Though the healthcare systems of the Military, Veteran’s, and the private sectors are very different, the mission is the same:  to provide quality healthcare to its patients.  However, there are key fundamental factors that set these systems apart from each other. Factors such as budget, billing, type of care given, and political influence serve to outline the types of polices that these very different systems have. Though the mission is the same at each facility, there are political and economic factors that dictate, direct, and limit the policy-making procedures of each. 

In the private sector, factors that limit growth are the number of patients within the system and the ability to remain competitive. In the Military and Veteran’s Health systems (MHS and VHS, respectively), congress and the national budget limit growth. The budget granted to Military and Veteran’s Health systems is also directly proportional to the volume of care given. One very important factor in the both the MHS and VHS is that the care is given free of charge to their patients. Therefore, the capital used for a healthcare system is truly a powerful force that drives a system’s policies. 

The cost of healthcare in the Military, the Veteran’s, and the private sector is on the rise and is expected to continue to rise without slowing (House Affairs, 2005). Take for instance the pharmaceutical needs of patients. This high cost service has put a great deal of pressure on Military and Veteran systems as well as private sectors. The medications given to the 9.1 million beneficiaries within the MHS are all free of charge to the patient. This is also true for VHS patients and their medications needs. This service is costly to these systems, and due to this, policies ensure that medications are only prescribed when there is a clear need. Moreover, as these costs are rising, the systems are changing policies in order to control costs. An example of this is reclassifying key medications to a non-formulary category (House Affairs, 2005).

In conclusion, the Military, Veterans, and private sectors are very different but the goals of quality care are the same. All three of these systems provide quality care to their patients with respect to the mission and policies mandated by the system. Furthermore, while one system may often face factors that the others do not, political and economic pressures are faced by each these organizations.   The pressures on one system can cause another to transition its policies to accommodate fluid reform.   Regardless of the type of organization, all these factors cause the systems to constantly form new policies and change current policies.   

References

House Affairs. (2005). TRICARE moves three medications to non-formulary status. Retrieved

June 30, 2005 from http://www.ha.osd.mil/asd/20050425.cfm

 

In these difficult economic times, healthcare must come to the front. From a socio-economic burden influenza has left its mark throughout known history. The massive death tolls and economic hardship is felt greatest in what world poorest countries but not limited to them. The 1918 flu that battered the world for a year left a wake of dead and a world scrambling to understand how and why. The burden that is thrust upon the world with each outbreak of influenza in deaths alone is unimaginable but the economic burden is all too clear. In the United States influenza accounts for 1-3 billion of the nations direct medical cost (Szucs, 1999). Losses due from lost earnings and future lost earnings due to death are a staggering 10-15 billion a year (Szucs, 1999). In a rough estimate about 9% of the world’s population will contract influenza infections each years with the greatest burden falling on children and elderly (Szucs, 1999). Moreover, as an investigation into the factors that make flu such a world issue it gets more and more complicated with more and more underlining social and economic burdens that the world faces as a whole. Influenza has become the equalizer of nations and no one nation is safe from the clandestine ever changing virulence. The burden is great and just how great will depend on the ability of our leaders to see this danger and plan for the next pandemic. Our economic systems growing pains in recent weeks should be a call to action to improve or nation’s healthcare system. Moreover, how flawed is our healthcare system will it fail when we need it most?

Szucs, (1999), The socio-economic burden of influenza, Journal of Antimicrobial Chemotherapy, 44, Topic B, 11-15

With the growing cost of medical care a great burden is put upon the world’s resources to treat and prevent chronic diseases. Primarily due to advances in medical science and an overwhelming number of poor life choices, chronic disease has become the world’s leading cause of death (Yach, 2004). Cardiovascular disease rose to become the leading chronic disease in 2002, with cancer; chronic respiratory disease; and diabetes following closely behind (Yach, 2004). Worldwide, these mostly preventable chronic diseases caused the deaths of 29 million people. The staggering burden on society due to lost productivity and rising healthcare costs leaves many nations clamoring to find a solution. 

One would think that a preventable chronic disease would be easily be extinguished through preventative measures such as educations and governmental policy. However, as billions are spent in the hopes of preventing chronic disease, barely a dent has been made in this growing global problem. This is due to a world of fearless smokers and binge eaters who want the government to bail them out after decades of poor life choices. Clearly the damage is done for the current aging generation, but there is hope for the next. For, educating youth on good life choices will lead to greater quality of life and better health. The hope is to reduce chronic disease through prevention, surveillance, and control.  

There is a great task ahead for chronic disease treatment and prevention. One generation requires acute and long-term care and another generation truly needs to understand the implications of poor life choices. The World Health Organization (WHO) has worked to set prevention, surveillance, and control measures to aid in the chronic disease crisis the world faces. Unfortunately, people will not change overnight. However, through social marketing and cognitive dissonance changes can occur in individual minds and hopefully cause them to make wise life choices.

Reference:

Yach. (20040. The Global Burden of Chronic Diseases,

            Overcoming Impediments to Prevention and Control

            JAMA. 291:2616-2622.

 When looking at the service of Medicare created in 1965, one can only hope there was the best of intentions behind its lofty goals. The truth is Medicare created jobs and has served to provide healthcare to more than 40 million older and disabled Americans. The goal of providing healthcare in 1965 to older and disabled Americans was both idealistic and well received. Nevertheless, as with any other “benefit”, problems arose by both poor quality of service and inadequate funding. Moreover, through the years Medicare became a political tool of power.   Finally, every administration since its conception has dabbled with the policies and services Medicare provides. For example, in Nov. 25, 2003, the Bush administration included a new prescription drug benefit (CBS News, 2003).

The changes to Medicare where deemed necessary due to the rising costs of medications and the debilitating burden that soaring costs put on the beneficiaries of Medicare. In 2002, the United States spent $162.4 billion on prescriptiondrugs with only about 22% of this paid for by the Government and 44% by personal healthcare prescriptions (Frank, 2002). The root of the problem lies in the inability of elderly and disabled Americans to be able to cover the rising price of prescription care. Each year the costs of prescription care are on the move up and out of the reach of most people on Medicare. This growing problem has forced many elderly and disabled people to choose between good health and paying one’s bills.

Beginning in 2006, the main provisions of the new legislation would allow seniors to purchase coverage for their prescription drugs as well as require higher-income seniors to pay more for Medicare Part B coverage (CBS News, 2003).  Estimates under this new program would have drug insurance premiums of about $35 a month and a deductible of $250 (CBS News, 2003). Seventy-five percent of costs would be covered until the recipient’s drug costs reach $2,250, after which there would be no drug coverage until drug costs reach $3,600, or approximately $5,100 in overall expenses (CBS News, 2003). After $5,100 in expenses, the plan would cover about 95% of prescription costs (CBS News, 2003). Even with political and special interest influences directing the policy, the Medicare reform goal was reached.   

Congressman Charles Grassley, R-Iowa, an architect of the bill, and many insurance and pharmaceutical companies were involved in setting the agenda for this policy reform to Medicare (CBS News, 2003). Together, with the support of the President, these parties and many special interest groups worked to set the formulation of change. Grassley stated that, “now was the time to act for it may be years before another opportunity comes along (CBS News, 2003).” The role of interest groups such as the nation’s various elderly and disabled groups served to display the needs and values hoped for in future reforms. Governmental leaders in both the Senate and the current administration worked to provide a service to beneficiaries that fell within current and future budgets. At times, the lofty $395 billion legislation was ignored and caused a great deal of political and public unrest.

This legislation was very controversial and in many cases proved to be more of a detriment than an improvement to Medicare.   Senate Democratic Leader Tom Daschle called the bill a "bailout for the HMOs and insurance companies (CBS News, 2003).” The administration stated that the change to modernize Medicare would have savings of between 15 percent and 25 percent off retail prices. The caused the many out-spoken critics to argue that White House estimates were inflated (CBS News, 2003). Many critics even stated that the pharmaceutical companies were the winners of this bill at the expense of low income Americans.

The stated goal of the administration was that it was time to modernize Medicare.  One factor that contributed to reaching this goal was the addition of electronic medical informatics. This electronically stored data is invaluable to evaluating both the financial viability and the practicality of medical procedures. The ability to evaluate patient data with respect to cost analysis was a crucial factor leading up to reform (Longest, 2002).   

In conclusion, the need to reform Medicare was clear and certain. The leadership at the time took decisive advantage of timing and resources in order to advance their goals and ideals. Moreover, the parties of interest and influence worked to motivate and render change. Even with all the political balancing acts, President Bush signed the bill, and it will take effect in 2006.  And while the initial goals were not entirely reached, the concept and practical value of the change can, in the future, prove to be of great value. The question to ask is whether people will appreciate it or cause it to become even more of a burden on society and political power tool.

References

CBS News. (2003). Medicare drug bill nears passage. Retrieved July 1, 2005

from http://www.cbsnews.com/stories /2003/11/25/politics/main585478.shtml

Frank, R. (2002). Prescription-drug prices. New England Journal of

Medicine. Retrieved July 1, 2005 from http://content.nejm.org/cgi/content/full/351/14/1375

Longest, B. B. (2002). Health policymaking in the United States, 3rd ed. Chicago:

Health Administration Press.