레이블이 Accounting Practice Problems and Answers인 게시물을 표시합니다. 모든 게시물 표시
레이블이 Accounting Practice Problems and Answers인 게시물을 표시합니다. 모든 게시물 표시

2013년 11월 27일 수요일

About 'cost accounting practices'|... of multiple occupancy complaints, those dubious accounts practice by cardiff county councils rent revenue account complaints...







About 'cost accounting practices'|... of multiple occupancy complaints, those dubious accounts practice by cardiff county councils rent revenue account complaints...








The               healthcare               reform               bill               wants               to               assure               all               Americans               can               afford               health               care               but               it               is               not               a               fix               for               the               system               in               general.

We               need               to               understand               fully               the               drivers               of               rising               costs               in               our               healthcare               system.

Americans               tend               to               blame               these               rising               costs               on               everything               but               themselves;               it               is               time               we               face               the               fact               that               we               are               a               very               unhealthy               society.

In               order               to               repair               our               failing               system,               we               have               to               look               at               how               our               habits               contribute               to               the               problem.

It               is               easy               to               criticize               the               healthcare               reform               bill               and               point               fingers               but               that               does               not               help               develop               solutions.

Sobering               Facts               about               Health               Care               Costs
               "Expenditures               in               the               United               States               on               health               care               surpassed               $2.2               trillion               in               2007,               more               than               three               times               the               $714               billion               spent               in               1990,               and               over               eight               times               the               $253               billion               spent               in               1980.

In               2007,               U.S.

health               care               spending               was               about               $7,421               per               resident               and               accounted               for               16.2%               of               the               nation's               Gross               Domestic               Product               (GDP);               this               is               among               the               highest               of               all               industrialized               countries".

(An,               Saloner,               Tisdale,               and               Ranji,               2009).
               The               Effects               of               Chronic               Diseases:               An               Ounce               of               Prevention
               According               to               An,               et               al,               "...chronic               diseases,               such               as               diabetes               and               cardiovascular               disease,               has               risen               dramatically;               both               of               these               chronic               conditions               are               known               to               be               correlated               with               obesity,               smoking,               and               diet,               and               are               very               expensive               to               treat               over               long               periods               of               time."               (2009).

We               are               a               generally               unhealthy               society               that               places               a               tremendous               burden               on               the               healthcare               system.

Our               goals,               if               we               want               to               start               repairing               the               system               and               decrease               costs,               should               be               on               prevention               and               education.
               I               have               had               patients               with               heart               and               lung               diseases               suffer               exacerbations               every               other               month               resulting               in               longer               hospital               stays               until               their               death.

Despite               the               patient               education               nurses               provide,               some               patients               continue               to               practice               bad               habits               that               worsens               their               chronic               disease.

Patients               post               laryngeal               cancer               with               tracheostomies               who               continue               to               smoke               through               the               hole               in               their               throats!

I               have               cared               for               men               with               hypertension               who               discontinue               their               medications               because               they               "feel               better"               eventually               requiring               open-heart               surgery               or               developing               co-morbidities               (such               as               kidney               disease               with               dialysis).

Patients               who               refuse               to               follow               their               prescribed               low               cholesterol               diets               that               end               up               with               coronary               artery               disease               leading               to               expensive               bypass               surgery.

These               actions               are               drivers               of               the               rising               costs               of               health               care;               no               reform               bill               can               eliminate               this               human               factor.
               Many               Americans               have               a               choice               of               not               being               obese               by               adhering               to               a               healthy               lifestyle               of               proper               diet               and               exercise.

Obesity               is               at               the               center               of               many               chronic               diseases               that               places               a               burden               on               the               health               care               system.

Our               love               for               fast               foods               continues               to               undermine               health               care               concerns               about               the               increasing               incidence               of               obesity               in               our               children.

We               are               raising               unhealthy               children               yet               refuse               to               actively               campaign               for               healthier               foods               in               our               schools.

American               children               are               also               transfixed               in               front               of               a               game               system               instead               of               physical               activity               and               exercise.

The               healthcare               reform               bill               will               not               change               American's               habits               that               lead               to               obesity               and               other               chronic               diseases.

The               system               will               continue               to               be               overburden               with               the               rising               costs               of               caring               for               these               people.
               New               and               Costly               Prescription               Drugs
               Again,               Americans               have               some               blame               in               the               fact               that               we               are               bombarded               with               antibiotic               resistant               infections,               which,               requires               drug               companies               to               produce               new               drugs               to               combat               these               bacteria.

Many               times,               especially               when               the               culprit               is               a               virus,               Americans               insist               the               doctor               place               them               on               an               antibiotic.

Super-bugs               are               developing               faster               than               drug               companies               can               produce               new               antibiotics.

People               who               fail               to               complete               their               antibiotic               therapy               also               assist               super               bug               development.
               According               to               Moroney,               "Several               studies               by               Lichtenberg,               et               al.

found               that               the
               replacement               of               drugs               developed               more               than               15               years               ago               with               newer,               "priority"               drugs               recently               approved               (within               the               last               5.5               years)               by               the               FDA               reduce               non-drug               medical               costs               by               as               much               as               the               cost               of               the               new               drug."               (2003).
               Another               problem               is               the               current               trend               of               suing               drug               companies               for               the               side               effects               that               are               listed               within               the               literature.

Lawyers               have               abundant               advertisements               for               customers               who               have               suffered               such               adverse               effects.

Every               drug               has               side               effects               but               not               everyone               suffers               from               them.

The               question               is               '"Should               the               unfortunate               ones               have               a               right               to               sue?"
               Sometimes               public               demand               for               quick               cures               force               the               Food               and               Drug               Administration               (FDA)               to               rush               a               medication               or               vaccination               to               the               market               before               all               side               effects               are               known.

That               is               why,               if               you               look               at               the               accompanying               literature,               there               is               a               number               to               the               FDA               to               report               new               adverse               effects.

Some               effects               are               beneficial               to               others;               I               remember               in               the               early               80s               when               Minoxidil               made               female               patients               very               hairy,               it               eventually               became               a               drug               used               for               male               baldness.
               I               was               on               a               medication               that               lawyers               advertised               for               class               action               respondents               because               it               was               believed               to               have               caused               diabetes               in               some               patients.

The               fact               was               that               the               medication's               side               effect               was               weight               gain;               I               gained               50               pounds               and               developed               diabetes.

The               solution               for               me               was               simple,               stop               the               medication               (only               under               my               doctor's               supervision),               and               lose               the               weight.

I               no               longer               suffer               from               diabetes;               I               did               not               participate               in               the               lawsuit.

When               drug               companies               have               to               contend               with               multiple               lawsuits,               the               cost               of               prescription               drugs               are               passed               to               the               customers.
               Defensive               Medicine
               Sometimes,               a               doctor               will               order               a               test               or               procedure               only               because               the               patient               persists,               knowing               it               is               not               necessary.

Cardiac               and               Gastroenterology               are               common               areas               where               this               may               occur.

Patients               with               chest               pain               may               have               classic               or               atypical               signs               and               symptoms               of               a               heart               attack;               a               trained               physician               can               discern               between               the               two.

If               a               patient               persists,               they               can               undergo               extensive               (and               expensive)               testing,               ending               with               a               prescription               for               an               antacid.
               According               to               Moroney,               "many               physicians               suggest               that               the               threat               of               litigation               forces               them               to               practice               defensive               medicine-prescribing               unnecessary               tests               and               treatments               largely               to               protect               themselves               from               possible               adverse               outcomes               from               doing               too               little.

In               addition               to               productivity               pressures,               providers               are               also               facing               increasing               malpractice
               insurance               premiums               that               have               forced               some               to               consider               leaving               the               profession               altogether".

(2003).
               Some               literature               blames               the               internet               for               increasing               patient               demands               for               new               technology,               treatments,               procedures,               etc.

The               public's               demand               for               the               newest               drugs               (often               encouraged               through               direct               consumer               marketing               or               TV               ads)               and               the               latest               diagnostic               technology               also               help               increase               health               care               costs.
               Patients               would               be               admitted               to               hospitals               just               to               have               special               tests               done               in               a               timely               manner.

Physicians               would               keep               patients               in               hospitals               so               long;               they               would               actually               get               sick,               especially               with               hospital-acquired               infections.

We               had               ICU               patients               who               had               to               stay               an               extra               one               to               two               days               because               there               were               no               available               beds;               the               backlash               was               a               hold               on               further               operations.
               American's               Bad               Habits
               In               addition               to               poor               eating               habits               and               obesity,               Americans               continue               to               drink               excessive               amounts               of               alcohol               and               smoke               tobacco.

These               two               habits               lead               to               many               chronic               illnesses               that               place               extra               burdens               on               our               health               care               system,               even               after               all               Americans               are               covered               under               any               healthcare               reform               bill.

Perhaps               taxing               industries               that               contribute               to               the               poor               health               of               our               society               can               help               fund               the               bill.
               Another               major               problem               is               noncompliance.

Patients               who               do               not               follow               their               medical               regime               usually               end               up               hospitalized               for               longer               days               resulting               in               higher               treatment               costs               each               time.

Sometimes               we               call               them               "train               wrecks",               those               with               multiple               medical               problems.

They               have               a               tendency               to               be               demanding,               blaming               their               woes               on               everyone               except               themselves.

Noncompliance               includes               failure               to               follow               a               prescribed               diet,               not               taking               medications               correctly,               and               continuing               to               practice               habits               that               worsen               chronic               conditions,               i.e.

smoking.
               Our               Aging               Society
               "Health               expenses               rise               with               age               and               as               the               baby               boomers               are               now               in               their               middle               years,               some               say               that               caring               for               this               growing               population               has               raised               costs.

This               trend               will               continue               as               the               baby               boomers               will               begin               qualifying               for               Medicare               in               2011               and               many               of               the               costs               are               shifted               to               the               public               sector.

However,               experts               agree               that               aging               of               the               population               contributes               minimally               to               the               high               growth               rate               of               health               care               spending."               (An,               et               al).
               Moroney               states,               "an               aging               population               will               require               expanded               services               for               such               specialties               as               cardiology               and               orthopedics;               ...91%               of               cardiology               patients               and               75%               of               orthopedic               patients               are               over               45               ...


               Solutions               Needed
               There               are               many               other               reasons               our               health               care               system               is               in               trouble.

The               signing               of               a               reform               bill               is               only               the               beginning               but               it               will               not               force               compliance               among               the               American               people.

We               should               stop               pointing               fingers               and               blaming               others               and               take               an               interest               in               our               own               health.
               Proposed               solutions               range               from               increasing               the               quality               and               efficiency               of               medical               personnel,               increasing               information               technology               with               computerized               medical               records,               a               fee               based               payment               system,               and               more               government               regulations.

None               of               these               solutions               will               work               if               Americans               continue               unhealthy               practices,               noncompliance,               and               a               lack               of               preventative               measures.

Only               then               can               we               begin               to               repair               our               health               care               system.
               References
               An,               Jane,               Saloner,               R.,               Tisdale,               R.,               Ranji,               U.

The               Kaiser               Family               Foundation               (2009,               July).

U.S.

Health               Care               Costs.
               http://kaiseredu.com/USHealthcarecosts/backgroundbrief.asp
               Moroney,               S.D.

(2003,               Feb.).

National               Institute               of               Health               Policy.

Understanding               Health               Care               Cost               Drivers.
               http://www.NIHP.org/mbc1_healthcare_cost_drivers.pdf






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