Managed Care Affects Speech-Pathologists

Another concern around such market-oriented reforms is that lower income people exit suffer. Under managed superintend, individuals with high incomes would be able to pay the extra premium cost to enroll in more expensive health plans part lower income people would not be able to undergo 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 work well is preventive medicine. However, in the case of speech- vocabulary disorders the Awellness@ notion of health does not necessarily work well. Speech-language pathologists are clear Aprofessionals who identify, assess, and treat speech and language problems including swallowing disorders@ (Moratorium Passed). While some procedures of prevention can be applied, overall roughly problems are kinky conditions Ainvolving speech, articulation, fluency, voice, verbal or written language, auditory comprehension, cognition or communication or oral, pharyngeal or laryngeal sensorimotor competencies@ (Speech Language Pathologists).

The point is that after identification and evaluation yield place, the called for handling plan is oftentimes long term, rather than minuscule term. Speech disorders involving neurological disorders, stroke related communication

brain injury, mental retardation, cerebral paralyze or autism often call for an ongoing, long term treatment plan, and the trained speech therapist, in consultation with the client, can be the best judge of what is needed. Unfortunately, caps stipulated by managed care and Medicare can in like manner often mean that the speech-language pathologist cannot follow through on the designated treatment plan and vital treatment can be disrupted.

An example is in the area of patients recovering from the debilitating set up of strokes. Of all the after egresss of a stroke, Abeing unable to talk, read, salve or understand those around you can be among the most upsetting@ (Speech After Stroke).

Of the 500,000 Americans who suffer a stroke from each one year, between 25 and 40 percent of those who survive will substantiate stroke related communications disorders (Speech After Stroke). The repute of speech rehabilitation for stroke victims extends beyond restoring speech and language into the realm of psychology; the ability to communicate can often lessen the depression and alienation that follow a stroke.

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

Moratorium Passed, (December 3, 1999). http://www.asha.org/media/priorities_passed.htm

smother Summary on $1500 Cap, (November 9, 1999). http://www.asha.org/medicare_cap/issue_summary.htm

The second adverse effect of the $1500 cap was the financial hardship it created for patients whose needs exceeded the limitations imposed by the caps. In addition, older Americans, Aespecially in long-term care facilities, who have exhausted the $1500 limit have no choice only if to disrupt their care and seek it in less amicable hospital outpatient departments, rather than with provide
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