Inpatient care health reform proposal 2

The United States is in great need of health reform. The inpatient sector of health care is suffering and measures need to be taken in order to ensure quality and access to the approximately 308 million individuals living in America. This reform proposal focuses on the role of the hospital in inpatient care. According to the 2006 National Hospital Discharge Survey there are 34.9 million discharges a year from U.S. hospitals. This number does not include the 15.3 million emergency room visits which result in admission into the hospital.¹ One can see that inpatient care is a crucial sector of the health care system. Therefore, a change needs to be made to the health system to not only ensure that inpatient care is maintained but also improved. Something needs to be done about the 47 million people who are permanently uninsured as well as the 43 million who spend a lot of their time uninsured.² According to Ricardo Guggenheim, MD, for HealthLeaders News stated that, “We have an uninsured crisis in our country that is creating great imbalances in the healthcare delivery system. A significant source of this imbalance is the result of the large number of uninsured patients that are turning to hospitals for medical care.” He then continued to explain that the majority of uncompensated care is delivered in hospitals. Hospitals nationwide, in a single year, provide 31.2 billion dollars of uncompensated care. As a result, many health systems face shutting down because they cannot deal with the financial loss they face by providing services which they are not compensated for.² This creates new issues because as the population ages, it is likely that the utilization of inpatient care will rise and we can’t afford to be losing hospitals. We also can’t afford to lose emergency room services because ERs are greatly utilized currently and are already overcrowded. According to the National Hospital Ambulatory Medical Survey there are 119.2 million emergency department visits a year.

It is clear that we need a solution to these financial problems created in inpatient care. The solution: universal coverage. Congress needs to pass a law that ensures that all Americans will have health insurance coverage. This would eliminate the financial burden hospitals currently bear due to uncompensated services. It would also improve access to inpatient care because there would be room for those who truly needed to stay in the hospital. Quality of care for patients in the hospital would also be better because there would likely be fewer patients for each physician to be responsible for. This would occur because, in our current, situation many hospital beds are filled with people who do not actually need emergency care. According to Guggenheim, many uninsured individuals currently use the emergency room for chronic health problems that become uncontrolled. If they are admitted to the hospital, they are released once their condition stabilizes but they will eventually need to be readmitted. Universal coverage will allow these people to get the medications and follow-ups they need to keep their chronic conditions under control and it will alleviate unnecessary hospital use.² According to John S. O’Shea, M.D., “In Maryland, for example, patients with non-urgent medical problems account for over 40 percent of ED visits.” ³

Some individuals believe that providing universal health coverage will create more problems for the health care system than it will fix. They believe that it will create a lot of issues when trying to receive outpatient care because so many more individuals will be accessing care. It may be true that more will seek care with primary physicians, but it will also free up the hospital emergency rooms which are currently overcrowded. Why is this so important? When emergency rooms and hospital beds are filled with individuals who could be treated in an outpatient center, care may be delayed for individuals who need emergency medical attention, which is a much more serious problem than having to wait a few days to see a primary care physician.

This reform proposal is more important that other reforms because it is crucial that hospitals are not closing due to financial burden caused by uncompensated care; this will cause further problems for the health system. The inpatient sector also needs to be taken care of so that the quality of care does not suffer for those who need serious medical attention. It is also important so that access to hospitals improves so that those in serious need can be taken care of.

Sources:

1. Hospital Utilization (in non-Federal short-stay hospitals). Centers for Disease Control and Prevention Web site. http://www.cdc.gov/nchs/FASTATS/hospital.htm. January 18, 2010. Accessed March 9, 2010.

2. Ricardo Guggenheim. Uncompensated Care is a $31 Billion Problem Waiting to Be Solved. HealthLeaders Media Web site. http://www.healthleadersmedia.com/content/220119/topic/WS_HLM2_LED/Uncompensated-Care-is-a-31-Billion-Problem-Waiting-to-Be-Solved.html. September 26, 2008. Accessed March 9, 2010.

3. John S. O’Shea. The Crisis in America’s Emergency Rooms and What Can Be Done. The Heritage Foundation: Leadership for America Web site. http://www.heritage.org/Research/HealthCare/bg2092.cfm . December 28, 2007. Accessed March 9, 2010.