Health care: Past, Present, and Future

By: Catherine Buckel, Amy Haines, Mickele Kohler, Jennifer Lokers, Courtney Olach, Laurel Rapson, Rachael Seiter, Ashley Spear

MI- Health Care in the PastSetting-County Houses•An Act of Michigan from February 1, 1809: “poor in the several districts within the Territory shall relieve and support all the poor, lame, blind, and sick, and shall provide for them houses, nurses, physicians, surgeons, in such cases as they shall judge necessary.”•Usually this ended up being families that were willing to take the needy in for cheap•Twenty years later a new law authorized a contract with a “competent physician”•1837 a new law authorized “county poorhouses with a superintendent”

Weaknesses in Michigan’s Health Care

SystemMichigan’s health care has had a few weaknesses in the past that are currently being worked on. These weaknesses include:

• Michigan is one of the most violent states in America, with a rate crime of 526 offenses for every 100,000 residents. It has lowered slightly over the past year, but it needs to be worked on more.

• Michigan’s public Health funding is one of the lowest in the nation, and was reduced in 2008. Having a low amount of public Health funding per capita could endanger the quality and accessibility of health care in the future.

• The incidence of smoking and obese residents is high in Michigan. One out of five residents is a smoker, and one out of four is obese

• The prevalence of binge drinking in this state has increased within the past year, an alarming fact. Michigan is now one of the worst states of the country when it comes to Binge Drinking

• The incidence of Cardiovascular-related and cancer-related deaths has been lowered within the past year, but nevertheless, Michigan still has some of the worst percentages in the US.

MPRO• MPRO, Michigan's Federally-

designated Quality Improvement Organization, works closely with healthcare providers and community organizations across the state to among other efforts:o Increase the quality of health

care for Medicare Beneficiaries

o Improve health for area populations

o Ultimately decrease the cost of health care through quality improvement

• MPRO, the Michigan Quality Improvement Organization, is an active member of the Michigan Health and Safety Coalition, appointed by Governor Jennifer Granholm in 2004 to serve as the official State Commission on patient safety. In the fall of 2005, the Commission issued a report and recommendations to improve patient safety across Michigan.

•Grand Rapids Orphan AsylumOpened in 1857, One of Michigan’s first children focused hospitals, Became wartime hospital, After WWI, all-purpose hospital

•Hurley HospitalOpened in Flint, 1908Free exams for patients due to city charterImproved hospital built in 1928State of the art

Hospitals Around Michigan

•St. Mary’s of DetroitFirst hospital with private managementBegan in 1845Still in existence

•Henry Ford HospitalDetroit needed a bigger hospital due to growthProject taken over by Ford when it faced financial issues in 1909Finished in time for WWIFord gave to government for war use in 1918

Education

• 1850-The University of Michigan establishes its Medical School.

• 1869-The first hospital to be controlled by a University Medical School is established.

• 1890-The University of Michigan’s Medical School implements a four-year curriculum.

• 1891-The University of Michigan University Hospital begins a training school for nurses.

• 1899-Clinical clerkship is introduced to Michigan and leads to a clinical teaching program.

• 1941-The University of Michigan School of Nursing is established and The School of Public Health is opened in Michigan to facilitate military research concerning respiratory disease.

• 1950-Michigan State University developed their College of Nursing.

Facilities in MI:

Education Continued....

• 1970- The University of Michigan established Family Practice as a specialty.

• 1984-Survival Flight is established to transport patients and transplant organs between the U-M hospitals and other health care facilities. (Medicine at Michigan)

• 1954-The University of Michigan became the largest medical school in the U.S and Canada

• 1964-Michigan State University established their College of Human Medicine (Michigan State).

Funding• 1939-The federal government is the main funding source for scientific

medical research.

• 1940s-Many congressional hearings regarding health insurance bills were held but nothing much came from these.

• 1950-Congress created a grant program to provide federal matching funds to states for health care payments for individuals on welfare

• 1960-Congress passed the Kerr Mills Act that created the Medical Assistance for the Aged program. (This was the immediate predecessor to Medicaid)

• 1966- Medicare and Medicaid programs were instituted by the U.S government to provide health insurance for senior citizens and the poor.

MI- Health Care NOWSetting-

681 Michigan certified Medicare home health care agencies and other 671 Michigan home care companies.

Many online resources- Like for Mental Health at http://www.michigan.gov/mentalhealth

WWW.justanswer.com DoctorsAsk a Doctors Question, Get an Answer ASAP!

Education• Albion College, Alma College, Alpena Community College,

Andrews University, Aquinas College, Baker College, Bay De Noc Community College, Beaumont Hospitals Schools of Allied Health, Calvin College, Carnegie Institute,…etc.

• Degrees covered include but are not limited to: Art Therapist, Biochemist, Biomedical Engineer, Certified Registered Nurse Anesthetists, Clinical Laboratory Scientist/Medical Technologist, Cytotechnologist, Dietitian (Registered), Funeral Director, Genetic Counselor, Industrial Hygienist, Occupational Therapist (Registered), Physical Therapist, Physician, Physician Assistant, Psychologist, Public Health Nurse, Radiation Therapist, Registered Nurse, Social Worker, Speech Language Pathologist, Toxicologist.

Affordable Care Act

•Forces insurance companies to play by the rules, prohibits them from dropping your coverage if you get sick, or discriminating against anyone with a pre-existing condition.

•Insurance companies have to cover preventative care.•“Health Insurance Marketplace” where people can choose insurance.•Will increase Medicaid access•Children can now carry parents insurance until the age of 26•Prescription drug coverage for those with Medicare more affordable•Companies must spend 80% on health care, if not they have to

rebate customers or reduce premiums•No more lifetime dollar limits on benefits.•Increases available funding for community health centers

HEALTH CARE REFORMTHE AFFORDABLE CARE ACT (ACA)

2014 will see a key part of the new law take effect. Individuals, families and small businesses will be able to shop for health insurance and compare plans through the Marketplace.

How the Health Care Law is making a difference in MichiganIt is already making a difference in

Michigan by:Expanding health insurance coverage in every state by establishing a health Insurance Marketplace and increasing access to the Medicaid program.

The New Law will make care more affordable by reviewing premium increases, small business tax credits, and by supporting early retiree coverage

Next the ACA will strengthen Medicare by reducing prescription drug costs, preventative care benefits, cost savings for seniors, and also by fighting fraud which saves taxpayer money.

HEALTH CARE REFORMTHE AFFORDABLE CARE ACT (ACA)

"The Affordable Care Act gives hardworking families in Michigan the security they deserve".

Increasing access to affordable care: 3:1 million adults who were uninsured have gained coverage by being able on stay on their parents health care plan until age 26.

Access to free preventative services: More Americans will receive wellness visits, cancer screenings, and other services that will help them get and stay healthy. These services will be free for most people with Medicare.

Coverage for all people including those with preexisting medical conditions

STRENGTHENING MICHIGAN by GRANTS"Michigan has received $41,517,021 in grants for research, planning, information technology development, and impLementation of Affordable Insurance Exchanges".

One Side -VS- The OtherHealth Care Reforms

For:www.healthcare

.gov/blog/2012/03/mycare_mark.html

Against:www.youtube.com/watch?v=Bzjp0t7B-F4

Mixed Views:www.youtube.com/watch?v=hiXr9X45za0

MI- Health care in the future

"Remote patient monitoring (RPM) is a technology to enable monitoring of patients outside of conventional clinical settings (e.g. in the home), which may increase access to care and decrease healthcare delivery

costs".Technology for RPM would incorporate sensors and wireless

devices that would communicate thereby allowing measurement of physiological processes within selected parameters.

APPLICATIONSDiabetes monitoring

Dementia and falls

Pills that track drug intake and effectiveness

Electronic implants that monitor organs or body systems

Congestive Heart Failure

"Remote medical or patient monitoring will be commonplace in the future and it promises to benefit both physicians and patients by saving time and and money".

Education• Changing to be delivered more online, Much like Ferris is trying to

incorporate.

Health Care Reform

Health care reform: Language in HR 3590 will ensure that all health plans offered through health insurance exchanges authorized in the Senate bill will be required to BOTH offer coverage of mental illness and substance use treatment AND do so in compliance with the new Wellstone-Domenici parity law.

Funding • Michigan leaders are currently reviewing legislation to expand funding for

the Medicaid and Medicare programs which would allow more residents to receive the care they need. This expansion “would help ensure more affordable, appropriate care for roughly 450,000 Michiganians, while saving state taxpayers up to $1 billion over the course of a decade”. Also “implementation of a health insurance exchange” is thought to “expand health care benefits to Michigan residents” by providing access to insurance through a competitive private market.

• Medicaid cuts result in significant losses for Michigan. When the state cuts $100 million in state funds from Medicaid, the true loss is $298 million when the federal match is included. These cuts make it more difficult for Michigan’s hospitals to remain open and fully staffed, providing needed care to all Michigan residents.

• Currently, the Michigan Senate and House of Representatives are considering two bills – Senate Bill 904 and House Bill 5223 – that would implement a suspicion-based drug testing program as part of the eligibility process to receive Family Independence Program (FIP) cash assistance. this could potentially increase funding.

References• http://humanmedicine.msu.edu/about/history.php?about• http://www.futureforall.org/futureof medicine/remote_medical_monitoring.html• http://www.healthcare.gov/law/information-for-you/benefits.html• http://en.wikipedia.org/wiki/Remote_patient_monitoring• HealthCare.gov• http://www.healthcare.gov/law/information-for-you/mi.html• http://www.homehealthcareagencies.com/directory/mi/• http://www.namimi.org/sites/default/files/attachments/What_Healthcare_Reform_

Means_to_NAMI_3-24-10.pdf• http://www.michigan.gov/healthcareers/0,4590,7-221-39732---,00.html• http://www.senate.michigan.gov/sfa/Publications/Notes/2012Notes/

NotesSum12fc.pdf• www,justanswer.com

Self Report:• Catherine Buckel-Researched sites for information on the "Affordable Care Act" and what it means to

Michigan residents. Designed and constructed ACA slides #12 and #13. Research future health care practices...some of which are in the beginning stages of being implemented now "Remote Patient/Medical Monitoring". Designed and constructed this information for slide #15. I offered ideas, collaboration/communication, as well as full participation with group in organizing and creating our presentation. Finally, proof reading the slide presentation prior to submission for technical and spelling errors.

• Amy Haines-Idea exchange, editing of PowerPoint• Mickele Kohler- slide 11• Jennifer Lokers- Leadership role, developed google document to allow for group editting and collaboration.

Developed presentaion shell with general tabs, and added animation. I also provided the content for slides 7,8,12,14,&15.

• Courtney Olach- offered ideas, collaboration/communication, as well as full participation with group in organizing and creating our presentation. Slides 6,7,8, and part of 18, Clip art throughout presentation and transferring information to slides 12,13, and 15. Finally, proof reading the slide presentation prior to submission for technical and spelling errors.

• Laurel Rapson-I submitted 4 slides for past information and we combined it into 2, slides 2 and 5, researched information for Michigan's health care history, presented ideas to everyone for which direction to take our project, and proof read the presentation.

• Rachael Seiter- I did research and sites used for slides on the past part of the presentation.  Continuous communication with group members and collaboration of presentation.  Offered idea on slide change when one slide was in wrong location of presentation through proofreading during additions. 

• Ashley Spear-Provided content for slides 3 and 4. Also, edited the PowerPoint for any errors.