Journal Topic: What is meant by the phrase “First, do no harm.” Future Trends in Healthcare 14 Journal Topic: What is meant by the phrase “First, do no harm.”

Learning Objectives Define key terms. Discuss what is meant by the phrase “First, do no harm.” Discuss the Children’s Health Initiative Program (CHIP). Describe who is covered under the Patient Protection and Affordable Care Act (PPACA). continued on next slide

Learning Objectives Explain what health benefits are covered by Medical Exchanges. continued on next slide

Introduction Healthcare is changing New treatments, medications, and procedures New laws Patient Protection and Affordable Care Act (PPACA) New ethical dilemmas

Problems in the Current Healthcare System First do no harm Preventable medical errors are killing 100,000 Americans every year Incorrect diagnosis, drug mix-ups, needle infections, and surgical mishaps More hospitals are creating educational programs continued on next slide

Problems in the Current Healthcare System Cost of healthcare Cost wasn't always deciding factor Expensive procedures MRI Prescriptions Defensive medicine Excessive medical screenings Yearly mammograms continued on next slide

Problems in the Current Healthcare System Cost of healthcare Medical bills and illnesses are currently responsible for about one-half of all bankruptcies in the United States. continued on next slide

Problems in the Current Healthcare System Lack of healthcare providers Low-income patients use hospitals as primary care provider Many are sicker than higher-income patients Generally admitted to hospital from ER Physicians who provide care to the indigent on the decline continued on next slide

Problems in the Current Healthcare System "Germ warfare" Nearly 2 million patients a year develop hospital-based infections Many of the deadliest bacteria are now drug resistant MRSA (Methicillin-resistant Staphylococcus Aureus) continued on next slide

Problems in the Current Healthcare System Fraud Intentional deception or injury to another person Credentials Medical records Billing Drug trials continued on next slide

Problems in the Current Healthcare System Prescription drug abuse Accidental fatal drug overdoses have risen 500 percent since 1990 Now at epidemic levels OxyContin Vicodin methadone continued on next slide

Problems in the Current Healthcare System Ethnic disparities in healthcare African Americans, Latinos, and American Indians do not always receive good health care Lack of insurance Language barriers Subconscious bias

New Advances and Improvement in Healthcare Promoting prevention and health screenings Too much emphasis on treatment rather than wellness continued on next slide

New Advances and Improvement in Healthcare Patient rights Awareness Hospital charts Right to be seen by a medical doctor, not just a resident continued on next slide

New Advances and Improvement in Healthcare Use of robotics Machines to perform human tasks Supply delivery Medications Meals Surgery Surgeon controls robotic arm Many applications Smaller incisions continued on next slide

New Advances and Improvement in Healthcare The ethics of using robots and robotics Robotics enhances surgeon skills, not replacement Some healthcare employees fearful of losing jobs to machines

Healthcare Trends and Reform History of healthcare laws and programs Federal Emergency Treatment and Labor Act of 1986 Children’s Health Initiative Program (CHIP) in 1997 continued on next slide

Healthcare Trends and Reform Accountable Care Organizations (ACOs) Group of providers accountable for the care of a group of patients MCOs HMOs PPOs Medicare and Medicaid COBRA continued on next slide

Healthcare Trends and Reform Health maintenance Patient Protection and Affordable Care Act (PPACA) in 2010 Affordable Care Act Supporters Opponents Revenue and cost Who is covered? Preventative care continued on next slide

Healthcare Trends and Reform Patient Protection and Affordable Care Act (PPACA) in 2010 Insurance exchanges American Health Benefit Exchanges Health Exchanges State-based Allow consumers to review and compare online plans in each state continued on next slide

Healthcare Trends and Reform Patient Protection and Affordable Care Act (PPACA) in 2010 Preexisting conditions Can not be denied coverage continued on next slide

Healthcare Trends and Reform Patient Protection and Affordable Care Act (PPACA) in 2010 Early implementation problems Initially no deadline Enrollment double expecations in some states Fine for those who fail to purchase insurance

The Ethics of Care under the Affordable Care Act "Adverse selection" Insurers must cover children despite the presence of preexisting conditions Birth control and abortion Insurers must offer preventive care Some organizations are exempt Some states may prohibit abortion coverage continued on next slide

The Ethics of Care under the Affordable Care Act Healthcare law scams Fraudulent claims to acquire personal information Subsequent Medicare claims paid Health literacy How do we teach our patients? continued on next slide