Market Continuum - Coursework Example

Introduction Health care delivery system is one of vital component of public welfare schemes of the government, throughout the world. The recent trends have shown that the rising cost of living has had an adverse effect on the overall public health care system. The healthcare components like accessibility to good medical care, quality and cost are increasingly moving beyond the grasp of general public. The inflationary trend in the economy and the rigidity in the health insurance are creating an extremely vulnerable segment of society who needs to be addressed urgently both in terms of micro level and at macro level. ‘The overall poor health status of the U.S population is, in part, the result of limited access to services, especially for the poor, uninsured and vulnerable population’ (Harrington, 2000). In United States, healthcare has become a major concern which needs to be addressed urgently. Anderson’s market maximise/minimise continuum In the fast changing environment of globalization and technological advancement, healthcare system of US has come under lot of stress from various factors. The transforming socio-economic and political paradigms have adversely affected the healthcare modules. Anderson’s theory organizes the healthcare system as per the contribution of government and private agencies in the healthcare delivery. The level of participation of the government and non government agencies in the financing and organization of the healthcare modules determine their position on the continuum. The continuum is basically a continuous sequence of healthcare elements where the two sequential elements are similar but the first and the last are very different. In US, the healthcare is market driven and the various modules, even the essential ones like insurance, accessibility etc are treated like commodities. Hence, academicians and scholars have placed the US Healthcare system at the market-maximized extreme of the Anderson continuum. Significance of Anderson’s market maximization continuum Anderson’s theory of market maximization has helped to study the imperatives of the US healthcare delivery system and the diversity of the issues that have significant impact on the healthcare delivery. Renowned scholar Jacoby says ‘Economists tend to see markets as timeless entities without geographic grounding and so use the same set of tools to analyze them all’ (Jacoby). Anderson’s theory explains the deteriorating status of healthcare delivery in America and increasing disparity in care provided to the American people, at large. In the market driven health system, consumers or people decide what goods (health module) to buy and at what cost. Therefore, the prices and the level of services become the crucial factor in the exchange of goods or the healthcare services. The paper would be analyzing the impact of the market maximization of health system on the four crucial areas: socio-economic; demographic; health status; and political. Socio-economic impact In the last few decades, United State has seen a marked shift in the healthcare which has moved from public driven policies to market funded paradigms. According to scholars, the migration of healthcare delivery towards a more market determined system has had major effects on the social and economic outcomes of the society (Nichols, Ginsburg et al., 2004). Healthcare is funded by private agencies and insurers and not by the government. Health insurance purchased by individuals and employers are the primary source of funding for healthcare delivery. 67% of Americans have insurance coverage through employers’ programs and therefore, the employment status accounts as a major factor for healthcare outcomes of the individual (Fronstin, 1999; Enthoven, 2003). In the changing economic scenario, guaranteed employment is not a feasible option. In the recent years, increasing number of Americans have inadequate or have no health insurance cover leading because of unemployment. According to Enthovan ‘more than 45 millions U.S. residents do not have access to health care (Enthoven, 2003). Lack of public funding and the increasing cost of healthcare deliverables has become a huge concern. Falling sick has become a luxury that very few people are able to afford. Sickness therefore has become one of the main reasons for personal and professional bankruptcy in the United States, in the recent times. Deckard says that ‘compared to other industrialized nations, the United States has shown the greatest reluctance to move into a unified publicly owned and financed healthcare system’ (Deckard, p. 2) which has adversely affected the socio-economic outcomes of the nation. Impact on Demographics Nation demographic has been the worst sufferer of market maximization policy of the United States healthcare system. The privately controlled health delivery has made it inaccessible for the less privileged segment of the society. The increasing numbers of baby boomers have become the major beneficiaries of the patchy public funded healthcare resulting in ‘increased use and, therefore, spending... we won’t be able to assure baby boomers that high-quality health care will be there when they need it; nor will we be able to assure the generation paying for this care that we won’t bankrupt it in the process’ (Ganim & Reinhardt, 2004). It has also been observed that better facilities and more aggressive marketing of the healthcare deliverables are observed in the areas where population has increased significantly. ‘In Fargo, North Dakota/ west central Minnesota an aging and declining population has forced local hospitals and physicians to align their Services and cut costs to compete for a shrinking patient base’ (Anderson et al., 1997). Impact on Health Status The quality of healthcare system in the United States is dependent on the overall cost of the healthcare services purchased and therefore, the overall status of the healthcare of the state is not adequate for common man with mediocre income. Heath insurance is another main factor that has become dearer. ‘Healthcare coverage should be universal.  Everyone living in the United States should be covered by health insurance. Being uninsured can damage the health of individuals and families’(NMA). Lack of awareness for quality healthcare and information based public funding has resulted in inadequate and low quality of healthcare with huge medical errors in diagnosis and cure. The market maximization and the competitive business rivalry have resulted in the low quality of the healthcare in the United States. The people who have been forced to accept under covered insurance are increasing opting for lawsuits. Davis et al. says patients in America were more likely to claim that a medical mistake had been made in their care than patients in the United Kingdom, Canada, New Zealand, or Australia. The market paradigms of the healthcare system have made it extremely discriminatory and unaffordable and thereby inaccessible for the unemployed and low income citizens. Impact on political system The healthcare system is one of the most vital issues that have considerable impact on the political system of the nation. It is for this reason that the different poitical parties have their own political agenda and healthcare policies to gain public support. The increasing apathetic attitude of political leadership in America has resulted in market maximization of healthcare delivery that has adversely affected the well being of the common man. The need for comprehensive feedback of delivery system as a whole and a careful consideration to all the various pros and cons of the developing situations in the concerned areas of the public health care, has become the need of the hour. In 2003, AHRQ1 ‘was mandated by Congress to develop NHQR2 and NHDR3 to assess the status of quality care and existing disparities in care provided to the American people’(Poker et al, 2004). Thus, they openly acknowledged the down trends in all the four important components of the healthcare system which might boomerang on the government with serious consequences, if not tackled timely. The government needs to come up with more stringent measures and controls so that ‘health for all’ could be realized for the American citizens. The government shift of policies for public-private partnership needs to be monitored so that market driven interests are not able to exploit the vulnerable class. Conclusion One can conclude that market maximization of healthcare delivery system of US has brought forth an unprecedented commercialization with the healthcare industry that has not boded well for the masses. It is a fact that the even though the state spends nearly $300 billion per year on the healthcare system, the complexities that encompass the inter-related processes of the various elements of the system, are seemingly contributing to its falling standard of effective delivery. The lack of transparency and cohesive integration of details of the deliverables like patients, payers and providers are few factors that undermine the accountability thus reducing the performance and increasing the cost management of the overall delivery system. Reference Anderson, G., Black, C. (1997). Willingness to pay to shorten waiting time for cataract surgery. Health Affairs, 16(5): 181-190. Deckard, G. J. (2006). Preparing managers for the U.S. health care system: models for designing and accrediting quality curriculum, United Nations Online Network in Public Administrators and Finance. Enthoven, A. C. (2003). Employment-based health insurance is failing: now what? Health Affairs, 13(2), 7-20 Fronstin, P. (1999). Employment-based health insurance for children: why did coverage increase in the mid-1990s? Health Affairs, 18(5), 131-136. Ganim, L. J., and Reinhardt, U. E. (2004). Baby boomers and Medicare. Health Affairs, 23(2): 282-a-283. Harrington, Charlene & Estes, Carrol,L. (2000). Health Policy: Crisis and Reforms in the U.S. Health Care. Jones & Barlett Publishers. National Medical Association (NMA). The Conscience of American Medicine. Available from: [Accessed 22 December, 2008]. Poker, Anna, et al. (2004). The First National Reports on U.S. Healthcare Quality and Disparities. Journal of Nursing Care Quality 2004;19(4):316-21. Lippincott Williams & Wilkins. Read More