Health Care Reform a Welcome Change

[NeoSeminole]

I wrote this paper for my PA Role course. It addresses the current debate over health care reform in the US from the perspective of a PA student. Feel free to comment. Enjoy!

Health is a valuable asset to man. It grants us the strength and vigor to carry out day-to-day activities – many of which we take for granted – such as earning a living or simply getting out of bed. It also plays an important role in our mental functioning and general sense of well-being. For this reason, every individual should be granted the right to fair and affordable health care to maintain the integrity of his or her health.

Unfortunately, tens of millions of uninsured Americans are economically deprived of access to the medical attention they need, and the number is steadily increasing every year. The alarming reality of this ‘crisis’ highlights the need for health care reform. However, the current system cannot be reformed without first addressing the health workforce. With plans to extend insurance to millions more, the shortage of primary care doctors will only get worse. One solution is to increase the role of physician assistants.

Physician assistants represent an economical approach to providing high quality treatment to patients. There is no doubt that PAs could be the essential factor in the health reform debate. As a student in PA school and a future health practitioner, I welcome any change that will facilitate the role of PAs and provide invaluable, cost-effective health care to many. Furthermore, the importance of increasing the medical workface with PAs is imperative if we are going to make a reform successful.

The argument in favor of health care reform is augmented by implementing more PAs in holistic medicine. By increasing access to and lowering the cost of primary health care, millions of more patients will be able to seek the medical attention they deserve. Moreover, by improving both preventative care services like routine check-ups, as well as care of chronic illnesses such as diabetes and high blood pressure, the overall cost of health care in the US will be drastically cut.

The debate over health care reform is primarily divided between those who prefer a free market approach and those who favor a single-payer plan, as in the case of universal health care. Considering our current system of a restricted market with its limitations placed on insurance companies by the government, the best solution would be to have a free market for health insurance. It would allow insurance to be bought and sold across state lines so that we can use it wherever we live. It would allow individuals to purchase policies and enjoy the same tax benefits as insurance purchased through an employer. This would give consumers more power to choose the best insurance plan that is affordable for them, with the overall goal of making health care more accessible.

Health care reform in the US is inevitable and physician assistants could be the essential factor in the national debate. PAs represent an economical approach to providing high quality treatment to patients. By utilizing PAs, health care may become more attainable and the overall cost of health care will be drastically reduced. A move towards a free market for health insurance would potentiate the extension of health care to millions of more Americans. Health care reform can truly be a win-win situation for the health practitioner, insurance company, and consumer.

[IndiReloaded]

We have socialized healthcare in Canada and we don't use PAs. Its just another category of nurse, really. One more psychologically acceptable to males, I suspect.

One could just as easily argue that, if its a separate professional designation, that you are merely creating unnecessarily duplication in the system.

PA = glorified nurse, IMO. I don't see them as different from nurse practictioner, maybe not even. Can PAs prescribe any meds?

Sorry Neo, my opinion, having lived in both US & Canada and used both systems. But a decently written essay, FWIW.

[Mish]

The only thing I don't understand is why there was (and is) so much resistance in the US to the health care reform. Reading all these cases how insurance companies manipulate the health care market and scheme how to avoid paying out their dues to their customers is mind boggling. And yet so many people (apparently) want things to continue going as they are.

[IndiReloaded]

Only the stakeholders who stand to lose money, Mish. Like the insurance cos. Powerful groups, those.

Also, the reasonable people who like the idea in theory, but know from experience that unless a SOLID plan is in place, it will be a disaster that will likely cost more than the current system.

[Sanctuary]

I think I agree with you Neo lol. Your 'solution' seems practical.

But I'm curious about the counter argument and how you would refute it. There must be some reason why PAs don't play a bigger role. I'm not well informed enough to comment on that though.

[Mish]

Only the stakeholders who stand to lose money, Mish. Like the insurance cos. Powerful groups, those.

What about all those people with "death before reform" signs that came out in their numbers a few months back when a whiff of change got out? There's hundreds of thousands of them, what are they protesting against?

[Sanctuary]

The only thing I don't understand is why there was (and is) so much resistance in the US to the health care reform. Reading all these cases how insurance companies manipulate the health care market and scheme how to avoid paying out their dues to their customers is mind boggling. And yet so many people (apparently) want things to continue going as they are.

I don't see what's wrong with denying coverage based on pre-existing conditions. I think if you forced the insurance companies to give coverage, you're screwing them over. Don't be so swayed by biased journalism.

Only the stakeholders who stand to lose money, Mish. Like the insurance cos. Powerful groups, those.

Also, the reasonable people who like the idea in theory, but know from experience that unless a SOLID plan is in place, it will be a disaster that will likely cost more than the current system.

A business is out to make money - that's what they do. That first line is so populist.

Though I guess I'm unreasonable because I don't like the idea in theory and I KNOW it will cost more than the current system. You cannot create demand while leaving supply constant and expect prices to not go up.

[vashti]

PA = glorified nurse, IMO. I don't see them as different from nurse practictioner, maybe not even. Can PAs prescribe any meds?

There is actually a HUGE (and stupid) battle between NPs and PAs. NPs bring a lot more actual patient experience to the table and have more autonomy, while PAs benefit from a more standardized curriculum (or so I'm told) and often make more money.

Both are mid-level care providers, and depending on specialty, usually end up doing pretty much the same thing, and lots of doctors don't like either of them, because they view them both as competitors to their own practice. As far as I know, NPs can write prescriptions, and in some states, so can PAs.

I see a nurse practitioner (for general care) that I like more than the doctor in the same office. Nurses tend to have better interpersonal skills than doctors in general, i think.

I believe many males seek out the PA route because they don't want to be associated with the nursing label. It's a macho thing, but in the end, it's six of one, half a dozen of the other.

[IndiReloaded]

A business is out to make money - that's what they do. That first line is so populist.

So, by your logic sweatshops and child-labour run businesses are totally fine. As are businesses that sell restricted technology to countries like Iran or N.Korea?

Your government disagrees with you. As do a large number of reputable businesses.

There is actually a HUGE (and stupid) battle between NPs and PAs. NPs bring a lot more actual patient experience to the table and have more autonomy, while PAs benefit from a more standardized curriculum (or so I'm told) and often make more money.

Both are mid-level care providers, and depending on specialty, usually end up doing pretty much the same thing, and lots of doctors don't like either of them, because they worry that patients won't regard doctors as highly.

I see a nurse practitioner that I like more than the doctor in the same office.

I just read up on the differences. I've also used both a PA and RNP. I agree, the RNP seemed more knowledgeable. But that's not surprising--don't you need an RN degree before doing the Masters or PhD that allows you to become a RNP?

As I understand it, all a PA needs is a two year degree beyond an undergrad diploma. Neo, yours is kinesiology, I think? So all the patient contact you get is really from those 2 years, correct?

Anyway, the distinction makes sense. A RNP can work independently, a PA cannot (must work under a physician).

Bah. Yer all glorifed car mechanics in any case.

[Sanctuary]

So, by your logic sweatshops and child-labour run businesses are totally fine. As are businesses that sell restricted technology to countries like Iran or N.Korea?

Actually, I do think most of the 'sweatshops' in Asia are fine. Child-labour is not fine, there are laws against that. Businesses that sell restricted technology are by definition breaking the law.

I don't see the parallel between insurance companies and businesses that engage in illegal activity.

You attack the insurance company because it worries about it's bottom line. I'm asking why can't it worry about it's bottom line? A business' goals should reflect the interests of it's shareholders. If it didn't, we'd have major problems.

[Mish]

I don't see what's wrong with denying coverage based on pre-existing conditions. I think if you forced the insurance companies to give coverage, you're screwing them over. Don't be so swayed by biased journalism.

Coverage of pre-existing conditions aside, there are many cases when they don't even pay out when they should be based on technicalities. Don't forget that insurance companies in US employ people to find reasons to enact these technicalities so they can reject legitimate claims of paying customers. They give these people bonuses based on the number of people that get rejected. If that's not down right devious, then I don't know what is.

But as far as coverage of pre-existing conditions goes there's no need to force insurance companies to give coverage, if there is the public option available they will have to adopt it if they want to survive.

[Sanctuary]

Coverage of pre-existing conditions aside, there are many cases when they don't even pay out when they should be based on technicalities. Don't forget that insurance companies in US employ people to find reasons to enact these technicalities so they can reject legitimate claims of paying customers. They give these people bonuses based on the number of people that get rejected. If that's not down right devious, then I don't know what is.

But as far as coverage of pre-existing conditions goes there's no need to force insurance companies to give coverage, if there is the public option available they will have to adopt it if they want to survive.

Yes I agree that insurance companies seek to avoid payments and regulation should be enacted to change that.

But what about the paying customers that abuse the system when they go to the doctor for checkups everytime they think something is wrong. Or the guy that goes and gets a prescription filled out everytime he feels he has anything remotely related to an illness. Things like this cause unnecessary burden on the healthcare industry and create extra costs for insurance companies. If you wanna regulate the insurance companies who take advantage of people, then you should also regulate the people who take advantage of insurance companies.

[vashti]

I don't see what's wrong with denying coverage based on pre-existing conditions. I think if you forced the insurance companies to give coverage, you're screwing them over. Don't be so swayed by biased journalism.

You very clearly have NO idea how many people have pre-existing medical problems. As a body ages, EVERYONE will have them..

[Sanctuary]

You very clearly have NO idea how many people have pre-existing medical problems. As a body ages, EVERYONE has pre-existing medical problems.

And I don't think you realize how much it would cost if you made insurance companies cover all that. They would definitely have to raise premiums or go bankrupt.

[Sanctuary]

Given the choice to save a life or not, of course I'll choose save.

But it doesn't seem like any of you think about the costs, you only see the upside. And don't give me the you can't put a price on human life argument.