Brasfield 6-10

I enjoyed how the book compared a bunch of different health care systems to each other from other countries. To see how other countries run when it comes to health care, can help understand health care systems as a whole. It also can show strengths and weakness of different health care system strategies. The countries plan I was interested by most was Germany. Just like ours, some health care is paid for by taxes, but I like that there is a standard amount that everyone pays, unless they can't afford it then it is covered by welfare. Throughout the course we have asked "Is health care a right?" I think it is in the sense that if someone cannot afford a health care policy, they should not be punished by having no health care at all. Budgeting will always be the center of the problems because distributing money fairly is hard, but denying certain people health care is just cruel. I think we should take ideas from other health plans and incorporate it in our own in a way that provides everyone coverage without changing too much of the money budgeting, if not even reducing costs in certain areas. Overall, it'll take a very long time to find the perfect and ideal health care system, but I'm hoping with all the knowledge out there that one day we will figure it all out.

Brasfield 3-5

When looking at chapter 5, and even the health care system alone, a big focus is on money. There seems to never enough. Health care systems are a necessity and we need to find more funding for our current technology and medicine and well as fund for research and new and developing technology so that treatments will become more advanced which could result in many lives saved. The US spends the most money on health care per capita than other countries, while on the same chart, we have lower life expectancy (though not by much). If we aren't living longer, where is the money going if its not keeping our people alive? We also have fewer doctors and nurses, but we have more surgeries and we pay doctors more. So the question everyone, even Brasfield, is asking: How do we reduce costs? To keep our health care system alive, it has to have money to keep it going. One answer he gives is to reorganize the system. I bet when people were forming the health care systems, they did not think it would become so pricey. Maybe if we did just wipe the slate clean and some how start over and distribute funding and costs in a more effective manner, then we would have a better and stronger health care system.

Research Paper Reflection

My paper was on the problem of malpractice in anesthesiology. The topic interested me because I want to be an anesthesiologist, and the idea of malpractice has a big impact of health care systems, which is what this class is all about. It took me awhile to come up with a thesis statement for which direction I wanted to go for my paper, and after my research I decided that my thesis should be a question: can malpractice be stopped? Finding research and information on the history and current study of anesthesiology and malpractice wasn't too difficult. Finding personal accounts of malpractice suits was a bit more difficult unless I looked on lawyer's websites. For my thesis though, technically I could not have a definitive answer, but when I put all my research together and look at outcomes, I could say that if anesthesiology and its methods are done properly 100% of the time and the education matches new and rising technology, then malpractice in the field should be at a very small minimum. Tying together all my ideas for my paper was kind of difficult because the paper could have went in so many different directions, but I think the way I argued the sides from the patients' perspective, the doctors' perspective and the medicine and technology itself, I think it flowed well to serve my point of answering my thesis statement with a logical conclusion. The majority of my sources were very reliable or educational and I think it all fit well into my paper and it ended up being the perfect length of not too short or not too long.

Brasfield Ch.1-2

I never thought about how health care cost was distributed. When looking at the chart about concentration of Health Care Spending, I see that the "healthy half" or the bottom 50% of the nation only used 3% of all of the health care money. Looking at the percentages, I was truly shocked. 22% is used just on 1% of our nation. A question could be is it fair that people pay increasing health insurance when the most insurance money probably doesn't go to them? Another question could be is there a way to fix this? Why should everyone pay so much money when about 80% of the health care spending goes to only the top 20% of the nation is reference to sick people? I don't think people really think about how unequal the distribution is because insurance is just a thing every thinks they need and just pay for like any other bill and thinks it gives you equal coverage. It will be interesting to see if and how the percentages will change over time as insurance rates increase.

Altman Part 4

One of the reasons that the book says that Obamacare has been the more successful of the plans because it was the one who wants the least amount of change. It was the one plan that was considered "a near universal plan". When it came to insurance policies, I'm glad that it expanded to cover more things at a cheaper cost and it keeps children on their parent's insurance plan longer. There are many more benefits on the Obamacare plan and it really does limit the amount of change that happens. It also provided a chance for more people to get insurance who were previously uninsuranced, which benefited doctors and hospitals because now they have insurance companies to pay them rather than treating people with no way to pay the bills. Hopefully this plan continues to improve and maybe even become a truly universal plan.

Altman Parts 2 and 3

This book is extremely hard to blog about because there are just so many points and plans brought up in each chapter, so its hard to choose one and expand on it. One of the questions from the notes was "What is the proper role of the federal government", and I'm assuming that it is referring to the government's role in health care plans, and since this book is all about politics I would like to expand on that. After reading all these chapters, it is clear the government is unclear about what should be in health care plans. President after president have changed the health care system trying to find the perfect balance. When it comes to the idea of a universal health care plan, I think the role of the government should be greater than if a person is getting a separate health care plan. If the government is backing up and paying health care plans, like medicare and medicaid, then they should have a more important role in determining the boundaries and guidelines of each plan. But some people require a more specific health care plan, and I don't think the government should be as involved in that, rather the specific insurance company or even the state should be more in control because the country is too big with too many people for the government to try to fit everyone's need. I hope that after all these failed attempts, a universal health care plan can come about that will fit the majority of people's needs, that is cost effective, that benefits the patients and doctors, and that covers all the important aspects that an insurance plan should, but it seems like the government have a long way to go on providing the ideal universal health care plan.

Altman Part 1

Looking at this book, seeing the differences in the plans of different presidents was very interesting. Each plans had its benefits and its imperfections. I don't think there will ever be a truly perfect health care plan that will cover everything everyone needs, but making the best one possible would be very beneficial to our country. I like many aspect of Clinton's proposal. I liked the fact people could choose there own plan rather being stuck with a plan they did not want or need. Clinton had the idea that these plans would make it so taxes would not increase. Money is such a huge factor in hospitals, doctors, and health plans. The government and its people pour so much money into the health care system, adding more money to that puts everyone at risk. We need to find a plan that everyone can benefit without breaking the bank of the government and the hospitals clients.

Hoffman - End

I was drawn in when in Chapter 8, they referred to not accepting a patient as "dumping" them because of their type of insurance or any other reason that the doctor or hospital refused to treat them. I think this was a horrible term to use and a horrible action as well. I don't think doctors should have had the right to chose to not treat someone just because of their insurance, or lack of. Though, the doctors may have not felt as bad because they did transfer them to other hospitals, they should feel bad if the hospitals were not equipped to treat the patients when the original hospital could of, like the example of the woman who had meningitis and was transferred to a hospital with not CAT scan when the first doctor knew she needed one. I'm glad today that emergency rooms cannot deny anyone because everyone is still a human being and they deserve care whether they can afford it or not.

Paper Topic

How did malpractice become more of a problem for anesthesiologist

Hoffman Ch.1-5

What I found interesting was the Rights to Refuse chapter. Just after reading the first story, and the trial I was shocked. The thought of a hospital refusing to take care of someone ill or dying is just crazy to think about. If we lived in a world like that with health care systems that could deny saving a person would be ridiculous. This shows that clearly health care systems and hospitals have a lot of things to improve on and rules and regulations to make a great hospital. Since we know that even then hospitals were very expensive to build and work, one would think that hospitals would not refuse people if they have a certain illness because they would want the money for the bills more. I think this law was a horrible law and I don't agree with it at all and I'm glad hospitals don't do things like that today.

Technology in the Hospital: 6-end

Before reading this book, I had no idea what blood counting was. If I had to take a guess about what it was before reading the book, I would have guessed it was counting blood cells, and I was right. But the method I thought was wrong. I didn't realize that in the early 1800s, physicians looked under the microscope and literally counted each cell. That was in no way practical and probably was a huge pain. The next method was using a grid in the microscope and just counting through that. That did not seem very easy or enjoyable either. As I kept reading, I wondered: What was even the point of counting and examining the blood cells. I learned that first off it could distinguish between red and white blood cells. As technology advanced, the red blood cell count could be related to types of disease. That was a good advancement in technology and methods, especially since taking blood from a sick or hurt patient became more and more common. This method opened up a wider possibility of other methods that can be used to examine the blood and determine other factors that related to the blood count as technology increased even more.

Technology in the Hospital: Ch. 3-5

I was interested by Ch.5 where it got more in depth about the x-ray image. What stood out to be the most was how important gender was in reading the machine. I did not realize that gender would even be a factor in making machines. I knew that clearly there were different parts and organs in males and females and that physicians needed to know the difference in interpret the image of an x-ray. I also like reading about the privacy part of this chapter. I never thought about that while the health care system was building up that there was not doctor-patient confidentially and that your x-rays and pictures could be every where. When I look at our technology today, I never would've guess how slowly everything came about and improved over time. We are so privileged with so much that I would not be able to imagine a time where there was not treatments or cure or machines that easily distinguished between broken bones and just a slight sprain. Slowly but surely, it seems like hospitals are definitely advancing more than the hospitals of the Civil War, and I'm ready to see what new machines or technique will come about next.

Technology in the Hospital: Ch. 1-2

Just the first 2 pages of the book showed so much. Comparing the two cases of broken legs that were about 25 years apart was so interesting to me. The way that laboratory tests had advanced so that they did not just take X-rays, but they took multiple urine and blood analysis and more detailed testing in the later case, was fascinating because nowadays we go through so many different tests when we are in the hospital that it is weird to think about a time where little to no in-depth testing was done. Another thing I like about this book is that they use example of individual patients. This helps in getting really involved in individual processes and understand how tests can be similar and different in case-to-case studies. It also makes the book more interesting since there are many different interesting cases instead of just a dull recap of a bunch of illnesses, such as the patients from war where doctors diagnosed many cases with one or two different diseases instead of doing super thorough testing.

Ch.7-Afterward

The part that stood out to be the most was the ending when they finally talked about The Germ Theory of diseases. As the book put it, "nothing in medicine was altered more dramatically in the last four decades following the civil war than the understanding of infectious disease". I think this really is the start of medicine. In the book, it showed basic understanding and treatments for diseases that had been around for years, but the cause was not as clear. Now that the cause is found, I assume this is the start of the better antibiotics that are about to arise over the next decades. This ending really sets the mark for where to other books may go, because medicine is a big part of health care and now that the causes of many diseases are know discovered, it makes medicine as advanced as it is today. This theory also helps in trying to prevent the spread of infectious diseases. After reading the book, I will hope I will enjoy the next few books more. This book is set into a far back period in history that really didn't spark my interest because I do not have much interest in wars, but it was a good way to lay out the simple foundation and beginnings of health care systems. I hope the next few books get more modern and more exciting and something that really catches my attention and that will give me a better understanding of health care systems as a whole.

Ch.4- Ch.6

These chapters added on to the previous chapters, but there was something that was explained in more detail that really interested me. The way that the USSC contributed to the war is amazing. Though they slowly advanced over time, I do not believe as many people would survive without all there efforts to save lives and improve overall health of people and hospitals. In my opinion, the USSC was definitely the best advancement and organization that was created at the time. There were some negative aspects about it, like some of the leaders were arrogant when it came trying to organize and agree on laws and trying to make sure they were in all the places the war was, but overall, it had an extremely positive outcome. It also helped involve women in the war. Women were not allowed to fight so they probably felt useless to their men, but when the USSC was organized, it allowed women to volunteer as nurses so they could help support their troops. Though men were still in charge of the USSC, I believe the women had the biggest impact when it came to making everything more sanitary and safer and giving the men the support and care they need while they were wounded or ill, and I think the author agree. The main goals of the USSC was to create, promote cleanliness, and make good hospitals and I am excited to see the end product of all the advancements the USSC makes.

Introduction to Chapter 3

The introduction gave a whole overview of the book, but one point that was really stood out was the gender approach. Females are said to be more nurturing so they are the caretakers when a member of their family is ill, and this evolved into women becoming nurses for wounded soldiers. There was also a role reversal when men had to learn the things women usually did like cook and clean and take care of themselves when they went off to war since in the beginning no women were really there. This lead into chapter one where it addresses understanding Civil War medicine. The medicine during this time was practically useless, because it either did not work efficiently or it caused more problems. The method used was the same as women used at home, a comfort tactic, where illness was treated by rest, hydration, good food, and quality care-taking, which really had a positive effect on the outcome of an illness. When women came to take care of the sick men during war, they made the hospitals into a home sickroom, so the men were comforted and felt like they were at home. Also, proper nourishment really outweighed the few drugs they had. One thing that shocked me was the importance of mental strength. It was said that people with a more positive attitude and people that were surround with more happy things, like singing, stories, and letters from home, were more likely to recover from their illness, than people who were glum and had no hope. The second chapter also focused on the position of women in war. Women were still nurses but some sought out to become physicians. There were still way more male doctors and surgeons than females, but I wonder when this will change and there are more than just a few female specialists. Though, nurses aren't as high ranked as doctors, making women technically still less superior to men, at least with the field of nursing, it allowed women to become more involved in the war, get a higher education, and expand their horizons so that they have more opportunities than when they were just stay at home wives and mothers, which I believe is a positive advancement in the slowly developing health care system during the Civil War.
The other big thing that stood out to me in these chapters were the hospitals. There were a few different types of hospitals that were mentioned and they increasingly became more efficient. The first one was the field hospital which was located very close to the battle itself and it was a key element in medical care because its where the wounded and ill were first sent to and it was the quickest place for them to get. Field hospitals were comforting because they had the good care of nurses and friends could visit since the hospitals were close to the regiments, but there were only a few surgeons, sometimes as few as one or two, so people would die waiting on treatment. Since this was said to be the "key element", one would think that there would be more surgeons present, especially since the wounded couldn't be transported to better hospitals. The Surgeon General put Jonathan Letterman in charge, who improved health care systems in the field. One big thing he did was having ambulances which helped with the transport and that is definitely a huge improvement and its very necessary, even today. Another thing he did was send fresh foods to the camps and promote sanitation in the camps. This brought a more feminine aspect to the camps, which brought back the idea of role reversal, and it greatly improved the overall health of the camps. Another hospital talked about were general hospitals, which were in large buildings, usually well outside of the war zone. There were a great deal more surgeons to deal with the great capacity of people in these hospitals. When reading about Churchill's experience in the general hospital, I was surprised. He said the hospital was depressing and terrifying because he could hear the screams of the other wounded people and there were even coffins in the hallways. Also, there was said to be a poor comfort and caring quality, as well as, a lack of sensitivity from the doctors. Since it was determined early on that the comfort factor had a huge impact on positive outcomes, I would have thought that there would be better quality in a hospital with better trained surgeons and more resources than the tents in the field that were used to help people. The other hospital mentioned was the pavilion hospitals in Europe. These hospitals were very sanitary, they had lots of daylight and fresh air. This was really the ideal type of hospital because it had a very therapeutic effect and clearly your surrounding had a huge impact on the outcome of your treatment. This hospital influenced some newer hospitals during this time and it also restated the importance of sanitation and good care-takers.
The third chapter was about infectious diseases, which can be related to the hospitals and the sanitation. Disease was more easily spread in close quarters of small hospitals or because of poor sanitation, which is what doctors thought was the main cause of disease. Doctors were very convinced that if there was good hygiene, then there would be better health and no disease. Good sanitation did have a positive impact on lowering the cause of disease because poor hygiene is a way disease is spread, but it is not the only way. As we know today, there are many other way diseases can form, as told by the theory of disease causation. I wonder if doctors at the time did not throw out the ideas the bacterias and viruses caused disease, if less deaths would have occurred and more advancement would have happened sooner. Eventually, we know these theories did become accepted and medical advancements became greater, which in the end is a very positive outcome for our overall health care system, then and now.

What medicine might have been like before 1920s?

Since there was no antibiotics at this time, medicine was probably not as effective as the medicine today, such as the narrow-spectrum antibiotics that directly go to the source of infection to fix it.