Analysis of a Health Care - Essay Example

Much has been said about the reform, which should take place at Medicare, and to view the necessity in these reforms, it is important to define, how the system works and how effectively it uses its resources. Medicare healthcare delivery system is influenced by a number of factors, among which are: the level of payment, medical education support, regulations relating to probable conflicts, the decrease in funding, etc. These issues are crucial in the activity of any healthcare delivery system, but attention should also be paid to the way these services are delivered to the elderly patients, as well as the ways of positive changes in quality and cost-effectiveness in healthcare delivery.

It is important to notice, that hardly any company, even the most successful, uses its resources to the fullest, and thus there is always a possibility for improvement in any area of health care delivery system. One of the primary purposes of Medicare at the time it was created was 'to provide coverage for hospital care'. (Marmor 2000, p. 25) 'This coverage was expected to be equivalent to the types of coverage available to the working population, however, typically required acute care services for accidents and injuries.

Having all the necessary resources at its disposal, Medicare tried to duplicate the health care coverage received by employees for coverage to elderly and disabled persons, but slowly came to the recognition that hospitals should not be the centerpiece of health care'. (Marmor 2000, p. 23)Thus, the main contribution and role of Medicare in the state healthcare delivery system was in making its main stress on chronic diseases, moving away from the hospitals being the center of any healthcare delivery system.

Another contribution of the system was in less attention to how to decrease the number of inpatient days, and more on how to provide the highest quality care in the optimal time. One of the drawbacks in the Medicare activity lies in its wrong management of primary care. First of all, it lacks financing for geriatric care. The model of primary care, which is used by Medicare, can be called disease-based system. The main principles of using and creating this system lie in regular brief visiting of elderly people, each visit relating to a separate disease; the follow-up is minimal and the use of auxiliary specialists and services is frequent, which are often not necessary, but demand additional financing.

On the other hand, if Medicare used its resources to the fullest, and made this effectively, there could be created other health delivery system, which, to my mind, would be much more effective. There should be created a team of several specialists for several medical disciplines, who would develop a complex primary care plan and would also perform a qualified evaluation of the health status of each patient, together with implementing the created plan. Taking into account that here we speak about elder people, it is better if the above mentioned plan includes possible so-called 'end-of-life' wishes of old patients.

The new progressive system could also include more frequent visiting, with monitoring of the patient's health via telephone calls and home visits. Among the possible options of the