Friday, April 25, 2014

Brasfield Pt. 1

I really enjoyed reading this book because it is laid out more like a textbook. It is easier to understand because in the first part Brasfield gives information on things the reader needs to know to fully understand the rest of the book. He includes graphs and charts to visually depict his ideas. All of this makes the book more enjoyable to read.
I found one of Brasfield’s statistics particularly interesting. He says that health care expenses have grown faster than inflation for a Half-century. I believe that this is due to the fact that technology is expanding therefore creating new and more expensive procedures. This could also be due to the fact that health care providers are requiring to be paid more. Regardless of the reason, the more health costs continue to rise, the more people will have to spend to stay well. It surprised me when Brasfield said with the rising health care costs, people will have to make decisions between paying for health care or buying consumer goods.

Brasfield also brings up the question, “If we as a public are spending more on health care for other people, does that mean our society is moving closer to socialism?” I believe that is a good question. This question was the reason why many people opposed the Affordable Care Act. Therefore we must be careful with what reforms we make so that our nation does not become totally socialized.

Altman - End

Altman begins Chapter 19 with what Obamacare can do for primary care and preventive health. According to him, Obamacare will use efforts to provide primary care to many individuals. Primary care physicians are the most underpaid specialty. Yet, it is the most important specialty because these doctors are typically the first doctor a person sees. My mother is a primary care physician, and even though her twelve hour shifts and part time at chiropractor’s office jobs pay the bills, she still does not make as much as other specialty doctors do. But it was her choice because she knew that her job would be one of the most important ones in providing good health care. The Obamacare will provide incentives for those who wish to become primary care physicians. There will also be a 10 percent bonus for those providers who serve Medicare and Medicaid patients. Altman describes the future of health care reform as “cost control”. This definitely true because the parts of Obamacare implements some cost control benefits that have tried to pass before with many other political leaders.

Altman Part 2 and 3

Why Many Health Care Reforms Didn’t Pass

Altman says that the wealthier tended to be healthier, while the poor tended to be sick. That is because the wealthy people could afford private insurance, while the poor either were not covered by Medicaid or could not afford a private plan. Even though there were efforts to change this, conservative republicans refused anything that meant the expansion of federal government. .  This is still the case today. There was much opposition to the Affordable Care Act because this meant the government’s involvement in purchasing health care plans. I think that it is interesting that even southern democrats supported the republicans because they felt that if any health care reform was passed then they believed that they would be forced to integrate hospitals. It still baffles me every time I read that page I despise the Jim Crow rules of the 60s. Others opposed health care reform because it meant an increase in taxes for the working middle class. The people who needed health care the most had no means to pay for it. But once Medicare and Medicaid is finally passed many people are happy because they are finally insured. 

Altman .Part 1

I do not particularly like this book due to its memoir nature. I found it sort of difficult to read because of this. However, Altman made very interesting points in the beginning chapters. His introduction opened up his discussion of government based insurance versus or for profit insurance companies. Even though Nixon and Clinton had plans to expand health care for everyone, taxes were going to increase no matter the plan proposal. People already can barely afford health care. There were different proposals during Altman’s time that tried to benefit the people but for various reasons they did not work.

Hoffman Ch 6 - End

I like the fact that this book gets into the explicit detail of the how many insurance plans ran during this day. For instance, on page 105 the author describes the way the policyholders paid for the services. Insurance plans were set up in such a way that discouraged people from going to the doctor for just a cold or the flu. It was all because the insurance companies were “rationing”. If you ask me, health care should be the last thing you ration. It is how a person stays healthy. Later on, in the 1960s, the government created Medicare to supplement the Social Security Act. The government also enacted Medicaid to help out poor people. With these two systems still in place today, there are still some families that are not covered by any type of health insurance. Hoffman makes it clear that there are still some changes to be made. I definitely agree with this because my mom used to work as a doctor in an undeserved community in North Charleston. Many of these people either had no insurance or were covered by Medicaid. My mother would come home complaining about how sick her patients were because they would wait until they absolutely had to see a doctor.

Health Care for Some - Part 1

You would think that during the Roaring Twenties that health care would improve. In some ways it did. But when the Great Depression came around, every aspect of the United States suffered, including health care. Even though during this time period, health care was seen as a right, many poor people were not able to be seen because they could not pay. The doctors did want too many charity cases because times were hard for them too and they had to pay bills just like everyone else. But at the same time, doctors did not people who could pay for their services to go to free health clinics because that would mean a loss in money too. The opening of the book makes you realize the seriousness of people’s die-hard situations during the Great Depression. A young girl died because of a burst appendix. She could have been saved if the doctor would have appropriately prioritized his patients based on the urgency of their condition. But the doctor did not want to see her during “regular business hours” because the family could not pay for services. The Great Depression really showed who was rich and poor because the rich lived fine while the poor died of treatable diseases.

Marrow of Tragedy: Ch. 4 - 6

The Sanitary Commission was responsible for the hospitals having as much order as they did. Without them, hospitals would have been total chaos during the Civil War. Since it was ran by mostly women, the women were able to think about the items and procedures that the men wouldn't typically think about. Furthermore, women had more experience in taking care of people, so their knowledge was most useful during this time. Even though the Sanitary Commission tried to provide as much help as they could, they were still criticized for the work that they did. Many people were uncomfortable with the charity work that they did. This situation can be related to how very conservative people now do not necessarily like giving welfare to people who desperately need it. Women at this time were always being criticized for the work that they did. But some how nurses were able to stick through the criticism because we still have them today. Back during the Civil War, nurses were new to the scene. They were all part of the forever changing health care system of this time.