National Health Care System In Japan And Taiwan - Would It Be Possible For Us?

Every society is affected by any national changes or new movement introduced; therefore, an issue one may think is unrelated to his environment can very well affect him through chains of cause and effect.

Health care is an immediate issue that concerns all of us. We all experience it and need it. Let's serious ask ourselves if the current health care system is satisfactory and available to everyone. Should health, medicare and treatments be available to only selected groups? Many people are voting for the presidential candidate who can restore the present health care system or who can pioneer a better healthcare distribution for our country. Personally, I hope to see a change that health care is available and affordable to everyone.

Being able to receive basic health care is a fundamental need of all people. Fulfilling this fundamental need makes people feel secured, and it makes sense that people with better health can contribute more to the society. A realistic and reachable standard of health should be set for all people. This effort needs a non profit driving entity to establish and to maintain it. People's life and health should not be compromised for the profit of few organizations.

Before moving to Japan, I was covered under my parents' insurance policy in the United States. Their policy covered children of the family until the age of twenty-four. Upon graduating from university, I moved to Japan and started my first job there. I joined the Japanese national health insurance through the company I worked for. There are basically two types of health insurance in Japan: national health insurance and employer-sponsored health insurance. Usually, under employer sponsored insurance, the insurance premium is calculated according to income, number of dependents, and the company' subsidies. For someone who is self-employed or unemployed, the national health insurance costs a minimum of 13300 yen, or about $110 per month plus a small percentage of income for those who are self-employed. In other words, everyone can get insurance from around $100 dollars a month. Unlike the Medicaid program in the U.S. which is only available to certain low-income groups with specific requirements for eligibility, the Japanese health insurance is available to every citizen and legal residents. There is a ceiling to what the Japanese National insurance covers, but it covers all the basics and beyond.

In most cases in Japan, patients choose their doctor and hospital. There is no limitation to the doctors or hospital they can visit. This is a true competition among the clinics, hospitals, and medical practitioners, not for profit, but for quality. The same insurance that people have in Japan gives them the freedom to get second opinions and naturally eliminates those doctors whose practices are in question. The doctor visits, treatments, and medicine are not free; one is responsible for thirty percent of their medical bills. Japanese health costs are much lower than the costs in the United States. Thirty percent of the medical bill is still a reasonable amount one can afford. There are also special cases or categories of illness for which the insurance would give more coverage. If one is late on his payment, his insurance will not automatically be invalid. The insurance will still cover the person as long as he makes up the missed payments. After all, some people do run into difficulties in life at one point or another. Sounds to good to be true? Well, It's real.

Taiwan, a place with no world recognition politically, has one of the top public health care system in the world. After moving to Taiwan due to my husband's transfer a year a go, I learned and appreciated the system where universal or national health care is available to all more than ever. When speaking of universal, national, or pubic health insurance, people often turn their attention to the well-debated and discussed health care system in Canada. There are those whose views are negative, claiming that the medical service in a single-payer insurance system may not perform at its ultimate, and those whose views are positive, saying that they do not live in fear of ever having to face bankruptcy for outrageous medical bills. From my informal inquiries, more Canadian I came across favor their national health care system. Most of those who favor their national health care system commented that people of Canada are more secured in having their basic physical and psychological needs met.

In Taiwan, there is also government-sponsored universal health care for not only their citizens but also for foreign residents who live in Taiwan. Foreign residents can apply for the government-sponsored insurance after proving their legal status of residing in Taiwan. The insurance fee starts from the basic 600NT, or around $18 a month. For people in higher income brackets, their insurance is calculated based on a percentage of their income over the 600Nt. Fees are waived for retired soldiers, those who are physically challenged, and people who have economic disadvantages.

Interestingly, Taiwan's national health insurance has only been established for little more than two decades, since 1985. The government policy-makers studied health care system from different foreign countries and composes the first Taiwan national health care from the ideas and methods of the system of other countries. It was said that Taiwan's national insurance system is like a completed puzzle made from pieces of which fit its country and people. This insurance now covers the entire population, including foreign legal residents. According to research funded by Taiwan's National Health Research and Taiwan's Bureau of National Health Insurance, the cost of health care did not rise after the universal coverage was established (Jui-Fen & Hsiao, 2003.) What does that tell us?

A basic health care program can greatly reduce the consequences of illness left untreated. Basic health care does not mean free of charge or mindless spending without control. To build a healthy nation, we should take a closer look at the current U.S. health insurance. After all, a sound nation starts with the health of its people.

Writer's Information:
The writer is a Chinese-American. After graduating from Queens College, New York, she moved to Japan and started teaching English as second language. In the 15years of living in Japan, she became a wife, a mother and a university lecturer. She continued her education after giving birth to her daughter and is now pursuing her ph.d in education. She is a positive person who is always looking forward to challenging new things. In Japan, many friends and students were affected by her words and encouragement, especially women. Using herself as examples, she encourages women to be a life time learner, open minded and to have self confidence. Now she is temporarily residing in Taiwan with her family.

A Flawed U.S. Healthcare System and Some Potential Solutions

Earlier this year, the Associated Press and other popular news agencies reported on the disturbing results of a study published in the March 16, 2006 issue of the New England Journal of Medicine that concluded that Americans receive, on average, only 55% of the care that they should receive at any given time 1,2. This study evaluated the care that individuals, from a wide variety of ethnic and economic backgrounds, receive in a variety of different healthcare settings (clinic, hospital, etc.) here in the U.S. The authors came to a conclusion that was, to me, very startling; but, as it turns out, this is not really new information.

With some minor variation across the boards, people were either under or over treated, for a variety of conditions ranging from alcohol dependence to urinary tract infection. This means that, although we have very well defined screening, diagnostic, and treatment protocols, nearly half of the time these protocols were not followed by physicians, other health care personnel, or the institutions in which they work.

While the Associated Press story decried this as "woefully mediocre... care," and the New England Journal authors concluded that the "problems with the quality of [health] care," are "widespread and systemic," I personally see this as an outright tragedy. Although we spend more money on health care than any other nation, and our massive research efforts have well defined the ideal mechanisms to prevent, diagnose, and treat disease, we are still unable to provide our mothers and fathers, sisters and brothers, husbands and wives, with the care that they all pay for, deserve, and that is available. I find the idea repellant that people's quality and duration of life is routinely compromised in this manner.

HealthCare Systems

This particular system is basically an institute that works towards the conveyance of appropriate fitness care. It differs greatly all around the globe. The people who work towards providing this service through the respective organizations are known as experts and professionals in their field. It is often argued if these systems oblige private rights of the public or amplify the regulation of these industries by the administration of the particular country.

The aim of these health care organizations according to a recent statement has been explained as the promotion of good health amongst the people around the globe and their reaction towards it. These organizations are mostly quality oriented, well-organized and resourceful.

The funding of these organizations is done via quite a few numbers of methods. Off these the top most are insurance (public or individual), funding it out of ones own budget or charities to name a few. A contemporary research has concluded that there is no proven relation between its cost efficiency and the method that is employed to fund it. It means that the quality of the service that the respective organizations are providing to their clients is independent of the financing method employed. We can take the example of India as a country that is financed by its administration in terms of the respective organizations. At times the private organizations and individuals also make contributions.

Amongst the top features of this system is the regard of the most fundamental therapies as a basic human right. It does not take into account the individual's ability or inability to pay, as many treatments are more pricey than the average family's financial reserves put together. Other than that the individuals who service people through these organizations are bound by both the law and a personal pledge that has to be undertaken at the time of recruitment in these systems.

France Has the Best Healthcare System in the World

As the United States struggles toward a system of universal health care, many have looked at the Canadian health care system as a model. Only a few have looked toward France. That's a mistake for at least 2 reasons.

First, according to the World Health Organization (WHO), France has the best health care system in the world . It has been widely reported that the WHO found the French system to be number 1 while the Canadian system is number 30 and the U.S. number 37.

It should be noted here that the WHO rankings actually contain multiple rankings and the numbers generally quoted are the ranking based on the measure that the WHO calls the OP ranking. OP is said to measure "overall performance" adjusted to reflect a country's performance based on how well it theoretically could have performed. When reporting the rankings of 1 for France, 30 for Canada and 37 for the United States, it is the OP ranking being used.

Why did the French system do so well in the WHO rankings? The French system excels in 4 areas:

* It provides universal coverage
* It has responsive health care providers
* Patients have freedom of choice
* The health and longevity of the population

Second, we should be looking more closely at the French system because it has more similarities with the U.S. system than either the Canadian or British system. Many Americans assume that the French system is like the system in Britain. Nothing could be further from the truth or more insulting to the French.

Exactly like the United States, the French system relies on both private insurance and government insurance. Also, just like in America, people generally get their insurance through their employer. What is different is that everyone in France has health insurance. Every legal resident of France has access to health care under the law of universal coverage called la Couverture maladie universelle.

Under the French system, health insurance is a branch of Social Security or the Sécurité Sociale. The system is funded primarily by taxing the salaries of workers. An employee in France will pay about 20% of their salary to fund the Sécurité Sociale. These taxes represent about 60% of the cost of the health insurance plan.

The balance of the funding comes from the self employed, who pay more than salaried workers, and by indirect taxes on alcohol and tobacco. Finally, additional taxes are levied against other income, both direct and indirect.

The French share the same distaste for restrictions on patient choice as American do. The French system relies on autonomous private practitioners rather than a British-style national health service. The French are very dismissive of the British system which they call "socialized medicine." Virtually all physicians in France participate in the nation's public health insurance, Sécurité Sociale.

An American Universal Health Care System

Health Care System Needs Reform, Not a Government Takeover

Believe it or not, America boasts some of the world's best doctors, the most advanced health care system, and the most technically superior resources in the world, bar none. Those who travel globally and have gotten sick know that their first choice for treatment would be in the U.S. Though health care in America is, more expensive than any other country, many of the worlds wealthiest come to the U.S for surgical procedures and complex care, because it holds a worldwide reputation for the gold standard in health care.

To examine the complex health care issue, a small research study was conducted from randomly selected doctors in a best doctors database. We ask 50 top doctors, located in different states and who practice different specialty fields, " Is a universal health care plan good for America?" Forty-eight of these doctors essentially responded that it was a "bad idea" that would have negative impacts on the quality of our nation's health care.

Social Engineering Medicine

One of the greatest mis-conceptions some people have relied on with regard to the health care debate is that, given a universal health care system, every person in the U.S. would receive the highest quality health care - the kind our nation is renowned for and that we currently receive. However, unlike some public amenities, health care is not a collective public service like police and fire protection services, therefore the Government cannot provide the same quality of health care to everyone, because not all physicians are equally good orthopedic surgeons, internists, neurosurgeons, etc, in the same way that not all individuals in need of health care are equally good patients.

As an analogy - stay with me - when you design a software program, there are many elements that are coded on the back-end, and used to manipulate certain aspects of the software program, that your average "John Doe" who uses the software (the end user) does not understand or utilize, nor do they care about these elements. Certain aspects of the program are coded, so that when one uses that portion of the program, other elements of the program are manipulated and automatically follow the present or next command.

Likewise, once a universal care plan is implemented in America and its massive infrastructure is shaped, private insurance companies will slowly disappear, and as a result, eventually patients will automatically be forced to utilize the government's universal health care plan. As part of such a system, patients will be known as numbers rather than patients, because such a massive government program would provide compensation incentive based on care provided, patients would become "numbers," rather than "patients." In addition, for cost savings reasons, every bit of health information, including your own, will be analyzed, and stored by the Government. What are the consequences? If you're a senior citizen and need a knee replacement at the age of 70, the government may determine that you're to old and it's not worth the investment cost, therefore instead of surgery, you may be given medication for the rest of your life at a substantial cost savings to the government, and at a high quality of life price to you.

Solutions:

Fixing the current U.S. health care system might require that we;

1. Encourage prevention and early diagnosis of chronic conditions and management.
2. Completely reform existing government are programs, including Medicare and Medicaid.
3. Forgive medical school debt for those willing to practice primary care in under-served areas.
4. Improve access to care, provide small businesses and the self-employed with tax credits, not penalties for providing health care.
5. Encourage innovation in medical records management to reduce costs.
6. Require tort reform in medical malpractice judgments to lower the cost of providing care.
7. Keep what isn't broken-research shows 80% of Americans are happy with their current insurance, therefore, why completely dismantle it?
8. Reimburse physicians for their services.
9. Innovate a system in which Medicare fraud is dramatically decreased.

Devil In the Details

Socialized medicine means:

1. Loss of private practice options, reduced pay for physicians, overwhelming numbers of patients, and increasing burn-out may reduce the number of doctors pursuing the profession.

2. Patient confidentiality will need to be compromised, since centralized health information will be maintained by the government and it's databases.

3. Healthy people who take care of themselves will pay for the burden of those with unhealthy lifestyles, such as those who smoke, are obese, etc.

4. Patients lose the incentive to stay healthy or aren't likely to take efforts to curb their prescription drug costs because health care is free and the system can easily be abused.

5. The U.S. Government will need to call the shots about important health decisions dictating what procedures are best for you, rather than those decisions being made by your doctor(s), which will result in poor individualized patient care.

6. Tax rates will rise substantially-universal health care is not free since citizens are required to pay for it in the form of taxes.

7. Your freedom of choice will be restricted as to which doctor is best for you and your family.

8. Like all public programs, government bureaucracy, even in the form of health care, does not promote healthy competition that reduces costs based on demand. What's more, accountability is limited to the budgetary resources available to police such a system.

9. Medicare is subsidized by private insurers to the tune of billions of dollars, therefore if you take them out of the equation, add a trillion dollars or more to the current trillion dollar-plus cost estimates.

10. Currently, the government loses an estimated $ 30 billion a year due to Medicare fraud. Therefore, what makes anyone think that this same government will be able to run & operate a universal health care system that is resistant to fraud and save money while doing so?.

Human Resource Management and Health Care Systems

Did you ever know that in the health care systems and services, the human resource management plays a great role? Yes, this is absolutely true especially in the global context because studies and researches have shown that their management techniques have largely helped to improve the health of the patient to a great extent. In fact, the health care and the management of the resources are very much linked to each other and there are several key factors that can help them to go with each other and work successfully. This in turn proves to be fruitful for the entire health care organization as well.

It is no doubt true that the human resource management is indeed essential and important part of any health care system. They work in such a way so that they can improve the overall model of the heal care. Though there are several challenges existing in the field of health care in the recent days yet these challenges are solved effectively by the management services to get overall success. The challenges faced might be of many different kinds and these challenges are examined and studied in various different ways by the organization to bring out an effective solution.

It is the proper implementation of the strategies of the human resource department that helps in finding out the right approach that should be taken to sort out the various different problems that might come in the way. Different places have different functioning in the health care systems and it is on the basis of these different functions that the effective solution is tried to be found out. The skill and the expertise of the different people involved in the department helps them to manage all the different resources effectively in any kind of situation.

Medical Device Technology That Saves Lives

Annual expenditure on medical device technology in the U.S. is around $150 billion. This is a large amount of money, but the devices save lives. Furthermore, thanks to medical device translation, the U.S. exports this vital technology around the world.

Glide Scope
Paramedics often attend patients who are having problems breathing. To provide help, they place breathing tubes down patients' throats. This is an awkward procedure. The risks include damage to the vocal chords.

The Glide Scope makes the procedure far easier and quicker. The device has a tiny video camera and monitor. As a paramedic inserts the breathing tube, he or she can see exactly where it is going. In this way, the paramedic can avoid harming the vocal chords and can ensure the tube is in position without delay. Paramedics who have used the technology report positive results.

Blood Pressure Management
Abdominal aortic aneurysms are a major cause of death in the U.S. High blood pressure can swell an artery in the abdomen. If the artery ruptures, it leads to uncontrolled internal bleeding. Because an increase in blood pressure can result in such a rupture, it's important to monitor the pressure, and therefore the size of an aneurysm, regularly.

The traditional way of doing this is with a costly CT scan. A cheaper and faster alternative is the Endo Sure Wireless A Pressure Management System. This takes a different approach to CT scans. Surgeons implant a tiny measuring device inside the patient. This device sends a wireless signal to a monitor. Doctors can then find out the level of blood pressure in the aneurysm sac. Knowing exactly what this pressure is can save lives.

The Endo Sure was initially tested in Argentina, Brazil and the U.S. Medical device translation helped ensure everyone involved understood the use of the Endo Sure and its potential.

Trauma Pod
A major issue facing troops in war zones is IEDs (improvised explosive devices). Soldiers wounded by an IED may bleed to death while their comrades transport them to the nearest field hospital. Although the trauma pod is still in development, it promises to be a remarkable piece of medical technology that helps solve this problem.

The trauma pod is a surgical field unit. Instead of human surgeons, it has robots. These treat soldiers immediately by staunching wounds and opening airways.

The robots in the pod also run CT scans. The scans provide information for diagnosis and further treatment. Surgeons in the field hospital control the trauma pod process remotely.

Ethical Issues in Healthcare Systems

Healthcare and affordable healthcare, at that, is important to everyone. Healthcare insurance, as a system, has to be doable, for the healthcare provider as well as the member. The benefits offered must provide adequate medical coverage to the member, and must be affordable and also available, without the problem of pre-existing condition requirements.

Benefits must, also provide an adequate range of services within the local, state, and national guidelines for the particular plan offered. They must be affordable, and yet inclusive enough, to service the needs of its members, and they should be flexible. Healthcare insurance is a commodity, that must be made available to all American citizens, irregardless of age, economic status, locality or previous medical conditions.

The recent healthcare legislation passed by Congress, and introduced by, President Obama's administration, has, for the first time offered most Americans, employed, and unemployed a chance to get adequate healthcare benefits at affordable premiums. They can save money by choosing a higher deductible, thereby, lowering monthly premiums. States not offering certain benefits, can allow the insured to build a coverage package, normally called a plan that works within the insured's guidelines, and needs.

I am not certain which Southern East coast states offer limited benefits coverage in some instances, I will be writing an updated article,' after doing more research on this topic, Limited Coverage, or No Coverage in Some States.

What does constitute ethical healthcare benefit coverage opportunities?

I would venture to say:

* Benefits that are available under conditions that are opened to most potential members
* No restrictions as to number of members, for example, group coverage as relates to small business, self-employed, group employee benefits coverage, requirements.
* No pre-existing condition requirements, causing a block as far as potential members being approved for benefit coverage.
* Healthcare benefits offered at an affordable cost all American citizens.

Other Options Available Within the Healthcare Industry

The great vanguard: opportunity, being at the right place, right time, a chance of a lifetime idea offered to those wishing to locate a niche in today's economy, for persons really wanting to offer a worthwhile service to all, is answered --- by becoming involved in the 'Healthcare Industry'.
Becoming involved in a self-employment venture which promotes and refers, others to providers (businesses that provide medical insurance coverage for its members).

Because of the fact, that there are about 70 million persons nationally, that are uninsured or underinsured, provides, a niche market available to entrepreneurs willing to accept the challenge.

Universal Health Care - Ethical Issues in Health Care Reform

Universal health care seems to be a hotly debated topic whenever health care reform in the United States is discussed.

Those who maintain that health is an individual responsibility do not want a system that requires them to contribute tax dollars to support fellow citizens who do not act responsibly in protecting or promoting their own health. They argue that they want the freedom to choose their own physicians and treatments, and suggest that government cannot know what is best for them. These people argue that preserving the current system with improvements to provide better insurance coverage for citizens who remain uninsured or under insured for their medical care needs is the only reform that is needed.

Those who believe health care is an individual right support a universal health care system with the argument that every citizen deserves to have access to the right care at the right time and that a government's responsibility is to protect its citizens, sometimes even from themselves.

Two opposing arguments arising from two opposing ideologies. Both are good arguments but neither can be the supporting argument for implementing or denying universal health care. The matter must be resolved through an ethical framework.

Examination of the ethical issues in health care reform would require consideration of much different arguments than those already presented. Ethical issues would center on the moral right. Discussion would begin with not "What is best for me?" but rather "How should we as a society be acting so that our actions are morally correct?"

Ethics refers to determining right and wrong in how humans relate to one another. Ethical decision making for health care reform then would require human beings to act in consideration of our relationships to each other not our own individual interests.

Examination of some of the common ethical decision making theories can provide a foundation for a different perspective than one that is solely concerned with individual rights and freedoms.

Ethical decision making requires that specific questions be answered in order to decide on whether intended actions are good or morally correct. Here are some questions that could be used in ethical decision making for health care reform.

* What action will bring the most good to the most people?
* What action in and of itself is a good act and helps us to fulfill our duties, obligations, and responsibilities to each other?
* What action in and of itself shows caring and concern for all citizens?

As the answer to all these questions, universal health care can always be considered the right thing to do.

The United States is in the most advantageous position there is when it comes to health care reform. They are the only developed country without a national health care system in place for all citizens. They have the opportunity to learn from the mistakes that have been made by all the other countries that have already gone down the universal health care road. They have an opportunity to design a system that can shine as a jewel in the crown of universal health care systems everywhere.

However, all ethical decision making is structured around values. In order for universal health care to be embraced by all citizens in the United States, they will first have to agree to the collective value of equity and fairness and embrace the goal of meeting their collective responsibility to each other while maintaining individual rights and freedoms. That may prove to be the most difficult obstacle of all.

The Long Term Care Industry Is Under Attack!

The industry is under attack! The long term care industry is under attack! There is no doubt that the long term care industry is going to experience major changes in the next 2-5 years. What are you going to do about it? Yes, you... I am talking to you. What are you going to do about it? Many of the people I talk to in the industry are saying there is nothing that we can do; we have to just wait and see what happens. I say that is... well I better not say what I was thinking, let's just say I strongly disagree. I think that we should prepare to battle. Right now we are under attack and we have no counter-attack, no plan. We are just asking them nicely to "please stop picking on us." And that tactic is never going to work.

First we need to face that fact that the current system is broke. We can't provide the level of care that people deserve now, so we definitely can't provide better care with less money... or can we? At the state level I have been asking legislators to put a 10-year moratorium on Long Term Care Medicaid cuts. This gives the industry 10 years to test, discover and implement a new (and hopefully) better system. I am working on establishing relationships with Congress on the national level to take this campaign to Washington, DC.

I spend dozens of hours every week brainstorming different scenarios and ideas for a new system, and to be completely honest... I am not as close as I need to be, but I do know what we need to achieve. We really need to accomplish only 2 things... Better Care & Lower Cost.

If we achieve that... we win! Actually if we achieve that... everybody wins! But it is pretty lonely over here in this corner, because most people think that this is impossible. I am willing to admit that it might be, but I am not sure enough to quit fighting. Whenever I wonder if it is possible, I consider the government created alternative... and that is not an option, it is a dead-end road.

You have two choices... sit back and see what happens or step forward and help make the changes. The changes that need to be made must be made by people inside the industry and not people who are trying to win political votes. Because if you walk through the halls of a nursing home you will likely find someone who was directly responsible for helping build America, you will likely find someone who was willing to fight a fight for the greater good. As a country, we can't turn our backs on the people whose backs built this country.

Cory Geffre is an author, speaker, trainer & thought leader in the Long Term Care industry. Cory works with Long Term Care Administrators, Assistant Administrators, Directors of Nursing, Assistant Directors of Nursing, Human Resource Directors/Managers, & Staff Educators helping them in Extracting Excellence and Unlocking Maximum Potential from their people, their organizations & themselves.

Understanding Ethics And Bioethics Of Medical Assistants

These days, people still have high respect for hospital staffs. When the children are down with fever, their parents would call their trusted pediatrician to seek for medical help. Most businesses and multinational corporations today even have their own industrial nurses or physicians to help the employees with their medical issues.

Currently, one of the most important members of the medical team is the medical assistant. Their role in health care are becoming more versatile and dynamic. They are now given more duties and responsibilities. Since they have so many tasks to care about, it is only vital that they understand what their profession demands. This is to avoid incidence of lawsuits and other dilemmas.

Yes, people trust their health care professionals. People trust them with their lives. It is important that they master the different medical terms and treatment procedures performed in their medical area. Also, they should know how to follow the different laws and bio ethical standards concerning their profession.

Since this article is about ethics and bio ethics of medical assistants, it is important to differentiate the two. First, let us discuss what ethics is. Ethics is a set of rules or guidelines. These rules are used to determine if the person is acting properly or not. Medical ethics are part of professional ethics. It governs the behavior and conduct of the health care professionals. To work ethically, the health care professional must remain truthful and fair.

Bio ethics on the other hand, is about life preservation. In the past, most medical decisions are made solely by doctors and physicians or legal professionals. But with the advancement of technology, patients are given more choices and medical alternatives. Since medical assistants are performing more active roles in health care, they should know how to attack different situations in a moral and ethical way. No one is perfect. Anyone can commit mistakes like giving the wrong medications or medical procedures. However, in the medical industry, a mistake can be detrimental. Yes, accepting and telling the main physician about the mistake is not easy, but it can save life.

Role Of The American Association Of Medical Assistants

In the medical assisting field, the AAMA or the American Association of Medical Assistants is responsible for setting the guidelines for ethical and moral conduct. They see to it that their members are always striving for excellence.

Certainly, one of the most promising industries today is health care. It can provide several opportunities and career advancements. However, it is not an easy job. Medical assisting is a popular health care profession. Like any other medical professionals, they too are facing many challenges in their career. Thus, knowing the different laws and bio ethical guidelines concerning their profession can help them a lot to becoming proficient and qualified health care staffs.

Implementing SOA in Healthcare Systems

Service Oriented Architecture (SOA) is the latest concept buzzing in software and IT circles. SOA is the next evolutionary step in systems development. Properly implemented, it builds upon existing architecture while it better addresses efficient reuse of business functionality inside and outside the organization. At its core, SOA is about providing true interoperability that reflects real-world use cases.

Most organizations do not realize the dream of enterprise-wide systems, but instead rely upon a portfolio of independent systems. Often these systems have duplicate data and functionality. The goal of SOA is to select and encapsulate certain pieces of functionality as services that can be made available across the organization. With this being the goal, the organization can shift their focus from individual, often file-based interfaces, to creating service-oriented applications. These new applications not only create a truly interoperable environment, but they also more accurately reflect the actual business functions in a healthcare environment.

Most industries, including healthcare, are faced with the dilemma of providing operational systems, supporting the revenue management and any administrative features. For healthcare, the operational could be capturing the insurance payment for a claim as defined by the remittance advice. The revenue piece could be the posting of that payment to the proper account and recognizing the affect on the aging balance. The administration piece could be the security that makes sure the person entering the transaction has the proper authority to do so. It is not unusual, nor is it bad, for this to be done in three different systems. SOA allows the different systems to know what has happened and to interact when changes are made.

SOA is different from legacy systems integration in that it requires system design and management principles that support reuse and sharing of system resources across the organization. It does this without requiring re-engineering the existing systems. With SOA, existing processes are combined with new capabilities to build a library of services. These services then become the solution. The goal is to create shared services that reflect actual business processes. SOA strengthens interoperability while reducing the need to synchronize data between isolated systems. Properly implemented, the organization has readily available services regardless of the originating system, department, location or desktop.

Let's examine a relatively simple transaction and how the SOA approach applies. A clinic has a new patient coming in for a visit. A list of items to be done includes:

* Examining if the patient exist
* Verifying patient eligibility
* Adding the patient to the Master Patient Index
* Examining the Doctors schedule
* Creating the appointment
* Accessing public records
* Creating an EHR visit

We have potentially accessed three to seven different systems depending on the functionality of the base applications. Many healthcare environments either do not perform all the functionality or do it with a series of point-to-point file-based interfaces. Still others do it by entering the data into multiple systems. Manually entering data into multiple systems is essentially human-interoperability because it is up to a person to coordinate and control the interfaces.

As the number of systems increases, standard interface formats, such as Health Level 7 (HL7), and central data interface engines are adopted by larger healthcare organizations. Internet-based communication allows organizations to exchange data with external organizations, such as payors.

Although data is passed among systems, the file exchange approach falls short of supporting true data interoperability. File exchanges can work, but they have multiple inherent problems:

* Multiple points of failure - creating the file, configuring where the file should go, security to write the file, confirmed delivery of the file, file reader services, configuration of picking up the file and reading the file are just a sample of the issues that have to be solved. Not that these are not solvable problems, they all are. With each point of functionality comes an increased probability that something can break.
* Increased cost - Using all of the multiple points of failure mentioned above, each step requires additional development, testing and maintenance. All of these combined equals increased cost and elongated time lines.
* Finger pointing - Any time a file is create and security is needed to create the file, we have a blending of development teams with infrastructure teams. Management never wins when both of these technical groups are pointing fingers saying it is the others fault.


With SOA, IT processing is organized and represented as a collection of services. Each service is made available to the entire organization through a standard protocol. All departments that maintain or use the same data use the same service. This makes any redundancies transparent to users. Applications supporting a specific workflow will reference the same service. Each service communicates with the systems to which it is related. Users no longer need to switch between systems to complete a workflow. Data is naturally synchronized between systems. Services aligned in this manner enable true interoperability among the healthcare organization's processes and people.

As SOA is further adopted by the healthcare industry, collections of services, as well as specific services, will be available for use by a healthcare organization's internal and external resources. This is possible because the origin of the service is transparent. Imagine adding a patient in one application and having that patient synchronized in all other systems without specific point-to-point interfaces and files being generated.

Integrating data and interoperability are key requirements in evolving healthcare technology, and healthcare is behind the curve in adoption and investing in these technologies. Healthcare adopting these technologies and getting the right information in the right place at the right time can result in the following benefits:

* Greater claim accuracy
* Reduced medical errors
* More accurate diagnosis
* Increased access for patients
* Reduced payment cycles

SOA takes on greater significance with the emergence of Healthcare Information Networks (HINs). A HIN is collaboration among the government, hospitals, specialty labs and pharmacies and payors to provide a network of data exchange that builds shared information, data repositories, applications and interfaces. The collective applications efficiently and accurately exchange key information across a spectrum of healthcare. Existing HINs are currently accomplishing the following:

* Exchange of patients' electronic medical record between providers to get key information like medical history, allergies, persistent problems, medications and active treatments
* Referral exchanges
* Electronic patient eligibility for a visit or procedure
* Electronic claim filing and payment
* Electronic ordering and monitoring of prescriptions
* A consolidated repository of key healthcare information for disease control
* A consolidated repository of data to support government-funded programs and benefits of those programs
* A portal for the patient, providers and payors accessing patient data

There is little debate regarding the benefits of implementing HINs. There is debate about the cost and the ROI of HIN investment. Part of the ROI equation is the cost of supporting the legacy applications and their participation in the network. If every time a new hospital, clinic, pharmacy, or government program was introduced a new point-to-point interface had to be introduced, it would not be feasible to build a HIN that has sustainable momentum. The cost of having to build a sequence of point-to-point interfaces for every system involved in the network would be unsustainable to all the practices and the software providers who support them.

When using SOA for HIN integration, the cost of integration can be reduced significantly and a sustainable community value is created. To accomplish this goal, SOA services facing the HIN must accomplish the following:

* Simplify and reduce the interface points to create data interoperability in the network
* Address the architecture, infrastructure, software, and related business functions as a cohesive unit
* Have services deployed internally and externally to support the needs of the organization and the HIN
* Support legacy systems
* Support current and evolving data standards
* Be tested for scalability so larger external organization can use it

SOA is the direction IT is moving. SOA gets our focus off of a single application and what it needs to do and onto how this application fits into a bigger world. Whether that world is the organization or beyond, SOA enables the applications key components to become exposed to all who need them. Healthcare, which as an industry has can achieve great benefits from this kind of interoperability, is behind others in achieving it. Healthcare IT managers, and the software companies that support them, need to evaluate how they are incorporating SOA in their design plans.

America's Healthcare System Ranks The Lowest Among Industrialized Nations

The U.S. doesn't get its money's worth when it comes to healthcare, according to recent statistics. The Commonwealth Fund released a report earlier this month on America's ranking in the world healthcare system -- and it wasn't good.

According to the report, residents of the United States receive the poorest quality of care, yet pay the most for it, among six of the top industrialized nations, including Germany, Great Britain, Australia, New Zealand, and Canada. The findings were based on measures including quality, access, efficiency, equity, and outcomes of healthcare. Germany took the overall first place ranking, followed by Great Britain, Australia, New Zealand, and Canada.

While the other five nations on the list provide universal healthcare, the U.S., with its unorganized mixture of employer-funded care, private insurance, and government programs, leaves nearly 48 million throughout the country with no insurance whatsoever. Ominously, the Fund also linked lack of insurance with poorer quality of care in another report released this month.

Texas ranks at the very bottom of the nation in numbers of people left uninsured, at just over 25%. With high incidences of poverty, unemployment, and chronic diseases, such as diabetes, the state stands to gain more than most by measures to update the healthcare and/or to make insurance available to more of the population. Most of those lacking insurance do not receive pertinent preventative care, resulting in increased long-term costs to health, as well as to the state and federal governments.

Particularly in the larger cities of Dallas, Houston, and Austin -- where many from rural areas of the state come seeking care, overburdening the system further -- change would be welcomed.

Activists and members of Congress are calling for an overhaul of the overburdened and outdated system, with suggestions ranging from instituting America's own universal healthcare, to subsidizing private insurance companies in order to make healthcare coverage available to all, regardless of income.

Obviously, it's an issue that needs to be closely analyzed, as it is "pretty undisputable that we spend twice what other countries spend on average," as reported by The Commonwealth Fund. While, in comparison to other industrialized nations, the U.S. has the fewest patients seeing a regular doctor (16%), is the least wired (working with the fewest electronic records, and receiving the fewest electronic updates on disease treatment options), and has one of the highest infant mortality rates, we are actually spending twice as much per capita on healthcare as Germany, at $6,102. Canada spends $3,165 per capita, Australia $2,876, Britain $2,546, and New Zealand $2,083.

The U.S. also has one of the longest emergency room waiting times, takes an average of four months to deliver elective surgery, and is considered one of the less "convenient" nations when it comes to general healthcare. Sixty-one percent of Americans surveyed found it "somewhat" or "very difficult" to receive care on nights or weekends.

What is most shocking perhaps, is the relatively high infant mortality rate, at 5 in every 1,000. The U.S. is tied with Poland, Hungary, Malta, and Slovakia for this statistic, and, among the 32 industrialized nations surveyed, ranked only above Latvia, at 6 in every 1,000 births. Japan, the Czech Republic, Finland, Iceland, and Norway beat the U.S. by a landslide, at approximately one-third the death rate. Every year, 16,000 newborn deaths occur in this country, mostly linked with low birth weights and premature delivery. This suggests a surprising lack of prenatal care and, indeed, measures of mothers' well-being ranks extremely low in comparison to other industrialized nations.

African-Americans suffer almost twice the national average of infant mortality, at 9 in every 1,000 -- which is closer to developing nations' statistics than to industrialized ones. Black babies born in the U.S. are also twice as likely to be premature and have a low birth rate than their white counterparts.

Throw in scandals -- like drug companies enticing doctors with "free" gifts and dinners to sell their medications, or multi-billion dollar pharmaceutical company investments in medical schools -- and it looks like a gloomy picture, indeed. Michael Moore's summer release of Sicko, though sure to be controversial, undeniably raises a subject on the national consciousness.

While it is painfully obvious that something must be done -- and quickly -- the next step is not so clear. States such as Hawaii and Massachusetts have taken their own initiatives with state-provided health insurance, resulting in nearly 90% of their residents having insurance, and therefore better access to care. California has debated its own measures, as well as many Midwestern states.

It's not a straight-forward debate, by any means. While nations providing universal healthcare rank higher in overall standings, the U.S. is still considered a leader when it comes to breakthrough technologies and treatment options. A balance must be struck between revolutionary research and making sure more people actually have access to its results. Reports on new HIV drugs, for instance, hint that turning HIV and AIDS into a chronic, versus fatal, condition is just around the corner...but those medications are expensive, and not everyone in the U.S. has access to them.

Residents of the U.S., however, have done little to push the initiative. The surprising lack of attention on the issue in political debates reflects the fact that voters do not choose their candidate primarily based on his or her plans for future healthcare reform. And, time and again, it has been proven that the masses' outspoken push for measures is what gets things done on Capitol Hill. In the end, it's really time for us -- the people -- to decide how to dig ourselves out of this one.

Integrated Healthcare Systems

The world of healthcare is always changing. When you think back to healthcare and health services back when our parents and grandparents were children and then compare things to healthcare today things are drastically different. One thing that has changed and developed and also continues to change and develop as we speak is what is called the integrated healthcare systems. Sometimes also referred to as multi-care providers or multi-care treatment, these systems intend on focusing on convenience for the client or patient and ease of working through the system. Typically these systems cover a wide area of travel and are operated through multiple levels. The systems also incorporate many different types of services including medical services and general health and wellness services as well. The goal is the get you healthy and to keep you that way with this type of integrated system.

A system such as Manhattan Illinois healthcare has many different offices and services connected to it. There is typically a large hospital that would be the main center and then many other clinics, offices, and even smaller hospitals that feed into and work off of or from the larger hospital. Patients can visit a doctor in a medical center or office and expect to the same level of service if they visit a different doctor, hospital, or other provider that is within the same integrated healthcare systems. There is also the benefit of having your medical records contained in the same system so that you don't have as much trouble trying to track down a get your medical records to all your different doctors.

Information is many times also maintained in the integrated healthcare systems information center so that if you visit Monee healthcare instead of another center then your information can be located because it is all consider the same provider. In a way this is like an umbrella system that covers the patient. There can be advantages for a patient and the goal of the integrated healthcare system is to make the experience better for both the patient and for the healthcare providers as well.

This way of providing care for patients is drastically different than how the doctors and nurses may have provided care in the past but one could say that it is an attempt on a large scale to make patients feel similar. A doctor from Manteno healthcare is not likely to come to your home to provide care but the hope would be that because you are in this network of healthcare and provided quality and uniform care that you may feel somewhat like your father or grandfather felt with the doctor at their home.

The Evolution Of Integrated Health Care Delivery Systems And The Singularity

If one had to design a health care system that would seem doomed to failure one might start with one in which the providers of care were fragmented, independent and driven through the reimbursement system to provide ever more services that generate higher income on a fee for service basis. The system would provide care to patients who were isolated from the economic costs of the services by third party payments, through employer funded insurance coverage. Third party payers would make their money through reducing premium payouts, by simply delaying or not paying out what they contracted to provide or extorting deep provider discounts in exchange for directed volume. The approach to care of individual patients would be ad hoc, without significant oversight. Severely ill patients would be passed back and forth by all providers like the black queen of spades in a deck of cards. Bad debts would be written off as "charity care." Insurance premiums would rise faster than the world's oceans in global warming. Sound familiar?

Unfortunately, in an contentious and polarized political democracy little can be done to re-design an antiquated, inefficient, ineffective, and bankrupting cowboy system of health care delivery in a focused, comprehensive way that will likely make a real difference. There are just too many moving parts and special interests involved. There is, however, an incremental change underway as a result of the recent health care reform efforts that have the potential to morph the system into a paradigm that makes more practical sense. Medicare will be providing contracts with Accountable Care Organizations that will have to become clinically integrated systems of efficient hospitals and care providers in order to obtain adequate reimbursement. Expect to see these new systems expanding in the private sector as well.

The government's push toward implementation of global electronic medical records systems will be key to the development of data driven systems competing not only for financial gain, but also for quality in performance and outcomes. Data capability inaugurates performance accountability in managing patient care. With the advent of reliable data there will be more and more focus on evidence based medicine, what works and what does not and we will be moving from a largely intuitive approach to an empirical design in health care delivery. Outliers will be reviewed, evaluated and addressed. The focus will be on system based accountability in providing the most effective method of care and the most reasonable price. This can only occur if hospitals and care providers are focused on and are compensated for the delivery of health not the delivery of care. Look to the rise and advance of fully integrated health care systems compensated in global fixed fees, and view the decay and death of fee for service medicine.

The pace of technology development in the form of electronic medical records, smart electronic medical devices and in communication, storage and cloud computer functioning, augers the potential for what what Ray Kurzweil describes as the "Singularity."

What then is the singularity? It's a future period during which the pace of technological change will be so rapid, its impact so deep, that human life will be irreversibly transformed. Although neither utopian nor dystopian, this epoch will transform concepts that we rely on to give meaning to our lives from our business models to the cycle of human life, including death itself.

Does the United States Healthcare System Need an Overhaul?

Healthcare is undoubtedly one of the United States' biggest challenges today. Having been declared "broken" by experts over ten years ago, the system has still not shown any improvements. Supposed "fixes" promised by managed care have not surfaced. Instead, health insurance premiums are rising, hassles for patients and physicians continue, and more than 45 million Americans are uninsured.

If the challenges with healthcare that the United States faces are not met swiftly and wisely, the current problems will worsen and new challenges will arise. Even considering that new technology, such as online medical consultations, will increase efficiency, the cost of new tests and treatments are projected to outweigh the savings. As physicians and online doctors get better at treating ailments and illnesses, they will in turn lengthen patients' lives, thereby increasing the number of people requiring medical care.

Additionally, as costs rise, many employers will not be able to handle providing healthcare benefits to their employees. This is just one contributing factor to the growing number of uninsured citizens.

Is Healthcare Reform in Our Near Future?

President Obama has plans in motion to ensure each and every American has access to high quality health care, deeming it "one of the most important challenges of our time." He stated that the number of uninsured Americans is growing, premiums are skyrocketing, and an increasing number of people are being denied coverage every day. In addition, President Obama believes that an improved healthcare system - including one that supports the use of telemedicine and online doctor consultations - is also essential to rebuilding the U.S. economy, in that an improved system will benefit people and businesses - not just insurance and pharmaceutical companies.

According to Darrell M. West, Vice President, Governance Studies at Brookings Institution, "the biggest obstacle to health care reform is fear of the unknown. Anytime you make fundamental changes in the system, there is going to be anxiety from doctors worried about reimbursement levels, patients concerned over access to care, insurers about market competition, and hospitals about cost structures. In this situation of complex proposals and unknowable consequences, it is easy to play to people's fears and scare them into resisting change. What President Obama has to do is persuade people that diving into the unknown future is less risky than the current status quo. If he can overcome the fear hurdle, he will get health care reform."

We Have Evolved...It's Time for Healthcare to Evolve, Too

The way of approaching healthcare in the United States has become outdated. With the rapidly expanding array of technology that is available to the people of the United States, it is no wonder why the way research is done has changed; and the ways in which people communicate has also changed. So what about change in the healthcare system? It is due time for physicians and other healthcare providers to evolve with the times and incorporate telehealth services, such as online medical consultations and online prescriptions, into their practices.

Datamonitor has predicted that the global telehealth market is expected to exceed $8 billion by the year 2012. Telemedicine (often used synonymously with telehealth) is the use of medical information being exchanged from one to another via electronic communication, whether it is the internet or phone. This exchanged medical information in the form of online doctor consultations and printable doctors' excuses online in turn is used to improve the patient's health or direct them in the right path.

Commonly referred to as online medical consultation services, telemedicine is not different from the actual practice of medicine; it is just the application of the standard, accepted practice of medicine, to electronic communication, thus making it more widely accessible and easier to obtain by the general public. With technology at everyone's fingertips, it is no wonder that a rapidly increasing number of people are turning to the internet for online doctor consultations and printable doctors' excuses. To date, approximately 36 million Americans have already been treated by telemedicine through online doctor consultations and/or prescriptions. A survey showed that over 70% of patients indicate that they are willing to try online doctor consultations and online prescription services rather than going into an office when they have a minor illness.

The American Medical Association (AMA) has reported that possibly 70% of all doctors visits are for information or a consultation of sorts that could easily be handled over a phone. All of these visits cost medical providers and patients alike for the unnecessary trips. It has been estimated that as much as $300 billion of health care costs are wasteful and unnecessary, thus resulting in higher insurance costs for groups and individuals alike.

Are These Goals Within United States' Reach?

The three targeted goals when it comes to improving the U.S. healthcare system according to President Obama are the following:

o Reform the healthcare system;
o Promote scientific and technological advancements; and
o Improve preventative care

With the rapid advancement of telemedicine, or online doctor consultation and online prescription services, the aforementioned goals are most definitely within our reach.

For premium telemedicine or "ask a doctor" services, consult with qualified, fully licensed U.S. physicians, or online doctors, on KoolDocs.com. KoolDocs.com telemedicine service offers patients increased access to health care services with added convenience and affordability. KoolDocs.com helps patients avoid the hassle of having to go into the doctor's office for acute simple medical conditions such as bronchitis, colds, coughs, flu, ear infections, sinus infections, laryngitis, sore throats, upper respiratory infections, urinary tract infections, smoking cessation, shingles, athlete's foot, acne, rashes, insomnia, weight loss, herpes, and more. Unlike waiting hours for the typical doctor's office to call back, KoolDocs.com physicians return patients' calls within a one- to three-hour window of time, or whenever is most convenient for the patient. For online doctor consultations, printable doctors' excuses.

Medical Alert Systems - A Life Line for Seniors

A personal emergency response system can save your elderly loved one's life in the event of a sudden illness or accident. How do you choose the best senior alert system? In today's feature, we'll review the most popular senior alert systems.

Med Alerts for Seniors
More and more seniors are living alone and wish to maintain their independence. They don't want to leave their home and move in with relatives or go into a senior residence. But if you're like millions of people who worry about an aging loved one, you need to know they're safe and sound. Luckily, today's medical alert devices can help you and your special senior citizen make safe independent living practical.

Medical Alert Systems: How They Work
Senior medical alerts systems are comprised of a push-button call device that activates an intercom device. The push button is worn around the neck as a pendant, around the wrist like a watch or clipped on the belt. Most companies offer all three choices.

When the call button is pressed it activates the monitoring system, which is essentially an intercom device that connects the senior with the monitoring company. The monitoring company's call center then calls the home and attempts to speak with the senior. Based upon the response they get from the senior, the company will follow a predetermined protocol. For example, if the button was pressed accidentally or just to test the device the call center will note the incident - they will not send 911 every time the button is pressed.

What You Need To Know
The call-button has a limited transmission range which is adequate for most homes. But if you wander out of range, the push button will not work. Some monitoring services will be alerted when the transmission device stops working (whether it is because the device is out of range, the battery is dead or other malfunction) - but many cheap monitoring systems do not have this feature. Make sure you pick the right one.

Another important point, with standard senior alerts if the wearer does not or cannot push the panic button, help won't come. If the wearer is unconscious, disoriented and can't push the button, the device won't be of much use. That's why many people choose a device with fall-detection. Many providers advertise "fall detection," but research shows that too often these devices don't detect falls in the real world. That's because these devices are only triggered by a sudden, violent drop - and that's not always the way falls happen in the real world.

Many elderly people fall down by slumping down to the floor. They might feel dizzy so they hold on to the wall and slump to the floor rather than dropping from upright to flat out. When people fall like this, these so-called "fall detectors are useless. So, what is the solution?

We like my Halo for true fall detection. Their device is worn under the clothing and besides being a call-button, it can detect when the wearer stops moving unexpectedly, when their skin temperature is outside the norm and even heart rate changes. It's an affordable service that offers more protection than the standard panic button system. But - since it has to be worn under the clothing and against the skin you may find that your elderly relative may resist wearing it at first. The good news is that it is light-weight and they will get used to wearing it. After a while they won't even notice they're wearing it.

A Socialized Health Care System Requires Population Control and Impeccable Registries

In a nationalized health care system, you need to know who is who - otherwise the system could never be able determine who is entitled. The structure depends on how the system is created and designed, but with a nationalized health care system you will be tracked by the state where you reside and how you move in a manner that is unseen in America. The nationalized health care system becomes a vehicle for population control.

If you leave the United States and are no longer a resident of the state, even if you are a citizen and might maintain a driving license, you will have to report immediately if you want to avoid the 13% health care tax. I use the number 13% as it is in Sweden to exemplify the actual tax pressure that is laid upon you for the nationalized health care.

Let's say you moved and you do not want to pay the 13% tax for services you do not receive, can receive, or want to taken out from the tax roll. The mammoth entity has no interest to let you go so easy. You will end up having to reveal your private life - partner, dwellings, travel, money, and job to prove your case that you have the right to leave the public health care system and do not need to pay the tax. If you have to seek an appeal, your information could be a part of administrative court documents that are open and public documents. As soon as you return to the United States, you will be automatically enrolled again and the taxes start to pile up.

Public universal health care has no interest in protecting your privacy. They want their tax money and, to fight for your rights, you will have to prove that you meet the requirements to not be taxable. In that process, your private life is up for display.

The national ID-card and national population registry that includes your medical information is a foundation of the nationalized health care system. You can see where this is going - population control and ability to use the law and health care access to map your whole private life in public searchable databases owned and operated by the government.

By operating an impeccable population registry that tracks where you live, who you live with, when you move and your citizen status including residency the Swedes can separate who can receive universal health care from those not entitled. The Swedish authorities will know if you have a Swedish social security number, with the tap of the keyboard, more information about yourself than you can remember. The Swedish government has taken sharing of information between agencies to a new level. The reason is very simple - to collect health care tax and suppress any tax evasion.

It is heavily centralized and only the central administration can change the registered information in the data. So if you want to change your name, even the slightest change, you have to file an application at a national agency that processes your paperwork. This centralized population registry makes it possible to determine who is who under all circumstances and it is necessary for the national health care system. Otherwise, any person could claim to be entitled.

To implement that in the United States requires a completely new doctrine for population registry and control. In an American context that would require that every existing driving license had to be voided and reapplied under stricter identification rules that would match not only data from Internal Revenue Service, state government, municipal government, Social Security Administration, and Department of Homeland Security but almost any agency that provides services to the general public. The reason why a new population registry would be needed in the United States is the fact that lax rules dating back to the 1940s up until the War on Terrorism, and stricter identification criteria following 9/11, has made a significant percentage of personal information about individuals questionable.

If America instead neglects maintaining secure records, determining eligibility for public health care would not be possible and the floodgates for fraud would open and rampant misuse of the system would prevail. This would eventually bring down the system.

It is financially impossible to create a universal health care system without clearly knowing who is entitled and not. The system needs to have limits of its entitlement. A social security number would not be enough as these numbers have been handed out through decades to temporary residents that might not even live in the United States or might today be out of status as illegal immigrants.

The Congress has investigated the cost of many of the "public options", but still we have no clear picture of the actual realm of the group that would be entitled and under which conditions. The risk is political. It is very easy for political reasons to extend the entitlement. Politicians would have a hard time being firm on illegal immigrants' entitlement, as that would put the politicians on a collision course with mainly the Hispanic community as they represent a significant part of the illegal immigrants. So the easy sell is then that everyone that is a legal resident alien or citizen can join according to one fee plan and then the illegal immigrants can join according to a different fee structure. That assumes that they actually pay the fee which is a wild guess as they are likely to be able to get access to service without having to state that they are illegal immigrants.

It would work politically - but again - without an impeccable population registry and control over who is who on a national level, this is unlikely to succeed. The system would be predestined to fail because of lack of funds. If you design a system to provide the health care needs for a population and then increase that population without any additional funds - then naturally it would lead to a lower level of service, declined quality, and waiting lists for complex procedures. In real terms, American health care goes from being a first world system to a third world system.

Thousands, if not a million, American residents live as any other American citizen but they are still not in good standing with their immigration even if they have been here for ten or fifteen years. A universal health care system will raise issues about who is entitled and who is not.

The alternative is for an American universal health care system to surrender to the fact that there is no order in the population registry and just provide health care for everyone who shows up. If that is done, costs will dramatically increase at some level depending on who will pick up the bill - the state government, the federal government, or the public health care system.

Illegal immigrants that have arrived within the last years and make up a significant population would create an enormous pressure on a universal health care, if implemented, in states like Texas and California. If they are given universal health care, it would be a pure loss for the system as they mostly work for cash. They will never be payees into the universal health care system as it is based on salary taxes, and they do not file taxes.

The difference is that Sweden has almost no illegal immigrants compared to the United States. The Swedes do not provide health care services for illegal immigrants and the illegal immigrants can be arrested and deported if they require public service without good legal standing.

This firm and uniform standpoint towards illegal immigration is necessary to avoid a universal health care system from crumbling down and to maintain a sustainable ratio between those who pay into the system and those who benefit from it.

The working middle class that would be the backbone to pay into the system would not only face that their existing health care is halved in its service value - but most likely face higher cost of health care as they will be the ones to pick up the bill.

The universal health care system would have maybe 60 million to 70 million "free riders" if based on wage taxes, and maybe half if based on fees, that will not pay anything into the system. We already know that approximately 60 million Americans pay no taxes as adults add to that the estimated 10-15 million illegal immigrants.

There is no way that a universal health care system can be viably implemented unless America creates a population registry that can identify the entitlements for each individual and that would have to be designed from scratch to a high degree as we can not rely on driver's license data as the quality would be too low - too many errors.

Many illegal immigrants have both social security numbers and driver's licenses as these were issued without rigorous control of status before 9/11. The alternative is that you had to show a US passport or a valid foreign passport with a green card to be able to register.

Another problematic task is the number of points of registration. If the registration is done by hospitals - and not a federal agency - then it is highly likely that registration fraud would be rampant. It would be very easy to trespass the control of eligibility if it is registered and determined by a hospital clerk. This supports that the eligibility has to be determined by a central administration that has a vast access to data and information about our lives, income, and medical history. If one single registration at a health care provider or hospital would guarantee you free health care for life and there is no rigorous and audited process - then it is a given that corruption, bribery, and fraud would be synonymous with the system.

This requires a significant level of political strength to confront and set the limits for who is entitled - and here comes the real problem - selling out health care to get the votes of the free riders. It is apparent that the political power of the "free" health care promise is extremely high.

A promise that can not alienate anyone as a tighter population registry would upset the Hispanic population, as many of the illegal immigrants are Hispanics - and many Hispanics might be citizens by birth but their elderly parents are not. Would the voting power of the younger Hispanics act to put pressure to extend health care to elderly that are not citizens? Yes, naturally, as every group tries to maximize its own self-interest.

The risk is, even with an enhanced population registry, that the group of entitled would expand and put additional burden on the system beyond what it was designed for. That could come though political wheeling and dealing, sheer inability from an administrative standpoint to identify groups, or systematic fraud within the system itself.

We can speculate about the outcome but the challenges are clear. This also represents a new threat to the privacy and respect for the private sphere of the citizenry as an increased population registration and control empowers the government with more accurate information about our lives and the way we live our lives. Historically, has any government when given the opportunity to get power taken that opportunity and given that power back to the people after the initial objective was reached? Governments like to stick to power.

To ensure the universal health care system is designed to function as intended it, would require procedures that would limit fraud, amass a significant amount of personal information, have access to all your medical data, and also determine who you are beyond any doubt. Just to be able to determine if you are entitled or not and, track the expenditures you generate.

The aggregation of these data could also open the floodgates for any data mining within these data under the pure excuse that it would help the universal health care system to better "serve you" and lower the costs.

To lower the costs also means to identify which procedures should not be done on which type of patients as it is not viable based on the government's interest to optimize your productivity under your life cycle. The collection of data has a tendency to look inviting and good when we start to collect it but aggregated data and personal information creates a deep intrusion in our privacy.

Electronic Medical Record Systems And The Environment

EMR, commonly known as electronic medical record, has opened a new chapter of service quality in the field of healthcare. It has brought opportunities for the medical staff to make their work life as effortless as possible by streamlining clinical procedures. In recent past when EMR was introduced it took huge amount of resources in the form of human capital, postal services and stationery item to process just one file. EMR software has proved to be a environment friendly healthcare system by removing the need for bulky paper work, piles of record keeping and hand written applications and prescriptions, substituting it with the sustainable and atmosphere pro electronic medical record system.

During 1990s, particularly in 1996 when the HIPAA Act came into effect, there was very low electronic medical record usage by physicians. Some of the adoption issues reported then with EMR systems were fears of poor security of sensitive information and the complexity involved in the personal information held. The resulting solution was industry led, as CCHIT was formed to only support the electronic health system but also certify it so that clinics and hospitals can widely adapt to the environment friendly health care option.

EMR Software - An Eco Friendly Alternative?

Much has been said about eco friendly or environmental friendly business alternatives and many business organizations are spending fortunes making their products friendly to the environment. This is the same for electronic medical record system companies. Many larger firms, such as CureMD, NextGen, CERNER, and Epic Care are developing electronic medical records system with paper-free services like electronic medical billing, business process outsourcing, and online registration of patients, online data compilation and electronic entry by physicians. Together with these solutions a popular recent innovation of EMR system is the use of web-accessible patient records.

With the advent of this important module, the healthcare facility becomes accessible nearly anywhere. The product of EMR system aims to deliver well-organized data and information directly to patients so they remain fully informed of their conditions throughout their recovery.

Meanwhile, the primary objective EMR system adoption is to make the work surroundings at clinics and hospitals paper free and efficient while including the minimum probability of errors. This environmental friendly health care system is not only sustainable but will also result in far fewer laboratory appointments for reports, thus easing patient's physical and mental condition.

The Green Merits Of An Electronic Medical Record System

Because a leading-edge electronic medical record system has high processing capability, with applications processed with a single click, it has provided huge efficiency bonuses to practices. With its innumerable benefits it intends to trim down errors and filing time.

These days, resources are limited and we all are trying to find the most environmental friendly way of doing business. EMR systems contribute towards environment protection by converting paper records into software databases. The energy saved in just one electronic medical record is truly surprising, and is a great step for an industry that definitely has no shortage of waste.

The Japanese Health Care System

Japan, a nation with a long life expectancy, a rapidly aging population and a reputation as being expensive, surprising has one of the lowest per capita health care costs among the developed nations. Here is a basic look at the system, how it controls costs and some of its positive and negative points.

Residents of Japan are obliged to join one of two types of health insurance systems. One type is a social insurance plan which is normally for corporate employees. The other is national health insurance, which is for the self-employed, students and others not covered under a social insurance plan.

When someone goes to a hospital in Japan, insurance will usually cover 70%-80% of the costs upfront with the patient paying the difference. For more expensive treatments, the patient can receive a reimbursement for costs incurred.

By law, the insurance plans cannot deny a legitimate claim or refuse anyone regardless of preexisting conditions. Also, medical care is not rationed by age or for any other reason. Most hospitals are privately owned. However, the rates they can charge for most services and drugs are set by Japanese Health Ministry every couple of years.

People are free to choose whichever hospital they like. In spite of the fact Japanese people receive more medical care and spend more time in hospitals, Japan spends less on health care, and health insurance costs are much lower.

Negative points of the Japanese system

Doctors on average see more patients and thus spend less time with each individual patient than in the US. Hospital conditions are often not as nice as those found in the US. For example, unless paying for a private room, most patients stay in shared rooms with the patients separated by curtains. Most hospitals do not take reservations. Patients simply go to the hospital and wait their turn.

Drugs are often over prescribed. One reason for this is that since doctors spend less time with each patient, the sometimes simply prescribe drugs for initial visits instead of more thoroughly diagnosing the problem. The other reason is that hospitals sometimes can make money off the prescriptions.

Since going to the hospital is relatively cheap, people abuse the system and seek medical treatment when it is not really needed. Many hospitals are losing money since prices are often set too low. Also, there is underinvestment in some areas and the system is laden in paperwork and regulation.

While premiums are still much lower than the US, they are rising and an increasing number of people cannot afford them. However, this is often offset by programs that provide medical care for the children and the elderly. Overall, while the Japanese health care system does a good job at providing nearly universal coverage at an affordable price, it is not without it problems.

Problems with Our Health Care System

Given the enormous amount of money that is spent on our health care system and the research that has gone into the various diseases we would be excused if we think that there should be able to trust our health care system to deliver quality health care. Sadly, our Western health care system falls well short of what is desired. Instead of healing and health it largely delivers suffering and further disease. Mendelssohn as far back as 1979 (and he wasn't the first to suggest it) considers that the public has been 'conned' about the benefits delivered by 'scientific medicine'. There is a great deal of myth that surrounds our current system.

A part of the myth is that medical practice has produced an overall increase in health in the past one hundred years. However, historical analysis has found that general improvements in social and environmental conditions provide a more adequate explanation of the changes than the rise of 'scientific medicine'. Factors such as the improvement in diet and nutrition, sanitation and improved general living conditions have made the greatest difference.

Hospitals are deadly. Mistakes/errors, accidents, infections, medical drug disasters, diagnostic equipment including; X-rays, ultrasounds and mammograms make hospitals very dangerous. Hard technology has taken over the central role in modern medicine as it is considered effective and efficient. This has however been questioned. It is considered uneconomic and it also causes an unnecessary amount of pain and suffering. Accidents in hospitals now occur more frequently than in any other industry except mining and high rise construction. In addition to this are the medical doctor caused diseases. They are so common that they have their own name - iatrogenesis. Again the general public is unaware of how common this disease is. All told, iatrogenesis accounts for 784,000 deaths each year in the United States - more American deaths than all the wars of the 20th century combined. 98,000 deaths a year are caused by medical errors alone, and surgical errors account for another 32,000 deaths. These figures include only deaths. Officials admit that medical errors are reported in official data only 5 percent of the time, so the problem is much greater - exactly how much greater, no one really knows.

Research carried out in Australia showed that the equivalent of a jumbo jet load of people died unnecessarily died each week in Australia because of medical interventions - this information was contained in an official Health Department report. It was substantially hushed up - because of the potential impact of the information on the general public! We talk about and work to reduce road accidents and we 'ground' airplanes that are shown to have faults - but the general public is generally unaware of the risks that they take when they come under the care of the medical health care system.

Apart from accidents and medical mistakes adverse drug reactions and infections account for many of the incidences of iatrogenesis. Adverse drug reactions are very common. Some of these reactions can be minor but they can also be deadly. There are five main groups into which these adverse reactions can be placed. Those that:

* adversely affect the blood cells,
* cause toxicity in the liver,
* damage the kidneys,
* affect the skin, and
* affect the unborn baby.

The hazardous side effects listed here do not include allergic reactions or medication errors, but rather the effects of the drugs themselves. Out of the 2.2 million cases of serious adverse reactions to drugs each year, authorities have listed four types of drugs as being the worst offenders for adverse reactions. These are antibiotics (17%), cardiovascular drugs (17%), chemotherapy drugs (15%), analgesics/anti-inflammatory drugs (15%). 198 drugs were approved by the FDA from1976 through 1985 and over 50 percent had serious post-approval reactions. Many adverse reactions were discovered during clinical trials and were covered up by pharmaceutical manufacturers in order to get FDA approval. The FDA is also far from blame free when it comes to giving approval for drugs that have serious reactions. The whole drug approval process has many problems and cannot be relied upon to protect the public from dangerous drugs.

Antibiotics are no longer working on many extremely dangerous bacteria or they only work in doses that that cause serious side effects. The development of these antibiotic resistant 'superbugs' is in the order of a crisis. In the years following the introduction of antibiotics they were (and still are) used for the treatment of common colds and flu and other complaints. Antibiotics, such as tetracycline were used (and still are) over long periods of time for the treatment of acne. Ampicillin and bactrim were used for the wrong reasons and there has been a reliance on antibiotics to treat recurrent bladder infections, chronic ear infections, chronic sinusitis, chronic bronchitis and non-bacterial sore throats. The UK office of health Economics in 1997 (cited in Chaitow) reported the following statistics:

· 5,000 people are being killed every year (in UK hospitals alone) by infections that they caught in hospital.

· A further 15,000 deaths are being contributed to by the infections that they caught in hospital.

· One in 16 patients who goes to hospital for anything will develop a 'hospital acquired infection'.

· Many of the infections acquired involve the difficult to treat 'superbugs'.

· USA figures published more than a decade ago show that 1 in 10 patients develops an infection that they caught in hospital - this involves around 2.5 million people every year.

· Every year 20,000 of these people die from their infections and the deaths of a further 60,000 are contributed to by the hospital acquired infection - a large number of these involve antibiotic resistant 'superbugs'.

The current approach of our health care system is ineffective and can potentially cause more harm and damage than the original condition. Although undoubtedly many lives have been saved by timely medical intervention much medical intervention is unnecessary and alternatives, which don't cause the same devastation, are available. Everyone needs to consider the way they interact with the medical system. Try to avoid the health care system if you can and certainly question your medical practitioner very carefully about any intervention they wish to make. Many will not like this questioning and just want to be seen as the 'all knowing, all wise doctor' - but this they are not! Do not be conned and do not buy into myths about the medical profession and health care.

Having said this it is important that if you are currently taking medication that you don't suddenly stop. Seek information, discover alternatives and discuss changing you approach to health care with a health professional. If your current medical practitioner is uninformed about alternatives (as many are) or unwilling to discuss these with you (as many are) then you may need to seek a different health professional who is prepared to help you improve your health rather than just use medical drug prescriptions or surgery!

The French Healthcare System is Universal

How did the French manage to achieve a system that has the advantages that American love but still gives everyone coverage?

The French legislature realized that they would need the cooperation of 2 groups if they were to get the kind of national health insurance they wanted. First they needed the doctors; second they needed the private insurance companies.

French doctors only agreed to participate in a compulsory health insurance program only if

* A patient's free choice of their doctors was protected by law
* Doctor's maintained control over medical decisions

Next the French legislators overcame insurance industry resistance by permitting the nation's already existing insurers to administer its new healthcare funds. France's comprehensive health insurance provides coverage for all or part of the following healthcare categories:

* Hospitalization
* Non-Hospitalization Benefits
* Prescription Drugs & Medical Equipment
* Medical Evacuation & Repatriation
* Dental & Optical Cover
* Emergency Healthcare is provided to everyone

But the Sécurité Sociale's health insurance plan covers only about 70% of actual medical fees. The balance of the bill is paid for through private insurance called assurance complémentaire.

Private health insurers are central to the system as supplemental insurers who cover patient expenses that are not paid for by Sécurité Sociale. Indeed, nearly 90 percent of the French population possesses such coverage, making France home to a booming private health insurance market.

Working with these 2 groups, France developed a program of universal health care that demonstrates that it is possible to achieve universal coverage without a "single-payer" system.

Why isn't Washington looking at the French system as a model? The concepts and the execution would be far easier to implement in the U.S. then moving to a Canadian or British system. The end result would be universal healthcare that would effectively marry the desires of both the public and private sector.

Tale of Two Healthcare Systems

With all the hoopla over the healthcare debate in this country I thought it about time I share my experience that was up close and personal. In the summer of 2008 I was enjoying a little relaxation with friends at our cottage on the French River, just south of Sudbury, Ontario, Canada. Now as I share this let me make it clear, we've been going to Canada for five decades and personally I love the place and the people. The healthcare on the other hand, not so much.

One evening one of the ladies visiting made her 'to die for' roast beef dinner and I nearly did. On the second bite mine got stuck in my throat and I was in for a long, painful and at times, downright terrifying night. I began choking about 4PM and it was weird, it would come and go in five minute cycles. I gutted it out for an hour thinking I could dislodge the blockage myself. Then another episode made me think I might check out right there in the north woods. My wife called 911.

The Regional Medical Center was over 80 miles away so it wasn't going to be a quick fix. Inside the ambulance and on the way I had my worst episode of the day. I thought I was a goner, hacking into a little pale while the EMT sat quietly looking at paperwork. The whole time the computer I was hooked to was saying over and over again 'check the patient - check the patient'.

When my episode was over I said to the EMT, "Aren't you going to do something?" He was a nice young fellow who promptly said, "No sir that's why we're taking you to someone who makes a lot more than us to fix you". It was then I realized my wife could have driven me up with our own pale and saved what turned out to be a $650 taxi ride.

When we arrived at the Regional Medical Center in Sudbury, a city of over 100,000, they whisked me into emergency where I would hack for the next 9, yes that is 9 hours. They gave me a pan and told my wife to call if I got worse. Well, I can't make sounds on the computer but my wife says I sounded like a moose bellowing in mating season. And it hurt. After one episode about 3AM I once again thought I was going to check out for sure. My wife retrieved a nurse who brought with him a young lady, an intern.

The Intern told me to take a sip of water. It was about 7 hours into the process and I had tried that before. It sent me into a coughing, hacking tailspin. She insisted, annoyed at her inability to listen I chugged the water she held as she stood silently for the next five minutes, looking quite embarrassed as I hacked my guts out.

She apologized and then decided to put a scope down my nose to insure I didn't have a wind pipe blockage. Now I know little about these kinds of things but I knew I didn't have a wind pipe blockage or I'd already be dead. She insisted so I relented between episodes as she stuck the instrument in my nose, down my throat and then said, "Oops". It seems the batteries were dead! She quickly left and came back with a couple double A's and proceeded again. To only her surprise, I didn't have a wind pipe blockage; it was apparently an esophageal blockage.

A couple hours later a Surgeon came to get me, yes he wheeled me to the operating room himself. He said if he had to wait on an orderly he'd be there another two hours. Once inside I started having an episode on the operating table. The Anesthesiologist insisted I lie down. I told her I needed a bucket to cough into and she said, quite irritated at my lack of cooperation, "This is an operating room and we don't have buckets!" I barfed into a towel and turned to the Surgeon and said, "You got five minutes."

That's pretty much the end of the Canadian story. The Surgeon told my wife he'd 'pushed' the food through and indeed it was an esophageal blockage, meaning it was below the wind pipe. They sent me on my way and other than sore ribs I seemed none the worse for the wear of the 13 hour ordeal. I was thinking the whole time 'where is Michael Moore when I need him?'

Fast forward six weeks and I'm in Decatur, Illinois having lunch with a friend of mine. At this point I'd become a vegetarian like my youngest daughter just on the chance this might happen to me again. But as time moved on I'm in the Mexican restaurant for lunch the chicken taco's I love got the best of me. I thought 'what the heck' and made one, took one bite and was hacking within seconds, I'd done it again.

The only advantage this time was to know the fix I was in. My wife and I took a quick trip to Decatur Memorial Hospital, one of two in this city of just over 100,000 people. It was a Friday so we expected a wait. We walked in as I hacked every five minutes. A nurse took me right in to emergency and was immediately joined by a Doctor and another nurse. The Doctor said, "You have an esophageal blockage. We get four a week, tow real and two imagined". He then gave me a shot and said, "This will stop you from hacking until we can get our Surgeon to you".

Wow! It worked and after about a 45 minute wait the Surgeon walked in, smiled as he was making a motion as if he was reeling in a fish and said, "I hear I get to go fishing?" We talked about my history and what had recently taken place in Canada. He asked me whether they had enlarged my esophagus while they were in there. I told him if they did they didn't tell me. He explained how easy it was to do since he'd already be in there anyway. An hour later I was on my way with before and after pictures of my esophagus and feeling great. The Surgeon told me it was good for 18 months to 2 years.

I know this is just one example of many but we have to be careful what we wish for because we just might get it. That same summer a good friend of ours from Canada had been waiting for gall bladder surgery, she waited a year. Another friend of ours up there in his 70's had cancer and couldn't eat. He waited upwards of two weeks for surgery.

With all the debate raging about our healthcare crisis in America we need to take a chill pill. We don't have a crisis of healthcare; we have a crisis of the cost and coverage of healthcare. I don't think anyone disagrees that we should have coverage for everyone in this country. But there is something badly wrong with a plan that is now before Congress that 'saves' all this money and increases the cost of those on Medicaid now. That's just a red flag as to where these Bozo's in DC are leading us.

I consulted in business for years, with large companies. The first thing you do is identify the problem you're trying to solve. I don't believe Congress is doing that. I believe they're playing to the new President's agenda supported by a few nut cases already in place, namely Reid and Pelosi. The real healthcare crisis is centered on three things:

1. Cost not Quality:

Our outrageous costs are getting worse. Why, because of all the lawyers and greedy drug companies, period. Do you think we can change that? No! Because Congress is made up of 98% lawyers and they take big money from the drug company lobby.

2. Coverage:

The problem in America is not the poor, they have coverage now. I know people in that category and they just go to the emergency room and everything is covered. The problem with coverage is the middle and they have no voice America anymore.

3. Inequality:

I'm not talking racial inequality but the inequality of our leaders and their privileges versus ours as a people. I believe that every single law they vote for us, from healthcare to pensions must apply to them. And their raises... put it on the ballot for all of America to vote. And while you're at it place term limits of two terms for every elected position.

We're rushing into this thing way too fast. It should be a priority but at what expense. If you keep doing the same thing you'll certainly get the same result. Why will this quick hit initiative be any more successful than Social Security which Congress has robbed and is bankrupt? Will it be any better than Medicaid and Medicare now in place? If you think so, why would it? And we know this type of program can be done well. I have a friend in England who swears by their coverage and has given me example after example of how even I as an American would go to England, have the problem I had in Canada and not pay a dime. Now that is something to think about - how did they do that?

I'm no longer against healthcare reform but I'm solidly for solving the correct problem. And I don't think we're about to do that. Einstein said, "You can't solve a problem with the same level of thinking that got you into it." I think we need new thinking, not just change. I decided we really should Go Green in 2010 and recycle Congress!