Brasfeild Ch.6-9

The last chapters of Brasfield, which includes chapter six through chapter nine, wrapped up what we have discussed throughout this semester pretty well. Chapter six's main topic of discussion was log-term care. The themes that Brasfield covered in chapter six included how care has changed, the policies that implement such care, the different diseases that elderly people are at risk of getting, insurance coverage for the elderly, and mental health. All of the previous topics interested me but one story stuck out. Brasfield had a student in a health policy class that was from Nigeria and at the end of a discussion during class he stood up and gave his view on nursing homes. The student made the argument that our parents raised us and taught us most of everything that we know about life, so why should we, as their children, desert them and not care for them when they are older and in need of our love and care. In Nigeria the children keep their parents and cared for them in the comfort of the home. This story stuck out to me because in todays society nursing homes are something that Generation Y assumes is a necessity for their parents in the future and I personally think part of the reason for that view is because of the health care institutions that the United States has today. Throughout chapter seven the health care reform was discussed. I didn't find chapter seven very interesting because it was a lot of repeated information about the policies and legislation that the health reform has required. Chapter eight was about how other countries implement health care and what kind of systems they have. One quote from chapter eight I found really intriguing was as follows, "The practice of medicine is the same but the financial and administrative systems differ". the different countries that were mentioned throughout chapter eight included the United Kingdom, Canada, and Germany. The United Kingdom has a system called NHS and every citizen has single health care. Canada has a system which says that the thirteen different provinces and territories operates under their own system which are formed under national guidelines. Also what I found interesting was that Germany's insurance system which includes the health system is the oldest in the world. Lastly in chapter nine Brasfield discusses what health care will look like in the year 2021. Basically, Brasfield predicts that the recovery from the recession will still be in the process of fixing, the federal budget will be high, and health care expenditures will have risen. All in all I enjoyed this book because it was partly politically focused and it discussed major issues in health care in the past, present, and future.

Reflection of Paper

    While writing my paper, I was suppose to post regularly about the progress I was making and the reactions I had to my research. However I worked on my paper over a long period of time, in short intervals. Therefore it would have been impractical for me to post short, vague sentence. As a result, I am going to combine those reaction posts into my reflection post.
    When I started my paper, my thesis statement was rather lengthy and didn't have a clear path. The first thesis I had mentioned society, nurses, surgeons, the military, and homes. I soon narrowed my research to nurses in the Civil War and how they changed the view of society and the treatment in the medical arena. One of the first books that we read in class has a vast amount of information about the role that the nurses played during the Civil War and how the soldiers made the role of those nurses a necessity. One of the most prominent themes that showed up throughout my paper was the organization of the USSC. Before I took this course I had not heard of the USSC or the role it played throughout medical history. Some of the regulations and orders that we have today are from the foundation that was instituted by the USSC. Also one of the most interesting themes that is underlying in my paper is the theme of perspective. Throughout time one of the reasons that certain things wee discovered at certain times is because perspectives and norms change. For example, during the Civil War the issue of sanitation was at the forefront. Today sanitation seems like a norm and it is what patients expect, but during he Civil War sanitation was advancing and helped form a foundation that caused sanitation to be perfected and more lives were and are being saved because of those advances. The  themes that are mentioned above are not the only topics that my paper contains, but they are the topics that captured my attention and helped me understand the history of medicine to a greater extent.

Brasfield Ch.3-5

At the beginning of chapter three, Brasfield clearly identifies the details of when Medicare was implemented and who put it in place. Medicare is the national health care for older Americans and, according to Brasfield, there are four sections that encompass what Medicare covers. Those four sections include hospitalization and skilled nursing facility payments, physician and out patient services, Medicare advantage related to private plans, and outpatient prescription drug coverage. The implementation of Medicare lasted from 1966 through 1969. Then the issues of costs and payments were discussed. An issue that I noticed was that the roles that social security would cover and the roles that Medicare would cover. Both of the roles overlapped in some areas and caused controversy. Then the next major theme in the chapter was core policy issues, which include social insurance versus private insurance, long term fiscal policy, cost control strategies, and more. Lastly the real issue, I feel like is discussed at the end, which is "who should pay for Medicare?". And honestly there is no clear answer. Throughout chapter four the theme of Medicaid is expounded upon. Brasfield says that Medicaid was almost creeping into the system by tagging along with the welfare system that was already in place. For the past couple of decades Medicaid has been growing and becoming a competing element with Medicare because of its growing size and costs. During the Reagan administration, they tried to reduce the growth of Medicaid and discourage the welfare system that was already so large. Medicaid covers so many people and is so big that it is possible that it is too large to deconstruct. The rest of chapter four discusses the future of Medicaid and the costs it will require and size to which it will grow. Chapter five talks broadly about the overall. The United States Health Care is so expensive because of the norms and lifestyle that everyone is used to and expects. I thought that chapter three through five were very descriptive and useful while expressing the actual size and cost of what health care encompasses today in the United States.

Health Policy- Brasfield Ch. 1 and 2

To begin with, Brasfield looks at health care from an economic standpoint, which is what past authors have done as well but the book "Health Policy The Decade Ahead" examines health care and economics more in depth. For example in chapter one Brasfield says that the basic measures of health care spending includes percentage of gross domestic product spent on health care, the annual rate of increase in health care spending, total of health care spending raised by taxation, the share of health care dollars spent for hospital services, and private insurance premiums. The list above, according to Brasfield, is the basic economics in health policy. Also I noticed throughout the first two chapters that there are a lot of graphs to show how economics and cost ebbs and flows when concerning health policy. Also throughout chapter one the author goes through the decades. For example he talks about the civil war era and then on through the 1900's. Throughout chapter two, Brasfield discusses and looks at the institutions and processes of government, and mostly focusing on Congress. At the beginning of chapter two the author goes through the fundamentals of introducing a bill and plays out hat that looks like in government. Then chapter two goes into details about what pressures push decision making in certain ways such as interest groups, lobbyist, or the bureaucratic system. So far I have enjoyed this book and hope to continue to!

Altman Ch11-Epilogue

To start off Part four of Altman's book, Obama's health care plan is discussed. Obama's main focus for election was his emphasis on a new healthcare system. The healthcare that he instituted and broadened, is the idea of universal healthcare. Supposedly he received advice from certain economists which include, two other men and Stuart Altman, the author of the book. Throughout chapter eleven, the aspects of this "universal healthcare" are mentioned. One such aspect includes employer-sponsored insurance system. Also the last part of chapter eleven I found rather interesting because it lists the summary of Obama's framework. The cost of this universal healthcare is discussed a bit, but in the summary it talks about expanding Medicaid for low-income individuals, which would automatically raise costs. The Book goes onto talk about past politicians who wanted to see universal healthcare become a reality. One major person that was mentioned was Ted Kennedy, which in a way creates emotion from the reader because it talks about Ted Kennedy's brain cancer, and that he fought for universal healthcare toward the very end. Throughout chapter twelve, Altman talks about historical background and how hospitals work with this specific healthcare. Then in chapter thirteen, fourteen. fifteen, sixteen, seventeen, and eighteen discusses the processes and details of Obama's universal healthcare. Then once again chapter nineteen talks about cost control, and mentions several health organizations and the GDP and OMB. The epilogue at the end of the book summarizes how history prominently influenced the path the U.S. is on today concerning healthcare systems.

Slow Expansion of Coverage, Altman Part 2-3

With the start of part two in the book "Power, Politics, and Universal Health Care", by Altman begins with chapter four. Chapter four focuses on free hospital care for the poor. While talking about logistics, Altman talks about many great political figure heads and leaders that had sort of a tug of war when concerning adequate hospital facilities and free hospital health care. The most prominent thing that was discussed in chapter four was the Hill-Burton Program, which gave power to the states to help make their hospitals well equipped. Chapter five is when he book starts getting into the details of Medicare and the controversies that it brought along, politically and socially. 1958 was the year when health care hearings for the elderly started to be heard in Congress. Throughout chapter six and seven, Altman focuses on Medicare and is rather repetitive because not a lot of progress was made, but he includes a lot of stories and advances that were made in the political sphere. Chapter eight goes into detail about Medicare still, but mainly on the prescription drug benefit. George W. Bush pushed for this concept for the first two years of his administration, which was viewed as strange because he was a conservative Republican. Part three mainly focusses on costs, which in my mind when anybody ever says health care my first thought is money. I feel like most other people I associate with at least associate cost and money with health care before they consider anything else. Part two and three of this book talk about politics mainly concerning issues and the advances they made with certain issues, which I find interesting but its rather tedious to remember and write about specifically.

Unsuccessful Health Care Proposals: Altman Part 1

   I have to say that this book was not what I expected when I began to read it. It has much, much more political background and political ideas throughout part one.
   To start off chapter one, Altman and Shactman talk about the secret church meeting. This secret meeting included Altman, who was the deputy assistant excretory for planning and evaluation--health, and some of his colleagues. The meeting also included Stan Jones, Bill Fullerton, and a few others. The reason why I listed the people that attended the meeting is because they all represented prominent politicians and this "secret meeting" shows the backstage part of politics.
   The whole purpose of part one, and I'm guessing the rest of the book is the health care system, and in particular what kind of health care bills have been constructed. Throughout part one, the book discusses Nixon's plan, Kennedy's plan, and Clinton's plan. Part one also spends a lot of time talking about different IGO's and organization that go into the healthcare system, and also committees that are governmental that are needed to get healthcare systems passed or even glanced at.
   Since I am a political science major I would have to say that this book is my favorite by far, and there are many things that I could go into that I read in part one but i touched on a few that were interesting to me.