the business of health care – Page 40 – watercress words by Dr Aletha

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The Patient Protection and Affordable Care Act (ACA) was enacted by the United States Congress in 2010 to guarantee basic health insurance to all citizens. People who object to the ACA ,aka Obama Care, dislike or even fear government involvement in medical care; they consider it interference, control, or even nationalization of the United States healthcare system.

I think many people, even physicians, don’t realize or forget, how involved the government already is in healthcare. As far back as the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system has evolved into the current military health care system which covers service members and the Veterans’ Administration system for veterans.

a Veterans Administration clinic (photo by Dr. Aletha )

American soldiers serving in Afghanistan

The year 2015 marked the 50^th anniversary of two other government healthcare programs- Medicare and Medicaid. The Journal of the American Medical Association, (JAMA), devoted an entire issue to them,the ACA and the implications for the future of healthcare in the United States.

Medicaid provides insurance coverage for adults and children who are unemployed or low income.

Medicare covers disabled children and adults and persons 65 years and older.

The numbers are rather staggering.

Together these programs cover at least 30% of Americans.
Together they comprise 25% of all federal spending.
Together they pay 40% of total U.S. health care spending.

An infographic from the Kaiser Family Foundation and JAMA explains this further.

Disabled children and adults may qualify for Medicare.

Children may be eligible for Medicaid if their families cannot obtain health insurance for them.

You may not be eligible for either of these programs now, but chances are eventually you or someone close to you will.

Anyone can become disabled from a serious illness or freak accident.
You or your spouse may lose your job and your employer sponsored health insurance.
Your child may have a disability that will prevent them from working when they grow up.
We may all live long enough to qualify for Medicare on the basis of age alone. Your parents or grandparents are near or already at Medicare age.

Senior adults age 65 and older use Medicare.

It’s important to understand how Medicare works, since it’s not automatic; even if you qualify, you need to sign up to be covered (with a few exceptions). The rules are summarized here. Or consider an easy to understand book here.

photos courtesy of volunteer photographers at Pixabay

The United States observes National Nurses’ Week every year in May; it is well deserved.

National Nurses Week begins each year on May 6th and ends on May 12th, Florence Nightingale’s birthday.

two hospital personnel working with patients' records at a nurse’s station. — Few nurses wear white uniforms or caps now. And most hospitals and clinics have digital medical records. But this is how medical care was done for many years. Photo credit Bob Sanders, used compliments of the Centers for Disease Control, CDC

collage of nurses working with patients in a mission clinic — CompassionLink medical mission trip- nurses on our team work with patients in Panama

I am a physician because of a nurse. As a child I was interested in health care and decided to become a nurse- that’s what girls did in the 1970’s. I needed advice so I talked to the nurse at my high school about her career.

After answering my questions, she looked straight at me and said, “Aletha, have you thought about going to medical school?” Until that time, I had not. But from that suggestion my path changed and grew into a medical career .

Some of my best friends have been and are nurses. They understand my crazy life. Since the majority of nurses are women, we have that common bond; they understand juggling a career with marriage and motherhood.

a doctor and nurse talk to a patient in an Asian country. — A local nurse assisted me with a patient encounter in Thailand

Unfortunately, nursing, like medical practice, has become heavy on documentation. I hear my nurse friends lament the amount of time they spend charting at a computer instead of caring at the bedside.

The American health care system is changing in ways sometimes characterized as an overhaul- payment reform, new delivery methods, quality measurements, patient engagement are all buzzwords now. But one thing hasn’t changed.

There are still women and men who choose to become nurses, not for a lucrative salary, or a convenient work schedule, but because they want to make a difference in the world, one patient at a time. For that, we offer our appreciation and respect.