Managed Care: Abackbone of health care delivery in the United States

Under managed care, individuals with higher incomes would be able to pay the extra premium costs to infix in more expensive health plans while trim back income people would not be able to afford the extra premiums, and would Abe relegated to lower-cost plans, and might experience inferior quality of care and health outcomes@ (Grumbach, Bodenheimer, 1995, p. 1227).

One area in which managed care may unravel well is preventive medicine. However, in the case of speech-language disorders the Awellness@ concept of health does not necessarily work well. lecture-language pathologists are licensed Aprofessionals who identify, assess, and insure speech and language problems including swallowing disorders@ (Moratorium Passed). While some procedures of prevention whoremaster be applied, overall most problems are abnormal conditions Ainvolving speech, articulation, fluency, voice, vocal or written language, auditory comprehension, cognition or intercourse or oral, pharyngeal or laryngeal sensorimotor competencies@ (Speech manner of speaking Pathologists).

The point is that after identification and evaluation take place, the called for intervention plan is a great deal tenacious term, rather than short term. Speech disorders involving neurological disorders, stroke related communication disorders,

brain injury, psychogenic retardation, cerebral palsy or autism often call for an ongoing, long term discourse plan, and the trained speech therapist

, in consultation with the client, preserve be the scoop out judge of what is needed. Unfortunately, caps stipulated by managed care and Medicare can too often mean that the speech-language pathologist cannot line through on the designated treatment plan and vital treatment can be disrupted.

The jiffy adverse effect of the $1500 cap was the financial hardship it created for patients whose necessitate exceeded the limitations imposed by the caps.

In addition, older Americans, Aespecially in long care facilities, who have exhausted the $1500 limit have no choice but to disrupt their care and seek it in less accessible hospital outpatient departments, rather than with providers such as skilled nursing facilities, replenishment agencies, independent practitioners, and comprehensive outpatient rehabilitation facilities (CORFs)@ (Issue Summary on $1500 Cap).

An example is in the area of patients convalescent from the debilitating effects of strokes. Of all the after effects of a stroke, Abeing unable to talk, read, write or understand those around you can be among the most upsetting@ (Speech After Stroke). Of the 500,000 Americans who suffer a stroke each year, between 25 and 40 percent of those who survive will have stroke related communication theory disorders (Speech After Stroke). The value of speech rehabilitation for stroke victims extends beyond restoring speech and language into the realm of psychology; the ability to convey can often lessen the depression and alienation that follow a stroke.

Speech Language Pathology, (April 2000). http://badger.state.wi.us/agencies/drl/Regulation/hypertext markup language/dod989.html

Grumbach, K.& Bodenheimer, T. (1995 April 14). Mechanisms for controlling costs. Journal of the American Medical Association 273 (15), 1223-1230.

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