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The support program identified for this paper is called the nationals Smoke-Fee Families (SFF) and it is funded by the Robert Wood Johnson Foundation (RWJF). The program was initiated in 1994 and it was aimed at supporting developments well as assist in evaluating innovative programs that are designed to help patients quit smoking habits during times of pregnancy. This program got established at the University of Albama at Birmingham as part of an initiative of the department of obstetrics and gynecology. The national program office for SFF had four primary purpose which include providing routine technical advice to t he RWJF pertaining to issues of the new initiative, management to the scientific review of SFF program proposal, provide technical assistance to grantee’s patient education studies and finally to help in coordination of the implementation of the studies.

Skin Conditions

Every long lasting skin condition is often linked to some psychological impact as it’s the skin that is used by individual to reflect what other perceive and consequently use it to base most of their judgments.  Most skin conditions are still widely ignored thus  many patients suffering from various skin condition like psoriasis ad eczema are forced o put up with ill-informed comments as well as the mistaken anxieties that such skin conditions are contagious (Raphael, 2008).

Skin conditions have various psychological conditions which include the following: skin conditions play a significant role in straining family relationships especially when a child is suffering from a skin condition like the eczema. One way skin condition impact on family issues is the fact that the disease makes the skin to be rough adversely affecting the sensation of touch which forms a critical role for bonding with parents. Also, the skin condition   result to skin inflammation which prompts a constant application of treatments which in most cases is messy and time consuming consequently resulting to conflict in the family. A child suffering from Eczema requires more attentions as compared to other siblings and thus skewing the family dynamics. Furthermore, children suffering from skin condition get picked from the crowd for wrong reasons resulting too uncomfortable feeling. Such selective treatment leads to shyness and withdrawal from performing of activities especially at school while in adults it causes anxiety and depression.

Psoriasis is a skin condition that results to depression which is one of the maladaptive reactions of the disease thus influencing adherence to treatment as well as perception of pritus. For instance, a study conducted by national psoriasis foundation (2004) shows that fifty four percent of the patients suffering from psoriasis suffered from depression. Moreover, patients suffering from psoriasis feel hopeless and as well as a tendency of self damage making them to culminate in suicidal ideation. Also, psoriasis patients tend to have higher levels of anxiety and worry a lot limiting their abilities to express their personal emotions. Patients also, have problems controlling their anger and tend to be aggressive during psoriatic eruptions which despite their attempt to cope up with the problems induce feelings of guilt in them when they fail to control them. Finally, patients suffering from psoriasis   also have their self efficacy affected thus fear revealing their aesthetic appearance in public.



The U.S. Health Care System

The United states health despite having contributed a lot in providing health care in the country, it has a lot of  setbacks that decrease the quality of heath cares services to its patients. Most of the problems associated with the health care system comprise of the delays experienced in getting appointment and tests, failure to grant specialists referrals, hiring of physicians with limited skill in health care provision, high levels of in decreased in service provision, high cost involved as well as irregularities associated with listing of drugs in the plans formulary leading to delays in provision as well as treatment of certain health conditions (National Center for Health Statistics, 2011).

One of the problems facing the United States health care system is the costs incurred in health care which have in the past spiraled out of control. In fact, the costs incurred by the health care system from one of the largest components of the United States economy and have been determined that it’s rising faster than even the rate of inflation. Such high cost have been attributed to  the country aging population  and the biomedical research and development that has served to bringing technological innovations that pay a significant role in driving costs up (Falvo, 2009).

One of the suggestion that will help enhance the managed care provided by the health care system is to streamline the current fragmented and wasteful system through elimination of inappropriate, unnecessary and wasteful treatments that decrease the quality of care while driving up costs. Such streamlining include establishment of an independent standards to be use to select appropriate care that relates to reimbursement to quality of service and reduction of administrative costs. Also, the political interference on the healthcare system must be eliminated as it limits transfer of research results into policies and practices that are universally available (Mossialos Et al, 2002).

Social values serve to influence the provision and payment of health care services because its pursuit often results to a steep economic c price and thus non –efficient economic terms. Social values determines the health system model to be used and this is attributed to the fact that health care system is described as a public  good therefore must reflect the social as well as the cultural values of the societies that are involved in design and adoption of them. Examples of social values include: solidarity, equity (vs. inequity), progressivity (vs. regressively, fairness, choice and dignity.

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