1. GREEN PARTY
1.1. The Green Party opposes the Affordable Care Act as it seems simply sell more insurance coverage and offers no amicable solutions to the provision of medical care for “all”. There is no real conversation as far as Medicaid and Medicare go, in that the party support for Universal – Single Payer Healthcare would alleviate the need for multiple programs. The Green Party has no interest in prolonging and perpetuating already preposterous costs. They support "bold and unencumbered” commencement of a new system. All stakeholders would be effected with the people benefitting the most with providers, carriers, and administrators needing to learn how to manage with the changes or explore other ways to assist in the new healthcare system. Consumers would have more choices, local care provision, and private physicians.
1.2. The Green Party opposes the ACA in that they would prefer to Improve and expand Medicare for all citizens. The idea is not to reinvent the wheel, but to expand and improve upon what is already there in the creation of Universal Healthcare.
1.2.1. Medicaid would no longer exist under a Universal Healthcare model, The funding and provision would be absorbed and/or reallocated through the modified Medicare system.
1.3. There was no clear cut plan for funding offered by the Green Party Platform.
1.4. The Green Party approach to the formation of a new system of healthcare is this : "BOLD AND UNENCUMBERED". with no set time frames for completion.
1.4.1. Proponents of Universal Healthcare would include providers and consumers of alternative and complementary therapies in addition to the millions that have been uninsured or under-insured for many years.
1.4.1.1. Opposition comes, once again, from those who are afraid of some one thing and then another. Politically, each Party wants it their own way and hope to wave a flag of victory over their plan proposals. At the end of the day, the number one issues is the almighty dollar $$$$
1.5. Proponents of change are afraid not to change. Profiteers are afraid of both changing and not changing.Opponents to the plan are afraid to allow change for fear that their support of change might interfere with the business of "politics".
1.5.1. Fear of change seems to be the biggest obstacle and has been so since the implementation of services in the 60's. We have a profit-driven economy and a fear-based population.
2. GENO-SOCIETY PARTY
2.1. The IRON TRIANGLE
2.1.1. Many healthcare systems are evaluated using the Iron Triangle of Health Care—a concept that focuses on the balance of three factors: quality, cost, and accessibility to health care (see Figure 1-1). This concept was created in 1994 by Dr. William Kissick (Kissick, 1994). If one factor is emphasized, such as cost reduction, it may create an inequality of quality and access because costs are being cut. Because lack of access is a problem in the United States, healthcare systems may focus on increasing access, which could increase costs. In order to assess the success of a healthcare delivery, it is vital that consumers assess their health care by analyzing the balance between cost, access, and quality. Are you receiving quality care from your provider? Do you have easy access to your healthcare system? Is it costly to receive health care? Although the Iron Triangle is used by many experts in analyzing large healthcare delivery systems, as a healthcare consumer, you can also evaluate your healthcare delivery system by using the Iron Triangle. An effective healthcare system should have a balance between the three components.http://samples.jbpub.com/9781284043761/Chapter1.pdf
2.2. I decided that being pro-society , as a whole didn't squeeze me into being a socialist, so I combined society with a new idea in american politics.
2.3. The proponents of genopolitics assume that there is a dichotomy in American politics today between conservatives and liberals that can be projected backwards and globally and that can be explained genetically.https://newrepublic.com/article/119794/genopolitics-social-science-and-origin-political-beliefs
2.4. The premise is that both social scientists and health care professionals share complementary intellectual interests in fostering empirical research on health and illness. Barriers built into the orientation and reward structure of both professions impede collaborative efforts. In our view, however, the advantages of working on these problems outweigh the disadvantages. Toward this end, we suggest several substantive and methodological directions to be encouraged and then discuss prospects for collaboration from the perspectives of social science, medicine and the wider society. We see opportunity for comparative work, synthesis and the systematic nesting of findings into a knowledge base that will permit generalizations. Our goal is to improve the fit between social science and health practice by increasing the relevance of social science findings for the delivery of care and the training of health care professionals. In addition, hopefully, our suggestions will advance social research independent of its impact on the health field. http://www.ncbi.nlm.nih.gov/pubmed/3317885
2.5. The Beginning
2.5.1. In my very own party, the Geno-Society party, I have pulled from each parties’ ideas and formulated some of my own into a package that is similar in ways, yet has a dissimilar focus in other areas. My party recommends a “pick-the-bones” approach. In this way, one would pick the good that is left in these various programs (ACA, Medicare, Medicaid, etc.) and add some fresh ideas that would make a new healthcare system that is familiar, yet more inclusive and user-friendly.
2.6. Medicare/Medicaid
2.6.1. In all fairness to Medicare recipients who have paid a lot of money into Medicare, I would like to derive a way to refund that to those people in some way, whether in goods and services, vouchers, whatever way could be afforded and accepted. Medicaid would fade away, as the Universal Single-Payer Plan enveloped all other programs with all citizens, regardless of socioeconomic status, receiving cost effective and adequate health care.
2.7. My Perfect World
2.7.1. In my idea of the perfect world of healthcare, the idea would be Holistic Care models with wellness being the crux of the system. Services that include a mind, body spirit approach for mental health, preventative care, institutional care with an emphasis on alternative and complimentary approaches to wellness and healing.
2.8. Future of Healthcare in America
2.8.1. I believe that this would be possible once we abandon the “Borrow from Peter to Pay Paul” system we use presently. Developing a tax system that is actually based on income, regardless of where one banks it, there would be a great deal of funding available for a revamped healthcare system that could be instituted as soon as possible, with the expectation of much stress and upset among all stakeholders, particularly the ones who forget who healthcare is for. It is for ALL OF THE PEOPLE, ALL OF THE TIME. It is not for corporations (who, indeed are NOT people in need of health care), administrators, carriers, pharmaceutical companies nor any other entity to gather enormous wealth for the sake of American’s health. We are a capitalistic society. That means that these companies and individuals have every opportunity to re-direct their talents and innovate around change just as other industries have had to do as we moved from the industrial age to the technical age.
3. HISTORY OF US HEALTHCARE
3.1. Table 1-1 Milestones of Medicine and Medical Education 1700–2013 • 1700s: Training and apprenticeship under one physician was common until hospitals were founded in the mid-1700s. In 1765, the first medical school was established at the University of Pennsylvania. • 1800s: Medical training was provided through internships with existing physicians who often were poorly trained themselves. There were only four medical schools in the United States that graduated only a handful of students. There was no formal tuition with no mandatory testing. • 1847: The AMA was established as a membership organization for physicians to protect the interests of its providers. It did not become powerful until the 1900s when it organized its physician members by county and state medical societies. The AMA wanted to ensure they were protecting their financial well-being. It also began to focus on standardizing medical education. • 1900s to 1930s: The medical profession was represented by general or family practitioners who operated in solitary practices. A small percentage of physicians were women. Total expenditures for medical care were less than 4% of the gross domestic product. • 1904: The AMA created the Council on Medical Education to establish standards for medical education. • 1928: Formal medical education was attributed to Abraham Flexner, who wrote an evaluation of medical schools in the United States and Canada indicating many schools were substandard. He made recommendations to close several schools, enact admission requirements, and set a standard curriculum. The Flexner Report led to standardized admissions testing for students called the Medical College Admission Test (MCAT), which is still used as part of the admissions process today. • 1930s: The healthcare industry was dominated by male physicians and hospitals. Relationships between patient and physicians were sacred. Payments for physician care were personal. • 1940s to 1960s: When group health insurance was offered, the relationship between patient and physician changed because of third-party payers (insurance). In the 1950s, federal grants supported medical school operations and teaching hospitals. In the 1960s, the Regional Medical Programs provided research grants and emphasized service innovation and provider networking. • 2008: There is increased racial diversity in the number of medical school graduates. Although whites continue to represent the largest number of medical school graduates, there continues to be a decline in white graduates. Asians represent the largest ethnicity of medical school graduates. Women medical graduates continue to enter the workforce in great numbers, but men still outnumber women physicians. • 2001–2012: In 2011, the ACA established the Center for Medicare & Medicaid Innovation that will examine ways to deliver care to patients. In 2012, the ACA provided incentives for physicians to establish accountable care organizations. • 2012: In 2012–2013, the average annual cost for a public medical school for an in-state resident was $30,000. The annual cost for a private medical school was $50,000. Approximately 47% of the students were females (History of the US Healthcare System)
4. Table 1-1 Milestones of Medicine and Medical Education 1700–2013 • 1700s: Training and apprenticeship under one physician was common until hospitals were founded in the mid-1700s. In 1765, the first medical school was established at the University of Pennsylvania. • 1800s: Medical training was provided through internships with existing physicians who often were poorly trained themselves. There were only four medical schools in the United States that graduated only a handful of students. There was no formal tuition with no mandatory testing. • 1847: The AMA was established as a membership organization for physicians to protect the interests of its providers. It did not become powerful until the 1900s when it organized its physician members by county and state medical societies. The AMA wanted to ensure they were protecting their financial well-being. It also began to focus on standardizing medical education. • 1900s to 1930s: The medical profession was represented by general or family practitioners who operated in solitary practices. A small percentage of physicians were women. Total expenditures for medical care were less than 4% of the gross domestic product. • 1904: The AMA created the Council on Medical Education to establish standards for medical education. • 1928: Formal medical education was attributed to Abraham Flexner, who wrote an evaluation of medical schools in the United States and Canada indicating many schools were substandard. He made recommendations to close several schools, enact admission requirements, and set a standard curriculum. The Flexner Report led to standardized admissions testing for students called the Medical College Admission Test (MCAT), which is still used as part of the admissions process today. • 1930s: The healthcare industry was dominated by male physicians and hospitals. Relationships between patient and physicians were sacred. Payments for physician care were personal. • 1940s to 1960s: When group health insurance was offered, the relationship between patient and physician changed because of third-party payers (insurance). In the 1950s, federal grants supported medical school operations and teaching hospitals. In the 1960s, the Regional Medical Programs provided research grants and emphasized service innovation and provider networking. • 2008: There is increased racial diversity in the number of medical school graduates. Although whites continue to represent the largest number of medical school graduates, there continues to be a decline in white graduates. Asians represent the largest ethnicity of medical school graduates. Women medical graduates continue to enter the workforce in great numbers, but men still outnumber women physicians. • 2001–2012: In 2011, the ACA established the Center for Medicare & Medicaid Innovation that will examine ways to deliver care to patients. In 2012, the ACA provided incentives for physicians to establish accountable care organizations. • 2012: In 2012–2013, the average annual cost for a public medical school for an in-state resident was $30,000. The annual cost for a private medical school was $50,000. Approximately 47% of the students were females
5. THE ACTORS
5.1. Healthcare Purchasers/Federal, State and Local Governments/ Industries and Businesses/Healthcare Providers/Hospitals/Nursing Facilities/Physicians/Nurses/Third-Party Payers/Consumers/Interest Groups
6. CONCLUSION
6.1. Despite U.S. healthcare expenditures, the U.S. disease rates remain higher than many developed countries because the United States has an expensive system that is available to only those who can afford it (Regenstein, Mead, & Lara, 2007). Findings from the 11th MetLife annual survey indicate that healthcare costs are worrying employees and their employers. Over 60% of employees are worried they will not be able to pay out-of- pocket expenses not covered by insurance. Employers are increasing the cost sharing Cost Containment Access Quality Figure 1-1 The Iron Triangle of Health Care Source: Reproduced from Kissick, William, MD, DR, PH, Medicine’s Dilemmas, p. 3. New Haven, CT: Yale University Press, 1994. Reprinted by permission. Chapter 1 History of the U.S. Healthcare System 12 9781284034417_Ch01.indd 12 1/25/2014 4:21:38 PM of their employees for healthcare benefits because of the cost increases (Business Wire, 2013). Because the United States does not have universal health coverage, there are more health disparities across the nation. Persons living in poverty are more likely to be in poor health and less likely to use the healthcare system compared to those with incomes above the poverty line. If the United States offered universal health coverage, the per capita expenditures would be more evenly distributed and likely more effective. The major problem for the United States is that healthcare insurance is a major determinant of access to health care. With nearly 49 million uninsured in the United States with limited access to routine health care, disease rates and mortality rates will not improve. Based on the fragmented development of U.S. health care, the system is based on individualism and self-determination and focusing on the individual rather than collectivistic needs of the population. In a recent 2013 report, the CDC indicates there was a decline in U.S. infant mortality rates between 2005 and 2011 because of declines in certain geographic areas. However, despite this positive result, the United States is still ranked worldwide much lower than other developed countries due to the continued preterm birth rates. This is an important statistic because it is often used to compare the health status of nations worldwide. Although our healthcare expenditures are very high, our infant mortality rates rank higher than many countries. Racial disparities in disease and death rates continue to be a concern (CDC, 2013b). Both private and public participants in the U.S. health delivery system need to increase their collaboration to reduce these disease rates. Leaders need to continue to assess our healthcare system using the Iron Triangle to ensure there is a balance between access, cost, and quality.
7. DEMOCRATIC PARTY
7.1. The Democratic Party Platform indicates that there is strong opposition to the privatization of Medicare. There is no mention of the fact that Medicare supplements are already private insurance companies that take over full management of services. One is asked not to give their Medicare card to any provider after enrolling in the private supplement, as those companies take over the management of the Medicare recipients care and payments. Some of the companies offer a prescription drug plan as an inclusion in the plan, but there are separate ones available that are also offererd by private companies.
7.1.1. Step by step approaches work nicely, but only if you have a place to eventually end up. I was unable to find information regarding the estimated time frames of projections for completion of a basic plan.
7.1.2. Medicaid is separate from Medicare in the way that people are selected for the programs and how they pay out on claims. The Democratic Party is supporting of the expansion of Medicaid to include every American that isn't on Medicare.
7.2. Proponents of change are afraid not to change. Profiteers are afraid of both changing and not changing.Opponents to the plan are afraid to allow change for fear that their support of change might interfere with the business of "politics".
7.2.1. Fear of change seems to be the biggest obstacle and has been so since the implementation of services in the 60's. We have a profit-driven economy and a fear-based population.
7.2.2. The stakeholders for any decisions regarding our nations healthcare conundrum will effect each and every American. The nature of our healthcare beast and how our economy is largely based on the "commodities" of health, wellness, and even death.
7.3. The Democratic Party wants to expand the Affordable Care Act in a step-by-step process until there is access for all. The expansions would include that of Medicaid and Medicare. Medicare would remain non-privatized, have better prescription drug coverage and offer an optional buy-in program to offer more choices to seniors. With these expansions, and some say probable Universal Healthcare System at the end of the process, the party hopes that the in cutting costs there would be less need for government financing of many other ancillary programs that boost most every other aspect of medical care. By expanding coverage stakeholders would not suffer complete losses, but may have to take less payment. However, with more people covered and accessing care, it would seem that it would al come out in the wash.
7.3.1. There are some nice discussions about what the party prefers, but I was unable to find a detailed plan for financing the continuation or expansion of either Medicare, Medicaid or any other big changes in our current healthcare system. What can be cut without costing elsewhere? Borrowing and not being able to replace funds that are designated for something else isn't long -term ways and means.