Health Economics by Bolnick - Essay Example

Health Economics by Bolnick Introduction The health care system is one of the most unique and complicated systems in the economic and social services industry. The descriptions made by Bolnick (2003) basically emphasizes that there is no particular template for the health care system to model on. I strongly agree with Bolnick’s ideas because all countries and health systems have distinct qualities; and because of these unique qualities, no fixed system can fit all these templates. This paper shall discuss Bolnick’s thesis and ideas in conjunction to the public and the private health care systems – mainly the UK and the US health care systems. It shall also discuss the personal, political, and ethical drivers of these two chosen health care systems. Discussion Bolnick emphasizes that there can be no ideal model for the health care system to apply. He also points out that pigeon-holing the health care system into a model is not a prudent move because the health system has unique peculiarities based on personal, social, and political factors. According to Bolnick (2003), the wants and needs of the health care system is driven by ethical and political considerations. The politics of nations differ from each other. For instance, the public health care system of the United Kingdom was adapted in response to the turmoil and chaos that the Second World War created (Bolnick, 2003). After the war, its people were also in a favourable state of mind to accept a socialised and public health care system, hence, the conditions were favourable in the UK for the introduction of such system. And, it proved to be beneficial for the people. In fact, “since the implementation of the NHS, the United Kingdom has experienced longer life expectancy rates and concomitant change sin disease patterns” (McCarthy and Schafermeyer, 2007, p. 525). Tulchinsky & Varavikova (2000) also describe the United Kingdom as a unitary state; as such, its health system is rooted at the local authority level. They further point out that UK’s national health system slowly developed since the 19th century and evolved to the comprehensive system it is today; and such system is being supported by taxes collected from the people. As a result, the people in the UK, through the National Health Service, are able to access free and quality health services (Tulchinsky & Varavikova, 2000). On the other hand, the health care system in the United States is difficult to describe. Shi and Singh (2004) emphasize that it cannot even truly be described as a system because it is not composed of collective units working together in order to produce a unified whole. The financing system of the US health care is not standardized. This uncoordinated quality of their health care system is however founded on qualities unique to the United States. Hence, assuming that the UK public health system would ‘fit’ the United States is a wrong assumption to make. The market-driven economy of the United States is another factor which negates the implementation of a standard health care. Shi and Singh (2004) also emphasize that this competitive system ultimately benefits the end-consumers who get to enjoy and choose from the best quality of health services from a variety of service providers. The US, does not have unitary system as seen in the UK and in other industrialized nations. And again, these facts support Bolnick’s statement about the inapplicability of a “one size fits all” premise in the delivery of health care services. In the United Kingdom, Bond and Westerhof (2007) highlight that the conditions described by the Beveridge Report in 1942 have essentially stayed the same. The subsequent reforms in healthcare which were adapted by the government sought to strengthen the public health care system for the most vulnerable members of society. The political powers in the United Kingdom also maintained the public health care system, even despite the privatization of various industries and services in the succeeding years. In the 1990s, the Labour government also implemented policies which would lend further strength to the public health care system. As a result, the “government-dominated nature of the NHS, and the public and professional support for it, would make it difficult to bring in strong market measures without a major change of philosophy; and there is no demand for that” (Callahan and Wasunna, 2006, p. 94). Managed care in the United States has risen to a point where it can dominate the community health care system. Analysts emphasize that before a public health care system can be implemented in the United States, such health system has to be reformed in order to “meet the challenges of marketplace health care and fiscal retrenchment” (Milo, 2000, as cited by Patel and Rushefsy, p. 37). The United States’ economic and political system has not made accommodations for these reforms to be implemented; and this is a huge stumbling block in the implementation of a public health care system. Harrington, Ester, and Crawford (2004) point out that the problems of the health care system in the United States are primarily owed to corporations who have a big influence on political power structures. Electoral politics in the United States also takes into account religious and cultural beliefs which limit privacy and free democratic discussion. This sense of morality affects the implementation of a standard health system in the United States. Some authors smartly point out that “the initial slow response of the public health system to the spread of AIDS also reflected the politics of morality and phobia” (Costanza, 1992, as cited by Patel and Rushetsky, p. 38). Many Americans view the public healthcare system as a means towards a socialistic end. Therefore, before the public health care system can be implemented in the US, implementers must find a way to balance individual autonomy and public welfare. Nations have different goals for their health care system. According to Leeder, (1999) the United Kingdom’s goal for its health care is equal access to all. Bolnick (2009) on the other hand, claims that the United States aims to achieve goals such as quality health care, cost-effective care, and extensive health insurance. Other nations like Canada, China and Australia have their own goals, and such goals are very much a product of their history, their political system, and their socio-cultural values. Australia, for example, exhibits a mix of the public and the private health care system. Based on the Australian Government Department of Health and Ageing (2005) through its Commonwealth system of government, the public health care system finds support. However, such system does not preclude support from the private and non-governmental organizations. The government encourages its citizens to acquire health insurance by subsidizing a certain percentage of their payments. And so far this system has proven effective for Australia as it offers one of the highest qualities of health services worldwide. These facts again reiterate Bolnick’s thesis, that there is no template for the health care system to be patterned on; and no standard health system can effectively work for all countries. The above discussion supports Bolnick’s thesis that in health care, one size does not necessarily fit all. Discussions about the public health care system of the United Kingdom and the private system of the United States demonstrate that each nation has its own historical and ethical standards which influence the effectiveness of a standard health care system. Also, the political and social climate in each nation is different; peculiarities do not ultimately support one common system to be applied to all countries. The aim of nations should be geared towards what fits its needs, not what fits all countries. We cannot ignore the distinct qualities of each nation. What may work in the United Kingdom may not necessarily work in the United States, and vice versa. Works Cited Australian Government Department of Health and Ageing – The Australian Health Care System: Introduction (04 February 2005). Canberra. Retrieved 04 September 2009 from the World Wide Web: http://www.health.gov.au/internet/main/publishing.nsf/Content/healthsystem-overview-1 Bolnick, H. (April 2003) Designing a World Class Health Care System. Society of Actuaries. Retrieved 04 September 2009 from the World Wide Web: http://www.soa.org/library/journals/north-american-actuarial-journal/2003/april/naaj0304_1.pdf Bolnick, H. (2009) Health Care Reform: What Problems Should We Realistically Solve? Society of Actuaries. Retrieved 04 September 2009 from the World Wide Web: http://www.soa.org/library/essays/health-essay-2009-bolnick.pdf Callahan, D. and Wasunna, A. (2006) Medicine and the Market: Equity v. Choice. Maryland: Johns Hopkins University Press Harrington, C. Estes, C. and Crawford, C. (2004) Health Policy: Crisis and Reform in the U.S. Health Care Delivery System. London: Jones & Bartlett Leeder, S. (1999) Healthy Medicine: Challenges Facing Australia's Health Services. New South Wales: Allen & Unwin McCarthy, R. and Schafermeyer, K. (2007) Introduction to Health Care Delivery: A Primer for Pharmacists. London: Jones & Bartlett Patel, K. and Rushefsky, M. (2005) The Politics of Public Health in the United States. New York: ME Sharpe Shi, L. and Singh, D. (2004) Delivering Health Care in America: A Systems Approach. London: Jones & Bartlett. Tanner, M. (18 March 2008) The Grass is Not Always Greener. Cato Institute. Retrieved 04 September 2009 from the World Wide Web: http://www.cato.org/pubs/pas/pa-613.pdf Tulchinsky, T. and Varavikova, E. (2000) The New Public Health: An Introduction for the 21st Century. New York: Academic Press Read More