CATASTROPHIC, LONG TERM AND INDIGENT CARE

Introduction
When considering questions about the economics and
ethics of health and medical care to people, one not only examines
what is current practice, but also paves to address far-reaching and
searching questions. Currently we are aware that there services are
discreetly described as catastrophic, long term and indigent care.

Meaning
Catastrophic
It is a term applied to a disease for which some form of
unusually expensive treatment must be available to sustain life for a
period of time.
Long term care
It is a care of those disease conditions which require
skilled or custodial care over a period of time.
Indigent care
This refers to populations, not to disease conditions, but
individuals too poor to contribute financially to the payment of
necessary services.

Features
We have not examined and planned carefully for the
integration of these three type of care and

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  catastrophic illness can readily lead to the need for long
term care and in order to quality for assistance in meeting
either a catastrophic illness or the need for long term care
may necessarily become poor, in that total asset can
become exhausted .
 On the other hand, if one poor, one’s situation may
contribute itself quickly to a catastrophic illness or the need
for long term care.
 In our present method of function, as well as our present
educational programs for preparing health professionals ,
the system for treating,
I. Catastrophic illness is the first class system.
II. Long term care is second class.
III. Indigent care is third class, described as such by
Anne Somers.
Ethics
An ethical dilemma presents itself to policy makers,
providers and users of services when resources are perceived as
limited by a society.
Inherent in us is a set of explicit principles that guide and
determine our behavior and decision making in serving needs of
societal members.
This dilemma is created by 2 forces
1. By an ethical obligation of a society to meet the needs of
people for health care and medical services.

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 2. By concerns over rising costs and the inequities that may result
for individuals and groups of people.
(Inequities in relation to cost, quality access and of care and
services.)

Ethical frame work

The ethical obligation to meet access needs has been
stated by the president’s commission for the study of ethical problem
in medicine and biomedical and behavioral research. It includes
A. Society has an ethical obligation to ensure equitable access to
health care for all.
B. The societal obligation is balanced by individual obligations
C. Equitable access to health care requires that all citizens be able
to secure an adequate level of care with out excessive burdens.
D. When equity occurs through operation of private forces, there
is no need for government, but the ultimate responsibility for
ensuring that society’s obligation is met, through a combination
of public and private sector arrangements, rest with the federal
government.
E. The cost of achieving equitable access to health care ought to
be shared fairly.
F. Efforts to certain rising health care should not focus in limiting
attainment of equitable access for the least well served portion
of the public.

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Current problems
The current problems are the deliver of catastrophic care
long term and indigents care is;
 Inadequate distribution of services, including both financial
support and labor exists.
 Fragmentation of health services, in that comprehensive care
does not result.
 There is failure to integrate these two into program of
care .linkages are not the others is cumbersome and confusing
to many users of the services.
 Inflationary health care costs
 Focus on crisis oriented health care and institutionalization
 Severe limitation on primary care and health promotion
 Non comprehensive care for the chronically ill and those
requiring ling term care
 Under utilization of medical services by the poor

Catastrophic, long term and indigent care and population need

 The perceived need for utilization of health care and medical
services depends upon the physical, emotional, social and
economical ground of the individuals as well as the cultural and
environmental background of the consumer.
 The total need is affected by changes in population
characteristics, changes in educational levels, emphasis upon
self care, technology and the economy.
 The population is distributed widely across many segments of
society. Their care needs reflect catastrophic, long term care

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 and to a grant extent, so called indigent care, because many of
them are poor.
 The impact of social inequality results in distinct patterns of
morbidity and mortality among different populations.
 The gap in health care for the poor remains.
 There is little debate that economic deprivation results in poor
health. The poor place a low priority on health and use less
medical service not only because it is less available, but also
because their perception of health id different from the middle
classes and upper classes and because of many other reasons
embracing cultural, social and psychological domains.
 They seek medical care primarily in emergency of crisis
situations, using very little to prevent illness.

Catastrophic long term and indigent care and equality of care

 Equal access to health services is necessary to provide
individuals with equal opportunity to make the most of their lives
 Equal respect for and among people is valued. Equal respect
implies respect for an individual’s right for self-determination
and implies that it is a responsibility of others to obtain informed
consent prior to invading that person’s or affairs.
 Individuals are entitled to equal relief from pain and discomfort.

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Implications for policy
 The policy makers can well consider the integration of
catastrophic, long term and indigent care into one program, with
single source financing, quality, cost access and management.
 The goal should be the attainment of equity in accessibility, cost
and quality regardless of type of population, income, nature of
illness and type of care require.
 A re-examination of adequate services is needed, with the
intent of working toward comprehensive care.
 Financial consideration should be given to those who are
uninsured and the poor.
 Reallocation of resources- brings about integration of programs
and planning emphasis upon the avoidance of the currently
most expensive modality of treatment.
 Control of excessive inflation in provides cost and charges.
 Reorganization of the health cares system so that primary care,
personal care and humanization are central characteristic.

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Summary
So far we have discussed about catastrophic, long term and
indigent care. Its meaning, features, ethics, ethical framework, current
problems, population need, equality of care, implications for policy.
Conclusion
Health is an investment we can not choose to ignore. the
quality of life ,believes we desire is one that in corporate for
individuals as much independence as possible, avoids paternalism,
is so far as possible and gives the responsibility for use of
opportunities to the individual.

Bibliography
 Mccloskey,(1994), “Nursing Administration” ,2nd edition, Mosby
publishers,Philadelphia,Pp no. 1106 - 1111
 Manual CICPF (2007)’reform act for the provision of health care
for the medically indigent) Article 15, Rev Jan.7.
 “catastrophic care management” (2008)
http//www.catastrophiccaremanagement.choosebroadspir.com/
servicesFCM/CCM
 ‘WHCC: Unreimbursed catastrophic and Trauma Care Study”
10/28/2004
 http//www.wyominghealthcarecommission.org/pdef/section/
catastrophic/care
 www.wikippedia.com