CaseStudy: An Analysis of United States Health-Care Industry at EmanuelMedical Center.
AnAnalysis of United States Health-Care Industry at Emanuel MedicalCenter
TheUnited States healthcare is an industry that has been rocked byfairly a lot of challenges ranging from legislations, both at thefederal and the national level, to the changing demands for healthservices. Changing demands encompasses the professional, financialand even the demographics as will be explained later, in this case,study. It is in the late 90’s that great changes were experiencedin the United States. This is the period that the health expendituresbegan to outpace the nation’s gross domestic product. According tothe Center for Medical and Medicare services, expenditure thataccounted for 14.9 percent of the total US GDP was registered in 2002(Salt, 2005). Despite these critical financial changes, it ismisleading to conclude that they have resulted in positive changes inquality of medical services and the management of bodies that areresponsible for health in the federal states and the nation as awhole. Emanuel Medical Center is an example of a center that has beensignificantly affected by the changes that were brought about by theintroduction of new policies and unfavorable financial administrationsystems.
EmanuelMedical Centre was founded in 1917 two pastors of the Swedish MissionChurch. It is situated in Turlock, California state. Emanuel MedicalCenter establishment was built on a mission to medical servicerequirement of the people in that community regardless of theirethnic, social and religious backgrounds. It was initially designedto receive 16000 patients annually. A report in 2002 projectedEmanuel Medical Center’s service area to be 200000 even though theywere later exposed to competition by other medical centers likeSutter Health, Catholic Healthcare, Tenet Healthcare and KeiserPermanente.
Onone Friday, a four-year-old girl was brought to the emergencydepartment of Emanuel Medical Center at night. She had complained toher parents, Mr. and Mrs. Eckman that she was feeling very weak, andher body temperature was increasing rapidly. It had risen to104-degree Ferheints, and her general condition was getting haywirefor Eckman`s and that is what prompted them to bring her to thehospital that late at night. They registered at the emergencyadmission desk and proceeded to the waiting desk for an assistance bythe medics. Mr. and Mrs. Eckman sat on the desk for long, and later anurse later comes out and undertook procedural evaluations on theirdaughter, Haley Eckman. To their amusement, the nurse never testedthe temperature of Haley, which is always a basic routine procedurein such processes. Shortly, he retreated to his room leaving theEckmans in yet another period of waiting. It seemed that thecondition of their daughter was deteriorating by time as she vomitedand got much weaker. On realizing how their daughters condition wasdeveloping, the Eckmans requested if she could be laid on one of thebeds that they could see from their position. A staff member deniedTheir request without a proper explanation.
Finally,at about 4.35A.M, they were directed to a room where Haley’stemperature was taken, and a physician on duty also conducted someexaminations on her upon which he ordered medicine to Haley. Theparents were then informed by the physician that Haley was sufferingfrom stomach flu and that she should be taken home to rest. Haley’scondition did not improve and instead her body temperature increasedfurther. The family decided to take her to a different hospital onthe following day, at Memorial Medical Center in Modesto California.She was diagnosed with urinal tract infection upon which she receivedadequate treatment with necessary antibiotics. The Eckmans wereextremely disappointed with services at Emanuel Medical Center thatthey were pushed to lodge complaints at the California Department ofHealth services. Mrs. Eckman also contracted the dailies newspapersconcerning the incident. The CDHS (California Department of HealthServices) inquiry confirmed that medics at the Emanuel Medical Centerfailed to observe the due process of treatments and their actions wasin disrespect to stipulated medical ethics.
Theabove was clearly an incident of neglect of duty or to say the least,deliberate abuse of necessary medical procedures. It is one incidentthat could be vital in depicting the entire medical servicessituation in America, specifically California State. It could pointto incompetency, laxity of relevant medical policy enforcers or evenstrained medical facilities in California.
EmanuelMedical Center top leadership defended their center by attributingtheir situation to the policy changes. They were majorly critical ofthe one new Emergency Medical Treatment and Active Labor Acts(EMTALA). The changes were to the effect that everyone had the rightto access medical services at the emergency centers of any medicalcenter regardless of the patients’ financial ability. These changesresulted to an increase of patients in the emergency departmentsexceeding the recommended capacity. The president of the EmanuelMedical Center also pointed to the underpayments that they weresubjected to for offering the emergency department services. Theseconundrums attenuated to high operating costs of in emergencydepartments and a serious strain on hospital facilities.
Indeed,Major health stakeholders in California and US cannot be absolved ofthese blames. It makes a lot of sense to impose rules that willsecure care for those who are in critical conditions withoutconsidering their financial conditions. The devastating effects ofthese changes were that the most expensive department of hospitalswas converted to free clinics for uninsured and underinsuredpatients. Most of which were just in need of primary tests as opposedto the emergency Medicare, which they are designed for.
Theseabnormal admissions were alarmingly scaling down the financialeconomics of hospitals. At the same time, the nurses and other medicswere withdrawing their services due to the underpayments that thehospitals were getting from bodies like California MedicalAssociations regarding reimbursements. With the downscaling labor,the employees were under intense pressure to increase theattractiveness of nursing jobs for qualified professionals by placingsuch incentives like offering flextime and some other nontraditionalstaffing arrangement (Quadragro, 2005). Additionally, they had toincrease payments for few nurses that were available.
Consequently,there was a general closure of most Medical Centers citing a shortageof nurses, declining reimbursements, and increasing strenuousregulations. Many State and federal government owned facilities, andnon-profit facilities were forced out of the industry leaving therelatively resistant not-for-profit facilities to handle theoverwhelming demand for healthcare services.
Thesituation was so worse that a medical center like Emanuel, whichposted total incomes of $4.7 million had to lose a whopping $4.1million on operations as a result of the rising employee wages andsalaries coupled with losses from capitation programs (Salt, 2005).
Healthcareis a very crucial industry that ought to be highly prioritized by thestate. However, handling the affairs of health industry could also bea delicate task that demands utmost caution and cooperation betweenrelevant bodies. In our case, the neglect incident that was involvingthe Eckmans and the medical staff of the Emanuel Medical Center waslarge as a result of the unfavorable emergency treatment policy. Itwas passed in 1986 though its active enforcement started in theearly 90s. The formulators of this policy might have significantlyoverlooked key health stakeholders like nurses and physicians,regarding their welfare and workload.
Inpassing this policy, bodies like the Health Maintenance Organizationshould have been instructed to increase their reimbursements tohospitals to compensate for the increased workloads and strainedfacilities. In Emanuel Medical Center, the enforcement of this policyresulted in an annual admission of about 45000 patients in 2002 atthe emergency department when it was designed to receive not morethan 16000 patients in a year.
Thenational government should also consider health expenditures toaddress the ever increasing demand for health services.Demographical, US population is majorly composed of old who are indire need of constant Medicare. This funding should also be donethrough health insurance bodies like Medi-Cal and organizations likeHealth Maintenance Organization to ensure adequate reimbursements forhospitals. Adequate reimbursement will enable hospitals to manageboth their external and internal economies. Most hospitals resort tousing of temporary nurses because of their understaffed centers.Payment of these temporal nurses is equally high and could easilycompromise the quality of medication.
UnitedStates Congress, Committee on Labor and Human Resources. (1988).Emergency Medical Services and Trauma Care Improvement Act of 1988:Report (to accompany S. 10). (1988). Washington, D.C.: [U.S. G.P.O.]
EmanuelMedical Center Inc. (2015). Hospitals.Retrieved from https://www.emanuelmedicalcenter.org/
Quadagno,J. (2005). Onenation, uninsured: Why the U.S. has no national health insurance.New York: Oxford University Press.
Salt,B. (2005). Populationgrowth report 2005: Demographic trends in Australia, New Zealand andthe US.Melbourne, Vic.: KPMG