Deck 8: Government Health Insurance Programs: Medicaid, Chip, and Medicare

Question 1

What do you think of the term medical error as adescriptor of adverse medical outcomes? After all, there are many medical procedures (e.g., invasive surgeries) and treatments (e.g., chemotherapy) that not only are inherently risky, but also cause painful and dangerous (and often unpreventable) side effects (i.e., that lead to "adverse" medical results). Given this fact, is it conceivable that the healthcare delivery system could ever operate free of "error"? Can you think of other terms that better (or more fairly) convey the range of adverse outcomes attending healthcare practice?

Answer 1

Medical Error:
Medical error considered to be bound and often occurs. Considering, medical errors are not an obvious new problem that frames issue of public health to relative new phenomenon, and providers of healthcare, public health professionals. This creates recent years of commitment that increases attention over problems related to medical errors.
Medical errors occur ultimately in adverse of health outcomes and morality indicating problem not confined to single ethnic or racial population, geographic, socioeconomic sectors. On the whole number of human die due to the medical errors than from diseases like breast cancer, Acquired Immuno Deficiency Syndrome (AIDS), and motor accidents.
Negative effects of medical error on individual patients and society include associated reductions over work productivity, associated costs correcting injuries, loss of income supporting medical errors. A public health problem needs sturdy response among others, legal system, and policy makers.
There are also different causes related to medical errors. They are caused of actions relatively concrete like failing to complete intended medical action, implementing wrong action, using fault equipment or products effectuating course of action. This occurs in failing stay abreast from an individual's field relating to medical practice or health of professional inattentiveness. The errors that occur due to wrong drugs are preventable.
There are varied causes of errors. They are broad and systematic, while certain remain incremental preventing their occurrences. Also risk management programs monitor risks effectively.
Most recent, public and private policymakers started to shift attention of medical error to reform less reactive and centered error prevention and improvements related to patient safety. The two primary objectives are:
1. Redesigning healthcare delivery methods and structure that limit probability of human error.
2. To prepare advance of inevitable errors occur over healthcare delivery not in regard with amount and types related to precautions.
Medical industry can act error free in consideration to the level of training underwent by the specialist. It also finds specialist's experience as a vital point to make error free treatments. However, humanly errors occur at any situation.
Medical error entails approach inclusive of medical procedural standardization, reporting of medical errors on daily basis, reduction of memory reliance on medical care, increasing medical information systems and making improvements. This includes encouraging patient participation on own medical care and established national focus on patient safety. Hence, these procedures remain as range of outcomes to attend health practices.

Question 2

Give some thought to the term national standard of care. What do you think it means, from both a healthcare quality and legal (i.e., evidentiary) perspective? Are you aware of any national body-governmental or otherwise- that determines the efficacy of new diagnostic protocols or treatment modalities? In the absence of such an entity, how are health professionals put on notice that a new medical care standard for a particular procedure or treatment has emerged?

Answer 2

National standard of care:
In 18 th century the English common law originated professional standard of care. The courts establish patient who hold physician's legal accountability respect to substandard care that proves doctor to violate customization on own profession. This is determined through other professionals contained in this profession.
Compilation of revamped legal rules regard with medical custom and local practice is combines to create national standard of care.
Not every medical error raises level of legal contrary. The section details measure utilized by legal system to determine errors prompt legal protections considered as professional "standard of care." This standardized care remains as key for both provision regard to high quality health care and legal claims that health professionals, hospitals, or managed care organization negligent to render medical care resulting in injury or death.
Yes, numerous national bodies, governmental or others determining efficacy related to new diagnostic protocols or treatment modalities. One such treatment is done for urinary incontinence (lost control over bladder) in women adults.
Health care industry was initiated to rely heavily on previous hospital that focuses patient care. Every healthcare setting based on hospital's medical practice was created with circumstances leading patients challenge quality of care.
From necessity over legal system in response to challenges applying liability theories premised national standard of care. This is meant for holding hospitals accountability of negligence occurred inside walls. The two theories are:
1. Premised on hospital relations with doctors
2. Actions and decision related to hospital dominating hospital liability
The former theory is vicarious liability and latter is corporate liability. Health professional notices new medical care standard or emergence of specific procedural treatment on absence of entities. These professionals conduct such substandard care or treatment using specific standardization of care using normal ability and skill set. This is done with enormous experience, opportunities, and possibilities.

Question 3

What do you think about the role and success of tort law in promoting high-quality health care? Does it help to deter errors? If not, why?

Answer 3

Role and success of tort law that promotes high quality health care:
Health insurers were not suspected to be sued for tort principles. They were subject to breach of contractual legal suits that failed in reimbursement of medical claims respect to services that are covered for beneficiaries of health insurance policies. It stemmed two linked facts:
1. Normative insurer practices leave medical judgments and decisions of treatment to doctor's hands. The meaning is rare to insurer related actions that lead types of injuries covered under tort law.
2. An insurer denied beneficiary claim respect to insurance coverage; this occurred retrospectively. Other words after beneficiaries received required diagnostic tests and medications.
This means that beneficiaries sued health insurer, it occurred not due to physical or emotional injured on insurer's decision denying insurance claim. However, there has been dispute as insurer pays already received medical care. Hence, coverage denials have potential economic implication related to affected beneficiaries that did not raise healthcare assess or quality issues.
Advent of managed care considered as primary mechanism to deliver and finance health care on magnified concern managed care uses techniques like utilization review. This opened door to most contentious health aspects of today's quality on extent of patients being sued for managed care organizations respect to negligent coverage or decisions of treatment. Tort laws deter hazardous behavior in systematical and comprehensive way.

Question 4

The critical intersection between health care and health insurance as exemplified by the Davila decision leads to an important question: Is it reasonable to treat a healthcare coverage decision as having nothing to do with health care itself? Put another way, given the expense of h ealth c are t oday, d o y ou b elieve t hat i ndividuals and families can afford necessary health care if there is no third party responsible for covering at least some of the cost?