Affordability, medical care

Prevention of medication errors is the primary objective of the USP Medication Errors Reporting Program. It collects and analyzes potential and actual medication errors submitted by health care practitioners. The program affords health care professionals the opportunity to report medication errors and thereby contribute to improving patient safety by sharing their experiences. 

The cost of health care became a hot public issue in the United States in the early 1990s. It swept an unknown, onetime university president named Harris Wofford into the Senate from Pennsylvania in 1991 and helped elect Bill Clinton president in 1992. Health insurance premiums were shooting up by double digits every year, some 37 million Americans didn t even have insurance, and if things kept on as they were, experts predicted, medical care would devour more than one-fourth of the gross national product by 2030. It was the rare case of an issue that seemed to unite both consumers, who couldn t afford to pay for health care, and business, which ended up being billed extra to pick up the unpaid charges of the uninsured. Some sort of national health care plan was a sure bet. 

Mr. Stossel makes the profound statement that poverty can be the greatest threat to a long life, Aecording to studies in Europe, Canada, and the United States, a person s life span can be shortened by an average seven to ten years if that individual is in the bottom 20 percent of the economic scale. Poverty kills when people cannot afford good nutrition, top-notch medical care, proper hygiene, and/or safe, well-maintained cars. Also poverty-stricken people sometimes consume more alcohol and tobacco than die general population. 

Medicaid is a cooperative state-federal program that provides medical care to those individuals who cannot obtain or afford the medical care through other insurance avenues. The states provide the care and the federal government oversees the administration of the care and contributes matching funds for approved state programs. 

It is usually based on the advanced determination of seriousness of injuries, kinds of treatment that can be afforded at the immediate location, and the availability and capability of emergency transportation to transfer victims to selected medical care facilities. As conditions at the location of a disaster fluctuate the sorting of victims may result in the re-determination of priorities that have been assigned. 

There is not a bottomless pit of resources, says Phil Wadeson, finance director for the National Health Service unit that oversees hospitals and doctors offices in Liverpool. We reached the point a while ago where there is far more medical intervention than any health-care system can afford. ... 

States should enact legislation to provide for. .. safe and effective medication at an affordable price. States should also take measures necessary to ensure for all persons, on a sustained and equal basis, the availability and accessibility of quality goods, services and information for HIV/AIDS. .. treatment..., including antiretroviral and other safe and effective medicines, diagnostics and related technologies for preventive, curative and palliative care of HIV/AIDS and related opportunistic infections and conditions. (UNCHR/UNAIDS 2003)... 

Merck and the others did have a valid point Without a solid health care system behind them, patients might not follow through on medication they started, which could lead to more resistant forms of the virus. Certainly, too, there needed to be more effort on the prevention side, at least to educate people about how AIDS spreads. It would be hard to ensure any of this while too many governments, particularly South Africa s, were pretending the problem didn t exist or denouncing standard HIV treatments as a Western trick. However, the countries still needed drugs they could afford. 

Probably the most challenging situation is to provide care for a patient who has no insurance. This often means that the patient is unemployed, between jobs, or has suffered a catastrophic loss. Many ethical issues are embedded in financial decisions about providing care. One way to address these issues is to find out what resources exist in the community for medically indigent patients. If it becomes financially impossible to continue treating a patient, therapists can still remain advocates and consultants in helping the patient find the best possible care he or she can afford—regardless of whether the therapists are compensated for their time. Some examples of this type of financial advocacy include the following ... 

Historically, a lack of public insurance programs created obstacles to health care services. For those who could not afford to pay for private insurance, the costs associated with health care were larger than most could afford. After lengthy debate, the U.S. Congress passed legislation in 1965 that established Medicare and Medicaid. Medicare covers over 95% of the elderly in the United States as well as many individuals who are disabled. Coverage for the disabled began in 1973 and is divided in two parts 1) hospital insurance and 2) supplementary medical insurance. The total disbursement for Medicare in 1997 was 213,575 billion, and there were 36,460,143 enrollees, of which 32,164,416 were elderly. 

HPI BB is a 21-year-old female nursing student who presents to her primary care physician with a 24-hour history of fever to 102°F, headache, myalgia, and sore throat. She notes that her roommate has had "flu-like" symptoms for the past 2 days and she thinks she is coming down with the same symptoms. BB states she has finals next week and cannot afford to get sick at this time. Her PMH is significant for mild asthma and seizures. Her medications include phenytoin, albuterol inhaler, ibuprofen, and birth control pills. 

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