Management Health Care in the United States - Case Study Example

Running Head: MANAGEMENT HEALTH CARE Management Health Care [Institute Management Health Care The paper entails a debate commenced over the concerns of current health care situation in United States and future role of health services providers. It comprises of a discussion on the four scenarios proposed by Shortell and Kaluzny for development of health care industry sector and its counterparts in the United States of America. Each scenario focuses the management of healthcare sector development from a unique perspective which is evaluated in terms of cost control considerations, accessibility of health care services to the individuals at large, proposed and expected organizational structure and culture of health care centers with respect to each scenario, and also discusses the implications of such efforts over the role of management of health care centers in United States of America. Introduction United States healthcare system is currently undergoing a transformation. The changes that are occurring in this industry are totally unprecedented and are responsible for the changed outlook of this industry. In the United States, healthcare services are fundamentally provided by separate legal entities belong to the private sector of the country. Government also lends it support to healthcare seekers in the form of government funded programs like Medicare, Medicaid, Tri-care, Child Health Insurance Program and Veteran Health Administration. In this industry, employers and health insurance agencies also play a vital role (Odier, 2010). Currently, in the United States a heated debate is going on over the issue of healthcare cost to the general public and its widespread availability at the time of need. These healthcare reforms seeks to address issues such as right to healthcare; access to health care for everyone; fairness of the healthcare service provider; and efficiency with which health care services are administered to patients. In addition to these issues, healthcare reforms are also discussing the issues of healthcare service value, quality, and choice (Shi and Singh, 2010). In this healthcare industry of the United States of America, healthcare insurance service provider, hospitals, employers, and the government are parties involved in the dynamics of the industry. Despite of huge investments in healthcare, it has been found that its infant mortality rate in USA is higher and life expectancy rate is less than any other industrialized nation. Recent industry data indicates that the country has gained little in returns against huge expenditures. Obesity, heart diseases and cancer has surged amongst American population. This signifies crisis in the healthcare industry (Dougherty and Conway, 2008). These above mentioned situations in the industry are heavily influencing the way the industry is shaping itself. Consequently, a heated debate is underway regarding the role of healthcare service providers and other stakeholders of this industry. Discussion The debate is over the current situation of health care industry in United States, these are administered from four separate perspectives which are elaborated below. Scenario 1: Business as Usual This scenario for health care management and development in United States stems from a business perspective. Accordingly, this side of picture advocates that the health care strategy and its corresponding procedure is a product of health care market demand and supply drift and government intercession. A trend of aging has been witnessed in America with time in the American population progression; it has been found that the life expectancy of Americans has been increased by 20 years over the last 5 decades. The percentage of the total American population heading towards aging has also been increased with baby boomers generations’ senescence. This wide fraction of Americans has identified the growing segment of market which demands integrated health care systems and institutions (Shortell and Kaluzny, 2005). The cost of establishing a system which meets the growing health care demands of aged Americans has cost and benefits implications for all the stakeholders of the health care industry in United States of America. Since the American health care industry is in the phase of transformation and transition, it is both implied and overt that the cost of creating integrated healthcare policy for aged and obese populace would bear huge cost of long term health care for both the government and the private care institutions. The returns for the stakeholders of the industry are marginal in comparison to the cost estimates because of the initial phase of health care industry transformation. However, the overall cost of the development of healthcare system is distributed amongst the various partners of the industry along with the government. Healthcare concerns include accessibility of the services by the general public without any discrimination. Here the health care business entities and the private sector would look forward to create maximum choices for all consumers to create value and deliver optimum care services quality i.e. consumerism. Since the health care industry is in the initial phase of development, it is characterized by functioning of numerous care providers which would create competition amongst the players. Consumerism phenomenon leads to rivalry amongst players for quality and value which automatically set policy and benchmarking standards for the industry stakeholders. The organizational culture of healthcare providers would revolve around customer-demands, cost efficiency and accessibility to the general public. The role of hospitals’ management is very important in collaboration with role and plans of government for providing health care access, long term care and delivering quality services to the growing obese and aged Americans irrespective of their ethnicity and race (Mays, Popay, Pope, 2005). Scenario 2: Hard Times/Government Pressured This scenario advocates that the perennial economic downturns in America have disbanded and disowned the regional health care programs and have transferred the healthcare burthen to the federal government. This has further compressed the United States federal budgets for investments and developments of health care system. Accordingly the healthcare advancement opportunities are restricted to the scope of government actions and policies developments. The private sector has been depicted as frozen as par this second scenario. Consequently the government would carefully plan its and expenditures by monitoring the populace demographics statistics, health care system info and facts, demand for health related products and services by the aged and obese public, cost of these services etc. Thus a wide and collaborative information system is required to manage the health care system development requirements faced with limited resources (Shortell and Kaluzny, 2005). In such depressed economic situation, the American government is faced with scarce pool of resources. Therefore for advancing the health care system, the government needs to deploy efficient information infrastructure and effective planning for creating innovation to meet the growing health care demands of the masses. However, for establishing such an innovation induced system would cost huge amounts to the government in the short run. The healthcare availability concerns would be there before the government. Making health services available to the public without adequate regional support would not only create financial problems but also create accessibility problems for the health services’ seekers because of lack of coordination and intermediation between the federal government and care providers in the absence of the local states’ role. Moreover, increased financial pressure over federal government might lead to inflated health care prices to overcome the increasing costs of managing healthcare system. This would create discrimination amongst public groups and ethnic sects in terms of access to health care especially in case of chronic illness and institutionalization of patients for long lasting care and might leave the access alone to the wealthy ones’ to avail the high tech services (Rudat, 1998). The organizational culture of health care centers in such a scenario would be based on an open system which focuses on the fact that the organizations depends upon their scarce resources, their immediate environment and their symbiosis with the technology and the environment. The organizational structure would be open to government’s intervention and surveillance. Faced with scant resources the health care institutions would develop inter-organizational relations with their counterparts in the environment to make most of others’ resources. This would help develop shared ways to reduce cost and ease availability. The role of management would be extremely important in inducing performance oriented and quality focused health care plans to be executed in times of financial crisis as proposed in this scenario. The management should seek information extensive processes to make informed and educated decisions to limit wastages and induce cost efficiency in the health care operations and for delivering quality services. These efforts might include adoption of quality management systems, integrated operations, supply chain management, inter-organizational relations and strategic alliances with industry partners (Egger, Smith, and Altman, 2001). Scenario 3: Health Care as an Economic Development Issue As mentioned before, besides government and health care institutions, the employers and insurance services providers also plays a leading role in providing health related services to the individuals working in American organizations. Employers offer health insurance services, retiree programs and other Medicare programs to design robust recruitment, selection and staff retaining plans to inculcate and deliver value for employees and prospects. Health Insurance companies develop strategic alliances with well known employers to help them provide health benefits to their respective employees. In this way the health insurance companies along with employers designs a better deal to approach and cater the health requirements of their mutual target market. The employer being the representative of many employees bargain deals with the insurance company and on the other hand the insurance providers capture a large group of targets on behalf of the indemnity ad credibility of the employer. This way the two players better off with employer’s health coverage plans (Shortell and Kaluzny, 2005). The third scenario deems the health care coverage by employers as an economic development issue because it has been witnessed that this health coverage trend amongst employers has increasingly adding to the expenditures of the organizations which shrinks the room for investment in other productive measures. In the long run this budding cost of employers affects the economic development, limits investments, and restricts flow of finance into money markets; because the employers tie their resources into long term health coverage insurance plans. Moreover, it has been found that employers’ share of investment is much higher than that of individual employee in a health coverage program, which put most of the financial burden on the employer. In such a situation the health care access is likely to be unjust and biased because the economic downturn has already deterred the attempts and it would continue to dispirit the employers’ practice of providing health coverage to the employees. Furthermore, with the aging baby boomers and escalating demands for health care, a chunk of American population would become dependent on government pension plans and hence the baby boomers may not be in position to avail the health care plans all on their own. The emergent issue here for the government is whether to focus on individual health coverage or invest in the broad based health development and innovation plans. Organizational culture as per this scenario is characterized by high values of adaption to environment dynamics and development of change management philosophy across the board. The role of health care management is crucial in supporting government by executing the policies and plans as proposed by the government (Burns, Bradley, and Weiner, 2012). Scenario 4: Health Care as a Shared Vision This scenario proposes health care as a shared vision. This points out towards health care sustainability. According to this scenario the development of healthcare sector occurs when plans are developed and executed mutually by all the stakeholders i.e. the care sources, the government, the businesses, the communities and the individuals. When joint efforts are made better outcomes are achieved in a relatively short period of time. However, creating awareness and motivation for such a shared vision and culture amongst all the stakeholders requires time and resources (Shortell and Kaluzny, 2005). The cost of developing a shared vision and culture to support healthcare development is not as high as that the cost anticipations in other scenarios. The mutual efforts of all the parties involved are cost effective because of two reasons; first, it distributes the total cost over all the participants; and second, it pool in resources from both public and sectors for development of health care. Health care access according to a shared vision is the mutual responsibility of government, care givers, non-profit organizations and even communities. Long lasting care for chronic and Alzheimer disease patients is made equitably available to all ethnic and racial groups without lack of correspondence due to mutual participation in health care development. This scenario presents a macro perspective of health care development; organizations are therefore required to adopt a culture that considers the big picture and broad outlook of the functioning of the elements and forces that exist in the external environment of the organizations. This requires organizations to employ strategic management perspective which involves vertical and horizontal integration strategy by developing strategic capabilities and resources, strong networks and systems, and supporting sustainability in healthcare. The role of management of health care along with the government is crucial for developing quality and cost focused accountability criteria for care suppliers, regulators, buyers, health agencies, NGOs etc to guarantee the execution of holistic sustainable health care objectives across the board. Conclusion The paper discussed separately the four health care management scenarios, from cost containment considerations, accessibility issues, and organizational cultural considerations and from management’s perspective. All 4 scenarios identified management issues in health care development in USA from business, government, economic development and shared sustainability outlook. Recommendation After doing the analysis of the scenarios, it has been found that health care development is dependent on economic expansion, and since the economy is facing a tough time; therefore the health care system and its participants are required to plan and execute strategies in collaboration with each other. Businesses, hospitals, health agencies and not-for-profit organizations should be subsidized by the government so that joint efforts are made by individual players towards development in healthcare. This distribution would distribute the burden from government to business, legal, social and health care participants and thereby distributes cost. Accessibility to health care would also become just when it is a shared responsibility of everyone. Integrated system and culture should be adopted by healthcare organizations to ensure good management. References Burns, L., Bradley, E., and Weiner, B. (2012). Shortell and Kaluzny’s Health Care Management: organization design and behavior. NY: Cengage Learning. Dougherty, D., and Conway, P. (2008). ‘The 3T’s road map to transform US health care: the ‘How’ of high quality care.’ The Journal of the American Medical Association, 299(19): 2319-2321. Egger, M., Smith, G., and Altman, D. (2001). Systematic Reviews in Health Care: Meta-Analysis in Context 2nd edn. London: BMJ Books. Mays, N., Popay, J., Pope, C. (2005). Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field. 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