The Health Systems Issues and Managements - Research Paper Example

? The Health Systems Issues and Managements al Affiliation: The Health Systems Issues and Managements According to the World Health Organization (2000), health system refers to all activities whose main function is to promote, restore and maintain health. The key aims of health systems are to respond to the needs and expectations of the public by offering services in a just and equitable way. Achieving these objectives has been a challenge to most health systems. Most countries still find it difficult to provide quality and reliable healthcare to their citizens in spite of the rapid improvements in health technology and knowledge. Developing countries are the worst hit with this problem. Most of them face challenges such as lack of enough health worker, little financing, poorly functioning information systems and lack of coordination between various agencies. The existence of these challenges in the health systems has been majorly blamed on their management. The managers have failed to tap the available resources and effectively use their management skills in planning and implementing interventions that reach all citizens. This paper identifies and analyses issues (challenges) that face the health systems and gives proposed strategies to be used in managing them. Developed countries such as the United States do not face serious challenges in their health systems as much as the developing countries. However, their health care concerns revolve around three major issues. These issues include cost, quality and access (Andersen, Rice and Kominski, 2007). In the United States of America, the cost of health care is very high and has become a leading issue for healthcare mangers. Since the United States moved from heavy-handed managed care, expenditures have quickly increased, and the number of people who are not insured has also increased. In fact, it is estimated that about forty seven million US citizens are not insured (AFL-CIO, 2011). In addition, the population that continues to increase every year has put a lot of pressure on Medicare. The crisis in state budget has forced nearly all states to make serious cutbacks in programs aimed at assisting the poor. These cutbacks have put America’s health care system in crisis since medical health care spending and the number of uninsured people in the country has increased (Trouth, Wagner, and Barrow, 2010). The rising cost of health care services in the United States has attracted a lot of concerns and featured in the news a lot. A large portion of the country’s resources is being spent on health care. The spending is not expected to go down soon but is predicted to reach 21 percent of the GDP by 2016. With this high spending on healthcare, most US citizens are still not able to access quality healthcare. Over 46 million Americans are currently uninsured even though America’s expenditure on healthcare is the highest globally (Farrell, 2009). Healthcare accounts for more than USD 2 trillion in the United States annual expenditure. While this is the largest economic sector of the country, millions of citizens are not able to take care of their health needs and the situation is getting worse (Farrell, 2009). For the past nine years, insurance premiums have increased therby making health insurance unaffordable to many US citizens. The rapidly increasing medical bills are continuing to leave families in debt. In fact, according to the organization Health Care For All –California, about one-half of all personal bankruptcies are due to medical bills. With this huge number of uninsured individuals unable to access quality healthcare and costs continuing to increase, the healthcare system of United States of America seems to be collapsing. The healthcare system of the United States of America is financed by premiums paid for health insurance or from government programs such as Medicaid and Medicare. The high numbers of people who are not insured in the country significantly increase the cost of healthcare. This is because health problems that could be detected and treated in their early stages fail to be identified as soon as possible. Later, they develop to worse states which need more expensive procedures to treat. As a result, the increasing costs of healthcare have forced most employers to reduce or drop their health insurance plans and shift health care costs to employees. This makes most workers to struggle paying the higher premiums and co-payments (AFL-CIO, 2011). The other reasons for the high cost of health care in the US include: increasing technology costs, high administrative costs and the rising cost of prescription drugs. The costs of healthcare in the US are increasing at five times the inflation rate. Without insurance, the workers cannot be admitted to the hospitals. In 2008, the US health expenditure surpassed USD 2.3 trillion. This was over three times the USD 714 billion used in 1990 (Centers for Medicare and Medicaid Services, 2010). Therefore, the rate at which the cost of accessing health care is increasing has attracted great concerns from the government and employers. It has become a major issue in the health systems with most health system managers now working hard to come up with strategies of making health care affordable to most people in the country. The rapid increase in the cost of healthcare together with the economic slowdown and the increasing federal deficit has placed a lot of strains on the systems used to fund health care, including insurance programs such as Medicaid, Medicare and the private employer sponsored health insurance programs. The government insurance programs which account for a major share of health care spending have increased at a slower rate than private insurance. Both Medicare and Medicaid expenditures have grown at slower rates than private insurance (Kaiseredu.org, 2010). Causes of the High Health Costs To control the high expenditure in healthcare, it is very important to understand the factors that cause the increase in spending. Although there is disagreement on the exact causes of this high costs, Kaiseredu.org (2010) gives the following as some of the major factors that contribute to the same: Administrative costs: these include costs of billing and marketing. About seven percent of the United States health care expenditures are for these costs. However, this cost is much lower in the Medicare program. Technology and prescription drugs: for several years most of the health spending of the United States has been on new medical technologies and prescription drugs. Aging of the population: the health expenses increase with increase in age. Therefore, as the aging population continues to grow, the cost of caring for them also increases thus raising the cost of health care. However, the aging of the population does not contribute much to the increasing health care spending. Chronic diseases: a huge number of Americans have chronic diseases which are very costly to treat. It is estimated that the cost of treating chronic diseases in the country accounts to over 74 percent of the national health expenditure. Solutions to the High Health Costs Ever since 1960, the United States of America has put a lot of effort to control the cost of its health care. However, it has not been able to come up with long term solutions. The failure of the country to come up with solutions to this problem has prompted a debate over what proposals or strategies can be used to sustainably reduce the costs. In 1980s and 1990s, the managed care policy was used and the country almost succeeded in solving the problem. However, currently spending has increased a lot and the country is back to the same problem. Among the proposals presented to solve the escalating costs of health care include: Investing in information technology: some experts propose that the US government should promote the use of technology such as electronic medical records as this will enhance information sharing and reduce overhead costs. The Obama administration’s health reform is implementing this proposal. It has allocated USD 19 billion in federal funding for upgrading the health information technology (Kaiseredu.org, 2010). Prevention: with the cost of treating chronic diseases such as diabetes and cardiovascular increasing, most experts believe the government of the US has should emphasize prevention so as to reduce the prevalence of these diseases and escape the long term treatment costs (Kaiseredu.org, 2010). Single payer system: this is one proposal that is gaining a lot of support. It is a system in which the government is the only body allowed to purchase health care for its citizens and pay standard rates that are calculated to only permit health care providers to survive. The system has been enacted with rational success in most European countries and Canada. Experts believe that apart from solving the problem of cost, this strategy will also resolve the problems of access and fairness (Farrell, 2009). Drug prices: Americans pay more for prescription drugs as compared to people residing in other countries. Therefore, to reduce this cost, experts propose that Medicare needs be given the opportunity to negotiate for lower prices of prescription drugs with manufactures and import cheaper drugs from abroad. Impact on Healthcare Needs, Policy and Future Practice The average healthcare cost per person is more than $6,500 per year in the US. The US devotes over 16% of its budget to healthcare. This kind of spending by the government and American citizens has had a significant impact on the general state of the country’s economy over the last decade or so. As the cost of health care goes up, more families and business are increasingly finding it difficult to purchase coverage (Farrell, 2009). This is because the price of insurance coverage has also increased and continues to rise as the cost of health care also rises sharply. In most instances, employers normally choose to raise the amount that their workers spend on their health. This in turn has the effect of putting pressure on the workers’ budgets and they have families the high cost of healthcare becomes a burden to them (Herzlinger, 2007). The high cost of healthcare and insurance coverage is cutting off a lot of people who may need medical care but cannot afford it. Most low income individuals rely on government coverage since it costs less than other types of medical covers (Emanuel and Fuchs, 2008). The government has tried to put up measures to ensure that every American has access to some decent form of medical care by regulating healthcare. Most of the new healthcare regulations have been geared towards ensuring that low income earners can afford healthcare without having to empty all their pockets (Herzlinger, 2007). However, there have many complaints that the new healthcare policy that was created to offer affordable healthcare to all may have adverse effects on the rest of the economy. To address the issue of rising costs of health care once and for all, there should be strong and practical policies in place. These policies should support the new medical technology that will ensure that the cost of medical care goes down. The use of information technology such as electronic medical records is just one of the ways through which the medical care cost can be reduced (Herzlinger, 2007). The policies should also emphasize on evidence based medicine and practices such as disease management, pay for performance medical services and healthcare that is consumer directed (Emanuel and Fuchs, 2008). Summary The aim of the health care system is to provide quality medical care services to all. However this aim has over the last few years become almost impossible to achieve mainly due to the rising cost of basic healthcare. This is despite the many improvements in health technology and knowledge achieved over the same period of time. A large part of the US budget is solely dedicated to the provision of healthcare. Spending in this area has rapidly gone up with the government devoting 16% of its resources to healthcare. The current policies allow the government to spend more on medical care than some of the other aspects that make up the economy. The rising cost of basic healthcare has also meant that more and more people cannot afford quality medical services. To solve this problem on time, the government and other stakeholders need to formulate new policies that will ensure that the rising cost of healthcare stops and the situation is reversed. More American will be able to enjoy cheaper and better healthcare services if there are practical policies in place to ensure that that happens. References American Federation of Labor - Congress of Industrial Organizations, AFL-CIO (2011). What's Wrong with America's Health Care? Retrieved on July 18, 2011 from file:///F:/What%27s%20Wrong%20with%20America%27s%20Health%20Care.htm Andersen R., Rice H. and Kominski F. (2007). Changing the U.S. Health Care System: Key Issues In Health Services Policy and Management. Los Angeles: John Wiley and Sons. Trouth C. and Wagner M. & Barrow B.(2010). Universal Health Care Problems in the United States of America. FriesenPress. Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group (January 2010). National Health Care Expenditures Data. Retrieved on July 18, 2011 from ttp://www.cms.gov/nationalhealthexpenddata/01_overview.asp? Emanuel, E and Fuchs, V. (2008). Healthcare, guaranteed: A simple secure solution for Amerca. New York: PublicAffairs Herzlinger, R.E. (2007). Who killed health care?: America’s $2 trillion medical problem and the consumer-driven cure. New York: McGraw-Hill Farrell R. Robert (2009). America’s Healthcare Crisis. Is There a Solution? Retrieved on July 18, 2011 from file:///F:/090203-005-health.html Kaiseredu.org (2010). US Healthcare Costs. Retrieved on July 18, 2011 from http://www.kaiseredu.org/Issue-Modules/US-Health-Care-Costs/Background-Brief.aspx World Health Organization (2000). World Health Report 2000: Health Systems: Improving Performance. Geneva: WHO. Retrieved on July 18, 2011 from www.who.int/whr/2000/en/index.html Questions Effective leadership and efficient leadership Effective leadership refers to the type of leadership that fulfils the intended objectives with utmost effect. It is well organized and is made up of energetic and active leaders who aim at accomplishing the set goals. Efficient leadership is a leadership that generates he preferred results with les s wasted efforts. I is a creative leadership that looks forward to responding to the challenges it faces. Thus effective leadership refers to the delivery of the required goods while efficient leadership refers to goods delivery with minimum waste. Domains of leadership effectiveness and leadership efficacy Expertise: this evaluates the competency, cognitive ability, talent and knowledge of the leader as to b e able to perform their role. Disposition: evaluates whether the leaders, characteristics, personal attitudes and type matches their level f effectiveness. Performance: evaluates whether the leader has follow up record which gives him/her the credit of being able to fulfill the results he/she can account for according to Owen (2007). Interpersonal: evaluates how the leader effectively coordinates others in a honesty way in order to fulfill organizational goals. Classification of types of health service systems Universal heal care system refers to a situation where the whole society is covered a certain form type of health care irrespective of their income or social status. Funding of such services is not only depended on government funding but also some universal systems which allows contributions from private systems. Medicare service system provides health care services to those citizens who are qualified at the age of sixty five and beyond. This system covers limited hospital services, services like X-rays, chemotherapy and ambulance services are provided. Proffered provider organization plans involve the user paying for the services they receive. Some enroll for payment through the employer and insurance companies. Highly deductible health care plans which provides quality and all-round service coverage for health matters. Medicaid refers to health care service system funded by both the federal government and the state government. Health services are provided to those with low income and other fall in other categories which have been specified. HealthCare outcomes in relation to systems issues and management Enhanced patient value with improved services to patent care Developed new business opportunities for health care services Developed approaches which are based on evidence for medicine and models of health care delivery Improved response as well as time performance Increased productivity in resource application in the effective way possible Enhanced reputation of organization in building the health of the community at large. Problem solving strategies in systems management Divide and conquer involves knowing the problem and the resources available however limited they are. Used where the problem has several components. The Deming Cycle it is used in resolution of issues which leads to continuous improvement. Provides structure for improving different processes as suggested by Ditsa (2003). Return on investments for quality efforts It can be used in evaluation of investment opportunities and provides the ability to perform the right selections. For quality efforts there should be measurement of quality and the existence of cause and effect relationship between financial outcomes and quality. Key elements of strategic planning in managing healthcare systems Situational analysis includes focusing on internal and external surroundings and the framework in which the system operates Strategy formulation involves examining the strengths of the company in order to come up with implemented strategies. Strategy implementation consists of putting the formulated strategies into action Evaluating the results of the of a strategic which has been implemented Healthcare cost economics in relation to delivering high quality patient care Health care costs economics evaluates a wide range of cost related matters in health care services to establish the cause for rise or fall in cost, the value for current spending and the how the health care system can thrive efficiently. Involve expenditures on Medicare and Medicaid for patients under healthcare services Population based care delivery and effects of resource allocation on healthcare outcomes Maternal and child health services Vaccinations A total budget is allocated which provides cost estimation health care programmed effects. It also provides assessment of individual program in relation to cost effectiveness. References: Ditsa, D. (2003). Information management: support systems & multimedia technology.New York: Idea Group Inc (IGI) Owen, H. (2007). Creating leaders in the classroom: how teachers can develop a new generation of leaders. New York: Taylor & Francis. Read More