FIU Week 9 Health Care Financing Infrastructure Discussion – Assignment Help

I’m working on a Psychology question and need guidance to help me study.

1. Based on the information provided to you in Chapter 8 (Financing Health Care ) of your textbook, you are to discuss one of the following:

  1. The healthcare financing infrastructure.
  2. Discuss the major factors that affect health care costs.
  3. The roles of government and the private sector efforts to link costs to quality.

Reply to the following posts.

Post 1 MT

The price of medical care is the single biggest factor behind U.S. healthcare costs, accounting for 90% of spending. These expenditures reflect the cost of caring for those with chronic or long-term medical conditions, an aging population and the increased cost of new medicines, procedures, and technologies. According to the Department of Health and Human Services, for the first time, the U.S. health care costs are likely to surpass $10,000 per person.

Healthcare gets more expensive when the population expands as people get older and live longer. Therefore, it is not surprising that 50% of the increase in healthcare spending comes from increased costs for services, especially inpatient hospital care.

Most insurers provide a fee-for-service system to doctors, health care providers, hospitals, and other medical facilities by reimbursing for every treatment, procedure or visit. When paired with a disintegrated medical system, it leads to over-treatment and repetitive tests, which gets accounted as health care costs. Also, a good majority of American population are either obese or overweight. This has led to inflation of several health issues including diabetes, heart disease, cancer, and other chronic health conditions. Treatment and management of lifestyle-related health problems and other chronic illnesses have further accelerated healthcare costs.

With rise in lifestyle and chronic health issues, the demand for advanced medical care has also increased. Most doctors and patients demand for newest medical treatments and use of innovative technologies that are often expensive. Moreover, medical advancements over the years, have paved the way for expensive patented drugs that were once generic, inexpensive, and easily affordable by an average consumer.

Other factor is people who are insured through their job, are ignorant towards their medical treatments and its relative costs. With very little information about any treatment and even for its slightest chance of success, people tend to make uninformed choices about their health care treatments, creating unnecessary hike in medical expenditure and their coverage.

Post 2 MJ

There are multiple major factors that affect health care costs. One of the biggest reasons that attribute to the rise of health care costs is due to fraud and abuse. While their may not be a complete accurate amount known as to just how much money is fraud in this country, the Federal Bureau of Investigation (FBI) estimates to be 3-10 percent of total health spending (Sultz & Young, 2018). That estimates to roughly around $75-$250 billion a year, and in my own personal opinion is probably even higher than that amount. Sadly, you have professionals like my own Uncle who I spoke about previously that allow greed to get the best and worst of them. They sacrifice their character, ethical obligation and care for their patients for money. This causes a major blow to the health care system and drives the cost to go up in order to compensate for the huge loss.

Another item that affects health care costs is the waste of spending. According to the book, it is estimated unnecessary cost of this waste is between $476 and $992 billion per year ( Sultz & Young, 2018). Causes of waste are items such as failures of care delivery and care coordination, overtreatment, administrative complexity, and overpricing to name a just a few. An example of this would be as followed per my own personal experience. When I gave birth to my third son back in 2000 at South Miami Hospital, I was given an itemized bill before being discharged. Thankfully I had insurance through my place of employment and did not have a high out of pocket amount. However, as I was going over the bill I noticed that they charged me $300.00 per Tylenol pill that was given to me for pain. This was regular Tylenol that I could have gotten over the counter. Overcharging at its best/worst to say the least.

Lastly, a few other factors that affect the cost of health care are the aging population, new drugs and medical and diagnostic technology, the emphasis on specialty medicine, large numbers of uninsured and underinsured, the volume-based reimbursement incentives, and lastly labor intensity. All of these play a role and have a factor into why our health care system continues to go up and health care continues to be hard to afford to many.

Post 3 DF

According to the textbook, studies from the U.S. Institute of Medicine (IOM) and the Congressional Budget Office (CBO) indicate that between 30 and 40 percent of total U.S. health care spending is “wasted”. In addition to the fraud and abuse that could exist in providing valuable services in an inefficient way that is not properly organized, all of this impacts health care costs. The main factors that are key and affect the costs of health care include:

  • Expensive medical technology: Technologically advanced diagnostic and treatment innovations require expensive equipment, computerization, and highly trained staff. Large capital investments to finance technological innovations drove economic and professional incentives unnecessary for their use unlimited by requirements to justify their cost or the validity of their clinical benefits.
  • Aging of the population: The increases in the longevity of the elderly, these people who are 65 years old are the main consumers of pharmaceuticals and inpatient hospital care, where they can generate waste and abuse. Aging has a big effect on federal spending on health because virtually all Americans are eligible to apply for Medicare when they turn 65 years old.
  • Specialty medical care: Growth in specialized medicine occurred as medical science and technology advanced. Americans’ preference for specialty care resulted in high utilization and rapidly rising costs, 60% + physician specialists, patient self-referrals, use of highest cost interventions without payment restrictions often unnecessary/inappropriate.
  • Un- or underinsured: Delays in obtaining services result in higher-cost interventions for late-stage complications.
  • Labor intensity: Health care is a labor-intensive industry that employs some of the most highly educated, trained, and compensated individuals in the U.S. workforce. As such, it is inherently expensive. Employment growth due to technology, the aging population, and other factors are anticipated to continue as significant drivers of healthcare expenditures.
  • Reimbursement system incentives: Private and government insurance have been favored high utilization by providers and hospitals, fee-for-service fuels high costs till the present time.
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