Learning While Caring

2016 ◽  
Author(s):  
Samuel B. Hellman
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
The United States ◽  
Quality Health Care ◽  
Health Security ◽  
Us Economy ◽  
Major Subject ◽  
The Us ◽  
Quality Health ◽  
Developed World

Learning While Caring is about what the author has learned during his half-century career as a cancer doctor. During this time, medicine has changed greatly. It has become more scientifically based, more institutionally located, and now comprises almost one-fifth of the US economy. Despite these changes, much remains the same, especially the primary obligation of the doctor to the patient. Also during this period, most of the developed world has recognized health care as a right for all its members. This has been resulted in greatly improved care for many, but not for all. For the last 25 years the United States has been experimenting on how this should be achieved, beginning with the proposed but not enacted Clinton Health Security proposal and currently with the Affordable Care Act. While efficiency and cost control are essential, cost cannot be the only parameter of success. Access to high-quality health care must be made available to all. Proper education for an informed public must include an understanding of the general principles of biology, while that of a doctor must result in a familiarity with the humanities and social sciences. An academic physician has three responsibilities: patient care, teaching, and research. These latter two, while essential, must not conflict, compromise, or limit the doctor-patient relationship. This book is about the author’s activities in all three endeavors. Since his specialty is oncology, this is the major subject, but most of the information is applicable to all caring physicians.

Workers' compensation: Poor quality health care and the growing disability problem in the United States

2014 ◽  
Vol 58 (3) ◽  
pp. 245-251 ◽  
Author(s):  
Gary M. Franklin ◽  
Thomas M. Wickizer ◽  
Norma B. Coe ◽  
Deborah Fulton-Kehoe
Keyword(s):  
United States ◽  
Health Care ◽  
The United States ◽  
Poor Quality ◽  
Workers Compensation ◽  
Quality Health Care ◽  
Quality Health

What Is the Affordable Care Act a Case of? Understanding the ACA through the Comparative Method

2020 ◽  
Vol 45 (4) ◽  
pp. 677-691
Author(s):  
Holly Jarman ◽  
Scott L. Greer
Keyword(s):  
United States ◽  
Health Care ◽  
Welfare State ◽  
Affordable Care Act ◽  
Strong Support ◽  
The United States ◽  
The Us ◽  
The Affordable Care Act ◽  
Shed Light ◽  
The Welfare State

Abstract International comparisons of US health care are common but mostly focus on comparing its performance to peers or asking why the United States remains so far from universal coverage. Here the authors ask how other comparative research could shed light on the unusual politics and structure of US health care and how the US experience could bring more to international conversations about health care and the welfare state. After introducing the concept of casing—asking what the Affordable Care Act (ACA) might be a case of—the authors discuss different “casings” of the ACA: complex legislation, path dependency, demos-constraining institutions, deep social cleavages, segmentalism, or the persistence of the welfare state. Each of these pictures of the ACA has strong support in the US-focused literature. Each also cases the ACA as part of a different experience shared with other countries, with different implications for how to analyze it and what we can learn from it. The final section discusses the implications for selecting cases that might shed light on the US experience and that make the United States look less exceptional and more tractable as an object of research.

scholarly journals The Implementation and Evaluation of the United States Affordable Care Act

2019 ◽  
Vol 12 (1) ◽  
pp. 17-38
Author(s):  
David Schultz
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Health Care Outcomes ◽  
The Us ◽  
American Health Care

In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.

Quality 101: What Every Audiologist and Speech-Language Pathologist Should Know But Is Afraid to Ask

2011 ◽  
Vol 7 (1) ◽  
pp. 4-7
Author(s):  
Tamala S. Bradham
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Management ◽  
The United States ◽  
Management Program ◽  
Market Place ◽  
Improvement Program ◽  
Quality Health Care ◽  
Speech Language Pathologist ◽  
Quality Health

The United States has the highest per capita health care costs of any industrialized nation in the world. Increasing costs are reducing access to care and constitute an increasingly heavy burden on employers and consumers. Yet as much as 20 to 30 percent of these costs may be unnecessary, or even counterproductive, to improved health (Wennberg, Brownless, Fisher, Skinner, & Weinstein, 2008). Addressing these unwanted costs is essential in the survival of providing quality health care. This article reviews 11 dimensions that should be considered when starting a quality improvement program as well as one quality improvement tool, the Juran model, that is commonly used in the healthcare and business settings. Implementing a quality management program is essential for survival in today’s market place and is no longer an option. While it takes time to implement a quality management program, the costs are too high not to.

scholarly journals Promoting Health Equity through De-Implementation Research

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 93-96 ◽  
Author(s):  
Christian D. Helfrich ◽  
Christine W. Hartmann ◽  
Toral J. Parikh ◽  
David H. Au
Keyword(s):  
Health Care ◽  
Implementation Strategies ◽  
The United States ◽  
Double Jeopardy ◽  
Socioeconomically Disadvantaged ◽  
Medical Overuse ◽  
Quality Health Care ◽  
Patient Race ◽  
Quality Health ◽  
Expected Benefits

 Ensuring equitable access to quality health care historically has focused on gaps in care, where patients fail to receive the high-value care that will benefit them, something termed unde­ruse. But providing high-quality health care sometimes requires reducing low-value care that delivers no benefit or where known harms outweigh expected benefits. These situations represent health care overuse. The process involved in reducing low-value care is known as de-implementation. In this article, we argue that de-implementation is critical for advanc­ing equity for several reasons. First, medical overuse is associated with patient race, ethnic­ity, and socioeconomic status. In some cases, the result is even double jeopardy, where racial and ethnic minorities are at higher risk of both overuse and underuse. In these cases, more tra­ditional efforts focused exclusively on underuse ignore half of the problem. Second, overuse of preventive care and screening is often greater for more socioeconomically advantaged pa­tients. Within insured populations, this means more socioeconomically disadvantaged pa­tients subsidize overuse. Finally, racial and eth­nic minorities may have different experiences of overuse than Whites in the United States. This may make efforts to de-implement over­use particularly fraught. We therefore provide several actions for closing current research gaps, including: adding subgroup analyses in studies of medical overuse; specifying and measuring potential mechanisms related to equity (eg, double jeopardy vs thermostat models of over­use); and testing de-implementation strategies that may mitigate bias.Ethn Dis. 2019;29(Suppl 1):93-96; doi:10.18865/ed.29.S1.93.

Ivana Krajcinovic, From Company Doctors to Managed Care: The United Mine Workers' Noble Experiment. Ithaca: ILR Press, 1997. ix + 212 pp. $37.50 cloth.

2000 ◽  
Vol 57 ◽  
pp. 173-175
Author(s):  
Michael Nash
Keyword(s):  
Health Care ◽  
The United States ◽  
Quality Health Care ◽  
Quality Health ◽  
United Mine Workers ◽  
Retirement Funds ◽  
The Many ◽  
Company Doctor ◽  
United Mine ◽  
Mine Workers

For much of the first half of the century the United Mine Workers (UMW) was the largest, most important, most powerful, and most progressive union in the United States. Among its many accomplishments was that it was one of the first to bargain for and win employer-financed health benefits. Health care was critically important to miners, many of whom were seriously injured on the job and by middle age were often disabled by black lung disease. In the isolated, rural mine patches, quality health care was rarely available. In the days before the organization of the UMW's Welfare and Retirement Funds, many miners found that the only health care that was available came from the company doctor. This medical practice was usually substandard and was one of the many ways the operators exercised power over the life of the miners, discouraging union and political organizing.

James Lawrence Cabell, One of the Most Influential of America's Early Surgeons

2015 ◽  
Vol 81 (4) ◽  
pp. 331-335
Author(s):  
Joseph Dubose ◽  
Curt Tribble
Keyword(s):  
United States ◽  
Health Care ◽  
American Medical ◽  
The United States ◽  
James Madison ◽  
Quality Health Care ◽  
National Board ◽  
Quality Health ◽  
The University ◽  
The 19Th Century

Dr. James Lawrence Cabell was one of the most important, farsighted, and influential surgical educators and leaders in the United States in the 19th century. He was appointed as Chair of Surgery and Physiology at the University of Virginia by Thomas Jefferson's successor as Rector of the University, James Madison, and held that Chair for over 50 years, the longest tenure of any American medical academician. He was a founding member of the American Medical Association, the American Surgical Association, and the National Board of Health. He is best remembered as an articulate, incessant, and early proponent of public health and the delivery of quality health care in the United States. His legacy and that of his protégés has continued to influence health care in this country, especially in the realm of the prevention and treatment of infectious diseases, even into the present time.

Public Interest Report No. 7: Rx: A Healthy National Organization for American Physicians

1973 ◽  
Vol 4 (1) ◽  
pp. 75-79
Author(s):  
Robert N. Butler
Keyword(s):  
Public Health ◽  
Health Care ◽  
Public Interest ◽  
The United States ◽  
Professional Organization ◽  
Institute Of Medicine ◽  
American Public Health Association ◽  
Quality Health Care ◽  
Health Association ◽  
Quality Health

The American Medical Association, like all organizations, is not guaranteed a permanent life. The AMA has shown serious signs of obsolescence after years of poorly representing both doctors and their patients. AMA membership has fallen below 50 per cent of American physicians. It is possible that the AMA might be revamped and become a major force for constructive change. It is also possible that a new professional organization will emerge along with unionization. Specialty groups have evolved. An Institute of Medicine has gained considerable status. Various socially-conscious groups like the Medical Committee on Human Rights and the American Public Health Association have made important contributions toward the ultimate goal of providing quality health care in the United States.

scholarly journals Improving health literacy – bridging the gap between newcomer populations and quality health care

2020 ◽  
pp. 43-45
Author(s):  
Richard Ying Yu ◽  
Anamika Mishra
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Healthcare System ◽  
Cultural Sensitivity ◽  
Oral Communication ◽  
The United States ◽  
Care Providers ◽  
Quality Health Care ◽  
Teaching Community ◽  
Quality Health

Health literacy is the ability to obtain and utilize health information in order to advocate for one’s health. It is paramount to a recent immigrant’s successful integration into the Canadian healthcare system and their maintenance of health in the long term. Despite its importance, 60% of native-born Canadians and an even higher proportion of immigrants indicate that they are not health literate. In this article, we focus on the importance of health literacy in an immigrant population and current barriers they may face in accessing health care. We discuss current shortcomings within the healthcare system in terms of improving health literacy for newcomers and explore strategies currently used in the United States and Canada. Based on our review of the literature, it is clear that promoting health literacy is a multi-dimensional challenge which requires the synthesis of many strategies, including clear written and oral communication, use of multimedia tools, cultural sensitivity, participatory teaching, community resources, and availability of diverse care providers who can relate to newcomers linguistically and culturally.

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