Health care in the USA

¶ … medicine, long valued for individual entrepreneurship and physician control, has undergone dramatic change. Physicians now face vexing oversight of case and utilization management and loss of control over the allocation of health care dollars. Managed care organizations control health costs by arbitrarily refusing reimbursement for certain medical procedures and reducing payments for others. Since medicine is now a less attractive career option, will fewer high performing individuals choose to become physicians? What are the implications for the quality of care?

The problems that doctors have to face in negotiating care for their patients lead to the profession becoming a less attractive option for a number of medical students. Given the rising costs of attending medical school, the number of students choosing to concentrate on family care is declining (Bodeinheimer 861). This existing shortage of doctors practicing primary care is further exacerbated by the challenges inherent in the industry, namely the fact that physicians have to adhere to an extensive list of requirements and negotiate with insurance companies to ensure providing care for their patients. While many students choose medicine because of a natural passion towards it, or because they want to help people, the financial benefits of the profession often contribute to a student's decision to become a doctor. The reduction of resources from insurance companies and the increasing need for doctors to navigate an increasing number of rules and regulations in order to guarantee care their patients deserve present an additional challenge that doctors have to overcome. Prospective students are aware of these problems, and many may decide to pursue a different career, turning away from medicine. Additionally, there is a problem of medical students choosing to pursue a concentration in medicine other than primary care, inevitably resulting in a reduced number of high achieving students practicing it. Finally, the reduced number of primary care providers affects the quality of care the average patient receives from their doctor.

2. Hippocrates, who admonished physicians to "first, do no harm," also stated, "in abundance, there is lack." Interpret the latter in regard to American health care. (50-100 words)

Hippocrates' remark that abundance can lead to lack is very befitting the American health care system, as extending care to a larger population inevitably leads to reduction of care across the board. It has been estimated that extending medical coverage to all Americans will lead to a 25% increase in physician demand (Dill 13). Given the current uneven distribution of medical professionals, these increases in care will lead to even bigger shortages in certain areas, as the concentration of physicians in a specific area is contingent upon the affluence of the area (Goldman 7). Thus, the shortage of doctors is likely to cause a lack in care in less affluent neighborhoods.

3. Defend the increasing relevance of epidemiology and health services research in market-driven health care environments.

With the misdistribution of care being one of the most difficult challenges inherent in the healthcare industry epidemiological analysis and research in health services is becoming increasingly relevant and necessary in a market-driven environment. One of the ways an epidemiological study can aid the health care industry is by allowing a better understanding of the need for care by a specific area (Hawkins 6). Since the requirements for care vary depending on the geographical area, and each neighborhood has specific healthcare needs, it is necessary for a market-based health care system to determine what these requirements are in order to provide adequate care without spending any extra funds. Additionally, this would allow providers and insurance companies alike to ensure appropriate distribution of care.