Comprehensive Health Care System Inc - Essay Example

? Comprehensive Health Care System Inc. I. Target Market & Corresponding Services In the USA, the private healthcare insurance provider has a 32% market compared to that of government’s 46.7%. This is according to Burkardt, N. (2010, p.4). However, there are still about 45.7 million people in the USA who are not yet insured as reported by the US Congressional Report by Lyke, B. and Fernandez, B. (2009-2010, p.2). As more and more find employment, there will be opportunities for parts of the 45.7 million without health insurance to avail of a private health care insurance, given the fact that government Medicaid and the other benefits have become insufficient as a result of higher costs of medical services. In the USA, government provides and pays for the healthcare of 46.7% of people, while the private providers of healthcare insurance account for 32%, according to Burkardt, N. (2010, p.4). Because health care services have to be a continuous benefit, it should be made available to every person who aims to stay healthy and productive until the time when the body finally weakens in spite of all the precautions in order to remain healthy. The ideal target market consists of those who will be joining the workforce without health insurance. First of all, there are millions of them. It is the hiring company who ought to provide such health insurance benefits. And the arrangement will be via salary deduction of benefits wherein the health care insurance is normally included. Employees will be made aware about the inadequacy of Medicaid because of the many limitations, like having a low income. A comprehensive health care insurance has broader coverage and usually better benefits, better terms, and can have more incentives. II. Vision, Mission, Objectives Every person who works should have Comprehensive Health Care Insurance from the start of employment or any productive and income generating work. It can be planned depending on the willingness to save, ability to save, and the individual’s preferred benefits after some time of saving with Comprehensive Health Care System Inc. (CHCS Inc.). The term “save” is used instead of “pay” because the money of customers are being entrusted to CHCS Inc. for a period of time, at least 10 years, after which the full benefit will be granted. Prior to the completion of the 10-year savings period, in case there will be an incident requiring some health care benefits, the customer will be afforded a limited value of benefits commensurate to the regular savings plan chosen. It shall be the mission of CHCS Inc. to provide a comprehensive system of health care insurance based on pre-calculated and cost-controlled plans pre-arranged with the actual providers of services. The concerned parties will include professionals contracted to render the needed health care on a regular basis even if the customer is not yet sick or in need of health care. Every quarter, customers will be contacted and possibly referred to a doctor for medical advices, to ensure ongoing good health. III. Organization of the Health Care System Leading to a Continuum Penner, Susan J. (2004, p.31) identified the different people with their respective interests in health care, namely, (1) the providers of health care, (2) customers who need health maintenance and the means to afford services and medications to stay healthy, and (3) the insurance company that will pay for the cost of healthcare. Factors affecting decisions of people to avail of specific health care providers include the financial incentives, the convenience to customers in terms of where they can get the services, the alternative choices of reliable health care, the extent of health care coverage, and the length of time of coverage. A long list of professional Health Care providers will be contracted for their periodic to long- term services. This should be acceptable to doctors and nurses because they will be assured of forthcoming income per customer served. Cost can therefore be expected to be controlled because of the prior arrangements. In most cases, customers will not need hospitals. And the periodic check-up and advices of clients will reduce the incidence of sickness requiring hospitals. At the start of a “savings plan”, limited services will be made available. As the years pass, pre-defined additional health care benefits will be covered. Additional benefits will be made available for not getting sick and incurring expenses due to sickness. The health care insurance will remain active for many years of ongoing savings not only leading to additional benefits as savings actually grows through monthly contributions. There will be no lapse for this system In case of unemployment the customer will still have some amount of benefits. And contributions will be made ongoing after every employment. If unemployment strikes, the customer may stop contributing for the duration of unemployment. In order to prevent losses for the company, the pre-arrangement should be limitations in benefits and ongoing contributions from employers as well as the insured. What will make this a business continuum are the limitations and benefits that will allow uncontrollable breaks in the contributions but will require a continuation once permitted by circumstances. This containment policy is actually not new. Some hospitals had tested this before. It worked. A good model for the provider of health care services in hospitals is Rochester’s Hospital in New York. In its cost containment program for all those accommodated with their share of health care, the management of that hospital considered government as a long-term partner who reimburses some costs. The result, according to Liebschutz, S. F. (2011, p.178) was very favourable to the nine hospitals located in Rochester, New York, because after serving many people with such a cost-containment policy, all of these hospitals became more financially stable and modernized. Hospitals implemented what became known as the Hospital Experiment Payment (HEP) program which served the community as a whole with acceptable quality that was within controlled cost level wherein the government played the role of reimbursing expenses. To further ensure maintenance of customers whether or not they are employed and contributing monthly, the comprehensive insurance will turn each member into a stockholder after some time of reaching a savings target. This will encourage every member to strive to reach the number of years designated in order to become a stockholder entitled to dividends and other benefits. Furthermore, because there is no default for this health care insurance, the number of years of savings will add up over the years so that they will be entitled to more benefits as they keep increasing their savings. The only thing they cannot do is withdraw such savings. This is important because the amount is supposed to be for health care maintenance over the long term. All contributions are computed using the annuity table of compounded interest rate. To ensure profitability, there should never be a time when customers as a whole will reap benefits beyond the income that the company earned out of contributions. However, there are time3s when individual customers will receive substantial benefits beyond what was contributed and earned out of contributions. But that should be based on “extraordinary savings growth” actually realized in a previous year, of which a part may be allocated to cover for substantial benefits of some customers in a given year. Thus, it follows the idea of earn first before spending within means. IV. Key Performance Indicators for Evaluation Like it or not, profitability is still the main key performance indicator. Growth in the number of policy holders will be another basis for evaluation. And trend in the cash collections are also the other side of the picture. The reality of USA present times among hospitals is that most may be tax-exempt for providing health care services. Nonetheless, Hammakerm D.K. and Tomlinson, S.J. (2010, p.144) noted that these same hospitals are “focused on financial; performance and survival”. The definition of “affordable health care” depends on who the customers will be. Those with health insurance have better access to more extensive and higher quality health care services (p.147). One of the main roles of the Comprehensive Health Care System is to enjoin all those without such plans to automatically have the discipline of saving for the time when funds for health maintenance will be necessary. This will be done at CHCS Inc. through companies who will be hiring and who will be in need of providing for the time when employees get sick and will have to incur costs of health care wherever acceptable. In conclusion, this Comprehensive Health Care System will be very acceptable to the general public, to doctors, nurses, hospitals, and even the government. The company will also be assured of profitability over many years. As President of CHCS Inc., I will convince those without comprehensive health care that they have much to gain and not a dollar to lose with such a system. References Burkardt, Nicole. Evaluation of the Marketing Environment for Private Health Care in the USA. Seminar Paper published by GRIN Verlag, 2010. Print. Hammaker, Donna K. and Tomlinson, Sarah J. Health Care Management and the Law: Principles and Applications. NY, USA: Cengage Learning, March 17, 2010. Print. Liebschutz, Sarah F. Communities and Health Care: The Rochester, New York, Experiment. University of Rochester Press, 2011. Print. Lyke, Bob and Fernandez, Bernadette. Health Care Reform: An Introduction. Congressional Research Service and Diane Publishing Co., 2010. Print NBER. Employer-Sponsored Health Insurance and Health Reform. The National Bureau of Economic Research.Working Papers, 2009. Web. Viewed December 5, 2012 @ http://www.nber.org/bah/2009no2/w14839.html Penner, Susan J. Introduction to Health Care Economics and Financial Management: Fundamental Concepts With Practical Applications. California, USA: Lippincott Williams & Wilkins, 2004.Print. Read More