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Nursing Student Places 2nd - MLK Essay Contest

Allyson Dodson, a second semester accelerated BSN student, placed 2nd in the "6th Annual Dr. Martin Luther King, Jr. Student Essay Contest".

Left to right ­ Allyson Dodson, 2nd place winner (College of Nursing), Andres Rodriquez, 1st place winner (College of Medicine) and Raena Hariharan, 3rd place winner (College of Medicine). Below is her winning entry.

MLK Essay Contest Winners 2012Precarious Progress: A Consideration of Healthcare Issues and Cautiously Optimistic Solutions to Solve Them

By Allyson Dodson, MUSC College of Nursing student

All progress is precarious, and the solution of one problem brings us face to face with another problem. It's easy to hear these words and get discouraged, or inspired, depending on which side of the issue you might fall on any given day. At face value, it is a given that with every solution, it is only a solution to part of the problem, or for only a portion of those affected by said problem. As Margaret Atwood (1985) eloquently wrote in the voice of one of her characters, better never means better for everyone. It always means worse for some.

As far as its relation to healthcare, it must be considered where progress is needed. The cost of healthcare is astronomical, and thus is a concern to individuals from all economic backgrounds. One devastating disease could bankrupt anyone, really. President Obama has attempted to mandate universal healthcare coverage, which is great from the perspective of healthcare providers and every health conscious individual. However, the concerns for providing it are great. Who will pay for it? Employer provided plans are often expensive, especially for families. Government funded programs are likely to only benefit those from lower economic status, while the middle class must shoulder most of the burden of cost and likely have to seek their coverage from other sources.

The United States struggles to pay for Medicare as it stands currently, and with individuals living longer, it is only a matter of time before this program, among others, is bankrupt. Of course, taxes could be raised, but how likely will it be that US citizens will support that? Dr. Arthur Garson (2000) of the American College of Cardiology suggests creating regional health insurance agencies that offer a variety of plans to choose from, having employers contribute a fee per employee to the agency for the employed, and government subsidies could be provided per individual based on income and economic status. Then, each person would be allowed to select their plan of choice, and pay for additional benefits as needed/desired in addition to the basic coverage plan. For instance, supplemental prescription coverage could be offered at an additional affordable fee. Also, a system where consumers are rewarded for health promotion behaviors, such as maintaining a healthy BMI, not smoking and managing non-modifiable health conditions effectively would be incentive to inspire a healthy society; if one¹s financial health depends upon his or her behavior, diet, exercise and/or drug regimens prescribed by doctors may be taken as more than just a polite suggestion.

This system could work. But, should government be able to mandate coverage in the first place? Many individuals think that having health insurance coverage or not should be a choice that lies with the individual alone, but that brings the problem full circle back to the affordability of it all. Some might argue that this is discrimination. However, mandating car insurance in order to drive, as well as rewarding good behavior with discounts and punishing bad behavior with increased premiums, has worked well in the auto insurance industry. The difference between an auto and a health insurance requirement may lie in that health or lack thereof is something that applies to all, whether we like it or not, whereas driving is a privilege, a choice. The Supreme Court will be reviewing the legislature in March 2012. Hopefully soon after, specific guidelines can direct the redesign of a healthcare system that will meet the needs of all of the people of the United States.

As a future healthcare provider, I specifically worry for individuals with chronic health issues. Of greatest concern is obesity, as approximately one-third of the United States population is obese, and its often subsequent issues such as heart disease, type II diabetes, and infertility. Healthcare facilities must be outfitted with equipment capable of handling the morbidly obese, and their staff must have a strong educational background in management of heart disease and diabetes. The cost of cardiac drugs and insulin must be managed and supplies well stocked. Currently, some of the drugs to treat heart conditions and diabetes are on the FDA drug shortage list, (Federal Drug Administration, 2011). However, most of the above conditions as well as others are preventable- if we had a system that rewarded healthy behavior, this could allow healthcare providers to focus our attention on encouraging and providing health promotion through screening, education clinics and wellness check-ups. A healthier society will mean that individuals will live longer, and healthcare personnel will need a thorough education in geriatric care. A healthier, older population will also require additional home care personnel as well as more assisted living facilities and nursing homes.

With every concern in health care, there are multiple solutions and each carries its share of benefits and additional problems. Who should be making the decisions is one of the biggest concerns at the present time, equal in magnitude to who should pay and how. For now, we must hope for guidance from the Supreme Court of the United States, promote the side of the argument most important to us with our votes and volunteering, and provide the best level of care at the bedside day to day with skill, encouragement and compassion. It is the one on one healthcare provider/patient relationship which will ultimately make the most impact on an individual's life, and as healthcare providers, this we can control today.