Home Based Care in the US Healthcare Delivery Continuum, Term Paper Example

Home Based Care (HBC) defines the process through which the needs of basic nursing care are provided by informal or formal caregivers to people with physical, emotional, mental and social needs in their own homes. Such people include those living with HIV/aids, frail older people, mentally or physically challenged people and the terminally ill people. This type of care aims at restoring and maintaining the individual’s health and function and maximum comfort for the individual until they die a dignified death. Some of the services include unskilled homemaker services and personal care services requiring minimal training while other services require professional treatment by practitioners. Some homecare services are made for a short duration of rehabilitation especially after hospitalization while others are continuum services especially for chronically impaired patients. Several policies pay for home care including Medicare, Medicaid and supplemental security income.  Medicare is the core federal home care payer which focuses primarily short-term and acute medical needs of the older persons following hospitalization.  Through its sponsorship the patient enjoys free, unlimited health visits if they are homebound and need intermitted care. Medicaid has also emerged as a source of home care payment. The home care services sponsored by Medicaid include home aide services and part-time nursing services directed to the medically ingent people. Other home care services supported by Older Americans Act policy include home delivery meals, shopping, homemaker, home health aide, home core and escort services.  . (Blogspot.com 2009).

The U.S. healthcare sector is careening toward collapse because it is unsustainable and indefensible (Kotlikoff L. 2007). The imminent collapse is clearly shown by the following facts: first the universal coverage is not affordable and hence the system leaves 47 million Americans uninsured. This is because high costs of insurance cause instability on the voluntary, private, and employer based system because increases in cost means purchasers limit coverage or increase the amounts they charge their workers hence the workers choose not to be covered. Second the U.S. system is in fact a nonsystem, an incoherent pastiche that has long repulsed reforms sought by private and public stakeholders and the last evidence is the extremely high health care costs. For example United States spends 16%of it s annual gross domestic product on health care compared to a country like France which is capable of providing cover for its population at only 11%GDP (Gerald F). State budget deficits and federal cuts result in reduction in Medicare and Medicaid programs and employees are devoid of employment-based benefits.

The provision of home based care has been a major source of discomfort for those clamoring for affordable health care to all. This has impeded the advancement of healthcare solutions since only few well off individuals can afford these services. This has made it be viewed as part of the reasons of the failure of the healthcare system.  Advocacy for providing affordable health care can improve the situation. State based campaigns and other campaigns developed by various social service organizations are developing strategies to solve the affordability problems in the health care sector. The major strategy is to socialize the Health Care System through the establishment of Universal health Care system. An example is the approach proposed by economist Laurence Kotlikoff to adapt the Medical Security System that takes care of all including the currently uninsured, Medicaid and Medicare recipients and those with private or employer insurance. Under this system all participants would get annual vouchers for health insurance with the amounts depending on their health conditions. The government would then control costs by setting the values of the vouchers such that the growth benefit does not exceed the nation’s per capita growth (Kotlikoff   L. 2007).

The medical security system combines funds from an existing government sources, a payroll tax, and other appropriations to provide a basic insurance plan to all individuals. Tax rates are originally set to approximate the current expenditure of private insurance. A portion of federal Medicaid, existing state and children health insurance programmes funds for poor populations along with additional general revenues.

The medical security system works through health insurance exchanges which organize the insurance market. The mss provides each exchange with enough funds to offer the plan free of charge. The mss exchange receives a fixed amount per every enrolled person and this is adjusted considering the age and gender of the enrollees.

The MSS advocates for individual choices .Individuals are able to choose their health plan and delivery system, choose their health care provider and a plan based at least in part on whether that plan includes the providers on whom the individual relies. They may always obtain services outside of the MSS if they are willing to pay for those services. Individuals can also determine the level of financial risk they are willing to bear and can therefore choose from a range of insurance structures. The homecare component of health delivery should adopt the medical security system to ensure universal care to all citizens including the uninsured, the Medicaid and Medicare recipients as well as those insured by employers and private insurance companies (Kotlikoff L. 2007).

The issue of health care revolution in US is a major concern to everybody following great influence from the modern technology that affects every aspect of healthcare nowadays. The technology has pervaded every aspect of modern healthcare right from pregnancy all the way to old age. It is by this technology that the diseases that were previously considered chronic or incurable have been treated and cured effectively. However the use of technology in healthcare has met its fair share of critics. Not only has it been opposed on the grounds of ethical considerations but also due to the fact that some scientific inventions are being hurriedly deployed for use in healthcare

President Obama’s push to revolutionize health care brings out suggestive issues among many people against it since the states are so over populated with low income families who do not get access to the current health facilities. Many people will suffer and die battling for their health, while insurance companies make good returns and enjoy health coverage at the expense of less fortunate. This on its own will defeat the basic aim of the healthcare and coverage plan. With the reforms, millions of people will remain uninsured in the near future since even the congress finds it difficult to cover everyone; therefore, under single payer everyone will access health care hence putting the problems of a patient first before giving the rest to the insurance industries (Zeese K. 2009). The is no chance of protecting the corporate interests of greedy statesmen who do not care about public healthcare, therefore adoption of  urgent measures to prevent failure of national security, public safety and also public health  (Blogspot.com 2009). The other thing is about the possibility of not delivering genuine life affirming reforms that ensures respect for life and dignity of all people from conception until natural death and therefore coverage for abortion will be abolished and instead the reforms will reflect basic ethical principles supporting the weak and most vulnerable in the society

The government is looking forward to making technical advancement the health care system. Areas that are most promising in improving peoples health include: the use of genetic markers in screening the population and hence be able to prevent development of specific diseases either through gene substitution or diet among other therapies., the nanotechnology through which some viruses can be combated, certain cells repaired and essential enzymes and proteins manufactured, the Human Genome Project through which genetic roots of many diseases can be isolated.  Most vital effect will not result in the adoption of new medical techniques but more in the effective use of already existing.

As healthcare goes upstream a continuing drastic shrink in he acute health care will be experienced .A third or more of all hospitals will be closed with others shrinking and hence becoming more intensive .A great number will join large –scale organizations which are bringing together  payment structure doctors, hospitals  among other services under one ownership. Reforms are also anticipated. The target is to involve business heavily in healthcare negotiations in amore sophisticated way and move from bargaining for cheaper rates to improving quality and keeping cost down by working together with hospitals and doctors. In addition business working together with healthcare persons, people from the government education among other sectors will help improve community health. The homecare entity should also target joining those organizations and include technologies especially those that target to prevent certain diseases as well as treat complicated disorders mostly found with its target group of patients and also use the existing techniques more effectively (Blogspot.com 2009).

References

Blogspot.com (2009). “Pro-life universal healthcare: Not the answer” Retrieved on July 22nd 2009 from< http://theresabarbale.blogspot.com/2009/07/pro-life-universal-healthcare-not.htm>. Us :Catholic    femina

Gerard F. Anderson, Uwe E. Reinhardt, Peter S. Hussey and Varduhi Petrosyan, “It’s The Prices, Stupid: Why The United States Is So Different From Other Countries”, Health Affairs, Volume 22, Number 3, May/June 2003. Accessed February 27, 2008.

Kothikoff, L (2007). The Healthcare Fix. Cambridge, MA: The MIT Press

Laurel Point Inn (2009). “Revolutionizing Health care with Informatics: From Research to Practice, Retrieved on July 22nd 2009 from <http://74.125.77.132/searchq=cache:YIJxb2ZV3X0J:itch.uvic.ca/+What+is+revolutionizing+health+care&cd=2&hl=en&ct=clnk&gl=ke> US:Victoria.

Zeese K (2009). “To tell ABC to ask President Obama about why single payer is off the table, Retrievedhttp://dandelionsalad.wordpress.com/2009/06/20/healthcare-hypocrisy-tell-abc-to-ask-obama-why-isnt-single-payer-on-the-table/ on July 22nd 2009 from US: blog at wordpress.co.