Factors Affecting Healthcare Systems Management - Term Paper Example

 Factors Affecting Healthcare Systems Management Healthcare sector in the United States has a number of factors that affect its efficiency and compatibility view to the society today. Some of these factors are attributed to certain historical events such as the depression of 1929, which led to social policies to secure the Medicare for the people of United States due to the hard economic times. Consequently, these policies made a significant effect on the perception of healthcare today in U.S. Other factors that affect healthcare system operations include management aspects for example the healthcare cost system organizations and the impact to the patients, problem solving, and the approach used to plan various issues in the healthcare care sector. The Impact of the 1929 Depression on the Perception of Healthcare Today The 1929 depression had significant social economic impacts to the society in healthcare system, which led to the introduction of plans that has persisted to today. The government and private sectors introduced health insurance programs after the 1929 depression with the aim of helping the citizens to obtain affordable healthcare services due to the hard economic times that rendered the citizens the inability to pay for health services (Loker 268 ). This program serves as a security for health service for the people although the government has taken advantage of high income among the Americans to increase the Medicare tax. Consequently, this has led to the perception of exploitation among patients and the public who pay for the program as most of the tax is not used on the healthcare system, which leaves most of the people wondering on what the government is undertaking to ensure that the crisis once in U.S in 1929 does not occur again. However, positive perception of the health system is increasing among the population of U.S. from the negative view that Americans have had towards the system since the 1929 depression. Cost and coverage is the main factor that most people consider when evaluating the effectiveness of the healthcare system. The peoples dissatisfaction on the healthcare system today in U.S. indicates that the impact on the 1929 depression to the health sector has devastated the balance between the cost and quality healthcare services, which has led to about 67% of the citizens dissatisfied by the healthcare system. The Canadian Healthcare System Canada is one of the developed countries whose health care an insurance system, known as Medicare, was introduced by the Medical Care Act of 1966 (Holtz 93 ). The system is run by private sectors, offers a global coverage, and is funded by the public through taxes. Doctors attending to patients are private practitioners who are paid fee-for-service and the health insurance plan is mandated to pay them direct payment claims. The federal government establishes the constitution that stipulates the operations of the health care while territorial and provincial governments manage and offers healthcare services and insurance plans. Primary care physicians are main healthcare services providers and coordinators in the Canadian health care system accounting to 51% of the country’s physicians. The Canadian Health Act of 1984 defines and solidifies the five principles and measures for the purposes of the territorial and provincial governments meeting on the basis financial aid from the health insurance plans (Holtz 93 ). The principles include i. Eligibility of the health care system to all Canadian residents ii. Universal and comprehensive coverage iii. Free accessibility and no other barriers to accessing healthcare services iv. Portability such that an individual can use the system while in the country and when travelling abroad v. Public administration for the assurance of accountability Table 1 Summarized health care system of Canada Type of Healthcare system Ownership of Healthcare system Financing of Healthcare system Reimbursement of Healthcare system (Hospital) Reimbursement of Healthcare system (Physician) Consumer copayment in for healthcare system National health insurance Public/private Single-payer (general taxes) Global budgets Negotiable fee-for-service Negligible Canada has successively contained costs in healthcare system using two broad methods, which include- i. Use of system-wide mechanism that include Single-payer financing , Global hospital/physician services coverage, Evidence-based information systems, and Regionalization ii. The use of sector-specific mechanisms that controls costs for drugs, hospitals, physicians, and technology Costs in the health care system. Table 2 Comparison of the Canadian healthcare system to that of the United States Canada Health Care System United States Health Care System Has a pluralistic type of healthcare system Has a national health insurance type of healthcare system Owned only by private sectors Owned by public and private sectors Funded by volunteers and multi-payer systems(premium/general taxes) Funded only by single-payer systems (general taxes) Hospital reimbursement varies including negotiable fee-for-service, capitation, DRGs, and per diem. Hospital reimbursement is through global budgets Consumer copayment ranges from small to significant Consumer copayment is negligible Physicians reimbursement is by RBRVs and fee-for-service Physicians reimbursement is by negotiated fee-for-service Differences between Problems-Oriented and Issue-Oriented Planning In Health Care Management Problem-oriented planning is a strategy applied to a particular problem. For example to train the traffic police officers on emergency treatments of wounds to help the patient before they are taken to the healthcare hospitals for further treatment after an accident. Issue-oriented planning is a comprehensive approach that deals with those issues that are most important and timely (Bryson 204). A good example of an issue-oriented planning is the construction and implementation of a veteran-centric health care model to be used for helping the Veterans explore the delivery system of the healthcare. Table 3 Differences between Problems Oriented and Issue Oriented Planning Problem-oriented planning Issue-Oriented Planning Planning is necessitated by the emergence of a crises or a trend that seems to obviously cause a disaster or disease outbreak Planning is necessitated by selected and pragmatic issues and may ignore some issues that people fell pose a problem to the society Planning is oriented on solving the specific problem facing the society Issue-oriented planning is oriented in solving a number and range of strategically important issues with an aim to trail multiple objectives. Planning commence in an approach focused on problems identification The planning starts by identifying strengths, weaknesses, opportunities, and threats. This process is known as S.W.O.T (Bryson 204). The solutions obtained from the planning may focus on the problems symptoms instead of solving the roots of the problem The planning seeks for maximum positive outcomes Advantages and Disadvantages of Group Problem Solving In Health Care Management Group problem solving is more convenient in organizations compared to individual problem solving. Group resolutions are because of several individuals contributing to solving a problem; hence, more problems are solved because of the teamwork involved. However, this method of problem solving encounters various advantages and disadvantages Advantages of group problem solving Higher output The people involved provide a wide scope of experience on different issues because each individual possess unique experiences, knowledge, and values. Consequently, there is a high number and variety of concepts that are applied to the problem being solved (Kreitner, 221). There is reduced bias There is a shared responsibility among the group members who arrives at a consensus, which encourages the members to exploit and explore ideas that may be seen unrealistic and gives them a forum to challenge routines of doing things attributed to certain issues and problems. Individual predisposition and biasness is confronted by other group members; hence, forces the individual to recognize others opinions and presence, which encourage acceptance of necessary change to a decision made regarding on how a problem is to be solved (Kreitner, 221). Increased individuals risk taking Members share responsibilities, which drive an individual towards the will to take risks. Various ideas discussed by the group offers a realistic way of risk assessment related to particular actions; hence, this guarantees positive returns. Better solutions for a problem Diversified ideas from the group members lead to a wide range of knowledge to apply on a problem. This interaction of a wide scope of intelligent ideas and skills lead to a high and efficient solutions (Kreitner, 221). There is improved communication The evolution of a problem affecting people and the procedure to be applied toward the resolution results to the awareness among all members on the solution taken and the reason that led to the particular implementation of problem solving strategy. In addition, individuals with required skills and knowledge can effectively present them towards the problem solving process (DuBrin 168). Increased commitments among members Agreed goals give similar purposes to each individual and the group in common. Subsequently, individuals develop a feeling of self-determination through various contributions towards a successful implementation of the solution to the problem. Disadvantages of group problem solving Competition among members There is a temptation of most people participating in a group to feel like they are in a competition. This results to destructive situations draining the group’s creativity towards reaching a solution. Power seekers are always found in groups, who use ploys to gain supremacy that create an incompatible environment for an effective problem solving process. Issues on conformity In a group, there is a tendency of each individual to conform to the reached solution. This result from the need to earn more respect and compassion that leads to people censoring their ideas accordingly. Group setting gains an agreement in a very quick way; hence, choose and accredit solutions in a quickly leaving other possibilities (Kreitner, 221). Consumes a lot of time Group problem solving involves a slower process compared to individual solution implementation because all members have to meet at set time, which takes time before they can commence on figuring out on how to tackle the problem(Kreitner, 221). There is lack of objective direction The absence of effective leadership in the group leads to directionless discussions, which make a smooth problem solving process impossible. Cost of Health Care in United States And Its Impacts To Citizens The phrase "Health care is too expensive” is common in the united states, which simply indicates the large amount of money used by an individual, as well as the government, to ensure health prevails among the citizens. It is adequate to concur with the phrase that is evidenced by the large amount the United States government spends on all sectors of health. In addition, the infant mortality rate in the U.S. is ranked the highest globally due to the lack of adequate women holistic, and patient centered care. Most of the women living in the U.S. are poor and suffer from chronic diseases due to lack of adequate funds to get special care attention in healthcare facilities. Statics indicate that U.S. is ranked first in maternal and infant mortality because of poverty among many women. This is a result of women disability to access better health care services available at very high costs. Kane explains that it does not matter whether the spending of U.S in healthcare is measured relatively to the population or country’s economy, the nation spends, by far, the highest amount on health care in the world as shown in the figure 1 below. Figure 1 cost on health care in U.S. OECD research indicates that the united states use $8,233 on health per citizen as per the year of 2010 analysis. This, by itself, clearly indicates that the cost of maintaining a healthy nation is much more than one would expect. Technology and communication technology that is required in hospitals pose a great cost to the government and private healthcare systems; hence, the hospitals has to take uncommon methodology to the health services performance improvement while reducing costs. Generally, factors associated with health care services, insurance, and HealthCare systems management are inter-related. The trend of healthcare system started by the government after 1929 depression has undergone various reforms, which of them, has led to negative view by the citizens from the increased tax to operate the sectors. Planning is a main aspect in the healthcare system to be considered as it determines the effectiveness of any health system on providing efficient health services. The type of healthcare system, ownership, hospital/physician reimbursement, and customer copayment collectively determines the cost effectiveness of the healthcare system in United States. Health is an economic issue that needs critical attention and planning to provide the citizens with quality and affordable health care services and insurance policies. Work cited Loker, Thomas. The History and Evolution of Healthcare in America: The Untold Backstory of Where We've Been, Where We Are, and Why Healthcare Needs Reform. United States,US: iUniverse, 2012.Print. Holtz, Carol. Global Health Care: Issues and Policies. United States,US :Jones & Bartlett, 2012. Print. OECD. Health at a Glance 2009 OECD Indicators: OECD Indicators. United States,US :OECD, 2009. Print. Kane, Jason “Health Costs: How the U.S. Compares With Other Countries” PBS News hour, October 22, 2012.Web 24 march 2013. Iyer ,Patricia, Levin, Barbara, & Shea, Mary. Medical Legal Aspects of Medical Records. New York, NY: Lawyers & Judges, 2006. Print. Kreitner, Robert. Management. New York, NY : Cengage Learning, 2009. Print DuBrin, Andrew. Essentials of Management. New York, NY: Cengage Learning, 2011. Print. Bryson, John. Strategic Planning for Public and Nonprofit Organizations: A Guide to Strengthening and Sustaining Organizational Achievement. New York, NY: John Wiley & Sons, 2011.Print. Read More