The Healthcare System Strength and Weakness - Assignment Example

Health Care Systems Name Institution Table of Contents Table of Contents 2 Question 1 3 Question 4 7 Question 5 8 Question 6 13 References 17 Question 1 The Abu Dhabi region has an estimated 130 million population with a diverse GDP ranging from US $ 900 to about US $ 43,000. Healthcare expenditure is reported to be about US $ 43 billion. Given the region size in regard to demographics and GDP diversity, the region certainly needs a well established native healthcare system. Based on the regions’ available statistics the infant mortality stands at 22%, while the CVD is responsible for 32% deaths among the women population and men at 27% (Roberts, 2001). Similarly, children under the age of 10 are reported to be diagnosed with diabetes. Over the last years Nauru is identified to have been registering the highest incidence of diabetes not only in the Abu Dhabi region but in the entire world. Qatar on the other hand, has the highest incidence of cancer, while obesity remains a serious problem in this region (Golden, 2007). The UAE Healthcare system strength and weakness Abu Dhabi Healthcare System Strength Abu Dhabi Healthcare System Weakness 1. Availability of healthcare workforce, the region is reported to have approximately 4,757 physicians, 8,221 nursing professional and over 1000 health-related professionals in the government and privately licensed institutions, that are all well equipped with medical necessities. a. The Abu Dhabi market for medical equipment is a monopoly market, with only one distributor who sells special product or brand. 2. All medical products getting in the healthcare system has to be registered with the ministry of health. b. The medical equipments imported in to this region carry an export duty and is estimated to be 5%. 3. The local business distributors play a key role in distribution channel and are the only way to buy medical equipment in the region. c. Healthcare equipments are expensive and require specialists in handling them. 4. The region has several healthcare financing systems, governmental revenue attained from general tax, donors among other funding bodies. There are social and private insurance d. The region relies on exported nurses and physicians services from non-emirate countries. 5. The UAE healthcare system has adopted newly developed medical technologies to boost health care service delivery. e. The Abu Dhabi Islamic culture limits provision of healthcare services. In the recent past, women populations were segregated against working as healthcare services provider as either nurses or physicians. Reform strategy on higher education While it is important that UAE governments proactively get involved in building a vigorous healthcare system in their respective countries. The governments’ reform strategy has to have intentions of fixing ineffective and clumsy system in order to meet the emirates needs so as to expand its economy that depend a lot on oil. On the contrary, most of the UAE governments have proved to be reckless as they get involved in hiring foreign experts who often under perform as they attempt to sell their models within the Abu Dhabi. Monitor and approve legally recognized healthcare institutions in the region Health care in this region is provided by different groups that include private institutions, Dubai Department of Health and medical Services and the Abu Dhabi Ministry of Health. According to Roberts (2001), the governments’ health care system is reported to only cover up to 75% of the health care cases in the region while the private sector covers 25%. With the growing population the private sector is reported to be increasing when it regards to improvement and reinstating of healthcare facilities. Identify the healthcare needs of the Abu Dhabi population The regions health care system lacks a reliable pharmacy and the neighborhood registered nurse practitioners’. As situation that is deteriorating health of the Abu Dhabi population and ultimately will build up to an explosive impact the regions’ economy. The region health care system too, lacks a well integrated preventive care, which may be used at education system, workplaces community and religious places. Developing healthcare Acts in support of better services The GAHS of Abu Dhabi has come up with reforms in the medical sector since the beginning of 2001. The healthcare system has been under restructuring process with reports indicating that over 90% on its previously held responsibility operations shifted its target by regulating and licensing primary medical care in the industry (Golden, 2007). The main strategy driving the industry revolution has been triggered by the match needed access to quality healthcare that is affordable offered mostly with private providers. In Abu Dhabi, the biggest healthcare providers were predominantly government sponsored institutions represented by a figure that is estimated to be 55% of the entire industry. However, since 2003 the governments brought in international companies responsibly manage the industry. Similarly, the Abu Dhabi governments advocated for privatization of the healthcare industry an objective that has so far seen a number of public healthcare institutions ceded both its administrative and operational task to the private investors. As a result, this has fueled growth of obligatory medical cover as required by the governments’ policies. Developing a nationally recognized medical cover plan Ideally, the fragmented nature witnessed in the healthcare systems within Abu Dhabi to date, remains despite improvement in the implementation of the health reforms in the emirates countries (Golden, 2007). The two major countries are reportedly under different stages when it regards development and implementation of healthcare reforms with a wide gap in aspects concerning access to healthcare services and medical cover plans, with Abu Dhabi public healthcare status reported to be waste. In either of the two, Services received by insured individuals are defined in two prime methods namely direct billing, here the patient presents either a card or their insurer details where the charges are directly incurred by the insurance firm. The second method works on a reimbursement, here the patient pays for the bills which are later repaid by his ore her insurance company. In both cases the insurance firm needs to verify that the treatment received has to be covered by the company’s insurance policy and the charges covered are normal compared to the local rates. Question 4 Medical technology in most countries has played a vital part in guarantee that the healthcare delivered is safe, of high quality as well extremely effective (Koechlin, 2007). It has come up with new life saving as well as life enhancing products.US remains the worldwide leader of medical technology innovation. It is the biggest producer of medical devises as well as diagnostics. It is also the largest exporter of this medical technology. This technology has a great potential to prevent, treat diseases as well as diagnose. Through the recent technology advancement the health care is now fully transformed. This is because the physician can detect infection as well as diseases earlier help in reduction of the patient’s recovery time. The use of drug-eluting stents is seen as being cost effective as according to patients’ in the US. German has made use of recent technology by ensuring that new individuals who are interested in joining its medical sector through organizations like DGBMT( German Association of Biomedical Engineering) where physicians, engineers and scientists are able to combine their efforts to facilitate use of advance technology for both therapy as well diagnostics. The health care business in Canada has recently undergone steady development recently. Due to the aging population; increase of lifestyle disease rates, as well as advancement of both pharmaceutical together with medical technologies (Busse, 2004). The highest challenges facing this healthcare is that of extended waiting hours that usually leads to inadequate or limited access to health services as well as health care financing shortages (Beaulieu, 2005). The Canadian medical sector is comprised of small organizations of which more than 57% have got less than 25 employees. An approximate figure of 90% of these companies is owned by the country’s citizens but about 95% has got 50 employees. The purchase of the equipment has shifted from physician to the patient in Canada; most of the people prefer having the device at their homes than visiting the hospitals (Busse, 2004). As new technology keeps on emerging and penetrating into the healthcare industry, both patients and the physician are enjoying the benefits of accessing medical information when they need it. The use of medical technology in the UAE has increased the cost of getting medical assistance hence making it unaffordable by the poor. Although, this has recently been improved as the quality of service given to the patients compared to the other countries in the World, the health system of UAE is seen as being good. Question 5 Japan Healthcare Reimbursement The Japan financing system posses features of multiples payers compare to the other countries’ systems (Busse, 2004). In this country, it is a requirement that every citizen should hold a social medical cover, in this cover the claims are developed under the insurance arrangements by the providers delivering services to the patients as the benefits of it kind. Basically, all medical cover arrangements are delivered under a uniform fee schedule recognized by the government. Under Japanese medical cover settings neither the insurers nor the healthcare providers are allowed to negotiate individually at a varied fee other than the government’s schedule. Ultimately, this position does not give the consumers any real chance to select their medical cover plan, as they are required to join an already identified plan provided by their employers, trade association or their respective local governments. Canada Healthcare Reimbursement Canada has adopted the tax-based healthcare services that are different from those of UK among other countries. In Canada, the insured health care services provided in the healthcare Act, which covers all medical services needs are fully financed by a public funds, while the private medical cover is prohibited. This when compared to England for instance, were private insurance firms are allowed to supplement the public funds through provision of medical services similar to public sector (Colombo, 2006). The government policies states that Canadians can get access to medical attention on a universal basis. However, developing a more unified set of insured healthcare services among its provinces aimed at protecting citizens that are not under any medical cover by either employers related covers plans remains a challenge in the industry. In early 1940s, the inter-departmental committee in regard to social insurance and allied services was kept up to review then existing NIS for the low-income working and unemployed insurance. In 1942, a report was released recommending establishment of a universal and comprehensive health care service in addressing limitation in medical services. Emirates of Dubai Insurance The UAE government provides its citizens with a health care system administered by the central ministry. For non-UAE citizens who are reported to cover about 80% of the population is required to pay up to US $82 every year in order to acquire a health card in supporting the card holder to obtain medical services at any given MOH facilities. This often a minimal fee charge, which is a mandatory requirement for expatriate working in the region, for those visiting this region for a temporal stay were expected to get relatively free health services during their stay. The cost incurred is approximately 80% of the MOH budget. The MOH administration confirms that although the ministry collects over 500 million Brahms on annual basis in form of medical services arguing that medicine is often misused as people on visit undergo complex surgery which is often charged at a very lower cost (World Bank, 2005). Recently a lot of the health facilities have adopted a way of paying the health providers varying amounts in regard to the difference in their service quality gotten through their attainment of the quality performance measures (Busse, 2004). Pay for performance is a type of reimbursement that specify on giving both financial and non financial benefits as well as incentives to the physicians as a result of attaining given quality benchmarks that are provided by their payers. The urgent need of incorporating pay for performance has led the UK National Health Service to dedicate $3.2 billion for funding for the next 3 years for the family practitioners by which 146 quality signs are used. The organization of the health service delivery in the UK is mostly characterized by the existence of physicians who acts as general practitioners. Normally they are the focal point of the patients contact acting as gatekeepers for the admission to the other secondary care services. In regard to cost sharing there a number of measure enacted to guarantee the arrangement of cost-sharing to the publicly- covered services, the drugs that are prescribed by the general medical practitioners are entitled to co-payment but approximate figure of 88% of the prescriptions are freed from the charges. These exemptions are mostly for aged individuals 60 years and above, children who are below the age of 16 year as well as that in full-time education but of 16, 17 or 18 years, pregnant women and those with infants. Similarly, people with certain types of disabilities or medical conditions, transport cost to the hospital and from the hospital are also provider for low income earners (Busse, 2004). Pay for Performance in the UK has significantly brought a positive influence on the healthcare quality provided to patient through out. Though this method could be discouraging and de-motivating to the low performers who at times may feel that the target set are too high for them to archive and due to this they might reject the program. On the other hand it encourages as well as rewarding the low performers on their efforts put in place and achievement (Koechlin, 2007).The table below illustrates the difference in healthcare reimbursement in the identified countries. Member countries Healthcare service reimbursement methods UK UK funds healthcare from general taxation rather than adopt the social insurance system as it is used by a number of other European countries. For technical areas such as pharmaceuticals, dental and ophthalmic services, long-term care for elderly people, there is still free provision of both primary as well as secondary care at the point of use. UAE The Abu Dhabi government provides its citizens with a health care system administered and funded by the central ministry. non-UAE citizens who are reported to cover about 80% of the population is required to pay up to US $82 every year in order to acquire a health card in supporting the card holder to obtain medical services at any given MOH facilities. In Abu Dhabi, Pay for performance is a type of reimbursement that specify on giving both financial and non financial benefits as well as incentives to the physicians as a result of attaining given quality benchmarks that are provided by their payers. Canada Canada has adopted the tax-based healthcare services. Insured healthcare services provided in the Canadian healthcare Act covers all medical services needs are fully financed by a public fund, while the private medical cover is prohibited. Japan Japan healthcare financing system posses features of multiples payers compare to the other countries’ systems. Both insurers and healthcare providers are allowed to negotiate individually at a varied fee other than the government’s schedule Question 6 The interest in ensuring quality health care services has been rising over the last years. This is as a result of financial crisis in these health systems which triggered government reforms and investments healthcare institutions. According to Busse (2004), medical sector in Germany is of high standards in general. This sector is financed by a system that is fee-based with a high number of insurances. One major characteristic of the health care system in German is that of self government tradition by the care providers. Over the years, the principle is meant to make these providers as well as insurances to be highly responsible for accomplishment of measures to ensure quality together with the needed financing. The other most important feature of this country’s health is the administrative separation of the services into two areas; in-patient and ambulatory care. Koechlin (2007), argues that increased demand on better health care and coordination between the two areas triggers the progress hence, the quality of the care offered. In order to solve this problem the introduction of management programs for diseases, integrative health perception and inter-department ways of institutions in a number of reforms of the system based on respective legal changes. Healthcare delivery in Japan has similar basic characteristics like those of the United States. Japan controls the uppermost per capita figure of CT scanners globally. Japanese patients are able to choose ambulatory physicians who are reimbursed by the government on the foundation of agreed fee-for-service program. These patients have access to the hospitals that offer tertiary care as well as the specialists offering these services. The country provides thirteen beds for a thousand populations this figure is above the average one in most industrialized countries. Another most unique attribute is that physicians are allowed to prescribe and dispense medical products. Approximately 30% of the country’s expenditure is used for drugs. Because the country’s fee program guarantees a unified form of payment to the medical care givers, assuming that the quality provided is uniform, there is no existence of an exact incentive that is aimed at maintaining quality. There is no existence of formal programs meant for quality assurance also the specialty departments do not contribute a lot the ensure quality provision. Due to these circumstances the public has now turned to large community as well as teaching hospitals. The healthcare system in U.K is viewed as being the most efficient in terms of quality, access to the health care, equity as well as healthy living. The country has short waiting time for primary health care as well as emergency services. In order to ensure provision of quality care, a number of regulatory bodies are put in place to monitor the exact quality of services provided by both public and private sectors. Targets are set by the government for a number of variables that replicates the quality of care offered to the patients. Substantial investment by the government in the Abu Dhabi has enabled it to create foremost advancement in the health care sector. The region has been aiming at adopting the recent medical technology which will help in improving efficiency aimed at maintaining quality (Colombo, 2006).The Canadian technology and services in the health care is viewed as being highly dependable and reliable hence when comparing it with the above countries it is ranked the best (Beaulieu, 2005). Generally because of the perfect reputation of health products and services bought from Canada. The Canadian government has come up with an agreement which aim at reducing the waiting times. The table below compares quality and access to healthcare in different countries Abu Dhabi Life expectancy is about 78 years Infant mortality rates 7.0 Hospital beds per 10,000 people is at 19 Physicians per 10,000 people at 28 Ratio of Nurse/physician is 1.6 Canada Life expectancy is 81.4 years Infant mortality rates 3.9 Hospital beds per 10,000 people is 34 Physicians per 10,000 people at 23 Ratio of Nurse/physician is 3.9 UK Life expectancy 80.1 years Infant mortality rates 4.8 Hospital beds per 10,000 people is at 25 Physicians per 10,000 people at 25 Ratio of Nurse/physician is 4.0 Japan Life expectancy 82.6 years Infant mortality rates 2.6 Hospital beds per 10,000 people is 164 Physicians per 10,000 people, at 21 Ratio of Nurse/physician is 4.5 Germany Life expectancy is 79.8 years Infant mortality rates 3.8 Hospital beds per 10,000 people is 35 Physicians per 10,000 people at 35 Ratio of Nurse/physician is 2.8 References Baker, G. A. (2005). Provider pay-for-performance incentive programs:2004 National Study Results. San Francisco: Med-Vantage. Beaulieu, N. A. (2005). Putting smart money to work for quality improvement . Health Services Research , 40 (5): 1318-34. Busse, R. A. (2004). Health Care Systems in Transition: Germany, WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies. Copenhagen. Campell, S. R. (2007). Quality of primary care in England with the introduction of pay for performance. . 357 (2): 181-89. Chaloff, J. (2007). Mismatches in the Formal Sector, Expansion of the Informal Sector. Paris: OECD Publishing. Cole, T. et al. (2000). Establishing a Standard Definition for Child Overweight and Obesity Worldwide International Survey. British Medical Journal , Vol. 320, pp. 1-6. Colombo, F. A. (2006). Evolution of Health Expenditure in OECD Countries. Dormont, B. A. (2006). Causes of Health Expenditure Growth: The Predominance of Changes in Medical Practices Over Population Ageing. Annales d’Économie et de Statistique , pp. 83-84, 187-217. Golden, L. L. (2007, August 26th ). Reform of health services in Abu Dhabi fuelled by wave of privatisation. Retrieved December 26th , 2011, from http://www.ameinfo.com/129954.html Koechlin, F. L. (2007). Comparing Price Levels of Hospital Services Across Countries: Results of a Pilot Study . OECD Health Working Papers . Roberts, M. J. (2001). Getting Health Reform Right: A Guide to Improving Performance and Equity. New York: Oxford University Press. World Bank. (2005). World Development Indicators 2005. Washington, DC,: The World Bank. Read More