Healthcare Topics In Medicine: Articles Review Essay Samples

Myriad convictions, contradictions, and startling aspects which never before confronted the world of medicine and healthcare has demonstrated a need in today’s society for more analysis, communication, and re-evaluation of healthcare in medical issues. The two articles under scrutiny for discussion include: (1) “Health Care Special Issue: Creative Destruction” by Jonathan Cohn, and (2) “The Health Care Crisis and What to Do about It,” by Paul Krugman and Robin Wells. The first article discusses the high cost of innovative health care around the application of ‘Deep-Brain Stimulation’ or DBS. It exemplifies the case of journalist Michael Kinsley, who contracted Parkinson’s disease, and was able to receive a high-tech (and expensive) medical solution for the motor impairments associated with disruptive markers of the condition. The second article discusses the general problem of healthcare costs in terms of employer-based insurance, aspects such as Medicare/Medicaid, and inefficiencies comparisons to other nations. The general task of this paper critiques the ideas posited by the two articles and evaluates, refutes, or debates in contrasting/comparing the concepts rendered.
The core issue of universal healthcare and research innovation cost-benefits, fosters justification for expensive specialty medical services – like DBS for Parkinson’s – according to the Cohn article if an equitable system can create coverage for most. In the case of Mike Kinsley, he was able to afford the specialized clinical treatment of the $50,000-$60,000 price tag of the procedure whose “main effect is to suppress and delay the onset of symptoms, rather than cure the disease” (“Health Care Creative Destruction”). In the argument for trade-offs and balances in universal health care insists that concerns for costs would diminish efforts for medical research, and technology innovations. And as a result, the public at large would ultimately lose out on vital beneficial care, if needed at such specialized levels of technological medical care. The problem with this assumption is that the implementation of a universal healthcare system has yet to be seen.
Despite the fact that the article was written some years ago, it did get one observation correct. Cohn wrote that “The forces that produce innovation in medicine turn out to be a great deal more complicated than critics of universal coverage seem to grasp” (“Health Care Creative Destruction”). A balancing act is at stake when healthcare cost efficiencies need to compete with the development of newly cutting-edge research medical technologies. The article acknowledges that a mountain of funding exists, from the United States’ biggest source, the National Institutes of Health (NIH). Prioritized budgets decide who gets what, when. In a journal article reflection on ensuring quality healthcare through indigenous research, Jawaid (2013) states “Different countries have their own problems and the best way to combat the diseases prevalent in their countries is through indigenous research and solutions” (p. 1291). While this concept does not disdain, nor dismiss the need for ongoing technological research, it places the focus upon what healthcare can do, upon reliance upon procedures that help solve (or prevent) diseases common to localities. Jawaid (2013) notes that the needs of the West are different from other parts of the world.
The Cohn article touched upon a most salient point. That is, the factor that many financial incentives go towards support of pharmaceutical drug costs – which have represented outlandish rises in prices – bringing to the table arguments over whether further scientific research can be fruitful, as opposed to simply throwing ‘pills’ at the problem. Yazdizadeh et al. (2010) adds, after performance of a systematic review of evaluating healthcare research, states that care must be regarded in disseminating “economic evaluation studies on health research” in the first place (p. 6). In other words, getting to the root of the problem in healthcare topic trouble spots must lead to sorting out foundational issues that undergird the whole system. It is also prudent and critical to understand that much research discoveries and medical technologies come from other countries. Yazdizadeh et al. (2010) wisely make the distinction, in terms of foreign investment “in healthcare research” pointing out that the value should not be overlooked (p. 6). Other ideas beneficial to healthcare management may also derive from unexpected sources. The U.S. government does a great job in allocating spending for healthcare costs, but efficiency has been lacking. However, beyond efficiency, some would argue that American lifestyles perpetrate diseases which instigate rising inefficiencies in the first place. The Krugman and Wells article mentions several problem areas of the U.S. healthcare system in medicine.
Krugman and Wells maintain that the U.S. healthcare system neither highlights quantity or quality of care, but inefficiency, which is exasperated by higher salaries of physicians. But this does not make much logical sense, because regardless of those who cannot pay cash, nor have adequate insurance, physicians will still be paid. If private and public insurers were sufficiently integrated into the system as a whole, administrative costs alone could help mitigate the cost challenge. Krugman and Wells rightly suggest that “In 2003 Medicare spent less than 2 percent of its resources on administration, while private insurance companies spent more than 13 percent” (“Health Care Crisis”). At this juncture, a comment on usage of electronic medical records is in order. Encinosa and Jaeyoung (2013) suggest that spending on Health Informatics technology will reach $1trillion minus any real cost-saving results, finding only “34% of those [related] studies” discovering significant cost benefits (p. eSP19). But the jury is still out, since the implementation of the Affordable Care Act (ACA). While it may be true that healthcare reform has its proverbial plate full in striving to solve a plethora of complexities, the key will be to efficiently manage – as Chernichovsky and Leibowitz (2010) note such provision in health insurance coverage that “take advantage of new knowledge about medical and nonmedical determinants of health” (p. 205). Obviously, common sense dictates that some of these protocols target preventive care.
In conclusion, all may not agree whether highly specialized and expensive treatments will ‘trickle-down’ to the masses who may require such medical attention. However, not many can refute the need for a total revamping of the healthcare system, and its need for optimum efficiency today. In commenting upon aspects of the ACA, Hoffman (2014) states that health insurers must legally provide “a certain percentage of their premium revenue” to promote improvements in quality delivery (p. 280). How that gets done in concert with information tracking, follow-up, and consistency in management, all depends upon mass cooperation of all healthcare professionals and political will (plus well-placed funding) to help smooth out the path for the future. Clinical prevention shall play a huge role. Fox and Shaw (2015) insist that “100,000 lives could be saved if more people received recommended preventive care” (p. e7). It is no secret that cardiovascular disease, diabetes, obesity, and stroke – as well as some forms of cancer – may benefit from the admonition. Given all the technology for medical record-keeping available, professionals should be able to harness the risks so involved, and thereby prevent unnecessary drain on the healthcare system to begin with.

References

Chernichovsky, D., & Leibowitz, A.A. (2010). Integrating public health and personal care in a reformed US Health care system. American Journal of Public Health, 100(2), 205-211. doi:10.2105/AJPH.2008.156588
Cohn, J. (2007, November 12). Health care special issue: Creative destruction. New Republic.
Retrieved from http://www.newrepublic.com/article/health-care-special-issue-creative-destruction#
Encinosa, W.E., & Jaeyoung, B. (2013). Will meaningful use electronic medical records reduce
hospital costs?. American Journal of Managed Care 19, eSP19-eSP25.
Fox, J.B., & Shaw, F.E. (2015). Clinical preventive services coverage and the Affordable Care
Act. American Journal of Public Health, 105(1), e7-e10. doi:10.2105/AJPH.2014.302289
Hoffman, J. (2014). Preemption and the MLR provision of the Affordable Care Act. American
Jawaid, S.A. (2013, November). How to ensure provision of quality cost effective healthcare
Through indigenous research and rational use of modern technology. Pakistan Journal of
Medical Sciences. pp. 1291-1293. doi:10.12669/pjms.296.4345.
Krugman, P., & Wells, R. (2006, March 23). The health care crisis and what to do about it.
The New York Review of Books. Retrieved from http://www.nybooks.com/articles/archives/2006/mar/23/the-health-care-crisis-and-what-to-do-about-it/
Yazdizadeh, B., Majdzadeh, R., & Salmasian, H. (2010). Systematic review of methods for
Evaluating healthcare research economic impact. Health Research Policy & Systems,
86-13. doi:10.1186/1478-4505-8-6