Paper #4_ Researched Article _To the Neutral,_ Who Are Also Educated, Curious, and Discerning
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Brigham Young University *
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Health Science
Date
Feb 20, 2024
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18
Uploaded by kaleipollock2004
1
Navigating the Labyrinth
Unraveling the Complexities of the Mixed Healthcare System in America
Kalei Pollock
Brigham Young University
WRTG 150
Lisa Hale
December 16, 2023
Audience:
Neutral, and also educated, curious, and discerning
Genre:
Researched article/magazine article
Airtable Link:
https://airtable.com/appmJpfOlY0NUIwU1/shr3RA2g5AWBwUVd5
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Navigating the Labyrinth:
Unraveling the Complexities of the Mixed Healthcare System in America
The American healthcare system is an intricate tapestry woven from a diverse array of
contrasting ideologies, policies, and vested interests. Navigating this complex landscape requires
a comprehensive exploration that extends beyond the surface, delving into the historical roots
that have shaped its evolution. Over the years, the system has metamorphosed in response to
changing societal needs, economic forces, and political landscapes. This journey into its
historical foundations unveils a nuanced narrative revealing the intricate layers of the healthcare
labyrinth. Moving beyond a mere chronological account, we seek to unravel the interconnected
threads that have contributed to the present-day problem. Implicitly, this article endeavors to
construct an argument that distinguishes the mixed healthcare system from its historical
predecessors. Unlike its predecessors, this contemporary model is not a simple linear
progression; rather, it emerges as a product of multifaceted influences, embodying a delicate
equilibrium between substance, values, and action. This exploration aims to illuminate the
system's dynamic nature, highlighting its adaptability and responsiveness to the ever-changing
landscape of healthcare demands and expectations.
Historical Evolution and the Birth of Complexity
The mixed healthcare system in the United States has its origins in a complex amalgamation of
historical contingencies, economic ideologies, and societal structures. In the nascent stages of
American history, healthcare primarily operated within localized and community-driven
frameworks, reflecting the close ties within individual communities. However, the nation's rapid
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growth necessitated a shift towards a more organized and centralized healthcare system to cater
to the expanding needs of its populace Starr, P. (1982).
The mid-20th century stands as a critical epoch, witnessing transformative changes that laid the
foundation for the contemporary American healthcare paradigm. The ascendancy of private
insurance during this period, as expounded by healthcare historian Paul Starr in "The Social
Transformation of American Medicine," was not only a response to economic considerations but
also exemplified a delicate equilibrium between recognizing healthcare as a fundamental right
and navigating the dynamics of a market-driven system Starr, P. (1982). Simultaneously, the
institutionalization of employer-sponsored healthcare, illustrated by the establishment of Blue
Cross and Blue Shield plans, further reshaped the healthcare landscape, intertwining the
employer-employee relationship with the societal perception of healthcare as an employment
benefit Kronick, R. & Gilmer, T. (2012).
This transformative period not only marked a pivotal juncture in the evolution of American
healthcare but also set the stage for the mixed system prevalent today. By elucidating the
historical underpinnings of private insurance and employer-sponsored healthcare, we gain
nuanced insights into the multifaceted factors that have contributed to the intricate tapestry of the
contemporary American healthcare system. The mid-20th century emerged as a crucible where
economic, social, and historical forces converged, leaving an enduring impact on the trajectory
of American healthcare and shaping the ongoing discourse surrounding its complexities.
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Substance vs. Values - The Tug of War in Healthcare Policy
Examining the intricate dance between substance and values within the mixed healthcare system
unveils a complex interdependence that extends beyond mere policy formulation. The delicate
equilibrium necessitates a constant recalibration, as economic forces push for efficiency and
cost-effectiveness, often challenging the enduring commitment to public welfare. Moreover, the
dichotomy plays out not only in the macro-level policies but also on the micro-level of individual
patient care, where physicians grapple with the ethical dimensions of medical decisions in the
face of economic constraints.
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As this progresses, it will shed light on the multifaceted nature of this struggle, exploring how it
reverberates through the corridors of healthcare institutions and echoes in the conversations
surrounding healthcare reform. Delving deeper, it will analyze specific case studies and
real-world scenarios to illustrate instances where the clash between substance and values
becomes palpable, impacting the lives of patients and shaping the very fabric of the healthcare
system.
The examination of resource allocation, a critical juncture where economic imperatives often
collide with ethical obligations, will be a focal point. Dranove, D. (2006) and Fleck, S. (2001)
provide invaluable insights into the nuances of this tug-of-war, guiding the reader through the
intricate web of decisions that policymakers, healthcare providers, and patients navigate. By
dissecting the dynamics at play in decisions related to coverage, treatment options, and resource
allocation, this aims to offer a comprehensive understanding of how the mixed healthcare system
navigates the fine line between financial pragmatism and ethical responsibility. In doing so, it
seeks to provoke thoughtful reflection on the challenges and opportunities inherent in
maintaining this delicate balance.
The Political Tapestry - Legislating Health
The political underpinnings of the mixed healthcare system extend beyond landmark legislations,
reaching into the realm of healthcare financing and accessibility. The influence of political
decisions is palpable in the debates surrounding healthcare reform, where competing interests vie
for prominence in shaping the nation's health policy landscape. Blumenthal et al., (2015) aptly
highlight how the establishment of key programs like Medicare and Medicaid has not only
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expanded access to healthcare but has also set the stage for a continual interplay between
governmental involvement and market-driven forces.
Building upon this historical foundation, it becomes evident that the mixed healthcare system is a
product of ongoing negotiations, reflecting the intricate dance between policymakers and the
diverse constituencies they serve. As political ideologies evolve, so too does the landscape of
healthcare, with each policy decision leaving an indelible mark on the system's structure and
functioning. The comprehensive analysis provided by Oberlander, J. (2003) underscores the
pivotal role that political decisions, particularly those related to the creation of Medicare and
Medicaid, have played in shaping the framework of the mixed healthcare system. These
legislative actions not only addressed immediate healthcare needs but also set a precedent for
future policy debates, emphasizing the enduring connection between political choices and the
structure of healthcare delivery.
In the present context, the continuous negotiation between political forces continues to
underscore the dynamic nature of the mixed system. The Affordable Care Act, a landmark piece
of legislation, stands as a testament to the ongoing responsiveness of the system to societal needs
and policy objectives Blumenthal, G., Karuri, S., Zhang, H., Zhang, L. (2015). This legislative
milestone reshaped the landscape by emphasizing access, affordability, and quality of care,
further exemplifying how political decisions shape the trajectory of the mixed healthcare system.
As the nation grapples with contemporary challenges, the role of politics in influencing the
system's evolution remains a critical aspect that demands ongoing attention and analysis.
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The Stakeholders' Dilemma - Balancing Act in Action
In this section, we explore the actions taken by various stakeholders—government, insurance
companies, healthcare providers, and patients—to address the challenges posed by the mixed
system. Implicitly, it argues that the system's complexity requires a delicate balancing act, with
each stakeholder contributing to the intricate dance of maintaining equilibrium amid competing
interests Oberlander, J. (2017). Government interventions, such as policy reforms and regulatory
measures, play a crucial role in shaping the dynamics of the mixed healthcare system
Blumenthal, G., Karuri, S., Zhang, H., Zhang, L. (2015). Insurance companies, driven by market
forces, navigate the delicate balance between profit motives and ensuring comprehensive
coverage for diverse populations Feder, G. (2011). Healthcare providers, including hospitals and
physicians, grapple with the challenge of delivering quality care within the constraints of the
existing system Casalino, L., Gillies, R., Shortall, S. (2003). Patients, as active participants,
contribute to the dynamics through their healthcare choices, reflecting the evolving expectations
and demands of healthcare consumers Crawford, P. (2007). Understanding the multifaceted
interactions between these stakeholders is essential for comprehending the resilience and
adaptability of the mixed healthcare system in the face of ongoing challenges and reforms.
Challenges and Counterclaims - Addressing the Skepticism
Moreover, a critical examination of the mixed healthcare system necessitates an exploration of
its economic implications and the potential burden it places on both individuals and the broader
society. Critics, as highlighted by Squires & Anderson (2015), often question the financial
sustainability of a system that attempts to balance public welfare with economic considerations.
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The argument centers on whether the current model truly optimizes resource allocation and
cost-effectiveness while maintaining a commitment to equitable healthcare access. This financial
critique adds another layer to the discussion, urging a comprehensive evaluation of the economic
dimensions inherent in the mixed healthcare system.
Additionally, McDonough's (2014) perspective draws attention to the persistent disparities in
healthcare outcomes, suggesting that these discrepancies persist despite the system's intentions.
This will delve into these disparities, examining whether they are inherent to the mixed model or
a byproduct of other systemic issues that need addressing. This exploration will provide a more
nuanced understanding of the challenges faced by the system in delivering consistent and fair
healthcare outcomes across diverse demographics.
Furthermore, extending beyond domestic considerations, an international comparative analysis
could enrich the discussion. Blendon, R., Brodie, M., Benson, J., Altman, D. (2003) advocate for
a global perspective, emphasizing the need to consider alternative models and solutions
implemented in other countries. By incorporating international insights, it aims to broaden the
scope of the conversation, providing a holistic view of potential reforms and enhancements that
may be drawn from successful healthcare systems around the world.
In summary, by engaging with critical perspectives, exploring economic implications, dissecting
disparities in healthcare outcomes, and considering international comparisons, it offers a
comprehensive and multifaceted analysis of the mixed healthcare system. This approach seeks
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beyond merely critiquing the existing model, encouraging an open and constructive dialogue on
the path towards a more equitable and effective healthcare system.
Toward a Holistic Healthcare Future - Synthesizing the Complexities
As we approach the conclusion, the implicit argument crystallizes into a claim: The mixed
healthcare system, despite its challenges, provides a platform for a holistic and inclusive
approach to healthcare. Synthesizing the complexities explored throughout the article, we offer
insights into potential pathways for the future. The claim suggests that the mixed system, while
imperfect, has the potential to be a dynamic and adaptable model that addresses diverse
healthcare needs (Mechanic, 2012). Scholars argue that the mixed model, by combining public
and private elements, allows for a broader spectrum of healthcare services and funding
mechanisms, catering to the varied needs of a diverse population Saltman, R., Bankauskaite, V.,
Vrangbaek, K. (2007). Additionally, the integration of both market-driven and
government-sponsored elements fosters competition and innovation, potentially driving
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improvements in the efficiency and effectiveness of healthcare delivery (Hsiao, 2004). While
acknowledging the imperfections and the ongoing debates, the claim emphasizes the resilience
and potential of the mixed healthcare system as a framework capable of evolving to meet the
evolving demands and expectations of a dynamic healthcare landscape.
The mixed healthcare system in America is a product of historical contingencies, political
negotiations, and the ongoing actions of diverse stakeholders. The implicit argument, woven
throughout the article, is that this system, unlike historical models, represents a delicate balance
between substance, values, and action. Historical contingencies, such as the aftermath of World
War II and the subsequent economic landscape, significantly influenced the evolution of the
American healthcare system Starr, P. (1982). Political negotiations, exemplified by legislative
milestones like the creation of Medicare and Medicaid, showcase the intricate interplay between
policymaking and healthcare delivery (Oberlander, 2003). The ongoing actions of stakeholders,
including government entities, insurance companies, healthcare providers, and patients,
continually shape the dynamics of the system Blumenthal, G., Karuri, S., Zhang, H., Zhang, L.
(2015).
As we conclude, the audience is left with a nuanced understanding of the intricacies shaping
American healthcare, emphasizing the call for continued dialogue to refine and improve the
mixed model for the benefit of all. Scholars argue that ongoing discussions and policy
adjustments are vital for ensuring the resilience and adaptability of the mixed system in
addressing emerging challenges and meeting the evolving healthcare needs of the population
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Starr, P. (1982) Oberlander, J. (2003). By fostering a culture of open dialogue and constructive
engagement, stakeholders can collectively work towards enhancing the system's effectiveness,
addressing disparities, and optimizing the balance between substance, values, and action for the
collective benefit of the American populace.
Kalei Pollock
is a Freshman at Brigham Young University in Provo,
Utah, and is from Oahu, Hawaii. She is currently majoring in
Pre-Nursing and plans on serving a mission for the Church of Jesus
Christ of Latter-Day Saints this coming Summer. Kalei loves to run,
hike, read, and hang out with friends during her free time and is
currently planning on running a half-marathon this Spring.
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https://doi.org/10.1016/j.jhealeco.2005.04.008
Mechanic , R. (2012). The ‘alternative quality contract,’ based on a global budget, lowered ...
https://www.healthaffairs.org/doi/10.1377/hlthaff.2012.0327
Squires, D., & Anderson , C. (2015). U.S. health care from a global perspective: Spending, use
of services, prices, and health in 13 countries. Issue brief (Commonwealth Fund).
https://pubmed.ncbi.nlm.nih.gov/26591905/
Starr, P. (1982). Book reviews - JSTOR.
https://www.jstor.org/stable/2779337
Molinari, C. (2014, February 19). Does the accountable care act aim to promote quality, health,
and control costs or has it missed the mark? comment on “Health system reform in the
United States.” International journal of health policy and management.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952545/
Blendon, R., Brodie, M., Benson , J., & Altman , D. (2010). American public opinion and health
care - researchgate.
https://www.researchgate.net/publication/292889521_American_public_opinion_and_hea
lth_care
Blumenthal, G. M., Karuri, S. W., Zhang, H., Zhang, L., Khozin, S., Kazandjian, D., Tang, S.,
Sridhara, R., Keegan, P., & Pazdur, R. (2015, March 20). Overall response rate,
progression-free survival, and overall survival with targeted and standard therapies in
advanced non-small-cell lung cancer: US Food and Drug Administration trial-level and
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patient-level analyses. Journal of clinical oncology : official journal of the American
Society of Clinical Oncology.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356710/
Lawrence Casalino, M. (2003, January 22). External incentives, information technology, and
organized processes to improve health care quality for patients with chronic diseases.
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Crawford, P. J., Aldred, M., & Bloch-Zupan, A. (2007, April 4). Amelogenesis imperfecta -
orphanet journal of rare diseases. BioMed Central.
https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-2-17
Feder , G. (2011, October 12). Identification and referral to improve safety (Iris) of women
experiencing domestic violence with a primary care training and support programme: A
Cluster Randomised Controlled Trial. The Lancet.
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Fleck, S. (2001). First-time mothers’ and fathers’ transition to parenthood: Infant care ...
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Saltman , Ri., Bankauskaite, V., & Vrangbaek , K. (2007). Decentralization in health care - world
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Self Evaluation Questions
Q.1. How engaging is your piece for the neutral/undecided audience, who is also educated,
curious, and discerning? Is it exceptional, very good, solid, still developing, lackluster, not
yet formulated? Give your rating (e.g., very good) and two specific reasons for the rating
I believe that my piece is very engaging for my audience of the neutral and undecided but that
are also educated, curious, and discerning. I give my paper the rating of very good because I put
a lot of time and effort into this piece with all of the information I found and the research I did. I
also gave it this rating because I think I made it a very educational read and put a lot of time into
making sure that it made sense and followed the thought process I had.
Q.2. If you pull everything that is implied and explicitly stated throughout your entire
article, what does it add up to? What is the article trying to do/say/persuade the audience
of? Said another way, what is your article's main claim? Don't overthink this one, nor
spend time making a perfect sentence. Just make sure to account for all aspects of your
article
I think my article adds up to the point that “The mixed healthcare system, despite its challenges,
provides a platform for a holistic and inclusive approach to healthcare.” The article is trying to
tell the audience that a mixed healthcare system would be a good idea for America to have in its
pocket. It would be useful and resourceful in all aspects of healthcare.
Q.3. From the perspective of your intended reader, what is most persuasive and credible in
your article, and why? And, from the perspective of your intended reader, what is the least
persuasive and credible, and why?
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The most persuasive part of this paper I found is the section that explores the historical
evolution and the birth of complexity in the American healthcare system. This section effectively
establishes the foundation for the argument by providing a comprehensive overview of how the
healthcare system has evolved, incorporating historical contingencies, economic ideologies, and
societal structures. By tracing the origins of the mixed healthcare system, the paper sets the stage
for a nuanced understanding of the complex factors that have contributed to its current state.
On the other hand, the least persuasive part might be the section discussing challenges and
counterclaims. While it is important to address skepticism and criticisms of the mixed healthcare
system, this section appears to be less detailed compared to other parts of my paper. It briefly
mentions economic implications and healthcare outcome disparities without delving deeply into
these issues. The paper could benefit from a more thorough exploration of these
counterarguments to provide a more balanced view.
Q.4. What are you particularly proud of? What do you feel you did especially well? Be
specific in your response
To be completely honest I am proud of the whole paper. I put a lot of time, thought, and research
into this paper. I used almost all new sources because I didn’t connect with the ones I already
had. I am proud of how dedicated and interested I was in this topic and how invested I became as
time went on.
Q5. If given more time, energy, skill, interest, and/or ability, what would you change/do to
improve the article? Be specific in your response
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Honestly, I probably could perfect more if given more time and ability. I have been stressed with
finals for other classes so I tried my best to put in as much time and effort as I could on this
paper. I know I tried my best and that is all I can ask of myself at this time, but I know if I had
more time and ability I could knock this article out of the park.
Q.5.
Application Question
—What are two specific things you learned—about
argumentation, writing, writing for a neutral audience, researching, the writing process,
the article genre, thinking, etc.—and how can you apply these to other situations and
scenarios in life? Be specific in your response
1. Thorough Research for Persuasive Communication:
Learning from the paper, I understand the importance of thorough research in constructing a
persuasive argument. This involves not only gathering relevant information but also considering
historical context, key figures, and diverse perspectives. Applying this to other situations, I can
ensure that any argument or communication I present is well-founded and supported by robust
research. Whether it's making a case at work, participating in discussions, or advocating for a
cause, the practice of comprehensive research will enhance the credibility and persuasiveness of
my communication.
2. Balancing Perspectives for a Neutral Audience:
The paper emphasizes the need to present a balanced view when writing for a neutral audience.
Acknowledging counterarguments and addressing skepticism without bias contributes to a more
inclusive and open discussion. Applying this principle in everyday life, I can approach
conversations with a neutral audience by considering various viewpoints. This skill is valuable in
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both personal and professional settings, fostering constructive dialogue, teamwork, and effective
problem-solving. By maintaining a neutral and open-minded stance, I can build stronger
connections and contribute to collaborative decision-making processes.
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