Cross post for topic on the Impact of Recession on Access to Health Care and Chronic Disease Management
it should be substantive and are to intended to critique the content of the initial post for completeness and accuracy and add to the topic by discussing an additional point to the initial post. Crossposts should be approximately 500 words with liberal use of references.
article to be critiqued:
Impact of Recession on Access to Health Care and Chronic Disease Management
The recent recession has affected the employment status of many people nationwide, but what is less known, is the effect that the recession has had on access to healthcare, and chronic disease management. A recent survey has reported that 90 percent of family care providers have had patients verbalize concerns over the inability to pay for health care (AAFP, 2009). The purpose of this paper is to discuss the background, and significance of the recession on access to healthcare, and chronic disease management; identify and describe stakeholder’s vested interests; and discuss the recession’s impact on access to healthcare, and chronic disease management, in relation to health policy and health care issues.
The economic downturn has placed many individuals at increased financial risk when considering access to healthcare, and chronic disease management (O’Toole, Buckel, Rediban, DeOrsey, & Sullivan, 2012). Medical costs are associated with the second highest number of personal bankruptcies in the United States (O’Toole et al., 2012). High rates of unemployment, and loss of employer-based health insurance has decreased the access to healthcare, and has made chronic disease management difficult due to associated costs (O’Toole et al., 2012). There are public programs in place such as Medicaid to help fill in gaps where healthcare coverage is minimal, but these programs are limited, and one must meet certain criteria in order to be eligible (Robert Wood Johnson Foundation, 2009). According to the Robert Wood Johnson Foundation (2009), the recession has led some individuals to neglect basic care, and treatment of chronic conditions, as well as elective surgeries, and preventive screenings. There is a lack of data that exists to understand the cyclical changes when concerning insurance coverage, access to healthcare, and use of health services through the course of economic changes (Robert Wood Johnson Foundation, 2009).
There are many stakeholders when considering access to healthcare, but the key stakeholders include patients, healthcare providers, government and insurance providers, and the general public (Blogger, 2010). Important factors to patients are quality, affordability, and access. Affordable coverage, and access to healthcare has been an ongoing challenge in the United States. Many citizens do not have health insurance, and cannot afford the quality care they need to stay healthy. These factors make the patients key stakeholders in improving access to healthcare (Blogger, 2010). Healthcare providers have a monetary stake when concerning access to healthcare. At this time, many providers are geared toward a high volume of services, in order to be paid adequately. With increased access to healthcare, the payout will shift from volume and intensity of services rendered, to accountability, and quality of services rendered (Brennan et al., 2009). An improved system should award value before volume, and quality before quantity, which make providers key stakeholders in improving access to healthcare (Brennan et al., 2009). Government and insurance providers are key stakeholders, because approximately 83 million of American’s have healthcare coverage from the government, and the rest of the insured population, from insurance companies. This makes them the two major payers of medical expenses, and thus key stakeholders (Blogger, 2010). The general public has a stake in improving access to healthcare, because healthcare initiatives concerning increased access to healthcare, health promotion, and disease prevention, are all aimed towards the general public (Blogger, 2010).
According to O’Toole et al (2012), almost two-thirds of the study participants had an annual income below the threshold for co-pay waivers, and the majority had at least one chronic disease (O’Toole et al., 2012). The majority of study participants had difficulty paying their utilities, affording food, and paying medical bills, as well as the economic condition contributing to increased stress. The economic downturn has made chronic disease management worse, and increased the rate of missed clinical appointments (O’Toole, et al., 2012). The results of this study suggest the need for a healthcare policy addressing the needs or at-risk people during economic struggles (O’Toole). Access for healthcare depends on affordable coverage such as health insurance, and government insurance such as medicaid (Justice Center, 2004). Reducing health care costs will help to ensure adequate access for people who have chronic diseases, and for those who cannot afford healthcare coverage. Improving access to healthcare will reduce morbidity and mortality associated with missed appointments, and interruptions in continuity of care and medications (Justice Center, 2004). Improving access to healthcare starts at the community and state levels (Kitzhaber, 2004). Some local communities have addressed this issue by creating non profit plans for low income workers, residence without insurance, or people with diagnosed chronic diseases (Kitzhaber, 2004). Some programs that have shown to be successful involve cost sharing between employees, employers, the community, and the government (Kitzhaber, 2004). Community health programs can increase access to healthcare by serving everyone without regard to ability to pay; serve in medically underserved areas; create services that are specific to individual healthcare and cultural needs; offer transportation services, home care services, comprehensive services, and extended hours; and operate through patient governing boards (National Association of Community Health Centers, 2009). Creating a policy that addresses the need for increased access to healthcare, will require the involvement of the state, government, patients, and providers, to provide a strong financing base (O’Toole, et al., 2012).
The recession has left many individuals and families without health insurance, and decreased their access to healthcare. Deficient access to healthcare decreases chronic disease management, which leads to increased hospitalizations, and increased costs. A policy that addresses access to healthcare is needed to improve morbidity and mortality rates associated poor chronic disease management. These policies require the involvement of each stakeholder, and will require a sound financial base. The current challenge of poor access to healthcare must be overcome in order to prevent a collapse of the nation’s healthcare system (National Association of Community Health Centers, 2009).
References
AAFP. (2009). National survey of family doctors shows recession takes startling toll on patients. Retrieved from
http://www.aafp.org/online/en/home/media/releases/newsreleases-statements-2009/ nationalsurvey-familydoctors-recession.html
Brennan, N., Cafarella, N., Kocot, S. L., McKethan, A., Morrison, M., Nguyen, N., . . . Williams, R. D. (2009). Improving quality and value in the u. s. healthcare system. Retrieved from
http://www.brookings.edu/research/reports/2009/08/21-bpc-qualityreport
Blogger, Johnny. (2010). Healthcare Policy Stakeholders. Retrieved from
http://emhhealthcarejobs.com/healthcare-policy-stakeholders/
Robert Wood Johnson Foundation. (2009). Impact of the economy on healthcare. Retrieved from
http://www.academyhealth.org/files/HCFO/findings0809.pdf
National Association of Community Health Centers. (2009). Primary care access: An essential building block of health reform. Retrieved from
http://www.nachc.com/client/documents/pressreleases/PrimaryCareAccessRPT.pdf
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