The US healthcare system has evolved over the years to be more efficient and integrative in the dispensation of healthcare over the years. The evolution has taken place in different constructs relevant to the healthcare sector. However, the most definitive and implicative construct that the evolution has taken place is in policy . In the US, the operations and undertakings within various sectors are guided by the relevant policies modeled and implemented within those sectors. Healthcare policies are crucial within American culture and demography. Great healthcare policies ensure that healthcare services are dispensed efficiently, properly, and professionally. For this reason, the changes in the American healthcare culture follow a concise chronological fabric defined by the evolution of healthcare policies.
One of the ways that the culture of health in the U.S. has changed over the years pertains to affordability and accessibility. Medicare is one of the earliest medical policies in the US that was introduced as a program targeting to reduce the medical expenses of people over 65 years (Sonfield, 2011). However, while Medicare was a great policy that increased the accessibility of healthcare for old people, there were still millions of Americans who could not access healthcare services due to high prices. In that regard, the Medicaid program was introduced to increase the affordability and access of healthcare to low-income households across all ages.
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The Health Insurance Portability and Accountability Act of 1996 was introduced to ensure that healthcare data and information is modernized. With modernization, the policy aimed at breaking the limitations and boundaries associated with accessing, propagating, and conveying healthcare data/information (Edemekong & Haydel, 2019). With this, insurance coverage would be centralized hence easing the process of dispensing healthcare services. The policy was also tailored to reduce data/information fraud in healthcare. The Medicare Prescription Drug, Improvement and Modernization Act of 2003 was implemented to address issues arising from how prescriptions were administered, who they were administered to, and who administered them. In 2009, The Health Information Technology for Economic and Clinical Health (HITECH) Act was introduced. Primarily, it was part of the American Recovery and Reinvestment Act of 2009 ARRA during the Obama care era (Dept. of Health, 2013). Ideally, it was introduced to increase the efficiency of healthcare delivery.
Through meaningful use (MU) of information technology (IT) in the health sector, HITECH would increase the efficiency of medical officers by enhancing how they access and relay healthcare data and information (Dept. of Health, 2013). In addition, it would increase the privacy and confidentiality of patient information. The listed policies are a retrospection of the history of the development of the US healthcare system and an overview of how the culture of health in the U.S. has changed over the years. However, the policies are specifically selected since they reflect on various aspects of both ethics and culture in healthcare.
In the earlier days, the healthcare culture was seemingly inclined to the relatively wealthy and able in society. The introduction of Medicare and Medicaid introduced a new integrative culture that enhanced the accessibility and affordability of healthcare across all American demographics. The information-based policies like HITECH changed the relatively slow and bureaucratic culture of healthcare provision to a fast, modernized, and effective culture. Also, these technological advancements significantly addressed ethical issues regarding privacy and confidentiality. The prescription policy curbed unethical conduct associated with improper or unauthorized prescriptions. Today, patient information confidentiality is still an ethical issue affecting the US healthcare system (Public Health Leadership Society, 2002). Another ethical issue revolves around wrong diagnosis, wrong treatment, and end-of-life issues. These are serious ethical issues that have often resulted in legal suits.
While the two mentioned issues are of great importance in addressing, issues of diagnosis, treatment, and ending life are more urgent. The reason is that these issues are directly consequential to the lives of patients. Chronic illnesses and other serious medical issues have occasionally been misdiagnosed or treated wrongly; sometimes resulting in the death of the patients. In essence, this is often due to ignorance or unprofessionalism in healthcare practice (Public Health Leadership Society, 2002). Therefore, the second issue is the most urgent and pressing one that should be prioritized. As a practitioner, the best way to address the issue is to first understand why it arises. Ignorance and unprofessionalism are the core reasons why the issue occurs. Therefore, the counter-strategy would be based on these two reasons.
One way to address the issue is to introduce new diagnoses and treatment bureaucracies. For instance, diagnosis can be diversified in departments instead of relying on a single department or professional. For instance, the diagnosis of lung cancer can be dissociated from the diagnosis of liver cancer. Therefore, if the doctor suspects one of the two cancers, they can be tested and diagnosed differently. Notably, this is synonymous with specialization, which enables professionals to focus on a specific medical field hence increasing their overall efficiency. The same model can be applied for treatment procedures. The decision on ending life should also have a bureaucratic system consent that is legally bound. Lastly, legal penalties like the seizure of practice licenses and imprisonment can be introduced to compel healthcare professionals to be competent.
References
Dept. of Health (2013). American Recovery and Reinvestment Act of 2009 : Advance Interoperable Health Information Technology Services to Support Health Information Exchange. U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology. Retrieved from https://www.healthit.gov/sites/default/files/2017-09/advancedinteroperablehie-foa.pdf
Edemekong, P. F. & Haydel, M. J. (2019). Health Insurance Portability and Accountability Act (HIPAA) [Updated 2019 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan.
Public Health Leadership Society (2002). Principle of the Ethical Practice of Public Health .
Sonfield, A. (2011). Implementing the Affordable Care Act : Enrollment Strategies and the U.S. Family Planning Effort. GUTTMACHER POLICY REVIEW. Volume 14, Issue 4. Retrieved from: https://www.guttmacher.org/gpr/2011/11/implementing-affordable-care-act-enrollment-strategies-and-us-family-planning-effort
