The provision of healthcare services in the United States of America has been subjected to a lot of conflicting philosophies and divergent ideologies for several decades now. The question whether healthcare should be treated as a social or an economic good has lingered and stakeholders are still debating on how best to structure healthcare policy. Cost, access and quality of healthcare services are the key pointers to how effective our healthcare system is. Cost and access have been the most deliberated aspects in the past; mainly because consumers have had little choice but to acknowledge practitioners’ assurances that American healthcare services are the best in the world. However, recent trends in the American healthcare system US have seen cost attract the most attention as it has the potential to compromise both quality and access (Shi & Singh, 2009). In this research paper, I analyze, in my own opinion, why healthcare should be classified as an economic good and what between cost, access and quality must be given most attention. I also discuss how stakeholders in the healthcare balance could balance between the three, and the role of the various stakeholders; parameters that should be clearly understood due to their significance especially now that we are reforming our healthcare system.
Healthcare as an economic good
Commentators and stakeholders in the healthcare system have differed on whether healthcare is a social or an economic good. After the completion of this text, I have come to believe that healthcare is an economic good even though it has some element of social good in it; and here is my reasoning. By definition, a social good is a commodity or a service that is supposed to benefit the largest number of people within a society as much as possible, with each person being entitled to unlimited share (Shi & Singh, 2009). Such a service or good may be clean air, public space or street lighting. Healthcare systems all over the world, on the contrary, are not equitably accessible and require an elaborate application of economic principles to ensure their sustainability and to uphold the quality of the services they deliver (Scott et al, 2009).
Formulating and implementing a healthcare system must involve how and what services are to be provided, how the services are to be distributed, the diversity of the target population and who is going to pay for the services. Even though health services lack the basic characteristics required to evaluate market prices like physical commodities (for example merchandise in a grocery store), resource allocation in healthcare institutions is analyzable using the production theory to determine how efficiently these resources are used (Scott et al, 2009).
The main concern in the design and implementation of systems aimed at serving the public is their efficiency in resource utilization. The other concern is choice, and it deals with issues of what services are to be included in the package in order to meet the demand of all consumers; and then the distribution of the services. The above concerns are directly applicable to the production and use of healthcare services. Policy makers and stakeholders in health are primarily concerned with methods of maximizing efficiency of current healthcare systems, their effectiveness and their potential to help people (Scott et al, 2009).
Additionally, healthcare, like all other economic goods, is rationed. The current healthcare system in the USA is rationed by the fees doctors and health institutions charge their patients, the deductions and the interest health insurance charge their clients and one’s employment status – whether one is unemployed or employed in a job that does not provide healthcare coverage (Scott et al, 2009). Part of the mission of existing health infrastructure is to garner maximum monetary returns and pay dividend to shareholders and other stakeholders, which is the capitalist definition of business.
Cost, quality and access to healthcare services
There are three conflicting objectives of healthcare in the United States: access, quality and cost. Up to until recently, quality of health services in the United States did not receive as much attention since patients had little to do than just accept their physician’s assurances that they were receiving services of the highest quality (Shi & Singh, 2008). Access to health services has been an international concern for decades. However, the cost of healthcare has in the recent past become the most significant issue of concern to the healthcare system not only in America but the world all over since it impacts directly on access and quality of health services. If holistic healthcare is to be provided to all, then cost is the most important objective since after it is sufficiently addressed, access and quality will be catered for (Shi & Singh, 2009).
The cost of healthcare in the United States has been exponentially rising. In 2009, the nation spent over 2.5 trillion dollars on healthcare or approximately 16.2 percent of the Gross Domestic Product (GDP). This rapid growth in costs, coupled with the just ending economic recession and an increasing government budget deficit has put a lot of strain on healthcare financing systems and citizens. Government sponsored programs like Medicare and Medicaid account for a larger percentage of healthcare spending in the United States. Privately sponsored initiatives are also present, but the cost of purchasing insurance is very high, making many people go without insurance cover at times.
High costs limit access to health services. The drive to reign in expenditure by decreasing the number of doctors to avail coverage will further increase the number of patients per physician, compromising the quality of service delivered (Shi & Singh, 2008). The approach therefore should be to place consumers in a position where they can influence how they run their health budgets and demystifying the billing process for prescription drugs, hospitalization and clinical visits so that consumers can be more cost-conscious. The government should also strive to achieve universal health insurance so that even those who cannot afford to pay can access health services.
Balancing Access, Cost and Quality of Healthcare Services
As seen in the above section, the cost of health services is the most urgent concern for the health system in the United States. If costs are kept at a level reachable to most citizens, then access to health services will improve. However, if costs lowered beyond a certain threshold, the quality of services may be compromised (Shi & Singh, 2009). Linear programming is therefore needed to optimize cost and quality of health services while increasing access.
One way of reducing overhead costs is investing in information technology (IT). Technology promotes research and leads to a more efficient sharing of information. Secondly, improving efficiency will make health services more cost-effective. Efficiency can be increased for example by decreasing unnecessary variation in medical practice and minimizing unnecessary care.
As the adage goes, prevention is better that cure. Chronic conditions such as lung cancer, diabetes mellitus, heart disease and many others are more likely to affect people who are obese or those who smoke and engage in unhealthy diets. These diseases are very expensive to treat but could have been prevented if the right lifestyles were followed. Financial incentives should therefore been made to workers and health education provided at community level to emphasize the importance of healthy lifestyles (Hyde, 2009).
Stakeholders’ Stand on Healthcare
Stakeholders in healthcare are the government, insurance companies, medical practitioners and the people. As it stands, insurance companies are controlling the industry. They determine what they deduct from their clients’ salaries and what doctors are to be paid for their services (Shi & Singh, 2008). Obviously, they want to maintain the status quo. I think the government, however, needs to provide health insurance to its citizens and leave employers out of the health business since retaining their involvement only serves to make healthcare purchased out-of-pocket overly expensive, especially considering such services are purchased with income after tax.
The people want the cost of health services to be reduced. Health premiums are an additional burden in an already harsh economic environment. On their part, doctors would like deregulation such that they interact with their patients freely as this will inject innovation into the sector. Private practitioners are also calling on healthcare regulators to permit office physicians to carry out specialized tests using the latest technologies to accurately diagnose and treat diseases early enough (Shi & Singh, 2009). The US government is on a quest to overhaul the healthcare system since it is inefficient and out of reach for many citizens. The plan is to make Americans pay for their insurance and to have employers help in covering for their employees’ health insurance. This calls for many concessions on part of the government, insurance companies and the private sector.
The Most Important Stakeholders in the Healthcare System
In my opinion, the most important stakeholders in the American healthcare system are the people (the patients). However, this is not the way the system has perceived it. Patients have been conceived as assets for the benefit of insurance firms and hospital systems (Gorin, 2009). Without the patient, there would not be the need for a healthcare system; but advances in technology and bureaucracy have combined to lock out the earnest opinion of the stakeholders who should be driving and controlling the healthcare system.
The government has a major role to play if America’s healthcare is to be streamlined (Hyde, 2009). It is the government, as the chief custodian of the people, to make sure that effective and relevant medical services are delivered to all citizens at a price they can afford. Despite the fact that excessive regulation of an industry kills innovation and competition, the government should put in place a mechanism to contain errant insurance companies and employers who arbitrarily fix costs of healthcare services by their own criteria (Hyde, 2009).
Reading this text has altered my perception about healthcare in general and the role of healthcare managers. Now more than ever, I appreciate that even though the healthcare industry needs to remain profitable, it has a very important role to play in helping humanity. Helping people who are unwell to get better and eventually be healed is a very special privilege. However, the responsibility of the physician or the healthcare manager does not stop at diagnosing and treating diseases and infections; they have an obligation to help people prevent diseases and stay healthy (Hyde, 2009).
The text has also brought into my attention various critical aspects of the healthcare system in the United States that need to be addressed with urgency. The United States has the most expensive healthcare system in the entire world but it lags behind most developed nations in terms of infant mortality rates and average life expectancy (Hyde, 2009). There is therefore a need to optimize our healthcare system to take advantage of the massive biomedical and pharmacological research conducted here to better the quality of life of all citizens.
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