solved Discussion Board 3From your reading assignment, let’s discuss the emerging

Discussion Board 3From your reading assignment, let’s discuss the emerging health care market in the early 1800’s. America has gained independence and built a government based on democratic values. However, as America was slowing shifting from an agrarian society to the beginnings of the industrial period, the political philosophy Classical Liberalism took root.Political FactorClassical liberalism, among other things, postulates that everyone should have equal opportunity and the free market should not be constrained by large government. These ideals helped spawn the explosive growth in industrializing America.Economic FactorThe tenets of classical liberalism were also designed to impact the economy. The philosophy supported economic liberalism where the ability to practice medicine is free from government interference (e.g. licensing, medical standards and education). Everyone has a right to make a profit with minimal government interference. Social FactorPhysicians started charging a “fee” for their services (fee for service). Some physicians were retained to look after a group of people. This form of “contract practice” is a cornerstone of modern health insurance.Here is some more social context of the time: life expectancy from birth was a combined 38-40 years (males and females). Compare that to what it is now (78 -79 years).Most significant during this time period is the ongoing health care practice from Lay healers:Bone setterMid-wifeApothecaryBone setterIn the context of the time, treating a broken bone was performed by lay people that had the knowledge and experience to set fractures and manipulate joints. Often this treatment meant the difference between death from infection and amputation to gaining use of the bone again. Bone setters did not have formal training but carried on knowledge passed down through the generations.Bone setters could reduce closed fractures (realign bone fractures that don’t break the skin) by feel; without the use of X-ray.Bone setter have led to orthopedic technician, physical therapists, and chiropractors in contemporary time. However, many nations still recognize and use bone setters to fill resource gaps.Here is an illustration of a complex fracture that is realigned and supported by orthopedic hardware that is screwed into the bone. Modern orthopedic surgery sped up the healing time and effectiveness of bone fracture realignment.MidwifeThe midwife was a lay healer specifically focused on childbirth. Much has changed over the years! Midwives are now formally trained in women’s health, which includes pre; peri; and post-natal periods from conception to routine gynecological care. Midwifery reached its apex in the 1950’s. Take a peek at the popular BBC series Call the Midwife, which chronicles the midwifery in the 1950’s and shows how public health care was originally supported by faith-based groups. Watch out, you could get hooked-this is good binge watching material! Chummy Arrives at Nonnatus House – Call The Midwife – Series 1 Episode 2 – BBC One (Links to an external site.)ApothecaryThe apothecary prepared medicines (herbal and chemical), concoctions, and remedies targeting the public, and eventually physicians. This lay healer was trained through Guilds (professional organization made up of other apothecaries) and apprenticeships. Apothecaries are now are modern pharmacists.Germ TheoryGerm theory posits that diseases are caused by microorganisms. In the 1850’s, Louis Pasteur and Robert Koch proved the theory true. This had a huge impact on medical care. Among other things, proving germ theory contributed to evidence-based medical practice, which gave the physician profession a boost in their level of authority and status; their practice became grounded in the scientific method.NursingWith germ theory in mind, Florence Nightingale assembled a staff of women and went to care for wounded troops during the Crimean War. This war exemplified how sanitation is important to health, especially the healing of the wounded. Nurse Nightingale started a nursing school in London in 1860. Her aim was to train nurses that were needed to staff the proliferation of hospitals, render bed-side care, and take control of sanitation in the healthcare environment. More on nurses later.Medical AdvancesAt the end of the American Colonial Period, Europe was leading medical research (mostly in France). Coming to America from Europe were advances that include:Blood transfusionsDentistryCataract surgeryStethoscopeCodeineAspirinHypodermic needlesStethoscope: From this…To this…In the early 1800’s, physicians in America could not live on earnings from a medical practice. Often, the costs of providing medical care were more than what a physician could charge for medical services. Physicians supplemented their livelihood by becoming farms or druggists. It was not until America’s transportation infrastructure improved and expensive health care resources were placed at hospitals, did physicians see a return on their investment (medical education, equipment, treatment supplies).The concept that transportation played a role in keeping physician’s earning down is best described by this scenario:During this time in our history, most Americans lived in rural or remote areas. Someone had to go and find the physician and bring the physician back to the homestead to treat the patient (health care was mostly rendered in the home). A traveling physician had severely limited access to rudimentary laboratory tests and could only carry a few medications to treat the patient. Additionally, the time spent traveling to the patient’s home also severely limited the physician’s availability for others that may need the doctor’s services. America’s population gradually moved to urban areas in the pre-industrial period, leaving the farms to work in factories. Transportation infrastructure was established for these new urban areas, increasing access to urban medical services as physicians began to set up practices in populated areas-working out of their homes.The concept of the hospital played a role in improving physician earning by providing resources:During this time in our history, hospitals underwent a metamorphosis. Up until this point, hospitals were generally run by faith-based organizations to provide charity care for those marginalized by society (e.g., homeless, mentally ill, hospice type care). Some public hospitals were established by local governments to do the same. The biggest change for hospitals emerged as providing physician resources: hospitals attracted business from local physicians by creating laboratories, x-ray machines, pharmacy, surgical suites, and in-patient rooms to house and monitor patients. Hospitals became a one-stop-shop for physician resource (those tools of the trade used by physicians), so physicians began using hospitals to see their patients and if needed, began admitting their patients to stay in the hospital for more tests and to be monitored by nurses during recovery. That was the then, here is an explanation of the now:The concept of transportation is still significant today. Rural areas in America are under-served by the health care system. Twenty percent of Americans live in rural areas, but only 9% of physicians practice in rural areas. The disparity is so severe that there are government programs that provide incentives to new physicians to set up practice in rural areas. Some folks have to travel great distances for physician or hospital services.The concept of the hospital has maintained these tenets:Hospitals still provide resources to physicians (and shared by physicians) that are otherwise too expensive to setup and maintain in private practice. Examples include laboratory and pathology services, imaging services (x-ray, CT, MRI, and ultra sound), surgical suites (for general and specialized surgery and cath lab), and beds to admit their patients so nurses can monitor care (general beds, telemetry beds, and ICU beds). Off course this list is not exhaustive, many hospitals provide out-patient services like GI lab, cancer treatment, rehabilitation care, etc.Physicians still use the hospital as a resource, 99% of physicians that use hospitals do not work for the hospital (are not employed by the hospital). Instead, the hospital extends “admitting privileges” to a physician, which allows the physicians to use their resources and place their patients in a hospital be. The patient, or the patient’s health plan, is billed for the physician’s services, as well as a bill from the hospital.Discussion Assignment:Watch this 17.38 minute video:Why U.S. Hospitals Are Closing (Links to an external site.)This assignment has two parts:Answer 1 question. You have the option to answer Question #1 or answer Question #2. Only answer oneRespond to a classmate’s posting.Question #1: Have there been any hospital mergers in Kern County? If so, describe the hospital merger (describe only one merger-there are several).Here are some hints for your research: Tehachapi hospital AND Adventist Health; Memorial Hospital AND CHW/Dignity Health; Dignity Health AND Catholic Health Initiatives. Describe only one merger-there are several to choose from.Question #2: What happened to Westside District Hospital in Taft?