The health care system in the U. S. will be facing a major overhaul in the coming years. As of this writing, U. S. President Barrack Obama has already signed into law a health care reform bill which aims to provide health insurance coverage to every U. S. citizen in the next ten years. The new health reform legislation focuses on the health insurance industry in the U. S. such as addressing the barriers in health insurance coverage and ensuring the availability of information in the health care marketplace.
In the latest health policy brief (Health Affairs, 2010, 2), the immediate reforms to the private health insurance market that will take effect in 2010 and 2011 is summarized. Among the topics covered are the temporary access to insurance for people with preexisting conditions, the no preexisting condition restrictions for children and the restrictions on certain insurance practices, just to name a few. Although most of the areas of the insurance industry that needs improvement have been covered by the new legislation, there are still some areas of the health care delivery system in the U.
S. that needs to be reformed. One is the advance care planning aspect of health care delivery. In this policy brief, advance care planning will be placed in context and analyzed in order to identify the areas that need improvement. When the health reform bill was still in the planning stage, a provision concerning advance care planning was made on the so-called House Tri-Committee bill, also known as the America’s Affordable Health Choices Act of 2009 (HR 3200).
This provision also needs to be put in the spotlight as it symbolizes the patient’s rights which is what health care reform is all about. Context Although the concept of palliative care and advance care planning has been a part of the health care policy in the U. S. , it does not garner the same interest as, for example, insurance coverage, when in fact, it is an important topic that concerns all people in the U. S. As a result, a lot of Americans are unprepared for serious illness and the eventuality of death.
Advance directives, which consist of legal documents such as the living will, durable power of attorney, and health care proxy, are not employed by most Americans. Basically, advance directives can be used by patients with terminal illness to declare their treatment preferences should they become incapacitated and a lot of Americans are not aware of its advantages (Health Affairs, 2009, 5). In a survey conducted in a study of Medicare patients with a mean age of 76, most of the respondents (86%) say they prefer to spend their last days at home rather than in a hospital or nursing home (Barnato 386-393).
This is an illustration of what is happening at present as most Americans who are seriously or terminally ill die in the said institutions, as opposed to what they really prefer. This is because there is no honest conversation between the patient, the health care teams and the patient’s family members concerning the patient’s conditions and needs. Under U. S. federal law, hospitals are required to inform patients that they have a right to state their preferences in an advance directive, however, only a few implements the said law.
I propose that more strict measures be enforced under the new health reform law to ensure that hospitals comply with this matter. Critique of Policy Options By viewing it from a patient’s perspective, one of the advantages that can be seen with the proposal is that it allows us to uphold the rights of the patient involved, to provide a semblance of control to patients during their remaining days and, in the process, give them the best care that they need.
A drawback to the proposal is that it gives the idea of promoting death by passing up other opportunities that can extend or save one’s life. Another hindrance to the successful implementation of the proposal is that health care professionals are not trained properly to handle such cases as they lack the communication or discussion skills needed to relay properly the benefits of advance directives without causing further damage to patients and family members such as psychological trauma. Policy Position
The National Hospice and Pallative Care Organization support the provision that was included during the drafting of the legislation wherein advance care planning consultations on end-of-life care are to be required for every Medicare members every 5 years. The organization states that, under the provision, health care providers are paid “to talk to Medicare patients about creating so-called advance directives, or ways to express their health care desires in writing before they become incapacitated” (Rovner, 2009). Policy Recommendations
• Include nationwide orientation for senior citizens on the desirability of advance directives and end-of-life care • Provide health care professionals with intensive training that will enable them to discuss effectively the concept of advance care planning to patients and family members • Establish measures to ensure that health care facilities comply with the implementation of advance care planning consultations Works Cited Barnato, Amber et al. “Are Regional Variations in End-of-Life Care Intensity Explained by Patient Preferences.
” Medical Care Vol. 45:5. (2007): 386-393. Print. Health Affairs and Robert Wood Johnson Foundation. “Key Issues in Health Reform”. Health Policy Brief. (2009). Web. Health Affairs and Robert Wood Johnson Foundation. “Near-Term Changes In Health Insurance: Newly Enacted Health Reform Legislation Mandates Dozens of Health Insurance Changes. Many Go Into Effect This Year and the Next”. Health Policy Brief. (2010). Web. Rovner, Julie. “Kill Grandma? Debunking A Health Bill Scare Tactic”. NPR. (2009). Web.