The Future of the Healthcare Industry
Introduction
Presently, the U.S health care system is experiencing numerous challenges ranging from staff shortage, overcrowding of emergency departments, high cost of medical care to reduced access for the underprivileged in the society. Although many people in the country are opposed to increased government participation in health care, many western nations except America have adopted some kind of universal health care which has ensured access to basic medical care for all. Among the developed countries, United States is the only country that spends colossal amounts of money in its health care and fails to provide health care for all its citizens. Mistakenly, many Americans are also often ensnared into ideological arguments such as the perception of freedom, a false feeling of autonomy of choice and phobia of government ineffectiveness in managing the health care system. In essence, the government’s increased participation in health care could help to ensure better quality, improved access to health care and also help to fully address marketplace failures.
Health Care Delivery
Society’s Obligation
The present rate of expansion in societal resources dedicated to health care is broadly thought to be unsustainable and fails to guarantee every individual access to basic medical care. To make it sustainable, limits on expenses of shared communal resources are needed for sustainability (Tenn, 2009). In addition to sustainability, universality should be recognized; to attempt to sustain health coverage by leaving out some sections of the population would be unwise. Instead, when the government intends to reduce the cost of health care, this should be accomplished through alterations in pricing, benefit design or via improvements in the effectiveness of health care delivery. All parties in health care including patients should be maintained in a system of responsibility for the efficient and effective functioning of the system. Any plan to improve accessibility should promote healthy living and community engagement to enhance adherence to treatments and self-care which have been agreed upon.
Increased Government Participation
The current state of health care system in United States calls for the government to assume a more aggressive role in reshaping the health care system. Signs that the system is going to collapse are almost everywhere, from hospitals overflowing with uncovered people to laboratories unable to establish MRIs (Lufkin, 2008). When the government fully caters for the expenses of medical care, individuals and employers would be freed from paying private insurance. Further, increased government participation in medical care provision would greatly decrease expenses not only as a result of exercising monopoly authority mainly in the process of purchasing drugs but also for the reason that management overheads linked with private cover and profit margins will be eliminated. Generally, the government can apply economies of size in controlling and administering medical institutions which would work to bring the cost of medical care down.
A common trend across numerous advanced democracies has been increased government participation in health care. As Lufkin states “They are more ethical, less expensive and equitable” (2008). These nations have proven that opinionate democracy is not ill-assorted with majority willingness to permit the government to operate as the controller of health care. Americans continues to suffer from outdated myths that the government should keep away from providing health care to its citizens in an attempt to evade universal health care. Any revelation of increased government participation in health care is routinely dismissed and vilified due to long held views that increased government participation in health care is un-American and undemocratic. Continued provision of health care through the market has resulted to various problems such as overcrowding in EDs.
Overcrowding in Emergency Departments
Overcrowding of hospital emergency departments has momentous health implications. Emergency patient’s rerouted to distant facilities risk increased mortality and morbidity. Overcrowding within the emergency department is linked with poorer results and can lead to prolonged pain and discomfort for patients. The system of health care depends on ED after a public health catastrophe, accident and overcrowding can wear away confidence in the entire system (Castro, 1991). The ED is also the center of the health safety net. It is frequently the principal end of contact with the system of health care for numerous people who are underinsured, uninsured and undeserved individuals. Overcrowding may serve as a barrier to medical care access for these individuals who do not have alternatives. Over-utilization of EDs is also an issue of concern due to cost. There exists no review of emergency department services and ED physicians are normally unfamiliar with the sick as well as their records. Consequently, Patients are frequently given an all-embracing set of diagnostic assessment that might alternatively be unnecessary. Moreover, health facilities incorporate fixed expenses in billing for the services. Consequently, the typical cost of emergency department services is normally high and signifies a huge expenditure for payers and patients. Additionally, research indicates that overcrowded EDs result to a poor quality care in patient outcomes, patient satisfaction and the delivery of inappropriate services. In an attempt to address this problem, many facilities have adopted ambulatory services.
Implications of Ambulatory Services
The present inclination towards ambulatory care, which in the widest sense of the word means outpatient health care for which the individual is not booked for an overnight stay, is linked with profound factors impacting the health sector. These underlying factors include; the dire need to stem increasing hospital expenditure; the increased demand for better patient-focused care and the craving for improved admission at the societal level. The growth of ambulatory health care may lead to greater patient contentment. This originates from the idea that ambulatory care is convenient for consumers and enables flexibility in preparation. Superior ambulatory care can result to improved patient access to health care and timelier admission may be attained by integrating numerous medical disciplines into a single clinical visit.
Quality of Health Care
Universal Care
Improving the quality of health care is a major priority for medical care providers with the sole objective of attaining improved patient satisfaction. Quality health care can be assured by creating more awareness among the population, creating more regulations and establishing keener competition (Castro, 1991). The quality of health care is in essence determined by the eminence of infrastructure, training quality, competence of physicians and the effectiveness of operational systems. The basic requirement is the implementation of a system of health care that is patient oriented. Problems in health care connect to both non-medical and medical factors and an all-inclusive system of health care that enhances both aspects should be implemented (Derickson, 2005). Various methods such as accreditation, peer review and measuring delivery outcomes have been implemented to ensure quality health care. Providing information in several areas such as comparative cost and patient outcomes is an acceptable measure of health care outcomes. This information may reveal the interdependency of patient values, business and employee values. Further, leaders can use the information to establish and monitor a tactical plan by setting standards for future performance and behavior. Information on health conditions which can be affected by physicians may help in illuminating the worth physicians contribute to the medical care
Peer Review Process
Hospital peer review is the procedure by which a group of physicians look into the medical care provided by an associate in an attempt to ascertain whether conventional standards of care have been adhered to. The personal or professional conduct of a physician can also be looked into. The process had serious problems since the review was grounded on the examination of medical records which placed the physicians with poor skills of record keeping at a disadvantage and largely ignored the notion that medical records are habitually a poor gauge of the eminence of medical care. Additionally, there existed no requirement that members of the committee executing the peer review be unbiased (Castro, 1991). In its form, the peer review failed to safeguard a physician under investigation from members of the committee having a personal or an economic bias. If the physician under investigation is an associate or a partner, any mistake that might have been committed is probable to be considered an unavoidable mistake. Other initiatives such as accreditation from independent organizations offers a suitable background for measuring performance-improvement systems within managed care organizations and helps to assess the clinical and administrative aspects of their functions. This process also makes sure that organizations create appropriate processes, monitors, improves and analyzes its performance to enhance patient outcomes.
Financing Health Care
Affordable Health Care
Affordable health care is a major concern for many Americans. More than eighty percent contend that the health care system is heading towards a calamity due to rising costs. Fortunately, it is possible to reduce the health care cost without government intervention. Unfair tax regulations are key reasons why few Americans can afford to purchase medical insurance. Employers disburse health coverage with pre-tax money. However, employees are forced to pay for their health coverage after taxes are deducted. This costs them twice as much to purchase health coverage as it does to the employer. The tax regulations should be altered so that health coverage becomes one hundred percent deductible. Further, costs of health care can be made more affordable by permitting employees into coverage-purchasing pools which may go a long way in reducing the costs even further.
Privatization of Medicaid and Medicare
Charitable assistance for the underprivileged is desirable, as many people would agree. Medicaid and Medicare invasive and harmful to the health of the patient. Medicare is too bureaucratic and expensive and is depriving health care to young workers. To make health care more affordable, voluntary charitable assistance should be provided to enable the poor to purchase personal medical coverage thus saving them the massive bureaucratic expenses and the unbearable book-keeping requirements as well as legal threats impressed upon insurers and doctors. Certainly, medical care has been a test to United States politics. The political revulsion for government participation in providing health care in America is similar to trends in other industrialized nations which have been towards opinionated pressure for increased rather than reduced government involvement and financing medical care. Neither of the major parties in America tends to favor a nationalized system which would make the government to be in control of doctors or hospitals but they occasionally have different views towards access and financing (Castro, 1991). Democrats seem to favor a major reform that will involve more control over financing the system of health care by the government and the rights of the citizens to access medical care. On the other hand, Republicans broadly favor the sustenance of the status quo or a change of the funding system to empower citizens mainly through duty credits.
Reductions in Federally Supported Health Care
The federally supported programs have been experiencing a runaway growth. These programs are supposed to provide coverage to those who cannot afford to meet the cost of coverage with every state making that resolve using its own means. But even these systems, for instance Medicaid which cost more than two billion dollars after it was established in 1967 now cost sixty nine times as much and can seldom afford to assist forty percent of the unfortunate (Castro, 1991). States which are hard pressed have found it difficult to meet the cost of the program and have consequently tightened standards of eligibility raising deep concerns about what may happen to those dependent on the programs. The solution lies in creating a universal medical plan or a combined model providing cover for basic preventive care for all citizens who cannot afford their own coverage (Wangness, 2008). To help meet its cost, Congress should do away with $53, 400 gaps in incomes on the tax payroll that finances Social Security (Castro, 1991). Removing the gap would offer approximately $25 billion that can be applied in funding the universal plan (Castro, 1991). Congress would then shift the federal programs to the universal health program. Presently, a large number of people relies on private health insurance.
Insurance
The notion of health insurance was first proposed in 1694 by Hugh. In the late 19th century, health insurance was basically a disability cover catering for the expenses of emergency care. Presently, majority of citizens rely on health insurance to obtain health care. Unfortunately, most Americans remain underinsured or uninsured. Some may be eligible for private programs but experience difficulties in navigating complex regulations and insurance jargon. Private insurance has served to decrease accessibility of health care while at the same time increasing the premiums payable. Moreover, insurance is widely availed through an employer group plan. This implies that self-employed and unemployed individuals do not have access to basic medical care.
Resistance to the Concept of Socialized Medicine
Even in difficult days, the benefits of universal health care in United States are sadly hidden from the general public. Instead, the negative effects continue to triumph in the minds of Americans. Many Americans believe that universal health care is linked to socialism and hence not suitable for the U.S health care system. Those who support the private system of health care often argue that universal health care will result into inefficiency (Lev, 2009). Individuals who are against universal health care should bear in mind that the country already has such a healthcare system in the form of Medicaid and Medicare as well as through medical facilities that levy high charges for the covered to cater for the expenditure incurred in treating the uninsured. Many who are opposed to the universal coverage on the grounds that they do not want to meet the expenses of someone else should realize that they always meet these expenses the moment they acquire coverage (Lev, 2009). The idea that private markets are effective and for that reason the best alternative is profoundly engrained in the brains of many Americans that makes them unable to conceive the idea that free markets are behemoths of ineffectiveness.
Though availability of hospital insurance removed an important cost constraint from hospital services and charges, they normally tinker with deductibles and co-payments; they limit the costs of health care by exerting pressure on clients to avoid visiting the doctor frequently. However, in practice, intentional frivolous appointments with doctors are rare and restricted to a small number of hysterics and hypochondriacs. Many people fail to access health care and their state of health suffers when the firms pressure people to limit their visits to doctors. The rising cost of health care and insurance liability has been partly due to some practices adopted by insurance companies. Most of the insurance firms hastily realize that their clients comprise of persons with high health expenses such that their cost per client become greater compared to those of a typical individual in the public. Consequently, the high costs must be covered through higher premiums. However this would chase away their healthier clients thus leaving the firms with a less healthy client base, calling for a further increase in premiums.
Conclusion
The current state of health care system in United States calls for numerous reforms. Signs that the system is going to collapse are almost everywhere, from hospitals overflowing with uncovered people to film laboratories being unable to establish MRI. In future, the government can increase its participation in health care to fully cater for the expenses of medical care and free individuals from paying private insurance. Further, increased government participation in medical care provision would greatly decrease expenses not only as a result of exercising monopoly authority mainly in the process of purchasing drugs but also for the reason that management overheads linked with private cover and profit margins will be totally eliminated.
References
Castro, J. (1991). Condition: Critical. Time, 38(21), 8-34
Derickson, A. (2005). Health security for all: Dreams of universal health care in
America. Mary Land: JHU Press.
Lufkin, K. (2008). Health matters, universal care is possible, but not without sacrifices.
Honululu Star-Bulletin, 13(244), 8-8.
Lev, S. (2009). Healthy Questions: Private versus Universal Health Care. Retrieved May
3, 2009 from http://www.groundreport.com/Politics/Healthy-Questions-Private-
versus-Universal-Health.
Tenn, C. (2009). A path to health care reform. Times Free press, p. B6.
Wangness, L. (2008). Health insurers lay out a path to universal care: Group calls for
Public-private partnership. Boston Globe, p. A14.