Family Health, Essay Example

Introduction

This paper examines the concept of family health for American families. Examination of the basic family structure is followed by a look at the typical health systems available in the USA today. This includes the barriers to obtaining good healthcare and the role of nursing as it applies to families.  It addresses the question of whether the USA Government is doing enough to support the healthcare sector and what may be done to improve deficiencies?

Family Structure

The early post-war depiction of the American family circa 1950’s was that of a dutiful husband at work with a wife who raised and looked after the children at home.  This profile has now changed in modern day America and become more complex.  Large families of the pre-war era are on the wane and the modest family structure is based upon two children supported by working parents. In addition, owing high divorce rates we are also seeing more single parents and this has placed more financial pressures, particularly on single moms.  The cost of high medical insurance has become an issue for the poorer and disadvantaged family units.

It is estimated that some 47 million residents of the USA are without health insurance.  As employees continue to try and shift the burden to individuals, the trend is set to increase.  As such, this creates a vicious circle where the average Americans continue to struggle with escalating health costs and adequate coverage.  The most successful of all the health care programs, i.e. Medicare is under increasing attack for lack about the service provision.  This particularly impacting the over 65 group that rely on Medicare for health support.  The question posed then is – are  all individuals entitled to healthcare?

Reasons Supporting Automatic Healthcare Entitlement

The number of uninsured American citizens has increased to over 45 million people.  The escalating costs of health coverage has  made health care become unaffordable for both individuals and businesses in the USA.  Companies already facing tough economic conditions are pushing back by transferring the cost from the companies to individuals.  It is considered that a centralized medical database would be easier for doctors and nurses to administer.  By the introduction of free medical services.  Patients are more likely to practice preventative medicine and inquire about potential problems more expensive medical tree becomes a necessity.  Also, those patients with pre-existing conditions should be able to get health coverage.

The USA is the only industrialized nation that is not guaranteeing health care is an automatic entitlement of its citizenship.  United States spends at least 40% more per capita on healthcare than any other country with universal healthcare system.  It has been estimated that a single payer universal health care system would save between hundred to $200 billion in one year alone.  These figures, even after factoring in all the uninsured and increasing health care benefits.  The cost of health care in Canada as a percent of GNP has reduced since 1971, when the system was first implemented.  In the US costs of increased despite having a stronger economy in Canada.

America cannot afford to have its working populace unable to afford adequate health coverage.  America already has the highest levels of obesity, diabetes, cancer and heart disease in the world.  As such, the American people paid the price for this with sickness, time off work, lost income and loss leisure time with family and friends.  As such universal healthcare is the only viable means of ensuring everybody is treated in an equitable manner and afforded human rights proper medical coverage.  Those countries with universal health coverage have demonstrated more concerned about human welfare and conservative citizens.

It is considered that there is a moral obligation to provide a citizen with universal health coverage.  The single universal health care system is the health care payment system and not be considered a free care system.  Polls in the USA have indicated that between 60 to 75% of Americans like to see a universal healthcare system adopted.  The current situation of the US healthcare system is ranked as the lowest of any industrialized nation.

Current Health System Assessment

Medicare –  Essentially,  Medicare provides health insurance cover for the 65+ age group and for those under 65 with certain disabilities.  In addition people of any age with Kidney or renal problems.  (Medicare.gov, 2012).

Medicaid – his is essentially a State and Federal partnership that provides for medical insurance coverage for the low income groups, older people, those with disabilities and certain disadvantaged groups. (Healthcare.gov, 2012)

Non Insured – These are groups of people that do not have medical insurance cover i.e. Medicare or Medicaid.  This includes many illegal immigrants, mentally retarded people, those essentially living outside of the state or federal systems.

Retirement Plans – Specific medical insurance plans offered as part of retirement packages.  These are mainly offered to retiring Executives and often are premium rate insurance policies offering extended health and superior coverage.

Indemnity Plans – These allow you the flexibility of choosing any hospital or Doctor that you wish and are often on a fee for service basis. Policies vary and you need to read the fee provision applicable to the policy.

Barriers in the Health System

The author laments on the poor state of the US healthcare provision.  In 1966 the US was on the verge of improving universal health insurance for children with the ultimate end goal of an inclusive system for all. The Clinton Administration set out an ambitious reform plan but this was badly flawed and it never really got off the ground.  Today there remains a similar crisis and there seems little room for optimism of reforms in the near future. As such there seems little hope for the 44 million Americans without health insurance. Public opinion polls have indicated that health care reform remains high on the agenda.  Without the reformation of the health care system the entire structure is in risk of collapse. With the baby boomers reaching old age it will impose a severe strain on the current health system in the US.  The government needs to commit to a universal coverage for all Americans now. (Southby, R.F., 2004)

There are many different representational points of view as to whether individuals are automatically entitled to healthcare.  On the one hand, many consider that healthcare is a human right and should be provided to all citizens regardless of race, creed or monetary status.  The other viewpoint is that health care is a privilege and should be earnt by responsible citizens through contribution to society.  This has been defined as those people who are employed and pay taxes or contribute financially to society in some other form.  In the United Kingdom and Canada the concept of a universal health system was decided by the electorate.  Perhaps ultimately in the United States, a similar situation will take place i.e., the people will decide on the most suitable system to be adopted moving forward.  (Woolhandler, S. 1991)

The arguments against adoption of the Universal healthcare system are equally convincing.  The concept of government intervention and running a state health system as opposed to the more entrepreneurial approach of the private sector is a persuasive argument.  In the United Kingdom, the national health service — NHS, has been the subject of considerable criticism in terms of sustaining good medical practice and retention of key staff i.e., consultants, doctors and nurses many of which departed to the private sector of the US healthcare system, where they received higher remuneration and improved medical facilities.  The NHS has also been the victim of financial cuts from UK government spending policies.  It is this argument that the anti-lobby put forward in terms of nationalizing the US healthcare system.

Role of Nursing in Family Care

The scope of the family nurse is defined under the auspices of ‘The American Nurses Association Public Health Nurses Scope and Standards of Practice’.  The Registered Nurse (RN) works under the supervision of the Care Manager and part of an interdisciplinary team designed to provide  healthcare and support for those families in need of medical support.  The RN becomes the lead contact person and in the front line for dealing with the family related issues.  This often means adopting the role of an advocate in terms of dealing with face-to-face issues, conducting interviews and completing regular health monitoring and checkup needs.

The Family Nurse has an important role to play in terms of getting the family to understand the beliefs and value systems of good medical practice. A considerable effort is spent on preventative care policies and promotion of positive health and wellbeing.  As such the RN is responsible for helping families with quality of life issues.  The Family Nurse can deal with most routine issues but equally is important in routing to the Doctors / Hospital where more intervention is required.  (Linn, L.S. 1976)

References

Healthcare.gpv. (2012, 8 22). Medicaid Benefits. Retrieved from Healthcare.gov: http://www.healthcare.gov/using-insurance/low-cost-care/medicaid/

Linn, L. S. (1976). Patient Acceptance of the Family Nurse Practitioner. Medical Care Vol 4(6), 357-364.

Medicare.gov. (2012, 8 22). Medicare Benefits. Retrieved from Medicare.gov: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/medicare-benefits-overview.aspx?AspxAutoDetectCookieSupport=1

R.F., S. (2004). Where do we go from here: is there any real hope for health care reform. Journal of law medicine and ethics, 442-445.

Steffie Woolhandler, M. M. (1991). The Deteriorating Administrative Efficiency of the U.S. Health Care System. New England Journal of Medicine , 1253-1258.