perspective of health care providers and health conscious individuals. However, the concerns for providing it also are great. Who will pay for it? Employer provided plans are often expensive, especially for families. Government funded programs are likely to only benefit those from lower economic groups, while the middle class must shoulder most of the burden of cost and will likely have to seek their coverage from other sources. The United States struggles to pay for Medicare as it currently stands. With individuals living longer, it is only a matter of time before this program, among others, is bankrupt. Of course, taxes could be raised, but how likely will it be that US citizens will support that? Dr. Arthur Garson (2000) of the American College of Cardiology suggests creating regional health insurance agencies that offer a variety of plans to choose from, having employers contribute a fee per employee to the agency for the employed, and government subsidies be provided per Allyson Dodson individual based on income and economic status. Then, each person would be allowed to select their plan of choice, and pay for additional benefits, as needed or desired, in addition to the basic coverage plan. For instance, supplemental prescription coverage could be offered at an additional affordable fee. Also, a system that rewards consumers for health promotion behaviors, such as maintaining a healthy weight, not smoking and effectively managing nonmodifiable health conditions, would be incentive to inspire a healthy society. If one’s financial health depended upon his or her behavior, diet, exercise and drug regimens prescribed by health care providers might be taken as more than just polite suggestions. This system could work. But, should government be able to mandate coverage in the first place? Many individuals think that deciding to have health insurance coverage should be a choice that lies with the individual alone. However, that brings the problem full circle back to the affordability of it all. Some might argue that this is discrimination. On the other hand, mandating car insurance in order to drive, as well as rewarding good behavior with discounts and “punishing” bad behavior with increased premiums, has worked well in the auto insurance industry. The difference between an auto and a health insurance requirement may lie in that health, or lack thereof, is something that applies to all whether we like it or not; whereas driving is a privilege, a choice.
As a future health care provider, I specifically worry about individuals with chronic health issues. Of greatest concern is obesity, as approximately one-third of the US population is obese, and thus often face subsequent issues such as heart disease, type II diabetes, and infertility. Health care facilities must be outfitted with equipment capable of handling the morbidly obese, and their staff must have a strong educational background in the management of heart disease and diabetes. The cost of cardiac medications and insulin must be managed and supplies well stocked. Currently, some of the medications used to treat heart conditions and diabetes are on the FDA medication shortage list, (Federal Drug Administration, 2011). However, most of the above conditions, as well as others, are preventable. If we had a system that rewarded healthy behavior, this could allow us as health care providers to focus our attention on encouraging and providing health promotion through screening, education clinics and wellness check-ups. A healthier society would mean that individuals will live longer, and health care personnel will need a more comprehensive education in geriatric care. A healthier, older population also will require additional home care personnel, as well as more assisted living facilities and nursing homes. With every health care concern there are multiple solutions, and each carries its share of benefits and additional problems. Who should be making the decisions is currently one of the biggest concerns and equal in magnitude is the question of who should pay and how. For now, we must hope for guidance from the Supreme Court of the United States, promote the side of the argument most important to us with our votes and volunteering, and provide the best level of care at the bedside every day with skill, encouragement and compassion. It is the one on one health care provider/patient relationship that will ultimately have the greatest impact on an individual’s life. As health care providers, this is something we can control today.
Editor’s note: This essay placed 2nd in MUSC’s 6th Annual Dr. Martin Luther King, Jr. Student Essay Contest.
References Atwood, M. (1985). The handmaid’s tale. London: Alfred A. Knopf. Federal Drug Administration. (2011, December 20). Current drug shortages. Retrieved from http://www.fda.gov/Drugs/DrugSafety/ DrugShortages/ucm050792.htm Garson, A. (2000, April 25). The US healthcare system 2010: Problems, principles and potential solutions. Retrieved from http://circ.ahajournals.org/content/101/16/2015.full Spring | summer 2012
MUSC College of Nursing magazine - Spring/Summer 2012