Health Management In It's Entirety

      It is easy to forget how many different parts and pieces go into community health and health management. As mentioned earlier in my blogs, it is quite common for most people to be unaware of community health and the issues that are faced. As time goes on, I hope that our world becomes more aware of health issues and how these things can affect their health. There are many health plans that have been implemented to improve population health and lower health care costs for the U.S.. I believe that if we can continue to educate people on public health such as the opioid crisis, the effects of sugar sweetened beverage, and the power of good health management, than it can be done. The communities health will improve, costs will go down, and we can take another step closer to this 20/20 health vision. We need to educate and create health management advocates and workers to provide leadership and direction to our health systems that provide our people with health services. Sometimes people just need to take a step back and look at the bigger picture. What I mean by it in this situation is, let us step back and not forget the importance of well developed and hardworking leaders and managers. Let us look at new factors in today's day and age that hinder our health such as the enormous consumption of calories through sugar sweetened beverages and unhealthy eating. Let us step back and not be angry but help drug addicts and make a peace offering to improve our community. Let us plan now for our long term care in the future to help with costs and preparedness. Let the medical world adjust to how the current generation, the millennials, do and learn and succeed. Let us learn from our errors in the health care field and become better at what we do. Let's continue to control infections, understand chronic diseases, and and enforce health policy. Many different aspects and health communities contribute to the over health and they all need health management skills so that the 20/20 health vision can be reached.

Opioid and Drug Epidemic Need Health Management Too

     As many people are well aware, the opioid and drug epidemic is increasing at alarming rates. New Hampshire faces many problems with this epidemic as there are many drug abusers in the state. Managing health care isn't always just in a hospital setting. It is important to remember that we need to look elsewhere in the community for good health management tactics as well. These management skills used by CEO's and health care organizations should be seen by doctors, pharmacy's, and public and state health facilities as well. Keeping an eye on positive health initiatives and enforcement throughout the community is not always easy but it is critical. Many people do not support clean needle exchanges and needle safe containers around the community but we need to remember these are the programs getting the dirty needles off of the streets and out from under our feet. We need to offer the help we can give to those who need it. We need to encourage and support doctors to give smaller prescription doses after surgeries and injuries. We need to encourage people to expose of extra pills appropriately rather than sell them on the streets. We need to offer as much help as we can to improve the drug crisis. Many people are sick and are willing to get help if it is there. Manchester turned a local fire station into a safe house for drug addicts to come in and get clean. More addicts retrieved the help offered than Manchester had expected. Superior and quality management skills are needed not only for the good but also for the bad. With determined individuals who show these phenomenal health management skills to the community can be the difference. These are the people who can improve the health of the community and the quality of life for everyone around them. The population will continue to see this opioid epidemic and a drug crisis. This is where health management is needed more than ever.

Minimizing Health Care Costs and Excessive Bills

Over the past years it is apparent that the United States is not effectively spending money on healthcare. We rank 35th for life expectancy, which falls on the lower side, yet the United States spends more money on healthcare than any other country. This should not be the case if the United States is effectively using it's resources and allocating supplies and money where it is needed. 

     One of the biggest problems is that doctors and surgeons may be over paid in the United States and there are far too many extra tests run at each visit. It is a very controversial decision because doctors and surgeons are highly trained and skilled workers who save people's lives. However, if health care costs continue to increase and life expectancy for the U.S. continues to rank at the bottom of the totem pole than more problems are going to arise. As a Type 1 Diabetic, I am in a hospital or doctor’s office more than the typical human being. I tend to see many unnecessary tests performed, whether it be on me or other patients. Now sometimes their is a patient who is very sick and the prognosis is unknown. These situations often require multiple tests which can get very expensive. However, I once went into the hospital because my insulin pump malfunctioned so my blood sugar became very high and I was headed towards ketoacidosis. I had been at the hospital maybe an hour, when the radiologist came into get me to take an x-ray. I did not need this x-ray for any reason but the doctors insisted and said it was part of the work up. This is a prime example of an extra test that costs both the hospital and me money and could have been avoided. Again, high salaries, high costs and excessive testing need to be improved so that we can work towards attainable health care costs for all and improve life expectancy. The system is looking at shifting towards value based care which could be another necessary step in lowering costs and improving the quality of care. This will allow extra costs to be avoided as well as improve the quality of care.

Managing Population Health and Prevention

    Population health is often misunderstood by the general population and therefore I believe it is incredibly important to educate people to the best of our ability. When I started as a Health Management and Policy major, even I could not truly answer what public health and population health was. The definition can vary and the aspects that contribute to population health are constantly changing as well and I believe this is what makes it so difficult to grasp. Over the past few years I have been able to gain a better understanding of population health and how to achieve it on a whole new level. Accountable Care Organization’s, Triple Aim, health payment reforms such as Value Based Care, Community centered health homes, and Health Impact Assessment are all important factors that impact and contribute to successful population health. 

            Primary prevention is also an important factor in the success of population health. Many initiatives have been taken in New Hampshire towards prevention. For example, a program was created by Rudolph Fedrizzi. This innovative program known as Healthy Monadnock 2020 was to become the healthiest community in the nation by 2020. This showed incentive in the community to reach population health by creating this program and advocating for new walking trails, available jobs for the unemployed, and healthy eating habits which would allow health care costs go down in the long run. Rudolph Fedrizzi was an advocate for saving community health and put an emphasis on it. Additional prevention strategies have been taken in Manchester as well. It is prevention strategies like these that need to be advocated for so that we can improve population health and maintain a healthy community. Taking precautionary measures will not only ensure better health for the population but it will lower health care costs as well.

Long Term Care Management and Planning

       Long Term Care, Nursing Homes, and Medicare need funds. The aging population of America also will need this care at some point. Both the care and the funds are essential for older population. But the question of where the funds will come from has no concrete answer. Many people do not realize the importance and costs of long term care until they are presented with a problem that correlates a family or friend with long term care. Unfortunately, The United States struggles with the costs of long term care because they are extremely high. The reason these costs are so high is because Americans do not like the idea of paying for this long term care in advance, or at a younger age.

The Older American Act is in place which could help elders by providing things like meals on wheels and elderly support in general. These precautionary measures and care could save money in the long run.  Medicare will slowly be pushed to a universal health care system but funding could make this impossible, however, I believe it could work with proper financial planning.  

Maggie Hassan, William Thomas, and Marco Rubio all bring an interesting view on how to provide funds for long term care. William Thomas created the Green house project which Maggie Hassan and Marco are in favor of, however, Marco believes premium support systems could be the answer that allows elders to have the choice of whether to spend their money on private insurance or Medicaid. Maggie Hassan also disagrees with the private funding aspect of the Green House Project. All this controversy of how funding should be accumulated, whether it be through the government or private insurers is the face of the problem. Ted Cruz is so against federal funding and social medicine. We face the problem of how to settle somewhere in the middle to find funding for the health care of the aging population. The question of whether or not we should make this long term care insurance mandatory in the United States is presented. I find it critical that we make this decision and decide how to start saving up funds to put towards our care in the future. I believe that acting and taking precautionary measures such as taking a percentage of our pay and putting it into an account to accumulate and gain interest could be the answer. Taking such precautionary measures and a primary approach could be essential. There needs to be a plan or some form of collecting money for long term care to help deal with the costs and provide the elderly with the care they deserve.

How Sugar Sweetened Beverages Effect Our Health

     Time after time we see science and health care changing. This change is inevitable and that is why it is necessary we recognize the change and work with the change. A simple public health crisis 20 years ago was tobacco and cigarette use. Although there is still some challenge ending tobacco use, there are new problems our society is facing such as childhood obesity. A small group of students that I have been working with have been doing some research on sugar sweetened beverages and how they affect the obesity of our population. 

     Beverages such as soda are becoming a health risk today and no one would have expected this, just as no one had known or expected cigarettes to cause as much harm as they do. Numerous studies have shown the correlation between sugar sweetened beverages and childhood obesity. Recently Mexico has implemented a tax on sugar sweetened beverage and there has already proven to be a drop in the number of purchases of these sweetened drinks. There are hopes that people will soon see a drop in childhood obesity and obesity rates all around. The idea of implementing this tax on sugar sweetened beverage is fairly new to the United States. Philadelphia has talked about implementing this tax and requiring that all funds collecting from this tax go directly to healthcare programs or schooling programs for children. 

     With concrete data from Mexico, perhaps the U.S. will be more likely to follow through. I do not believe this taxation will take place anytime soon in the U.S. because many people are likely to fight it. However, I believe if a small amount of tax is put on these sugar sweetened beverages in the United States it will beneficial for many. Some people will not continue to buy soda, and hopefully sugar sweetened beverage sales will drop and so will obesity rates. Those who do not mind paying the tax will continue to buy sugar sweetened beverages and the tax will help fund education and health promotion as well as contribute to primary prevention of obesity and diabetes. It is important for many of us to see numbers and exactly where the money from the tax is going so that we support it. For me personally, I would not mind paying a few extra cents on things if I knew it were going to benefit and improve the health of our community. "According to the city of Philadelphia, a three cent per ounce excise tax could raise approximately $400 million over the next 5 years" (Sugar-Sweetened Beverage Tax, Philadelphia). Even this one example can show just how much money can be raised if this plan is executed. 400 million dollars is an incredibly large amount of money to be made and used in health care from something that is currently making $0 on tax. In addition to the fact that the intention of this is to improve the health of our people. Making the change with health and medicine is often difficult but essential. 

References: 

-Afzal, Stephen C. Resch and Angie L. Cradock J. Ward, Jessica L. Barrett, Erica L. Kenney, Kendrin R. Sonneville, Amna Sadaf  Steven L. Gortmaker, Y. Claire Wang, Michael W. Long, Catherine M. Giles, Zachary. 2015. "Than They Cost To Implement Three Interventions That Reduce Childhood Obesity Are Projected To Save More"."Than They Cost To Implement Three Interventions That Reduce Childhood Obesity Are Projected To Save More". Retrieved 11 November 2017. http://content.healthaffairs.org/content/34/11/1932.full.html

-Choices Project. Sugar-Sweetened Beverage Tax, Philadelphia. 2017. Retrieved 11 November 2017.
PA BRIEF_Cost-Effectiveness-of-a-Sugar-Sweetened-Beverage-Tax-in-Philadelphia-PA_CHOICESproject.org_5.20.16.pdf.

Millennial's in Health Care

     I had the opportunity to attend the Northern New England Association of Health Care executives this weekend in Ogunquit, Maine. This conference took place at the Cliff House and I was fortunate to be surrounded by many intelligent and upper level health care executives such as CEO's, CNO's, COO's and more. The amount of knowledge in the room was incredible. One man, however, really stuck out to me and all the things he had to say were important in my eyes.

    Josh Luke is a well developed and experienced health care futurist and has had some of the best opportunities in the game. Josh has a lot of strong beliefs in health care and how to improve healthcare as a whole. Much of what he said came back to Millennials and how we do things as a generation. He said " When I ask baby boomers to jump, they say how high, but when I ask millenials to jump, they say why?". We as millennials will always ask why and that is how we think. Why would we do something? Why would it help us, hurt us, improve us? We want to know why. We constantly ask questions and we want an explanation for most things. I think that this is important because we all think this way and function this way. We do and will think this way in our future healthcare jobs as well. I think many of our "why's?" have led to new techniques, discoveries, and advances in health care and they will continue to do so. Josh then proceeded to say that "there is nothing wrong with the way the millennials think but it is different and we need to learn and adjust to it because they are going to be running our health care system soon". Josh Luke made so many great points about fixing the bad, fixing the problems, and working to improve. It is essential that current healthcare professionals and millennials work together to advance health care and understand one another's mindset. We use technology in everything we do, for example every hospital is implementing EMR's if they haven't already. A millennials train of thought and technological skills are already being seen throughout the healthcare world. As millennials trickle into health care systems and spread their "why's" and technology knowledge things will continue to change. Adjusting current views and working the two generations into one another is key for success in running any healthcare system. Millennials have a different way of thinking that has the potential to improve healthcare systems as we face the challenge of continuous change in healthcare.