outside thebox and seeing healthcare as a growing trend of technological and philosophical thoughts ofrevolution. Take care and be in good health.
16 American Healthcare Reference PageAnonymous (2009).Mobile Phone Enhance Global Healthcare, Appropriate Technology, pg 54-55Chen, C. Y. (2012). Overlapping Prescription of Stimulants for Children and Adolesants withAttention-Defict Hyperactivity Disorder. Psychiatric Services Inc.David R Gwatkim, M. G. (November 1999). The Burden of Disease Among the Global Poor.The Sitter Source, 1.Fidler, D, Dragner, N (2006). Health and Foreign Policy. Geneva: World Health Organization.Grall, T. (2009). Current Population Reports: Controdial Mothers and Fathers and their ChildSupport. United States Census Bureru,Hamilton, S. (2010). Healthcare: Global Savings. Employee Benefits Magazine , pg1Xiung, H. S, Shi J, Lu B, Wheeler K, Zhao W, Wilkins JR 3rd, Smith JA, (2012). MedicalExpenditures Associated wiht Non-Fatal Occupational Injuries Among Immigrant and US BornWorkers. BMH Public Health , 678.
17Tazelaar, G. (2011). Challanges and Trends in Global Helathcare Missions. Journal of ChristianNursing , 152-157.NCCP: Texas Food Stamps . (2010). Retrieved from NCCP: Texas Food Stamps:http://www.nccp.org/profiles/TX_profile_29.htmlMartin, M. (2011). Introduction to Human Services. Boston: Pearson.National Cancer Institute. (2010).Wood, L. (2010). Healthcare: Global Industry Guide. M2 Presswire, 1. American healthcare Appendix 1 Questions used in the research 1. What makes a good healthcare provider? 2. What is your definition of culture sensitivity toward a patient? 3. What can you do to improve company culture to enhance positive patient outcomes? 4. What do you think about the healthcare policy in your neighborhood 5. How can we as healthcare providers help those in need? .