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Criticism has been leveled at the curative rather than health promotion/disease prevention focus of the U.S. healthcare system Answer

Criticism has been leveled at the curative rather than health promotion/disease prevention focus of the U.S. healthcare system. Should the focus change? Why or why not? Do you see evidence of a shift occurring? If so, what do you think is contributing to that change?

The focus is changing through changes in the Medicare benefits, curative was the primary focus of healthcare and now it is preventative. It should be prevention because it saves millions of dollars in healthcare benefits to prevent instead of cure. Our government is getting smarter by covering more prevention services than waiting for someone to get sick before we care for them. However, we are not there yet but moving into that direction. The wellness approach is a great way to encourage and prevent illness. Changing your lifestyle to a more healthy way of life a little at a time helps a lot. It is all about prevention instead of curative because curative costs and prevention saves healthcare dollars.

The preventive approach is being utilized at the Queens Long Island Medical Group (QLIMG) at all the various locations listed below. The healthcare professionals do their very best to direct their patients in the right path to go to prevent further serious illnesses.

Astoria Medical Office

31-75 23rd Street

Astoria, NY 11106

(718) 956-2200

Babylon Medical Office

300 Bayshore Rd.

North Babylon, NY 11703

(631) 586-2700

It makes sense to move to a preventive style, it saves money and saves lives. My employer is currently moving in that direction and it’s saving me money ever month for both me and my wife, by simply not smoking and getting a check up once per year. Americans need to be educated on better health.

In general, I believe health care organizations are putting more emphasis on preventive medicine. In a different thread, I’ve discussed my organization verifies that all patients admitted to the hospital and those who come in for clinic visits are immunized. If they are not up to date on immunizations, we ensure that before they leave they receive their vaccines unless parents oppose to vaccinating their children. We also spend a great deal of time teaching our patients and their families about their disease process and what their plan of care entails in order to avoid future hospitalizations (asthma teaching, diabetes management, etc). I wonder if there is a difference in the payer ratio between preventive medicine and curative medicine. I thought I heard that Medicaid pays more for preventive medicine. Also, just today, I received a letter from my primary physician’s office stating that it’s been a year since they’ve seen me and I should schedule an appointment for a routine check-up. I’m one of those people that usually sees their physician only when something is wrong. It could be partly due to having a high deductible plan and I don’t want to pay for it and it could be due to the fact that nurses usually don’t make the best patients. Either way, I think individuals (including myself) need to prioritize and realize the importance of preventive medicine. My friend was diagnosed with breast cancer at the age of 26; the lump was found on her yearly physical by her primary care physician. She told me that she usually goes in for a yearly physical because it’s one of the few visits that is 100% covered by her insurance.

As an educator, I am a firm believer of preventive medicine. I get to promote that in my Nutrition classes with actual evidence that many of our public health issues can be addressed before they reach critical levels. For example, back in 2010, we spent $147 billion on patient care that could have been prevented because it was all related to obesity. Conditions like heart disease, diabetes, circulatory problems, kidney disorders and many others are the end results of a consumer based culture that promotes harmful habits such as eating fast foods, drinking beer and convenience I like to call a drive through mentality. Why is it that our politicians are still fighting over who is going to pay for patients treatments instead of focusing how to prevent disease in a first place? It is simple. There is no money in prevention like there is for treatment.

What are the cultural factors which impact the way in which we approach our healthcare system?     Why do we not focus on prevention more on our system?

If we would focus more on Prevention it could eliminate a lot of surgeries and major illness. this that is possibly could lower some medical cost. I think most people do not focus on prevention because they wait until something goes wrong to get help. Many people can not afford healthcare insurance. So, they are faced with putting food on the table or going for an annual exam. Of course putting food on the table is a more important priority. I believe that in many instances individuals have indicators that alert them that something is not right with their bodies. It’s not until they can’t function or is forced to seek medical attention before they will go to the doctor. My mother is one of these individuals. She just will not go to the doctors. I try to encourage her to go but she just won’t do it.

How does the media impact our attitude toward prevention and wellness both in a positive way and a negative way?

Positively I think the media put the concern in our minds by making us aware of different illnesses. Recently I saw a commercial were a variety of people were laughing at one moment then crying seconds later. I initially thought this a comical commercial, but at the end of the commercial this condition was given a medical name. The commercial caught my attention because it was different, but it actually ended up being very informational. On a negative note things in the media may make individuals worry more. They may decide not to seek medical assistance out of fear of the unknown, or vice versa where they may go to the doctors unnecessarily for everything.

The media has positive affect when it properly educates and creates a sense of urgency for change. I think unfortunately that “fads” are created and the longevity for change fall to the wayside. The media focuses on diets and the new supplement of the month and Dr. OZ and misses that fact that our children are going to have a shorter sicker life than we are. We need to properly educate America and then maybe provide an insurance incentive for those who don’t drink or smoke and those who eat right and exercise regularly. We are less of a burden on the system and we should pay less because we cost less. I want to say that just because you have a reoccurring illness or a mental health diagnosis I don’t think you should have to go broke paying but paying a little more over a long period of time is better than not having insurance at all. We need big changes in attitudes and lifestyles in America and I can’t wait to

Medication commercial should be outlawed like cigarettes or booze; oh that right we have allowed those back in the media mostly due to ridiculously large donations by the company who produce them. Anyways, drug companies develop a new drug and they want to get it into the market as fast as possible so they advertise. These advertisement create a buzz about the product, they consumer then asks their doctor about it, the doctor prescribes it. Right? Well, almost. The manufacturer develops a drug and a representative goes to the doctors most likely to prescribe they offer presents, samples and cash bonuses and leave the product in the doctors’ office. What do you think a doctor is going to prescribe mediation in generic form or the new shiny box in the closet that makes him a little more money or a trip? Sometimes the pharmaceutical companies offer large gifts to the doctors and their staff so that they will advertise and advocate their medications. I have a friend that works for a pain management company and she has yet to pay for her own lunch, and she has been there over a year. There are some many pharmaceutical representatives in and out of their office offering them a variety of gifts just so the doctors will prescribe their meds.

According to our text book, “Individual factors include inherited (i.e., genetic) characteristics and individual behaviors that reflect a person’s beliefs, attitudes, and values. Another individual factor, health literacy, has only recently begun to be examined. Some databases (see the statistical section on the World Health Organization’s website) note that the United States has a 100 percent literacy rate, which is seriously overstated. A person’s ability to read and understand prescription dosages and times and conditions of usage will affect the outcome of treatment. A language barrier may affect a person’s ability to comprehend the proposed treatment plan.”

http://devry.vitalsource.com/#/books/978-1-56793-374-1/content/element/2010?locs[]=11-7&q=factors

What are the cultural factors which impact the way in which we approach our healthcare system?

 

Cultures plays a major role when it comes to healthcare. By health professionals understanding their patients cultures will makes them better understand them. Doctors should take some time to find out their religion, diet, communication/interaction. For example, Muslims fast during certain times of the year. If a Muslim is a diabetic then the doctor would have to explain that it is best not to fast in order to avoid hypogloycemia. Another example, would be Muslims are not comfortable with shaking hands with the opposite sex.

Why do we not focus on prevention more on our system?

I believe that we do not focus on prevention in our healthcare system, because it takes a lot of time. Most people do not worry about going to their annual check-up because they are not sick, they keep postponing it and it is the same with the regularly scheduled preventative exams such as mammograms and colonoscopies. People have to take time out of their busy scheduled to tend to their own maintenance. We as American workers focus too much on others and not ourselves.   If nothing is wrong, it is hard to spend the extra time and money to go to a checkup where they tell you everything is fine. The co-pays are too high and our employers are not very understanding when it comes to yearly physicals and other preventative procedures. The doctor’s offices and procedure places of business are just as bad. They do not offer appointments that would work around the regular Monday through Friday 8 – 5 pm schedule that most Americans work with. Perhaps if we were given a couple of days a year that was paid by our employers to get this all done, then maybe we would have better preventative care. You would have to show proof that you went to the doctor or had your procedure, which isn’t hard to do and then when submitted to work, you get paid. The government could offer some type of incentatives to those employers that have 90% or above compliance with preventative healthcare measures. Another idea would be a scheduled by the employer appointment for preventative care. They would schedule it, pay you for the day, and of course give you the day of, so that you would be able to get your preventative care done. Some companies already have a form of this where they receive a company physical. When I first was hired at St Vincent, I received a physical that was scheduled by them, but I have not gotten another from them. If they did this every year or every 2 years, this would be a great start towards preventative care compliance.

Many families are lacking the knowledge of proper nutrition, many doctors as well. The drive thru is killing us, a family can be feed from the dollar menu, this is a cheaper option for some people. Yes it should change because the greatest advances in America’s health have come from preventive and public health measures, and based on the history and evidence of disease prevention the opportunity remains vast for further gains through disease prevention and health promotion. Promotion/disease prevention also promotes a since of shared responsibility for the health of our nation and its communities and it gets all involved in the processes as well.

 

Human behavior plays a central role in the maintenance of health, and the prevention of disease. With an eye to lowering the substantial morbidity and mortality associated with health-related behavior, health professionals have turned to models of behavior change to guide the development of strategies that foster self-protective action, reduce behaviors that increase health risk, and facilitate effective adaptation to and coping with illness. Several decades of concerted effort to promote health and decrease risk through individual behavior change have produced successes, failures, and lessons learned.

Human behavior plays a central role in the maintenance of health and the prevention of disease. Growing evidence suggests that effective programs to change individual health behavior require a multifaceted approach to helping people adopt, change, and maintain behavior. For example, strategies for establishing healthy eating habits in children and adolescents might be quite ineffective for changing maladaptive eating behaviors—that is, when they are used to substitute one pattern for another—in the same population (e.g., Jeffery et al., 2000). Similarly, maintaining a particular behavior over time might require different strategies than will establishing that behavior in the first place (e.g., Ockene et al., 2000). Models of behavior change have been developed to guide strategies to promote healthy behaviors and facilitate effective adaptation to and coping with illness.

http://www.ncbi.nlm.nih.gov/books/NBK43749/

One of the strategies that is being used by employers and health insurance companies is to provide incentives to individuals to engage in healthy behaviors.   Do you support this approach?

Yes, I definitely support these incentives provided as employees who have desk jobs, do not get much exercise in general. Healthy behaviors such as getting up and taking a break every 2 hours, taking a walk, ensuring proper usage of back support and ergonomics for typing would decrease carpel tunnel syndromes, back pains and other injuries which would benefit the company by not paying for work compensation. Also having a gym in the company would be a great benefit for the employees as well.

Is there some financial incentives that we can provide to employees that may be effective?

Some companies have offered annual raises, or even an annual bonus to the best performers of healthy behavior. These kinds of financial incentives do usually make employees think about the change in a whole new light. All the guidelines of the healthy behavior program should be given to everyone that is willing to participate. Make sure that these and other incentive’s are monitored closely so the employee does not feel slighted by a missed bonus or raise.

My company currently offers wellness bonuses. These bonuses are our unused sick time. At the end of the fiscal year we can either cash them out for the bonus, or bank them for later use. Wellness programs can also penalize employees for not participating or having an categorized unhealthy life style. The link below is to an article that describes how large companies’ like Wal-Mart and Pepsi, charge there employees higher premiums for not participating in the wellness program. The gave of an example of a smoker vs non-smoker. The smoker paid $2000 more in premiums than the non-smoker. The article discussed how this practice and penalties will increase with the Affordable Care Act.

http://www.huffingtonpost.com/2013/02/22/health-insurance-should-employee-lifestyles-determine-cost_n_2741589.html

“As Company Wellness Programs Grow, Effectiveness of Finical Incentives Debated”

 

 

What do you think of the types of employer programs that are idenfied in this post? Do you think they are effective? Should employees be required to participate?   What are the benefits?

I think its good but maybe the cost could be reduced. Its good because the purpose of the program is to increase health prevention and health awareness. The Health Reform Act wants more health prevention to make people aware of their health choices and empowers them to become healthier by implementing programs to address’s questions that could prevent illnesses as well as injuries thus reducing the cost of health care.

Health promotion, also known as primordial prevention aims to help people increase control over and improve their health. Although it may have an effect on specific diseases, it has a more general aim: to enhance health in order to develop the person’s resistance to the adverse influences of physical and social environments. Illness prevention involves actions to eliminate or minimize conditions known to cause or contribute to different diseases.

 

http://www.sagepub.com/upm-data/44223_

http://phprimer.afmc.ca/Part3-PracticeImprovingHealth/Chapter8IllnessPreventionAndHealthPromotion/Healthpromotion

Curative Approach is used by treating the illness (cure), where preventative approach is used to prevent the illness such as a healthy lifestyle change or going for medical tests that your healthcare suggest or require a head of time. With that said, in my household we are take a preventative approach we all take vitamins and try to eat healthy on a daily basis, in which this helps with the costs of doctor visits during the year. I have noticed that my children have a healthy check up visit, which requires me to take them once a year for a physical or their routine shots. It has worked for my family. I would like to think that the curative approach will more doctor visits, more money spent, and less of me going to work. This wouldn’t make me a happy camper by using this type of cuarative approach.