Heath Care System And Reforms Essay Examples
Healthcare is a basic right. In this regard, all citizens of a country should have access to affordable healthcare. There has been a huge interest in the comparison of the Health Status and Health System in both United State and Canada. United State and Canada are considered an open border and are the same in a number of ways. However, they are also very different in a number of health policies such as health care services funding, its organization and the way it is delivered (O'Neill, O'Neill & National Bureau of Economic Research, 2012).
It is evident that in both countries that the government is greatly engaged in health care. The major difference between the two is the central structural. For instance, in Canada, the government offers the funding assistance to all levels of governments on all its health care expenses as long as they act as per the Canada Health Act. The act does not allow charging of the end users on what is catered for by the Medicare. In addition in Canada, the system covers both public and private health delivery. On the other hand, in United States the government funding is limited to Medicare, Medicaid and also State Children’s Health Insurance Program. These programs offer services to senior people, the poor, the disabled and children. Additionally, there is Veteran Administration for the retired and disabled people who are considered veterans. The uninsured are entitled to the enrollment of the above programs. Other individuals are, therefore, supposed to pay for health insurance privately (Thomas & Biette, 2014).
In terms of funding, the government also injects huge sums of money into the health care as compared to that injected into to both Social Security plus defense. The government is also involved in health care through regulation and legislation. Taking into consideration coverage and access to healthcare, in both US and Canada, it is a problem. From studies, it is evident that in US almost 40% cannot access health insurance. The underinsured citizen accounts for about 24% of the population and therefore not ready to pay the medical costs. In Canada, only 5% cannot access regular doctor. Despite this, all Canadians are covered with the national healthcare system. Considering the Financial spending it is evident that United State spends a huge sum of money on health care as compared to Canada. This is measured as per capita spending and the percentage of gross domestic products. A huge sum of the funding is derived from the private sector in United State (O'Neill, O'Neill & National Bureau of Economic Research, 2012).
One of ineffectiveness in the both system is the fact in both system, the government is a major source of finances. Therefore, based on the fact that often the government cut their budget expenditure depending on the economic constraints, this tends to affect health access among the citizens (Thomas & Biette, 2014).In addition, wait time and referrals are a major challenge in both health care systems.Part B
Currently, hospital bill patients that are charged for a given room either private or semi-private are fixed every day. The nursing cares that a patient requires are also included in these charges. The most interesting part is that the total bill for nursing care are calculated in the department cost centers and are not specifically stated in the Medicare Cost Report that is applied to the Medicare reimbursement rates. Joining of these issues brings about false notions. For instance, from this, there is an assumption that nursing care is fixed for all patients in the billing code. There is also an assumption that nursing care is completely joined to medical treatment. Based on this, there has been much debate on the change on the way nursing care is billed and reimbursed in our hospitals. The major question is how will this be achieved? Linking a nurse to a patient in billing system is a good idea. However, the major barriers is that there is no existence of well-known technique of collecting data showing real hours of nursing care offered and that gave rise to a given bill for the hospital stay (Buerhaus, 2010). Second is the fact that, there are no specific nursing costs or total hours of care in current schedule and intensive care on the Medicare Cost Report to establish relationship between cost and charge that are supposed to impact on DRG reimbursement.
Based on the above discussion, it is evident that there has been a lot of debate on the best policy to implement a national billing model. Therefore, the separation of the nursing costs from room changes will be advantageous in that it creates some independence in the nursing practice and economic independence. Additionally, this also creates some good nurse-patient relation in since transparency is created in terms of payments (Buerhaus, 2010).However, this can create alienation of patients who require a lot of care in an attempt to reach more profits. Additionally the separation of cost can give rise to a lot of an avoidable episode of care or even limit access to specialists during an inpatient stay.
This adoption of this legislation policy would have an impact on in that integrating the level of nursing, direct costs of care and the compensation for the care offered in the billing and reimbursement system would greatly alter the connection of nurses and hospitals. As a result, data required to rise staffing and quality of care would be acquired. This is currently not evident due to lack of data on real time on nursing care (Buerhaus, 2010).
Buerhaus, P. I. (2010). Healthcare payment reform: Implications for nurses. Nursing Economics, 28(1), 49–54
O'Neill, J., O'Neill, D. M., & National Bureau of Economic Research. (2012). Health status, health care, and inequality: Canada vs. the U.S. Cambridge, MA: National Bureau of Economic Research.
Thomas, D. M., & Biette, D. (2014). Canada and the United States: Differences that count.