State and Federal government would be involved with this reform. In Minnesota, the Governor has proposed cutting $350 million from health and human services. Limiting the number of budget cuts a specific section within the health care workforce can experience in a given year. For example, not allowing a state government to continually cute funding in the area of health and human services, thus human services is forced to cut many positions as well as beneficial programs. The individuals and families affected by the cuts of these beneficial programs including, health care, cash assistance, and food assistance are already struggling in this economy. If they lose these basic needs they are more at risk for illness/death and abuse to self and others. If the allied professionals such as social workers are being forced to carry heavier caseloads due to positions being cut or positions remaining vacant, then it is the vulnerable individuals and families who will suffer. They may be neglected or get lost in the system. It should be a priority to enforce those who have the ability to work or pursue an education to do so. But to do this we need more allied health professionals rather than less.
Programs would not be cut altogether in the health and human services division but rather forced to make budget cuts. Each different area of health care would be an equal playing field, in that they would all feel the effects of these budget cuts, but no programs would be completely eliminated. Individuals who are able to work should be expected to work or get an education for future employment, so that they can support themselves.
This reform would insure that a service that is especially helpful for an under served population does not continually face losses. Instead, budget cuts would be equally felt throughout many different areas of health care, but each would not suffer as severe cuts as they would if they were the only one facing the cuts. Those who genuinely need the services would continue getting them and those abusing the system would be cut from getting those services.
Those receiving services and already vulnerable would not lose the needed services mentioned previously. This reform would increase the quality of health care in the US by providing education and health and wellness/promotion programs that would occur on a community level. This would increase the quality of care because the health educators and chamber would be able to better focus their efforts on the community and the individuals in that community by working with smaller groups/populations.
Health and Human Services is the backbone for many communities. When services/employees are cut it has a direct impact on the basic needs humans rely on and should have access to such as food, clothing, shelter, and health care. The government is depriving these individuals of those basic needs in a time when we are expected to help those who are without. By having a fund that supports health educators and promoting the health of the US by having community based programs, its intentions are to cut health care costs down the road that are associated with secondary and tertiary care.
Sources:
Center on Budget and Policy Priorities. (2010). An Update on State Budget Cuts: Governors Proposing New Round of Cuts for 20011; At Least 45 Have Already Imposed Cuts that Hurt Vulnerable Residents. Retrieved March 11, 2010 from http://www.cbpp.org/cms/?fa=view&id=1214
Minnesota Budget Project. (2010). Governor's Supplemental Budget Proposes Widespread Cuts in Health and Human Services. Retrieved March 11, 2010 from http://minnesotabudgetbites.org/2010/03/09/governors-supplemental-budget-proposes-widespread-cuts-in-health-and-human-services/
Palfreman, J. (Writer, Producer, and Director) & Reid, T.R. (Writer). (2008, April 15). FRONTLINE: Sick Around the World. Boston: WGBH educational foundation.
Shi, L., & Singh, D.A. (2008). Delivering Health Care in America: A Systems Approach (Fourth ed.). Sudbury: Jones and Bartlett.
U.S. Department of Health and Human Services, Health Resources and Services Administration. (2006). The United States Health Workforce Profile. Retrieved March 11, 2010 from http://bhpr.hrsa.gov/healthcareworkforce/reports/#multiple
Wednesday, March 17, 2010
Monday, March 1, 2010
Workforce, Reform Proposal #1
The US government and/or a private organization should mandate how physicians are trained. According to Russell Robertson M.D., the chair of the Council on Graduate Medical Education (COGME), there is a lack of interest, support and funding for our nations primary care physician residency programs.
Similarly to Great Britain or Canada, we should have either the government or a group of private "provincial ministries of health care" (negotiations between the medical schools, provincial governments, and physician associations) finance all residency slots and controls the number of positions by specialty (Shi and Singh p 129). According to Robertson, about 65 percent of all physicians in the U.S. are sub-specialists and 35 percent are primary care physicians. It is necessary to create incentives to entice medical students to pursue careers in primary care. In Great Britain, the primary care physicians known as “gatekeepers” are paid bonuses for keeping their patients healthy and not needing specialty care. Our reform would also offer the same financial opportunities to those going into NPP positions, such as NPs; PAs; etc. due to the fact that they can improve primary care access to those individuals in rural settings, provide high quality and cost effective care, and show greater interest in patients (Shi and Singh p 144).
There would be a more balanced and controlled distribution of specialists and generalists as well as NPPs. We need to start transforming the current system, and start pushing for primary health care and a wellness perspective. The promotion of preventive care with primary care physicians and NPPs will reduce the number of patients seeking care from specialists. Increasing the funding for NPPs education by having a portion of taxes designated to help compensate those students pursuing a degree in a NPP field. This would allow for the medically underserved communities to receive high quality, low cost primary healthcare in order to prevent diseases that in the long run will cost more money over time.
At first this would be a costly change, however, over time costs would level off because of increased access and therefore more people would utilize primary care instead of putting off medical problems until they become something bigger, and NPPs deliver high quality care with cost effectiveness in mind.
Arvantes. J. (2009, September 23). Primary Care Physician Shortages Can Be Traced Largely to Pipeline Issues, Says FP. Retrieved February 25, 2010 from http://www.aafp.org/online/en/home/publications/news/news-now/professional-issues/20090923medpac-pcps.html
Center for American Progress. (2010). Closing the Health Care Gap. RetrievedFebruary 15, 2010 from http://www.americanprogress.org/issues/2010/01/health_workforce.html
U.S. Department of Health and Human Services, Health Resources and Services Administration. (2006). The United States Health Workforce Profile. Retrieved February 15, 2010 from http://bhpr.hrsa.gov/healthworkforce/reports/#multiple
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