Month: April 2022
Heroin Abuse
This can cause some heroin users into criminals. As heroin use increased so did the illegal acts to support their habit. Crime rates were on the rise and so was health issues. People who engaged in drug use or risky behaviors tend to have an increase in spreading disease. Heroin use was concerned with Hepatitis and HIV/AIDS. The viruses can spread thru make more risky behaviors. Sharing needles also was a major concern in spreading diseases. When the AIDS epidemic started, a harm reduction program began and clean needles started to be distributed. The government was trying to get a control of the epidemic that was rising. In 1981, the purity level of heroin was around 10 percent and the price of a gram, 3260. By 1999, the purity of heroin increased to close to 40 percent and paying less. Since 1999, purity levels rose and prices stayed low. Today, heroin is between 40 - 60 percent pure. People in the last few years had started using synthetic opioid, like fentanyl. Fentanyl is a lethal drug. Since fentanyl is so much cheaper and more potent than heroin is a deadly combination. The Center for Disease Control (CDC) states that heroin and fentanyl are most likely combined and increases the risk of overdoses.
Many drug dealers have been mixing the two and causing an increase in overdoses. This didn't decrease till the government began to prosecute those drug dealers. Fentanyl raised the risk of heroin abuse and became deadly combined with heroin. Fentanyl has an effect on opioid receptors. Those receptors control breathing rates. Too much can cause breathing to stop and it can lead to death. Since 1999, opioid deaths have increased by more than 5 times it was similar to the death statistics during the AIDS epidemic. In the United States, almost 600 people use heroin for the first time. The US governments have bulked up efforts to cut supplies of heroin. Federal and state officials have even begun having more treatment centers, focusing more less on punishment and more on treatments.
Doctors are also monitoring and screening patients, especially since many blame the medical field for the increase in opioid dependency. Federal and State agencies, insurance companies and physicians are trying to battle this growing epidemic. There are new limits on prescriptions and how physicians can prescribe them. In 1989, George H W Bush administration provided non-violent offenders aid rehabilitation services and probation rather than jail time. In 2016, President Obama granted more than a billion dollars in funding. This funding was for state grants, treatment programs, and prevention programs. Naloxone, a drug that can counteract heroin overdoses were available. Harm reduction programs were launched to help provide a safer drug use, to help contain it. This continued even till now, while President Trump is in office. In October 2017, President Trump declared a public health epidemic, to give more money to the crisis of heroin use. Addiction to heroin cannot be cured but it can be treated. Medical Assistant Treatment is providing a safe level to overcome heroin use.
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Heroin Abuse. (2022, Apr 13).
Retrieved November 5, 2025 , from
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Huge Epidemic of Drugs
The United States is dealing with a huge epidemic of drugs. More than 175 Americans are dying today from opioid overdose and many feel this number may not peak for years to come. While there is an increase in overdoses, while others are suffering from opioid addiction. The crisis had reached a point that it is a risk to the public health. Some blame the medical field, for the over-prescribing of pain medicines. Heroin is an illegal drug derived from a poppy plant that is highly addictive and can produce deep feelings of euphoria. As of today, heroin is a schedule 1 drug and highly addictive but it was not always that way. There are many street names, like Black Tar, China White, Dope, Eight, H, Horse, Smack and many others. The way heroin looks depends on where it comes from. White heroin comes from Southeast Asia, Off white-light brown from Columbia, Brown from South West Asia, or dark brown/black from Mexico.
Smoking heroin in the United States do not tend to smoke heroin but may inhale or inject it. Heroin was not really invented until the late 1800s and branded a non -addictive cough suppressant and on the public market. Bayer Laboratories marketed it to the public because it had minor effects. It wasn't until the mid-19th-century opioid dependency began to develop. Long-term opioid use became a patent medicine and a standard to self-medicate. Heroin started as a cough suppressant, then a pain reliever, much like morphine until it was finally banned in the Heroin Act of 1924. Illegal Abuse of heroin began when heroin was smuggled in from China. This spread quickly until the Mafia drug distributors took over. Between 1965 and 1970, there were more addicts in the country. With the Vietnam War going on, many feared the heroin epidemic would rise, and they were correct. South Vietnam held 95 percent pure heroin sold openly.
It wasn't until 1971 reports stated that 10-15 percent of American troops were dependent on heroin. That is when the US government began to step in and regulated urine tests before discharge. After, President Nixon created the Drug Enforcement Administration (DEA) to battle the drug epidemic on June 1, 1973. Once heroin is smoked, snorted or injected, it converts and binds to opioid receptors that control pain perception, reward, blood pressure, and breathing. Arousal is also affected while using heroin. Heroin induces a high immediately after taking it and last for about 30 minutes. The high can consist of “ the nod’; a back and forth state of consciousness and time consciousness. This feeling gives a cloudy mental ability and inability to function. Heroin causes concern because it has the potential to cause respiratory depression because of the toxicity potential and the dependence potential. This continues the pattern for addicts to use. Tolerance depends on the usage but with repeat experiences, it increases. There are usually negative psychological behaviors that accompany heroin use. Since injection is the cheapest and easiest drug to hide, it became more common because the “high” was so intense. That is one reason heroin could turn into an expensive habit, the intense high.
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Huge Epidemic Of Drugs. (2022, Apr 13).
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Drug Abuse of Minority Groups
There are various personal qualities and abilities that I feel will be helpful in the social work profession. Firstly, competence is a valuable attribute that I require to demonstrate professional skills and understanding of social contexts. In most cases, troubled persons in the society would prefer a social worker that is diligent and understands the scope of their work. Secondly, the respect for the value and dignity of a person will be helpful in social work. Among the abilities include a passion for service. The fact that social work does not generate profits, passion, and devotion to service is a crucial ability that every worker should portray. Additionally, I must be able to establish or strengthen human relations. A combination of the abilities and personal characteristics improve my service as a social worker.
My strengths and areas of improvement form an environment of edification. As a strength, I am patient with persons seeking services. This attribute helps me to understand the root causes of the challenges facing young persons in marginalized areas. Further, I am organized and flexible. The two attributes have since improved my interpersonal relationships with the victims in the society from cases of drug use, violence, and poverty. My areas of improvement include the need to outsource for specific donors and resourceful parties that can help break the vicious cycle of poverty. Additionally, I have identified that I would need to create social groups and representations in the minority group as a way of facilitating social participation. Allowing the members of the disadvantaged communities to participate in their own reforms and social change would be instrumental in promoting appreciation of ideas and incentives.
My professional interests and goals act as a driving force in my daily endeavors. Firstly, the most prominent goal is to educate and empower the youth in minority cultures and communities. Empowerment at the society level includes the education and instilling of values and virtues. Additionally, I strive to contribute and improve the social work profession. To do so, I will create incentives and social attributes through which the young persons in the community can participate. Among my social work goals include promoting social welfare through an all-inclusive participation plan. I am interested in community participation field of practice, minority groups such as people of color and homeless persons. My interests in these groups include the fact that they do not have resources to outsource for professionals to argue their needs.
Among the contributions I wish to make in the profession include the creation of active participant groups. The groups will range from simple social interaction activities such as sports to advocacy groups such as children’ homes and social insurance funds. The active social participation will be more realistic in making a significant positive impact to the marginalized communities. Some of the reasons I opted training in social work from other fields was the rising social gap. There is an extensive social gap in the determination to help the helpless. As a result, I felt more connected to making a change out of compassion. Improving the livelihoods of the disadvantaged groups by empowering them to make personal and social changes is far-reaching. Clearly, social work is a passion for the betterment of a society that has no resources and infrastructures for the change.
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Drug Abuse Of Minority Groups. (2022, Apr 13).
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Marginalized Communities
My interest in social work was motivated by the need to help families in minority groups. Having been brought up in a neighborhood dominated by people of color, I understood poverty as a challenge among minority communities. At a tender age, I experienced challenges related to access to social amenities such as education and healthcare. There are different personal experiences that confirmed my interest in this profession. first, the struggles to enroll in a health insurance program in my childhood made me want to make a positive influence future generation. So, children in my neighborhood had inconsistencies in attending school leading to exposure to violent crimes and drug abuse. The negative experienced attributed to a developed passion for participating in social work to make a difference.
There are different factors that indicated that I needed professional education. Firstly, observations into the changes that were happening among the youth in a minority culture created the need to attain professional education. I watched young adults drop out of school due to social disincentives and poverty. In most cases, the young adults that are not able to complete their education are lured into drug peddling and usage. I realized that the only way I could change the situation was by getting to influence. Clearly, professional education was my best choice for solving the community problem in my neighborhood and at a larger scope. The other factor indicating the need for professional education included the need to portray a positive example that a person that has grown up in a troubled community could still make positive changes in society. Now, I resolved that I would work towards a professional education. My understanding of social work is derived from the need to make a positive change in a troubled community. So, social work is an integrated activity that involves contributing to activities which improve the general welfare of disadvantaged groups, persons in need as well as other areas without expecting payment in return. Among the factors that have contributed to my desire to understand and work with disadvantaged groups include; the need to rectify their lives and the understanding
of their challenges. Having lived amongst marginalized communities, I understand the challenges they face, the areas the system has failed them, and I have the insights on different courses of action that can be taken to solve their challenges. So, I developed an interest to work with the disadvantaged groups.
There are different groups and issues that I find challenging. The first issue is creating incentives that would break the vicious cycle of poverty among families in marginalized communities. The daily activities they face are systemic and versed with differences and challenges that can only be solved by breaking the vicious cycle of poverty. The groups that are most difficult dealing with include the youth that is already addicted to drugs or the ones that participate in organized criminal activities. The challenges in reaching out to these two groups are characterized by the fact that they have formed firm negatively motivated societies. In other cases, the social constructs have low reception to positive changes which make it difficult to infiltrate their social cocoons and impact on them.
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Marginalized Communities. (2022, Apr 13).
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Substance Abuse in Childhood
All through out histoy child abuse has always be apart of society. There is no denying that it is still an issue in an American today. Back in the 90s there were more than 18 million cases reported on child abuse to social services. That would also include about 2,000 child deaths reported annually. Furthermore more there were more than 100,00 that were reports of serious injury made towards a child. Unfortunately all those counts of abuse still limited our knowledges of the long term effects a child undergoes for the remainder of their lives. These reports brought to light the little we know about how society interacts with each other and how it leads to the abuse.
It is safe to mention that we as a society still have an issue with trying to figure out what the root cause of this issue is. There are services required for children faced with neglect and abuse, but the services are very costly. Services that are known as conscleing, medicare, foster care and special education. It was estimated that back in the 90s these services cost the U.S more than 500 million dollars. Another daming fact was that child neglect was in direct correlation with juvenile delinquency, violence and substance abuse meaning the requirement of further services is needed to combat this issue.
Why is it important we have thr proper research on child abuse?
Conducting research on child abuse and neglect is not an easy task to do. As of now we are in the shadows of what we know about the cause of child maltreatment. We are not as informed of the consequences of child maltreatment. The information we have does not always match the reports we have under our data. As you can tell abuse of any kind is usually reported due to suspicious meaning the person committing the crime is trying to conceal evidence as much as possible. By the time authorities find out about the abuse it is usually too late or as matter of fact it is extremely difficult to treat a victim someone who has been through such trauma. They then deem a danger to society and could grow into troubled adults. But still there is little known knowledge of child maltreatment and what the cause of it is. Little is known on what presidoses adult to commit this abuse as well.
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Substance Abuse In Childhood. (2022, Apr 13).
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Problematic Addictions to the Drug
Heroin is a drug with a lot of representation in the media. There are shows like “Breaking Bad,” who take the serious route of attempting to display the effects of drug abuse, however, as it is entertainment, there is a lot that can be misconstrued. There’s also the card game “Cards Against Humanity,” where you may pick up the infamous card option that says “black-tar heroin” as a response to a fill in the blank to create a funny statement. However, a highly addictive narcotic like heroin is no joke. Heroin is one of the most addictive drugs due to the short length of time it takes to infiltrate the brain.
Heroin is made of morphine, which comes from the seeds of various opium poppy plants grown in regions in Asia, Mexico, and Colombia. To extract the opium, and processed juice with immature poppy heads. In the late 1800’s, heroin proved to be more effective than morphine during drug studies, so The Bayer Company began to commercialize on what many believed to be a wonder drug. However, the patients that were administered heroin ended up with problematic addictions to the drug. In the 1910s, morphine addicts realized that heroin resulted in a high, especially when inserted through the veins. The abuse of heroin spread rapidly, and while many restrictions were made to help control said abuse, underground productions of the drug helped the addicts get their fix.
Heroin is one drug from the group classified as “opioid.” This means that when administered, the drug activates receptors in the brain that usually regulate pain, hormone release, and feelings of well-being. When activated with heroin, they stimulate the release of dopamine, which is a naturally occurring chemical in our bodies. However, too much of it being released unnaturally at once creates a high, which in turn, creates what many would call an addict, as addicts chase the feeling of dopamine release. However, these highs do not last forever. Because the user experiences small, but very high highs, use of it causes very low lows as well. The symptoms of heroin addiction that effect the user’s mood are depression, euphoria, mood swings, anxiety, and hostility. The physical symptoms are track marks on arms and legs, a constantly running nose, short breath, nausea and vomiting, respiratory infections, dry mouth, heated skin, constricted pupils, heaviness in arms and legs, extreme amounts of itching, weight loss, and the last one (in my opinion, the worst), scabs or bruising due to picking at the skin in order to get high again from the needle insertions. Psychologically, addicts also experience delusions, disorientation, hallucinations, and paranoia.
It doesn’t take much for heroin to take an effect on one’s body. The level of toxicity for negative impact/lethal dose for 170lbs user is between 75 and 375 mg, depending on the way it is administered. The long-term effects of regular use of heroin are intense sadness, irregular periods and/or difficulty having children, constipation, damage to heart, lungs, liver and brain, vein damage and skin, heart and lung infections from injecting, and dependence. In addition to the previous symptoms, the development of a tolerance to heroin causes the user to need to use more in order to get the same high they experienced with way less. While some of this damage is irreversible, there are ways to help stop addiction, such as medications developed to ween the users off the drug, similar to nicotine patches for someone with an addiction to cigarettes. There are also behavioral treatments such as therapy with voucher-based systems in which the patients earn points based off staying sober, which they can exchange for items that encourage healthy lifestyles.
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Problematic Addictions To The Drug. (2022, Apr 13).
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https://studydriver.com/2022/04/page/11/
Comprehensive Process Food and Drug Administration
The role of the federal government is that marijuana is subjected to the same rigorous clinical trials and scientific scrutiny that the Food and Drug Administration (FDA) applies to all other new medications, a comprehensive process designed to ensure the highest standards of safety and efficacy. The role of the executive branch is to create a labyrinthic world of marijuana rules and regulations. Legislative branch reschedules cannabis, expunge the records of those with prior marijuana convictions, and impose a five percent tax on sales, revenue from which would be reinvested in communities most impacted by the drug war. The administration of the judicial branch has the role of law enforcement.
In the state of Texas, possession of two ounces or less is a class B misdemeanor, resulting in up to 180 days in jail apart from a fine of $ 2,000 or more. California has a similar system in which possession of an ounce or less is considered a misdemeanor, punishable by a fine of $ 100 or more. And in Algeria, with a similarity to the previous ones, the possession of more than sixty grams, which is a little more than two ounces, is considered a serious crime, punishable by up to twenty years in prison and a fine of up to $ 50,000.
But in other places it has different points, for example, in Alaska, when a person has four ounces of drug in his house it is considered to be legal. In Canada, adults can legally possess up to 30 grams of marijuana, but it is not used in public areas. Minorities are affected by the fact that marijuana is illegal affects people because they live in an environment of corruption, fear, and a lost society because there is no control over the sale of this product. lower socioeconomic groups affected by this issue because by legalizing marijuana, more jobs would be created for this group of people. Companies would be created, in this industry, there are three types of areas in which sufficient workers are employed.
Surveys show that adults support the legalization of marijuana the most. Most people 65 years of age or older are in favor because they voted to approve the legalization. Compared to 39 percent of youth under 24 and the other 42 percent over 34. As seen above, there are partisan differences and why they have a contrast in views on the legalization of marijuana. A statistic says that eight out of ten Democrats and Democrats with a tendency, about 78% say that they are in favor of marijuana. Republican leaders are less supportive, with 55% in favor of legalization and 44% opposed.
To the extent allowable under state law, the Austin Police Department has a state law that prevents people from being arrested for possession of marijuana. Only a fine or bond must be set. In 2018, when sales of low-T-H-C medical marijuana began, a compassionate and limited use program began in some Texas cities. Although the program this program helps some patients, it is limited and controlled.
The ban has only generated the creation of an organized mafia, violence, crime, and resources that enter an illegal business. That is why to improve our society it must be legalized. A suggestion is that you approve the legal use of marihuana, create a law approving the sale for recreational or medicinal use with the exception for use in public spaces, only at home or legalize marijuana and that only approved companies can sell and create marijuana, to create jobs and have control over the sale of this product. It is the beginning of a change for not only medicinal, but recreational use of marijuana. Where consumption, sale, possession, and even cultivation for personal purposes is not punished, you must begin a process to harmonize the regulation of marijuana use. The legalization of marijuana will bring us great contributions, social, economic, and health.
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Comprehensive Process Food and Drug Administration. (2022, Apr 13).
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Drug Abuse Act of 1988
This letter is to let you know about a problem that affects my community in Texas, waiting for a solution that will help us. I am living in Texas and have seen this problem for a long time. The problem is about marijuana, specifically about the legalization. There is evidence that marijuana use does not cause health or safety risks.
The legalization of marijuana, the possibility of regulating its trade and production have been discussed as part of a strategy to combat organized crime that is dedicated to its commercialization. We will point out some positive and negative aspects that involve the regulation of sale, production, and sowing. In the United States, 58% of the 50 states have legalized marijuana. The last month more people support the legalization of marijuana in the whole country going from 61%, while a year earlier the figure was 57%. Since the legalization of marijuana in Colorado shows that its use has been regulated, it has produced a moderate drop: it has gone from 40.2% in 2018 to 37.5% in 2019.
The legalization of marijuana is the economic boom in other states a market full of small and large companies has been generated, the most important thing from the legislator's point of view: allowing a significant collection of taxes. Texas needs a higher income for its population to have a better quality of life.
There is a fund that supports an adjustment in the law to make it a civil, rather than a criminal, crime so that adults who possess a small amount of marijuana, approximately one ounce for medicinal or recreational use, receive a penalty of less than A $ 100 well without the need to go to jail. The Comprehensive Drug Abuse Prevention and Control Act of 1974 says that mandatory penalties for crimes related to the sale of drugs and marijuana are explicitly differentiated from harder drugs. They appoint a special commission to carefully analyze marijuana. In 1969, Operation Interception demonstrated that it was difficult to seal the Mexican border, but despite this, efforts to improve border surveillance and penetrate drug trafficking networks have continued. In 1994, after a fight involving a marijuana user, the El Paso, Texas city government passed the first law on the illegality of marijuana, this law says that a drug that had been used legally is prohibited. Other cities and states also did the same. Over time, marijuana was banned in many parts, and its use was punishable by law either by fine or by jail. In 1980, even when millions of people refused to follow the warning not to use drugs and that is why Congress passed a series of anti-drug measures, including the Drug Abuse Act of 1988.
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Drug Abuse Act of 1988. (2022, Apr 13).
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Biopsychosocial Model of Addiction
Now, let’s take a closer look at the biopsychosocial model of addiction. According to Borrell-Carrio (2004) in The Biopsychological model 25 years later, “biological, genetic, personality, psychological, cognitive, social, cultural and environmental factors” are the main cause of the addiction disorder. The model comes to show that the body and the mind act interpersonally and thus create the foundation of the disease. However, the suggested biological predisposition doesn’t affect the personal choice that one has before turning into the illegal substances. This genetic condition only plays a major role into increasing the risk of addicting and not necessarily inheriting the full terms of the disease.
In the Scripture there aren’t any direct statements about the biopsychological model of addiction but it does talk about temptation, sins and how to turn away from the evil. A very relevant citation from it would come from 1 Corinthians 15:33: “Do not be deceived: ‘Bad company ruins good morals.’” Another reference suitable to describe how much He is able to love and protects us from all evil if we don’t slip into the temptation could be found in James 1:12-15: “Blessed is the man who remains steadfast under trial, for when he has stood the test he will receive the crown of life, which God has promised to those who love Him. Let no one say when he is tempted, ‘I am being tempted by God,’ for God cannot be tempted with evil, and himself tempts no one.” The people who are facing an addiction have to learn and accept that God still loves them in times of trial. Endurance is not something we get born with but a skill we develop throughout our entire existence. James reminds the readers not to have any doubt or to stop relying on Him when they are suffering and feeling lost. Only He is able to heal us and show us which way to go if we decide to turn away from the sin.
Similar to most existing diseases, addiction can be treated and cured as long as the patients are willing to get help. The medical history has seen many addicts who manage to recover and never look back to the previous temptations. And while everywhere around us it is so popular to talk about much needed integration and acceptance, in today’s society some issues still remain heavily stigmatized. A great first step would be a decision to understand the root of the biopsychosocial problem itself and to acquire additional information about the numerous existing options for a treatment. If only we are willing to take that step.
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Biopsychosocial Model Of Addiction. (2022, Apr 13).
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https://studydriver.com/2022/04/page/11/
Drug Abuse and Addition
Drug Abuse And Addition
The American society has reached a point where according to the National Survey on Drug Abuse and Health, over 28 million American citizens over the age of 12 suffer from a disease related to a different drug addiction. Addictions are some of the most challenging issues in the twentieth first century. Our modern society still perceives the ongoing addictions as stigmas and sees the diseased people as being immoral, weak, deceptive and having failed at following any high values. However, stigmatizing this worldwide issue creates a barrier for those who are willing to ask for help and get a proper treatment. The negative perceptions that the majority of the population religiously follows are some of the main reasons which continuously affect the biopsychosocial model of addiction.
Suffering from an addiction has been defined as a medical disease, however, in people’s mind it still falls under the negative types of worthless acts of humanity. A simple reaction of the human brain is to easily judge certain addictions without trying to seek what the actual root of the issue might be. Our society acts lightning fast when it comes to hate the diseased and absolutely despise their behavior. If we think about it more carefully, we have all faced addiction at some point of our lives- food, alcohol, drugs, a person, a song, a place or even a memory? Addiction could be found in many different shapes and sizes, substantial or triggered only by our minds. And society creates an enormous impact on the amount of public support as well as the lack of such.
Our world is now facing two opposite positions - those supporting the addicts and others who choose to despise an belittle them. It is most certainly always be that way. The fact that we are all different in our beliefs and we are raised with different values is enough by itself to prove that there will always be an ongoing argument about whether or not addictions are socially accepted. Depending on the culture, background, family history and many other factors affecting our perceptions, the controversy will most probably keep its existence for many more decades. The ambivalence that exists among our society could be proved by the rising number of rehabilitation clinics throughout the world while at the same time many patients feel highly discriminated after they speak up about their addiction.
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Drug Abuse And Addition. (2022, Apr 13).
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Marijuana Drug Abuse
According to the National Institute on Drug Abuse, “marijuana is the most commonly used illegal drug in America -marijuana is 'illegal' in the sense that it is a controlled substance under federal law, with no recognized legitimate value.” There were heavy consequences if found being in possession of marijuana or even storing it.Under federal law, possession by itself is a misdemeanor punishable by up to one year in prison and up to $1,000 fine for a first offense. When possession is tied with sale or other criminal enterprises, federal penalties are much harsher and categorized as felonies.
As California opens the world’s largest legal marijuana market.Though the state has had a massive medical marijuana industry for more than 20 years it is just now that some states have started to legalize medical and recreational use. There are also a multitude or rules and regulation being implemented as well to control the cannabis industry. As of January 1 of this year anyone with a valid ID of 21 or older can go into a dispensary and purchase up to 1 ounce of weed but no more than that. You can also even get Cannabis deliver to your doorstep but you must input a valid state ID online as well as show your ID on arrival of the item. Not only did they tighten up the ID rules they also just recently implemented taxes on the seller, consumer and grower.
All cannabis sold legally in California from Jan. 1 will include a special 15% tax. And recreational cannabis will also be subject to state sales tax, which is around 8 percent. Local governments that allow businesses also can tack on their own taxes, which are expected to be around 5% to 10% . Growers are also being taxed $9.25/ounce of flowers and $2.75/dry leaf. Since cannabis has been taxed and regulated it has become much more of a controlled substance in which it is obtainable but not to the younger population. For now we don't expect to be seeing people smoke it in public as its only allowed on private property right now. Even still the tax on cannabis has been able to create a much more controlled market in society as it is no longer illegal to have as long as you are over 21.
Since the increase of vaping users in young teens since 2011 the F.D.A has done very little to stop this problem till now. Even Though the F.D.A are placing new limitations on vaping companies we should still be taxing and regulating vaping products, we have seen other products being taxed and in turn have decreased in sales. As well as having similar health risk as cigarettes it has become a new trend sweeping over the nations young adults.
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Marijuana Drug Abuse. (2022, Apr 13).
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Drug Abuse is a very Serious Issue Throughout the World
It is very common in the general public that most people are reluctant to get involved in social projects. A few examples of those projects are community improvement programs, social movements in regards to a number of different situations, and more. I believe for the most part people are afraid to voice their opinions just to have them rebuked by the rest of their community or the general public. Not all people are going to have the same or even remotely similar views on certain topics. So for example, most people will shy away from participating in political campaigns mainly due to the fact that politics is such a wide open spectrum in terms of differing opinions and stances. When it comes to social movements, the issue is almost the same but not quite in comparison to people’s involvement in political campaigns. To begin a social movement, people need a big enough support group to even get it running and noticeable. Sustaining the support and maintaining the movement itself is a whole other issue that I think people are worried will be the most difficult and stressful part of it all. I believe people need to feel very strong about in issue in order to be involved in it. Most people just aren’t passionate enough about a social enough to put their time and hard work into. In my opinion, people just need to realize that with just some passion and determination any social movement can be started and maintained for a very long time.
Drug use and or abuse are serious issues that need more attention. At times it's as if communities are far more worried about the distributors of drugs rather than the abusers, who need the attention the most. In order to show the importance of drug reform, certain actions and plans should be made and addressed to fix the issue. Funds should be made available for a drug for program, whether it is for the youth or older users of drugs. Classes or seminars should be provided as well, as most of the time people begin using hard drugs without knowing the effects that can be made that will eventually harm their bodies and psyche. The people closest to the drug users should be encouraged to be more involved as well, not only as a source of help for their own people, but also to set an example for outsiders who may know of someone who is using drugs.
Currently, drug abuse is a very serious issue throughout the world. In many countries around the world the circumstances are simply disastrous, as people die from drug abuse, from a different variety of drugs, and mind-altering substances on a regular basis. Drug addiction is due to the fact that economic and geographical situations play into whether or not a person will eventually fall into a life of drug abuse. A few examples of consequences of poor social conditions include unemployment and daily stress. All of this gives people a real reason to run away from their real issues in reality and instead go into the world of drugs in order to be in a different “world” with the help of drug use. Drug use puts ones human health at a very high risk. According to the WHO classification, the list of drugs includes: alcohol, opiates, cannabis, sedatives, cocaine, stimulants (including caffeine), hallucinogens, tobacco, and light substances (World Health Organization).
The key problem of drugs is that they cause drug addiction which is a disease that makes a mental and physical well-being and mood entirely dependent on that specific drug being in his or her body. Mental dependence is displayed by the fact that a drug addict believes if he or she does not have whatever particular drug in their body, then they will not be able to function properly. The need of a drug becomes damaging when it confines a person of their real self; damages relationships within the user’s family or friends; sparks up issues between the user and the society they live in; causes psychological damage to the point where the user can’t function without a dose of their preferred drug. Drugs are a major issue within any type communities, whether it is a smaller city or a very populated city. It is definitely time to take all this information into account and start a movement in order to diminish all the issues that come with existence of drugs, but most importantly the problems that come up when someone uses drugs.
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Drug Abuse Is A Very Serious Issue Throughout The World. (2022, Apr 13).
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Drug Abuse as Discrimination
Jim Crow laws are historically known to be based on pure discrimination and racial segregation. Although they came to an end when the Civil Rights Act of 1964 was signed, their propagation has been undertaken in the Justice System of the US. This is where Alexander derives the name of her book ‘The New Jim Crow: Mass incarceration in the age of colorblindness.’ The title of the book and its thematic areas are given a lot of weight in the first chapter. In this chapter, Alexander gives a chronological explanation of how racism, discrimination, and inequality came to be. She centers slavery, social discrimination, and other inhumane acts that were undertaken in the name of ‘race.’ It is in this first chapter that she reviews the evolution of civil rights movements and other humanitarian organizations. She lays a foundation for her audience so that they have a solid understanding of the pertinent issues she covers in her book.
From the early 19th Century, Alexander peruses through all the major steps and events that Blacks undertook to get closer to an equitable America. She looks at the activist works of notable figures and other socio-economic aspects like employment and the distribution of social amenities. It is in this first chapter that she finally arrives at the ‘War on Drugs’ subject of 1982. Reagan was the president at that time. The 1980s is historically one of the most dynamic and eventful centuries. It is from this ‘War on Drugs’ that the concept of ‘mass incarceration’ is introduced. She paints a picture of how certain law enforcement agencies were involved in drug trafficking and the elevation of the vice. Sadly, these drugs were traded in the predominantly Black communities.
It is from this war on drugs that the Justice System of the US begun using incarceration as an ethnic discrimination tool. Ranging from drug trafficking to other crimes, the incarceration started developing a pattern of being racially biased. It got to a point where some analysts felt that the war on drugs was a government-instigated phenomenon aimed at orchestrating one of the greatest genocides on Blacks. It is important to read this chapter because it lays the foundation for the readers so that they can have a ‘virtual feel’ of the thematic subjects explored in the book. The drugs theme is very crucial in Alexander’s book. It is from this theme that she bases many of her discussions. This theme is introduced in this first chapter. This the theme that readers should take from this chapter.
Conclusion
Alexander’s book is undoubtedly a great piece of writing. With the multidimensional approach that she uses to explore her theme, she is successfully able to propagate her ideas and ideologies to her readers. It is true that the US is still lagging behind when it comes to ethnic equality. Despite the significant progress that has been made in the last two centuries, the US still remains many strides away from being the epitome of an ethnically integrated country. Therefore, by identifying and exploring the modern forms through which inequality is being undertaken in the US, Alexander is able to both prove her point and bring to light important societal issue.
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Drug Abuse As Discrimination. (2022, Apr 13).
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Drug Abusers as Criminals
The Moscow Government's opposition to Needle and Syringe Programs backlashed with the epidemic of HIV and AIDS. There is not a unified drug addiction rehabilitation system in Russia. The state facilities are usually full, so addicts must find institutions, and religious organizations, that are mostly not qualified to deal with the problems of drug addiction or substance abuse. Anya Sarang, President of the Andrey Rylkov Foundation for Health and Social Justice in Moscow, knows the damage done in her country with such an extreme approach. “We now experience a health crisis,” she says. While majority of Russians still view drug abusers as criminals, the science is showing they could have become mentally ill and are in need of help. With the crisis at hand Moscow Social Services, signed contracts with OPORA (the Russian word for 'support') a Moscow-based non-governmental organization. OPORA was contracted to train a team of professionals from each of the Moscow Districts, with a point to begin programs to reduce high risk behaviors in youth, also providing District Coordinators. OPORA was appointed to the committee that studies prevention efforts and programs in Moscow. While others like the A.R.F. offers harm reduction services for drug users in Moscow. Russia and its citizens are facing one of its largest challenges and it is raising new debates on human rights in the country.
Substitution treatments plus needle and syringe programs are supported by most of the scientific studies and are supported by the World Health Organization and other UN agencies as the best tools to stop the HIV crisis. Rapidly it has turned to a human rights discussion with the substance and drug abusers. Some are starting to view the abusers and addicts as needing help, rather than the governments strictly enforced policies and laws that make addicts out to be criminals. Responses in Moscow have become mainly a thing for local communities and non-profits, with help from large organizations and networks outside of Russia. The necessity for new guidelines with drug policies and on human rights cannot be understated, that is alone the greatest tool available against the HIV and AIDS epidemic happening across the country. Also utilizing education and opportunity for youth, and all those interested in advancing beyond barriers of the harmful tendencies drug and substance abuse brings those affected. All the volunteers, the substance and drug abuse survivors, and all the donations to non-profits and charities, it appears are the best hopes for a change in a struggling Moscow.
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Drug Abusers As Criminals. (2022, Apr 13).
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Increase in Drug Addicts in Russia
Russia's average life expectancy rate has severely decreased over time. Accordingly, the mortality rate of the country and other areas surrounding it has increased greatly, which is a fact that is being recognized around the world. Experts who are studying Russia's alcohol and drug abuse issues have concluded that both addictions have played a major role in their declining health. In addition, their reasoning is due to the increase in related deaths having to do with binge drinking, drugs, or simply consuming them once. Death or severe injury from cardiovascular issues increase significantly on the weekends where excessive drinking is most likely to occur. Hearts and other organs tend to appear different in those who binge drink and consume drugs compared to those who don't consume at all. Alcohol consumption is allowed and even encouraged in most places because of the significant revenue it brings to the country.
Vodka is a large part of their culture and the area's income. Moreover, there is also evidence and studies to show that alcohol and drug abuse can reduce or mask political disagreement. Likewise, this may also contribute to their leniency in solving the abuse. The country has shown their part in creating and contributing to the issue, whether they want to recognize it or not. They have a substantial role in resolving the problems as well. Cutting the taxes and funding for alcohol and tobacco is a step that the government could easily take to lessen excessive use or dependency. Russia’s government has a major issue with encouraging the consumption of alcohol, which doesn't help to cease anything in the long run. Abusers of both drugs and alcohol can also develop issues with shame and guilt, leading to depression or other mental illnesses.
Manipulation and mind control are easier to inflict on those who consume. Some of the more serious abusers of alcohol do not live long enough to even suffer from liver cirrhosis. Abusers of both are not considered patients or like sick people in Russia. Hence, they are looked at like criminals. This has to do with the fact that the experts on both of the addictions claim that Russia is number one in denying scientific studies. Furthermore, there is also a widespread HIV and AIDS epidemic in Moscow, Russia. In addition, the main citizens that suffer from this disease are drug injector addicts. Without excessive alcohol and drug abuse, the country would have overall healthier and more intelligent citizens. For instance, there would be less of the issues contributing to the deaths and injuries. Finally, there would be a major attitude shift and a major decline in the negative statistics surrounding health.
Initially, in 1985, Mikhail Gorbachev started a nationwide anti-alcohol campaign that had an extremely positive impact on the issue at hand. Sales of alcohol and the amount of consumption quickly decreased. However, the campaign's success almost immediately fell through afterward. By the 1990’s, the total amount of alcohol consumed by the Russians significantly increased. Both of the wars were believed to have contributed to the abuse of many citizens shortly after. Vodka is a large part of Russian culture, so it has to contribute to the fact of why a lot of visitors and citizens alike justify the behaviors. Justification tends to stem greatly from the government of Russia as well. For instance, the government charges a significant amount of duties or taxes that citizens are required to pay when purchasing alcohol. Therefore, the citizens of Moscow, Russia are funding the government with every drop of alcohol they consume a day. Many areas in Moscow, Russia and elsewhere encourage binge drinking due to this factor that contributes to the abuse. Consequently, many experts and others condemn the Russian government on their contribution to the abuse.
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Increase In Drug Addicts In Russia. (2022, Apr 13).
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Drug Abuse in Russia
Russia has a major health crisis at hand, with the governments extreme policies on drugs and alcohol, it appears to have streamlined the discussion into a human rights one. Most Russians are still with a conservative view when it comes to recreational drugs and drug abusers. “For the time being, proposals to help drug addicts are in the realm of rhetoric — not politics,” Andrei Zykov has said. The problem is multifaceted and the solutions are not easy ones. While the crisis grows, there are some that are doing everything possible to make a difference for the better. There are also issues and those that exacerbate and enable these problems making the solutions all the more difficult to solve.
Alcohol and drug dependency are extremely important issues that have the potential to significantly harm many individuals. Excessive use of these drugs tend to be more prevalent in Moscow, Russia than elsewhere. Thus, there are many factors of the country that contribute to the main issue of abuse. Russia is number one out of all of the countries in total average alcohol consumption per year. Furthermore, the country takes first place in the highest increasing amount of drug injectors and abusers around the entire world. The number which grows every day consists of approximately 1.8 million addicts. In addition, one in three families in Russia have experienced an addict in their home. According to the World Health Organization, the annual per capita consumption of alcohol by all citizens was about 15.67 liters total. Consequently, the substantial number is nearly double the amount that the experts at some organization consider to be a national crisis. Other countries have recognized that there is a major issue behind Russia's problem. Drug abusers in Moscow, Russia have increased from 7.3 to 8.5 million in the past several years. In addition, this number grows every single day that the issue is further ignored. The extremely large amount of younger adults and teenagers who severely abuse drugs and alcohol are an increasing concern, not only in the country but worldwide. As a result, a majority of the drug users in Russia are only between eighteen and thirty years old. The average consumption among working adults is a full bottle of vodka a day or more, depending on the area that the abusers live in. These facts surrounding the main issue at hand have serious consequences on every factor and all of the citizens surrounding them.
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Drug Abuse In Russia. (2022, Apr 13).
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The National Institute on Drug Abuse
The National Institute on Drug Abuse (2016) reports that 12% of young adults age 18 to 25 reported using prescription drugs nonmedically within the past year. Additionally, young adults tend to enter treatment with higher levels of substance abuse and more anti-social behaviors, such as more illegal activities, more serious family problems, more difficulty controlling their violent behavior, and increased likelihood of pending legal action (Morse and MacMaster, 2015).
Theoretical Framework as Lens to View Intersectionality of Opiate Abuse and Young Adult Population
The intersectionality of opiate abuse and young adults naturally lends itself to the ecological and systems theory. These two theories combine to the ecosystems framework. In viewing the situation through this lens, one can examine not just the individual, but the family impact, and the larger system impact. The social worker could more accurate address the scope of the impact that opiate abuse has on not just the young adult themselves, but on all of the many ecosystems with which they are connected.
Ecological theory has a focus on inter-relational transactions between systems. Due to the interconnectedness of all of the systems impacted by this crisis, it is imperative that it be examined through this lens. Families have been impacted, school communities, medical communities, public health, substance abuse treatment facilities, pharmaceutical companies and physicians. There are so many various implications to not just how this opioid epidemic came to be, but what the best solution would be. The financial, political, interpersonal, cultural, and societal impacts of this epidemic must all be examined.
Systems theory, therefore, naturally lends itself to this as well. Systems theory examines the parts that make up the whole. This is an effective lens to view this epidemic, as there are many different stakeholders to this epidemic, and may people have been affected by it. Additionally, a solution will only be effective if the needs of all impacted systems are addressed.
Conclusion
The opioid epidemic is a crisis within the United States that first began nearly forty years ago. The implications of this epidemic have been widespread. The young adult population is particularly affected by this epidemic, as research shows they are the group most at risk for use and with the highest reported usage and overdose fatalities. It is imperative that this issue be examined through several theoretical frameworks so that one can develop an in-depth and well-rounded idea of the scope of this epidemic.
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The National Institute on Drug Abuse. (2022, Apr 13).
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Reinforcement of Federal Health Care Penalties
Doctors need to be better trained and aware of how not to commit healthcare fraud. They should be evaluated every five to ten years on their work and the practices they use.
Another form of healthcare fraud is upcoding. Upcoding is defined as: “refers to situations where providers bill for services that are more expensive then the services that were actually provided.” (Payne,2013) Upcoding is a major problem because offices are receiving large payments for services that weren’t worth half of what they received payment for. This is a type of fraud because the doctors are charging the patients insurance companies for more money than the treatment that the patient received. Most Patients never go in depth about what their insurance companies are being charged because they figure that the insurance companies will handle the expenses and they will pay the remaining amount out of pocket.
Another example of Healthcare fraud is Fraud by Pharmacist. Many people. May think that there is no way that a Pharmacist can commit fraud. It is easier than you think. A pharmacist can get a prescription note written by a doctor for a patient and they can say that they misinterpreted the three for a five or something in that nature. Ultimately, what they do is request more medicine than what is required and they either take it home or stash it in a place that only they will know that it is there. According to the article, Compounding Fraud Scheme: Pharmacies in Tampa and Miami were working with eight men from within the area to commit Pharmacy Fraud. “The pharmacies submitted approximately $633 million in claims for prescription compounded medications and received approximately $157 million in reimbursement based on the claims.” (Mena Report, 2016)
There are many changes that can be made to correct and overall deter healthcare fraud. Healthcare fraud didn’t begin with one person and it will not end by being stopped by one person. Overall, I think doctors and Pharmacist and everyone in the medical field need better training and education on fraud being committed in the healthcare system. Some people may not know they are committing fraud until they are too far gone and don’t know how to control it and they don’t know how to stop or don’t want to stop. A pharmacist or doctor is not going to know how to commit fraud or do fraudulent things unless they are shown or taught how to.
According to the article Health Care Fraud and Abuse, “One of the most effective ways of controlling fraud and abuse is through reinforcement of federal penalties.” (Rudman, 2009)
I think that statement is very true because if a person knows that if they are caught doing fraudulent things and know that there are federal consequences for the fraudulent behavior they will be less likely to commit Healthcare Fraud. Aside from training and education I think that is the most effective way to stop Fraud in the Healthcare system. Also stated in the article, “During 1988 and 2000, the federal government recovered slightly over $1.8 billion from healthcare providers who committed fraud.” (Rudman,2009) Healthcare fraud has been going on for years and people are caught committing fraud all of the time. I think once you get the government and federal people involved then people become scared and stop committing fraud.
When people know that there are consequences and strict laws against a crime they are less likely to commit the crime. But if they see others getting away with it and not being caught then they think that they will be okay to do it also. If there are televised and new stories about people being punished for committing healthcare fraud I think then people will see the real harm in the situation. Overall, I think with better Training and understanding of Fraud and the harm that it does to not only the insurance companies and the patients also the doctor offices and employees involved. People will be better educated and encourage others not to commit fraud. I also think that there should be televised and printed awareness seminars and rallies against Fraud in the Healthcare System. The more people are aware the less it will transpire and the consequences need to be fair and strict.
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Reinforcement Of Federal Health Care Penalties. (2022, Apr 13).
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Healthcare Fraud
There are many crimes committed daily. Many people wouldn’t consider this specific crime to be as serious as murder or rape. Overall, it is still very important. Crimes in the Health Care System is a very serious White-Collar Crime. There are many elements with crimes in the health care system. Fraud by Doctors, Unnecessary Surgery, Medication Errors, Fraud by Pharmacists etc. The most important topic is Fraud by Doctors.
Fraud by Doctors is a very serious matter. There is a certain level of trust that you give someone who knows everything about you. It is very concerning to know that they may be sharing your personal information with others or committing fraud. According to the textbook, “The most pervasive form of Fraud committed by doctors entails the commission of Medicare and Medicaid fraud and abuse. (Payne, 2013) By using the Medicare and Medicaid as a form of fraud the Doctors are taking money from innocent people. They are making up claims and charging for visits that never happened in the end the only person that suffers is the insurance companies and the patients.
“It is estimated that between 3 and 10 percent of health care spending is lost to fraud.” (Payne, 2013) Some people are not aware that their insurance companies are being charged for visits or other things even though they may have never been seen by a doctor. In my opinion,
a great target for Doctors would be elderly patients that may not be aware of their payments and doctor bills. Elderly patients aren’t going to question their insurance company if a doctor visit mysteriously raises in price or if they get a bill in the mail for compensation for a visit that they never received.
“The Medicare and Medicaid Anti-Kickback Statue (“AKS”) is the main federal fraud law applicable to financial relationships within the healthcare market, including relationships between providers and their patients and between healthcare manufacturers and their customers.” (Krause, 2012) Kickbacks are used as way to get monetary gain from other doctors and their patients. For instance, if you schedule an appointment to see your primary care doctor for an illness. And as a result of the illness you need surgery. Your primary care doctor will refer you to a surgeon. But have you ever noticed that they won’t name multiple surgeons? They usually name one surgeon that they are aware that does the specific procedure that you need. In other words, they are more than likely in a kickback situation with the doctor that they referred you to.
Training and Education play a major role in Healthcare Fraud. For instance, when you are studying to be a doctor you may not know all of the problems that may occur along the way. Many doctors follow what they are taught in training and what they learned in their programs in college and etc. If you are trained to be a corrupt doctor or to steal from patients then that is what you will practice. “Implementation of fraud and abuse education and training programs may be facilitated through establishing corporate or staff coding committees to create standards and protocols. (e.g., standard abbreviations, documentation for medical necessity).” (Rudman,2009)
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Low-Cost Care
As long as demand for medical care is greater than the supply of providers and facilities (it always will), rationing is inevitable. One suggestion to combat this, as this is the chief complaint of a single-payer system, is to enforce a policy of transparency. All payers must completely disclose levels of coverage and price, giving consumers the ability to choose. This aligns with the current policy in privatized health care, which exists alongside a single-payer system. In this way, no one is “forced” to accept the inherently long wait times associated with a single-payer system. Cost is the key factor with this suggestion. The VA offers low-cost care. This transparency plan would require all payers to price their policies competitively, otherwise many individuals will go uninsured.
Another approach would be to improve the existing single-payer system, extending coverage to all Americans. The current health care budget would be utilized. Infusing the total budget into one system as opposed to many would likely improve outcomes. Competition would exist among hospitals and providers, as each individual would have the liberty to choose where he or she wants to receive care. Choice appears to be a leading reason that people oppose a nationalized health care system. To address this, a more provider-friendly reimbursement system would be adopted. Emphasizing performance on key metrics, including wait time and patient satisfaction, could motivate providers to provide a higher quality of care and reward them for meeting these metrics. Thus, a more welcoming environment for patients would be created. Also, dollars from businesses could be used elsewhere. Perhaps to provide other benefits to their employees. This option would also call for transparency among hospitals and providers for billing, which would increase competition and incite competitive pricing for services. Finally, this option would offset the risk assumed by the government due to a larger number of members.
FUTURE EVIDENCE
The two main complaints about a single-payer system are lack of choice and long wait times. Evidence should be obtained that supports the claims that a single-payer system would increase choice and improve or leave wait times unchanged. Currently, there is no evidence that the VA’s wait times are any longer than non-VA wait times. The average wait time in major metropolitan areas for non-VA hospitals is 20 days (Klein, 2014). In areas like Boston and Los Angeles, wait times are about 60 days on average. Current and trending data on wait times needs to be obtained by both the VA and non-VA hospitals to determine how the single-payer system performs in this regard. Also, a common set of metrics should be developed to accurately compare the performance of the single-payer system to the multi-payer system in the U.S.
CONCLUSION
Based on the information provided, it can be concluded that the VA Health System is a model for a single-payer health system in the U.S. The VA Health System satisfies each of the criteria in Berwick, et. al’s Triple Aim. The VA Health System offers a high quality of care and improves on it, as evidenced by patient satisfaction surveys and self-reported metrics. The VA, although it is experiencing a shortage on the supply-side, is increasing population health among veterans by expanding access to care and carefully coordinating that care. Finally, the VA offers low to no-cost care to all its members. It meets the Triple Aim to the best of its ability and, therefore, serves as a model of what a single-payer system in the U.S. could be with more support, staff, and funding.
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Population Health Care
Quality of Care
A common complaint about the VA health system is the long wait time. This means that care is not being provided in a timely manner. This is because there are not enough doctors, nurses, other medical staff, and hospitals to accommodate all VA members and their needs. This limits access to care, which is likely to decrease desired health outcomes as described in the definition of quality of care. It was also reported that claims for disability, which the VA uses to determine the amount of cost-sharing, can take up to 36 months in some areas (LaForce, 2017). This can also hinder access to care, which would decrease quality given the definition used for this criterion.
Population Health
Due to the long wait times experienced by some VA members, have resorted to going without care or (in some extreme instances) killing themselves (LaForce, 2017). As population health is related to the health outcomes of a group of individuals, if individuals in that group have declining health or are killing themselves it can be said that population health is decreasing rather than improving.
Cost of Care
Due to the VA assuming most of the risk as the single-payer, it has resorted to rationing care as a means of reducing its risk. If tax dollars will not cover care, care must be rationed. As stated previously, most veterans have low to no copays for most services and prescriptions. However, there is a tradeoff. While the VA is reducing the financial cost of care, there are other implications.
CURRENT CONTROVERSIES
Rationing of Care
As the VA offers low to no-cost insurance to its members, it resorts to supply-side, or nonprice, rationing to control utilization. With this type of rationing, resources are limited. While the VA is not purposely limiting access to care, it does not have enough resources to accommodate its members. This results in the rationing of care. The VA’s rationing of care comes in the form of long wait times. Patients have died while waiting to receive care. In a 2018 report, it was revealed that patients at the Washington, D.C. VA Medical Center underwent prolonged anesthesia because the necessary surgical instruments for their procedures were not available. Doctors and nurses at that facility also admitted to borrowing supplies from a nearby hospital to try to overcome the shortages (Spradley, 2019). Due to being underfunded and over budget, the VA Health System is unable to manage its facilities to offer care to all its members in a timely manner.
Cheating Metrics
The VA hospital has a performance metric with the goal of seeing veterans for non-urgent appointments within 2 weeks. The VA offers financial incentives to hospitals that meet this metric. As a result of cheating metrics relating to the wait time, the VA hospital in Phoenix is responsible for 40 deaths (Klein, 2014). At the Phoenix location and others, administrators created secret waiting lists to hide the true wait times.
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Quality of Health Care
Quality of care is challenging to define and measure. The definition of quality of care that will be used for this discussion is how well health services increase desired outcomes, given current knowledge. Quality is assessed using predefined metrics. The VA uses a tool called Strategic Analytics for Improvement and Learning (SAIL) to assess performance on the desired metrics. The VA keeps track of each hospital’s performance quarterly. The VA also gives each hospital an End of Year Hospital Star Rating based on these metrics. A hospital may receive a rating of 1 to 5. As there are many metrics the VA uses, the star rating will be used to discuss how well the VA addresses the care component of the Triple Aim. Per the VA website, at the end of 2019 57% of VA hospitals improved their EOY Star Rating from the previous year (“Quality of Care”, 2019). More than half of the VA’s hospitals improved their performance between 2018 and 2019. Also, 81% of patients surveyed were satisfied with their care, as compared to 77% of Medicaid patients (Klein, 2014). Based on this information, it can be said that the VA is improving the quality of care and meeting the first criterion of the Triple Aim.
Population Health
Population health can be defined as the health outcomes of a group (Kindig & Stoddart, 2003). The VA refers to it as “Improving the health of each veteran, by understanding the health of all Veterans” (“Population Health Services”, 2015). The VA hospital system has a department that has created performance measures that it uses to make decisions that impact the health of all veterans. For example, the Population Health Services office of the VA uses Clinical Case Registry software to help doctors monitor, track, and coordinate care for veterans with chronic conditions. Using data that is gathered from this software, the VA makes informed decisions regarding care for its members. The VA is addressing the population health component of the Triple Aim.
Cost of Care
As of 2016, the VA reported annual out-of-pocket costs of $320 for its members (“The Affordable Care Act, VA, and You”, 2016). The VA boasts that it does not charge monthly premiums, enrollment fees, or annual deductibles. Members may pay copays for medication and primary, specialty, or inpatient care. As of 2020, the VA’s copay rates remain the same. Also, the VA only charges its members one copay per day, regardless of the number of appointments a member has (“The Affordable Care Act, VA, and You”, 2016). The VA has an 80% discount on prescription drugs, as compared to Medicare Part D (Oprysko, 2019). The VA also does not charge a copay for mental health counseling, care related to service, lab tests, EKG, and wellness programs. Members with at least 50% disability, or who cannot afford care, receive free care. As reducing each individual’s cost of care is an element of the Triple Aim, it can be said that the VA is meeting this criterion.
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Quality Of Health Care. (2022, Apr 13).
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Single-Payer Health Insurance
Running head: The va healthcare system 1
The va healthcare system 8
The VA Healthcare System: Is It Really a Model for Single-payer Health Insurance in the U.S.?
Alexandria Watson
Texas A&M University – Corpus Christi
HCAD 5312
The VA Healthcare System: Is It Really a Model for Single-payer Health Insurance in the U.S.?
A single-payer health insurance system is one in which there is one primary payer. A single-payer system is also called a national system because the primary payer is the government. A government agency pays providers in this system. In the United States, the single-payer system exists alongside private health insurance options.
The Veterans Administration (VA) Health Care System is a single-payer program in the U.S. In recent times, keeping the Affordable Care Act (ACA) versus adopting a nationalized health care system has been discussed. As the VA is currently an example of a single-payer system in the United States (Medicare is another (Stark, 2017)), it makes sense to use it as a reference in these discussions. If it is used as a reference, it must be determined whether the VA is a model for a larger single-payer system. There are arguments in support of this idea, which claim that the VA has spearheaded advances in medical technology (“The VA”, n.d.). There are arguments in opposition to this idea, which claim that the VA is inefficient and has longer wait times (Stark, 2017).
In light of the opposing views, both viewpoints will be discussed along with current affairs and controversies relating to the VA as a single-payer system. Based on the collected evidence, public policy will be suggested with contingencies for future evidence that needs to be collected. Finally, a conclusion will be made as to whether the VA can truly be considered a model for single-payer health insurance in the U.S.
First, some criteria need to be set. The criteria to be used to determine if the VA is a model for single-payer health insurance is the Triple Aim developed by Berwick, Nolan, and Whittington. The Triple Aim is a set of interdependent goals for improving health care (Berwick, et. al, 2008). The three aspects of Triple Aim are improving the quality of care, improving population health, and reducing the cost of care. The population that is being used as the sample for this discussion are those currently insured by the VA. Each of these criteria will be discussed with evidence in support of the VA as a model for a single-payer system, as well as evidence in opposition to the VA as a single-payer system.
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Baby Boomers and Health Care System
“According to the U.S. Bureau of Labor Statistics (BLS), demand for registered nurses is expected to increase by 16 percent from 2014 to 2024. This rise will add an additional 439,300 job opportunities for nurses.” (Bradley, 2016) So, why is this prediction so precise? This prediction of the fall of our healthcare comes from the aging baby boomer population. Approximately 75 million people, who fall into the category of having a birth rate following the World War II are considered to be baby boomers. The baby boomers are heavily influencing the health care system and the nursing profession. Hypertension, high cholesterol, obesity and diabetes all challenge nurses to provide more critical and invasive care to ensure this generation to live longer. (Bradley, 2016)
On the same hand, the older the generation is getting, the lower the jobs are becoming. While we already have this relevant problem of nursing, the demand of nursing is intensified by the aging baby boomers. Nurses considering retirement are two-thirds of baby boomers. This seems to be an unending cycle. As there are not enough spots for nurses to fill, some employed nurses are soon to be resigning from their nursing position which causes even more of a shortage.
“The harm to the healthcare industry goes beyond the numbers. The loss of this intellectual asset may be acutely felt in terms of quality of care and patient satisfaction. To withstand this loss, healthcare administrators need help in preparing for the nursing workforce of the future. The survey found that nursing education roles will be hit hard by the retirement surge, which could impact the ability to educate incoming nurses who will replace those who retire.” Numerous factors play into this problem because without experienced nurses to educate and gain knowledge from prevents potential new nurses from gaining experience and becoming an effective nurse. You can't become a successful, life saving nurse a priori, and just expect to know what to do in every instance in real life, you have to observe other nurses and doctors. You gain knowledge watching other people work to know how to treat patients and how to communicate effectively.
What are things our healthcare can do to prepare for this shortage? Healthcare is constantly evolving, and nursing advancements must continue to include changes in the technology used to support it. Currently at the forefront of healthcare is the need to be ready for the aging population of baby boomers (a generation of people born 1946-1964). Because health deterioration affects more people over the age of 65, the healthcare infrastructure must adapt to this diverse groups needs. Mannheim’s Sociology of Generations, a book written by Jane Pilcher, analysis the problem of generations and the rhythm to it. She states, “He maintains that attempts to discover the ‘rhythm of history’ can be achieved only through research into the ‘nearer and more transparent fabric of social processes’ and their influence on the phenomenon of generations, since ‘any biological rhythm must work itself out through the medium of social events.” I think this is a very relevant concept because this shortage has been a long going with no or very little effort to fix this problem. People should start analysing our society as a whole in relation to chronic disasters to potentially fix these problems.
Even though there are challenges adjusting to any new advances in healthcare, the world's current fast paced current technological advancements mold well with the successfully and timely inclusion of necessary requirements for managing this boomer generation. According to Shiftwizard, nursing officer Shane Parker offers his own solutions to overcoming this shortage. One of them being accommodating schedules to professional nurses. He states, “Achieving and maintaining a personal and professional life balance is often difficult for nurses, and nurse leaders can improve nurse recruitment by offering altered schedules for nurses that better accommodate both their personal and professional needs.” This could be an effective solution because some potential nurses who are interested in the health field simply can't because of their background and schedule. For instance, a single mother of 3 children can't simply work 12 hour shifts as she has to transport and take care of her kids. The ability of offering flexible shifts can easily draw in more nurses and gain satisfaction.
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Nurses are the Backbone of Future Public Health System
Nurses are the backbone of future public health system. Nurses take on the roles of empowering patients to actually look at their lifestyle and identify how they can care for their own health. It doesn't have to be high tech, or even hugely costly, but getting people involved in active lives in our communities will assist the health promotions and well-being agenda for the future generations to come. Although a nursing shortage has been a chronic disaster for numerous years without the problem being fixed, non-eligible nurses, shortage of educators, and baby boomers have all factored into this shortage immensely increasing the shortage.
People often underrate nurses and the complex education credentials they have to uphold to. According to the statistics of the National Council on State Boards of Nursing (NCSBN) only 84.5% of the 157,882 whole took it passed on the first attempt in 2015. With that said, the other 15.5% failed the National Council Licensure Exam (NCLEX) RN. The test is graded as pass or fail, and although you get a Nursing License and are qualified enough to start working in the hospital, no plague will prepare you for the high stress and critical thinking you have to endure on your own. As they say, it takes a special type of person to become a nurse.
A big problem that is attributing to this shortage is the intense competition getting into nursing programs. The general response to this would be, “How would there be a competition getting into nursing schools if there's a high need for nurses?” Cable News Network (CNN) Money wrote a story on how in the middle of a nursing shortage, nursing schools are actually rejecting thousands of applicants. While there is a worldwide nursing crisis, applicants that have graduated at the top of their class, some with a 3.5 GPA or better, are getting turned down from nursing schools. As I'm sure you have to pass and score above a certain percent, its shocking to see how lucrative and hard it is to be accepted to further your education to contribute to this disaster. (Kavilanz, 2018)
The struggle to find qualified teachers is also a problem with not only properly training nurses but it limits the nursing school staff which limits potential applicants. According to CNN, “The annual national faculty vacancy rate in the nursing program is over 7%. That's about two teachers per nursing school or shortage of 1,565 teachers.” This is a very high percentage of nursing schools without enough teachers. It puts enormous stress on the health care system in general. Clearly, there's a supply and demand gap in nursing and nursing teachers and it is likely it will only continue to grow. Not to mention the NCSBS raised the passing standard on the NCLEX further complicating the matter.
Taking a closer look at the reasons behind the faculty shortage there are a complex amount of factors which all have a interconnected role as why such a shortage currently exists. Low salaries is one of the primary drivers why many clinical practices do not pursue to academia. Older age of faculty and their pending time of retirement also play a role. The workload of faculty is a problem when its constantly changing, many faculty feel they are not meeting the role expectations.
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Healthcare System has Many Pros and Cons
Despite the documented challenges that the U.S. health care system faces, it also enjoys a number of advantages over other systems around the world.
Choose 2 other countries from around the world and discuss the strengths of the U.S. health care system as compared to these countries from an administrator’s and a third-party payer’s perspectives.
In your answer, be sure to not only discuss each strength, but provide an explanation as to why you believe the United States has this advantage over the other countries you chose.
What determines if a country has good healthcare? The United States healthcare system has faced many challenges on its journey to provide good healthcare that is adequate for both the country and its citizens. Despite the challenges the United States healthcare has faced it has a number of advantages over other healthcare systems around the world. The strengths of the United States healthcare system can be noted in this comparison with healthcare systems in Canada and United Kingdom from an administrator’s and a third-party payer’s perspectives.
Canada healthcare system is thought by many to be free and advantageous over the United States healthcare plan. Although Canada’s healthcare plan has many pros compared to the United States those pros do not make their plan superior. This essay will discuss some of the strengths of the United States healthcare system compared to Canada’s. Canadian Healthcare plan has often been considered free healthcare. Canada’s healthcare, however, is not free.
Canadians do not get billed after using healthcare services, instead Canadians pay for healthcare through the country’s tax system Canada’s healthcare is funded by a “single-payer” system. Coverage is publicly-funded, meaning that the funds come from federal and provincial taxes. Additionally, care is provided by plans created in each province or territory, rather than a single, unified federal health plan.
Canadian government only covers necessary health services (US). This differs from the United States healthcare plans that are mostly ran by private healthcare companies. There are some instances where the government steps in with some safety nets for those who have disabilities, are unemployed, or live at or close to poverty level. Otherwise, Americans take care of their own healthcare without assistance from the government (US).
In the United States third party payers are able to collect more of a profit from citizens due to individually purchased health insurance and administrators are able to run their facilities without a large amount of government intervention. Canadian also have long wait times for healthcare. These wait times stem from many things, but currently here’s about one primary care physician per 1000 people, and the rate of available specialists is similar. From the time it takes to receive a referral by a GP – to receiving treatment – Canadians wait an average of 21.2 weeks to receive treatment from a specialist. MRI procedures could take up to 10.8 weeks. Some argue that the wait times are far too long (Are).
Patients are guaranteed reasonable wait times for urgent needs but can expect to wait longer to see a specialist or have an elective procedure done. Generally, all efforts are made to streamline appointments for life-threatening issues but there can still be some wait time involved (US). The United States has the advantage of shorter wait times. This is due to administrators wanting to continue to receive business from patients and keep their turn around time good. Third party payers want to keep their profit margins high, so they need their facilities to be able to see a large number of patients at a fast pace.
Healthcare in every country is unique and each country’s healthcare system has many pros and cons. It is important to consider healthcare from all players perspectives. The one thing each nations healthcare system has is common is the goal of providing quality health care services to its citizens. Healthy happy citizens are able to live long productive lives which creates a stable society.
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COVID-19 is a Health Care Crisis
The corona virus pandemic has not only caused tens of thousands of deaths, more than a million people have been infected in the past few months across the planet, but is also disrupting the values and social order of the world. Covid-19 is causing a crisis from health, spread to economic, social, and political. Many major stations in the world such as BBC, VOA, RFI, RFA, VATICAN NEWS update daily news about Covid-19. Since January 2020, there are 503,594 cases and 18,860 deaths identified Covid-19 cases throughout the United States (Sources: John Hopkins University). According to the World Health Organization (WHO), Coronavirus disease 2019 (COVID-19) is defined 'as illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).' It is short for “Coronavirus Disease 2019 (Covid-19). It was first reported to WHO where it happened in Wuhan City, Hubei Province, China on December 31, 2019.
Since then, the situation has changed drastically. The wave of Covid-19 is rushing into the United States. America has to concentrate its efforts to fight the epidemic. With most states establishing 'stay-at-home orders,' public gatherings of any kind are prohibited. Many festivals have been postponed and restaurants closed, allowing for pick-up or delivery only. The US government has recently implemented guidelines for 'social isolation' and 'self-isolation.' Social distance is considered deliberately increasing physical space between people to avoid spreading disease. Staying away from others for at least six feet will reduce your chances of catching COVID-19. People who have been exposed to new coronaviruses and who are at risk of COVID-19 infection may practice self-quarantine. Health experts recommend that self-quarantine lasts 14 days. Two weeks provides enough time for them to know if they are sick and can spread the disease to others.
All these have affected individuals and households. For individuals, the fear of the spread of the disease is so terrible that it makes people worried they might be the source of spread to their families or relatives. Non-essential offices are closed, causing financial and economic fears due to unemployment. For households, outbreaks of COVID-19 disease can occur at any time in the community. Therefore, adherence to CDC guidelines is essential.
Practice everyday preventive actions such as avoiding close contact with an infected person, staying home when sick, covering coughs and sneezes into tissues, cleaning surfaces and objects that come into everyday contact (for example, tables, countertops, light switches, doorknobs, and cabinet handles) with normal household water and detergent.
Learn about workplace emergency plans such as sick leave policies and telework options for sick employees or those who need to stay home to care for sick family members.
In short, the global picture of the worldwide epidemic is spreading rapidly within the community. Measures such as mass testing, mask use, traceability of cases and rapid isolation of suspected people have brought positive results in reducing Covid-19 spread. These help prevent or slow the spread of disease allowing the health care system to more easily take care of patients over time. Although such measures have caused economic losses to the nation, as well as social and psychological consequences, but in return, the disease will be repelled. Fighting an epidemic that is destroying human life and threatening the planet is an absolute priority. It is necessary to immediately support medical measures, encourage the implementation of such measures and violators must be punished. It is respect and support for health workers who are exhausted on the front lines against epidemics. Between health and freedoms, we have no choice.
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Uninsured People
The barriers to health care among nonelderly adults by insurance status as of 2016.
This high rate uninsured people are due to high cost, and unfortunately due to this many people are not able to receive the medication they need. An article in the Henry J Kaiser foundation said, “In 2016, uninsured nonelderly adults were three times as likely as adults with private coverage to say that they postponed or did not get a needed prescription drug due to cost (18% vs. 6%).” (“The Henry J. Kaiser”).
Nevertheless, those that are uninsured do not get all the recommended services for follow up care after the treatment of an injury or chronic disease even if they are on the similar plans with an insured person. (“The Henry J. Kaiser”). However, with the enation of the Affordable Care Act (ACA) there hasn’t been so many changes. The goal of this system was also to give those with low income the chance to afford Medical bills. The ACA created an even operation for the government, employers, and individuals, making sure that all Americans have access to affordable and good-quality health insurance. (Dickman, Samuel et al).
Unfortunately, over 27 million Americans are still uninsured even with the gains from the Affordable Care Act. And this number is said to likely increase under the reforms advocated by Republicans. (Dickman, Samuel et al). The insurance policy that was created in the US was created to help reduce expensive health cost but there is still an increase in the number of Americans that cannot afford insurance. This high cost has led to the widening in life expectancy among the wealthy and the poor and if this continues, United States may become a nation which there will be little or no care for the poor and only the wealthy will be able to afford medication which will continue widen the life expectancy of the wealthy to the poor. (Dickman, Samuel et al). Healthcare bills in US has left so many people in debt.
In an article in Lancet, it is said that “One in four non-elderly adults younger than 65 years (and one in three with annual household incomes $3000) and worse health than the overall population are particularly at risk” (Dickman, Samuel et al). These statistics shows how much debt so many young Americans are into because of medical bills in 2015 and one can only imagine how much change has occurred over the past 3 years.
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The Health and Medical Service Act
In the graph above, it is seen that the United States spent almost three times on healthcare as the average of Sweden and other developed countries with comparable incomes, according to data from the Organization for Economic Cooperation and Development (OECD). However, despite spending more the result gotten from US health care system does not bring better result compared Sweden’s system who only spent half. Sweden who spent $5,000 less per person than the United States on healthcare still has a higher life expectancy at birth than the United States. (“Los Angeles Times”)
However United States remains a great nation and I believe there could be a change in the health-care system if high quality care is given to all citizen. Sadly, financial institute of the health care system in the U.S. has not made this possible and this has left so many American uninsured. Compared to Sweden’s health care system, inequality in the U.S. system keeps rising and leaves millions of Americans not visiting the hospital. The United States is one of the developed countries that do not provide health care coverage to all citizens as a right. But I think it is high time U.S. found a new model of care that is both less expensive and gives better outcome. This can be done, but it is left for the citizens to insist on a more reliable and equal financial health system (Harveston, et al)
On like the U.S. system, Sweden uses the Beveridge system, where it is government funded but private physicians exist too. This government funded system gives everyone access to equal healthcare right and even non-citizen don’t pay as much as you will pay for medication in the U.S. The responsibility for health and medical care in Sweden is taken care of by mostly the central government, county councils and municipalities. These levels of Swedish government are involved in the health care system. The Ministry of Health and Social Affairs at national level takes care of the overall health and health care policy while they work with eight national government agencies. The monetary health services are taken care of by 12 county councils and 9 regional bodies in the regional level and 290 municipalities are responsible for care of the elderly and the disabled at the local level.
The Health and Medical Service Act takes care of the responsibilities of county councils and municipalities and this gives local governments more freedom in this area. The work of the government is to make principles and guidelines, and to set the political agenda for health and medical care. This is done successfully through laws and ordinances with the Swedish Association of Local Authorities and Regions (SALAR), that represents the county councils and municipalities. Everyone in within the municipalities are on the same level, so this helps give equal responsibilities to achieve a great system. In Sweden county councils, about 90 percent of their work concerns health care. The municipalities also take care of people with one physical or psychological disorders. They also provide support and services for citizens who are just released from hospital. Sweden also focusses on the use midwives for child births. Midwives is a person trained to assist women with child birth. Midwives play a vital role in the reduction of mortality during childbirth (Sweden).
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American Health Care System
The health care policy of a nation is a very important aspect of a nation which should be one of the major priorities of the nation. However, regardless of how important a health policy is in a country, the way it is run differs from one nation to another. One can define a health care policy as a policy given to achieve a functioning health care system. However, health care policies are also decisions, plans, and actions which are undertaken to achieve specific health care goals within a society. An excellent health policy can achieve so many things which may include creating a future which will help in the establishment of targets and points of references for different term (“Journal of Healthcare Communications”). There are four major types of health care system. Firstly, we have Beveridge Model. In this system, majority of the hospitals workers and doctors work for the government. Nevertheless, they still have the private physicians available. Secondly, we have Bismarck Model, this is a national single-payer health care system. This system looks like to the United States(U.S.) system because employers provides their employees insurance but unlike the U.S. in this system, everyone must be compensated. Thirdly, we have National Health Insurance Model, this system offers a third type of national single-payer health care system. These types of healthcare systems are very popular in Asian countries and the National Health Insurance Model put together some of both Beveridge and Bismarck. Finally, there is the private insurance system. In this system, individuals are either covered by their employers, covered by a private policy the policyholder purchases themselves or they go without coverage at all (Harveston, et al.).
However, in this paper we will only be comparing two countries who uses two of these major types of health care. We will be comparing Sweden who uses the Beveridge model and United States who uses the private insurance system. The results gotten from the health care in these countries are quite surprising given that U.S. has a larger GDP for health care than Sweden, still Sweden is still able to provide full health insurance for citizens. This paper will also aim to compare the differences between the health care policies of these two countries, how they successfully apply the policies and what they can get from one another to help them achieve a better healthcare system for the citizens.
The U.S. has a very high scientific research standard, which has helped the U.S. health system have one of the best medical treatment techniques around the world today. This high standard as even led foreigners to come to the U.S. for medication from all over the world (“Pocketsense.Com”). However, it is quite sad that the United States health care system does not cover all its citizens. Most people must be registered in a program or another, so they can have reduced health bill. Some are fortunate and can get insured under the company they work for while others will have to pay out of pocket. The U.S. has two major types of healthcare insurance system. An article ballotpedia said “The nation uses a mixed system of public and private insurance. In United States, there are two major health care programs. These programs are Medicaid and Medicare. Medicaid are for low-income people and individuals with disabilities while Medicare are for people 65 or older or younger people with certain disabilities or kidney disease. Also, about 48 percent of Americans are enrolled in a private health insurance through their employer. While the remaining 52 percent remainder purchase private insurance from personal insurance company or they get insured through a different community funded program, such as the military's TRICARE” (“Ballotpedia 2018”, par. 3 ). These programs help create stability in the way the health care system in U.S. is. Although Medicaid was created as a program for low-income citizens, there is still so many citizens out there that are still uninsured.
This is quite unfortunate that with how developed U.S. is and the improvement they have tried to make to their health care system, some people never get to visit the hospital throughout their whole life since they are unable to pay medical bills. A single doctor’s visit can lead to so many financial crisis therefore, some people are unable to get optimal care because they are not able to afford a good insurance or doctor. Thus, they are driven to either pay coinsurance or make a component which only leads to more financial crisis. Nevertheless, some people are still able to pay hundreds of thousands of dollars in premiums, which are mostly made through their workplace donations. Some of these contributions don’t include prescriptions which are sometimes expensive. (Newkirk, par.2)
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