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Speaker of the House Thaddeus Sweet vetoed the bill in committee. In , after 20 years of congressional debate, President Lyndon B.
Johnson enacted legislation that introduced Medicare and Medicaid into law as part of the Great Society Legislation. Since becoming law, additional rules and regulations have expanded upon the Patient Protection and Affordable Health Care for America Act.
Choosing a healthcare plan illustrates the complexity of health insurance plans in the U. About half of Americans who have private health insurance are covered under self-insured plans, each with their own design.
The one commonality among all insurance plans is how dramatically they vary. Deductibles, co-insurance, co-payments, and maximum out-of-pocket expenses are a few of the inconsistent variables among insurance plans. Additionally, some insurance companies are for-profit and others are not-for-profit, indicating another point of confusion.
Insurance is not the only complexity within the system. The Affordable Care Act added more agencies to this list, including state insurance exchanges and the Center for Medicare and Medicaid Innovation. Each area of healthcare has its own complexities.
As components of the larger healthcare system work together, the complex layers unfold. While change is expected in the coming years, it is likely to occur slowly.
Changes in the healthcare industry usually occur at the legislative level, but once enacted these changes have a direct impact on facility operations and the use of resources. For example, the ways patients and administrators utilize resources such as Medicare and Medicaid have changed due to legislation.
Technology has had a further impact on how healthcare administrators handle resources and manage medical centers. Cultural shifts, cost of care, and policy adjustments have contributed to a more patient-empowered shift in care over the last century.
Technological advancements contribute to a shift in our patient-centered healthcare system. This trend is expected to continue as new healthcare electronic technologies , such as 3D printing, wearable biometric devices, and GPS tracking, are tested and introduced for clinical use. Policies and procedures in individual facilities may restrict how and when new technologies are introduced, but cutting-edge technology is expected to play an increasingly larger role in our healthcare system within the coming years.
As legislative and demographic changes trickle down into care facilities, the use of hospital services is expected to grow significantly between and This growth is due to an anticipated increase in Medicare beneficiaries in the coming decade. The cost of hospital care is expected to rise from 0. Since then, Congress has made Medicare and Medicaid changes to open eligibility to more people.
For example, Medicare was expanded in to cover the disabled, people over 65, and others. Medicare includes more benefits today, including limitless home health visits and quality standards for Medicare-approved nursing homes. Medicaid has also been expanded to cover a larger group than initially intended. This includes coverage for low-income families, pregnant women, people requiring long-term care, and people with disabilities.
Wide variations in Medicaid programs across the nation occur because individual states have the ability to tailor Medicaid programs to serve the needs of their residents. Potential consumers can now use the Marketplace website to determine their Medicaid eligibility. As the baby boomer generation approaches retirement, thus qualifying for Medicare, healthcare spending by federal, state, and local governments is projected to increase.
Assuming the government continues to subsidize Marketplace premiums for lower-income populations, this increased government healthcare spending will greatly affect the entire healthcare system in the U. Although Medicaid spending growth decelerated in due to reduced enrollment, spending is expected to accelerate at an average rate of 7.
Along with policy and technological changes, the people who provide healthcare are also changing. Providers are an important part of the healthcare system and any changes to their education, satisfaction or demographics are likely to affect how patients receive care. Future healthcare providers are also more likely to focus their education on business than ever before.
This growth may result in more private practices and healthcare administrators. In recent years, the demographics of the medical profession have shifted. Women currently make up the majority of healthcare providers in certain specialties, including pediatrics and obstetrics and gynecology. Nearly one-third of all practicing physicians are women. According to an Association of American Medical Colleges AAMC analysis, women comprise 46 percent of all physicians in training and nearly half of all medical students.
Based on these statistics, we can assume more women may enter the medical profession in the coming years. African-American women are more likely to become doctors than their male counterparts, according to AAMC data. While African-Americans comprise only four percent of the physician workforce, 55 percent of the African American physician workforce is female. This shift in demographics to include more women in healthcare supports diversity in the industry and represents overall population diversity.
The prevalence of malpractice lawsuits is one way to evaluate the competence of healthcare providers. The amount of malpractice claims in the U. As the trend of declining malpractice lawsuits continues, it may indicate that provider competence and patient care will continue to improve. Job satisfaction is one area that must improve. Nurses report higher overall career satisfaction than doctors, based on results of the latest Survey of Registered Nurses conducted by AMN Healthcare and compared to the Physician Compensation Report.
Nine out of 10 nurses who participated in the survey said they were satisfied with their career choice. However, one out of every three nurses is unhappy with their current job. It is difficult to say whether job satisfaction will increase in the coming years, but continued technological advancements designed to streamline the healthcare process offer hope to those who may be frustrated with the complexity of their jobs.
Demands on healthcare change due to various reasons, including the needs of patients. Every year, new cures and treatments help manage common diseases.
Each such development affects the entire healthcare system as much as it has a positive impact on patients. As illnesses become more common, our healthcare system must adapt to treat them. Patient care needs will also evolve as the population ages and relies more heavily on resources such as Medicare and Medicaid.
Patient empowerment is expected to increase with advances in technology. Thus, it is important to use a conceptual model that relates cost to quality of care when approaching the problem of reducing the costs of healthcare.
It is also necessary to define quality of care and necessary care, so that the clinical process can be re-engineered to ensure that both quality and necessary care can be delivered. The financial incentives that support the implementation of this process can then be put in place. Quality of care at an acceptable cost can only be obtained if waste is identified and eliminated, resources are applied to necessary and appropriate care, variations in the quality of care are eliminated, and economic policies consistent with a country's culture and expectations of value for money are adopted.
Accomplishing these objectives will be difficult and costly.