Health Care Services

Contents

TOC o “1-3” h z u HYPERLINK l “_Toc377467358” Introduction PAGEREF _Toc377467358 h 1

HYPERLINK l “_Toc377467359” 1. How would your plan provide coverage for currently uninsured citizens? PAGEREF _Toc377467359 h 2

HYPERLINK l “_Toc377467360” 2. How would your plan deal with economic issues? PAGEREF _Toc377467360 h 3

HYPERLINK l “_Toc377467361” 3. How would your plan avoid fraud and abuse of health care services? PAGEREF _Toc377467361 h 5

HYPERLINK l “_Toc377467362” 4. How would your plan deal with the need to allocate services given the limited resources and increasing demand and a population which is both aging and increasingly poor? PAGEREF _Toc377467362 h 6

IntroductionThe United States is perhaps the largest economy in the world which implies that it is a leader in nearly every important service delivery systems in the economy. Among the vital service delivery systems that an economy with such a stature is expected to flawlessly take care of ahead of other economies is healthcare. Despite the sensitivity with which healthcare has in defining the success of relevant institutions and departments, the American authorities have struggled with efficiency in the sector. It has not only been extremely expensive for the government to provide sustainable healthcare to its citizenry but is has also become a yardstick and critic tool against the political class. The impact of politics and financial players’ manipulation to healthcare policy setting and implementation seems to be a complex cycle that only radical surgery can intervene to provide the needed realignment. When compared to the best standards in healthcare provision, the US performance is not a reflection of its capacity in a number of aspects which need urgent addressing if equity among the poor and rich populations is to be achieved. It could be ironical for the country to lead in assisting other poor countries in meeting sustainable economic performance characterized by efficient systems such as healthcare provision while it continues to suffer with poor results in such areas due to poor strategy and planning.

Many challenges facing the sector present an important policy and managerial headache to the involved stakeholders in a way that many agree that it could be avoided. Borrowing a leaf from major performers in the industry could assist in formulation of appropriate mechanisms to deal with the healthcare condition in the US, although some interventions would require extensive consideration due to inherent differences between various countries (Johnson, para.5). Other solutions could be improvised from available practices in other sectors with equal importance such as food security and homeland security. This discourse interrogates the unprecedented poor performance by the US healthcare system while compared with a number of other world leading economies. The outline of the paper is as guided by the questions under consideration giving possible interventions that can be incorporated to improve the situation.

1. How would your plan provide coverage for currently uninsured citizens?There is a huge proportion of the American population without healthcare coverage due to the traditional policy of health care insurance. Due to the financial complexity of meeting the insurance coverage, a huge section of the population amounting to over 47 million people cannot afford healthcare. This makes the implemented healthcare system inefficient in covering the entire population, despite the heavy spending by the federal government. Taking sides with the UK healthcare system, I would provide healthcare provision to the uncovered population through provision of affordable financing for the low income earners. This financing would require realignment of major government spending needs for proper priority needs. In the realignment, the most important aspect of policy targets would include political and management contributions.

In terms of political involvement in the healthcare provision realignment for the uninsured, focus will be paid to the legal hurdles involved in making radical changes in the healthcare sector. High level lobbying is usually involved in the modern healthcare provision systems to such an extent that the political class makes political mileage on healthcare debates. Incorporating healthcare within the seriousness that national security framework has would be important for the country. Political integration for a policy that would ensure a fundamental change from the current ineffective system will ensure that the political bureaucracy is handled with accuracy. Perhaps the most potent hindrance for a complete overhaul to the ineffective regime is due to the inability of the government and political process to take healthcare delivery seriously.

Managing the healthcare in the new system will be realigned to eliminate excesses in the staff requirements, which contributes to excessively expensive regime. Ensuring that the state owned system takes charge of the healthcare industry does not necessarily mean that the private sector will be locked out of business. However, facilitating protection of the populations whether insured or uninsured while maintaining high quality delivery will need government contribution in terms of management and other controls. Whichever the cost the government would incur in the beginning by implementing such firm grip on the policy guideline, it will pay off in the end. The cost of such realignment may necessitate changes in liberalization terms in the industry such creating a boundary in the role of public and private policy in the sector (Chantrill, para. 6).

2. How would your plan deal with economic issues?

In terms of the above mentioned input in handling excessive spending in the healthcare service delivery, the government will ensure that specific steps are taken to avoid destabilizing the public and private sector partnership. Firstly, government spending which appears to be insufficient may prove to be more than sufficient if the funding priorities are redefined. In redefining funding priorities, the government will need to overhaul the current service delivery arrangement where individuals take care of their own expenses. A significant of the heavy spending is directed to administration, which is only incidental to the real spending needs. While it would be important to directly fund the most definitive healthcare needs such as drugs, facilities and research, paying the personnel handsomely seems a priority in the US. Training nurses and doctors in the US is one of the most expensive aspects of the healthcare system, which becomes even complex in their pay packages that are higher than anywhere in the world.

Secondly, the source of funds may be the cause of the confusion in the healthcare sector in the US. While the UK funds its healthcare sector directly, it seems that the spending is not as bloated as it is with the US spending with regard to the national economic performance. Adopting the format in the UK, the government must take care of the spending which is characterized by a mixed up conflict of interests between the government and the private sector. Without destroying the partnership with the private service sector, the government can define the role of the private sector in service delivery while funding could be conducted by the government through arrangements such as taxation. The insurance system is heavily considered than it should be in the US while it is expensive to run for the individual healthcare seeker and the government. Reducing its effective portion in the US healthcare market would prove to be efficient since it only caters for the healthcare of only a few people who can afford the payment demands. Thirdly, introduction of funds to take care of the poor and needy people in the uninsured population would act as a short term move to cushion those who cannot afford healthcare against the impacts of inequitable service provision from the system. By assisting the poor in healthcare, it will ensure a significant proportion of the uninsured population will shift the burden of spending from the expensive insurance coverage. Enhancing activities of government agencies involved in healthcare will lower costs of operation due to less bureaucracy and waivers thereby making healthcare less expensive for the populations. This will further ensure that the poor are able to afford meeting healthcare through government shielding.

3. How would your plan avoid fraud and abuse of health care services?

Perhaps one of the most disturbing loopholes in the management of healthcare in an inefficient system is the management of funds allocated for such systems. In a complex healthcare system with many players as the US case, there are inevitable challenges in the correct application of healthcare funds to the rightfully intended projects. It therefore follows that input must be made in order to improve the situation of accountability and transparency in the use of funds made available for the system to improve healthcare service delivery. Among the most basic accountability inputs that the involved stakeholders need to implement is the basic planning for accountability structures. In the proposed system, structures for funds control which include internal control standards and audit systems will be emphasized. The primary challenge in the setting of the structures is the authenticity of the process where political and financial players would want to make their authority to be felt in key structure positions at both institutional, state and national level. Perhaps one of the most advisable approaches to deal with accountability is ensuring that a standard institutional design exists and is followed at the different levels of implementation. Standardization of the institutional structures for accountability purposes will ensure that financial offices are given the importance that it deserves (Chantrill, para.3).

In dealing with fraud, internal control standards set out in professional accounting and audit requirements for public and private institutions will be emphasized. In the standards, processes involving funds handling will be formulated in line with efficient financial management practices. It will be important that handling of funds is conducted with professionalism from petty cash transactions authorization, authentication and documentation to medium transactions and large multimillion transactions. Requirements for overall accountability at the institutional level will be rolled out in the other higher levels of service delivery to complement the national outlook for funds management. Internal controls will require constant reviews and enhancement programs rolled out across the country just as it happens in other sectors such as the education sector. Involvement of financial professionals and experts in the building up of the necessary structures for accountability will be sought, since the medical staff may not competitively deal with financial challenges with the required concentration.

In dealing with abuse of healthcare services, strong system implementation oversight teams will be incorporated in checking management and authorities in implementing the proposed healthcare system. It is perhaps important to implement a unique management initiative that will ensure that irregularities in the management of healthcare resources are avoided or firmly dealt with. Ensuring that the control of the resources is followed up to the last detail will ensure that the loopholes involved in accountability are also appropriately dealt with. Among the most important deterrent measures in dealing with misuse of funds is formulation of severe punitive actions such as harsh fines and jail terms or both. It therefore implies that legislative input must be sought in various capacities.

4. How would your plan deal with the need to allocate services given the limited resources and increasing demand and a population which is both aging and increasingly poor?Limited resources funding the massive needs in the healthcare service delivery is perhaps a creation of the complexity of the system in the US. To ensure that the resources become available for various needs of the health sector as mentioned above, it will be important to facilitate a complete overhaul in the setting up of priorities. The most important aspects of the healthcare system are underfunded while subsidiary and support services are not proportionally taken care of with regard to the quality and actual delivery of the services. In terms of unlocking the development of activities in the healthcare sector in terms of redirecting funding from the less important channeling to the fundamental needs of healthcare elements, it is important to carry out an analysis of the actual breakdown of funding. After defining the funding units and areas in the industry, it will be possible to formulate policy in order to facilitate discriminative shifting of funding to the appropriate areas. Just as in flexible budgeting which realigns itself with the most pressing needs as a priority, it will ensure that the limited funds are applied in the most important areas of spending.

The limitation of funding in the US healthcare system is mainly represented by the fact that the administrative costs of the complicated system outweigh the benefits of healthcare to the population. Management of public resources in such a scenario will necessitate a different approach in allocation of funds for the various areas of concern in the system. One of the most important interventions in management is total quality management which applies principles of maximum production and quality while targeting the most minimum of costs and excesses. In such a management system, the bloated wage and remuneration element of the healthcare system would be found to be the hindrance to delivery of results.

Increasing demand in healthcare would be facilitated by ensuring that the healthcare system is funded to meet the numerous numbers by raising the number of nurses and doctors per unit population. This can be achieved in line with the total quality management which will save on excesses in the system and spare them for such elements in the healthcare delivery systems. The state of the US number of healthcare attendants taking care of a unit population figure is poor than that of the UK. For midwives and nurses, the US has 94 per 10000 while the UK has 128 per 10000 respectively. Bearing in mind that the US has an expansive geographical coverage, it is a poor score when compare with the UK. In terms of beds for the same population, the US has 31 while the UK has 39, which shows a huge disparity in coverage of the entire population in the two economies. This may be the explanation for the score in life expectancy at birth difference in the two economies with the US scoring 78 against UK’s 80. This is a stunning contrast in terms of per capita spending between the two countries which stands at $6719 (0ver 15 per cent of GDP) for US and $2815 (slightly over 8 per cent of GDP) for UK which is not represented in the results (Heslop, para. 4).

An increase in the aged population healthcare seekers implies that the number of people dependent on the government is also likely to exceed. While the heavy spending in the government budgetary allocation patterns regarding healthcare is not likely to fully support the aged, it implies that the aged population will increasingly face difficulties if the above outlined measures are not taken. The most important move in this scenario is to lay down the infrastructure to ensure that funding for healthcare of the aged, the poor and children is sustainably supported by the excessive funding of an inefficient system. Borrowing a leaf from the case of healthcare in the UK, healthcare provision for such vulnerable groups should be conducted in a different approach. Pensionable individuals should make savings towards their retired days needs among them being healthcare which should be under the control of the government. Subjecting these populations to cheaper healthcare services funded by sustainable programs will ensure that the other vibrant population finds it possible to meet their own healthcare since the dependants are fewer (usa-vs-uk.com, para.2). Alternatively, providing healthcare to the aged will ensure that they don not continue to work past their working days in order to meet their own healthcare expenditure. Such a move will facilitate the creation of job opportunities for the young generation raising economic benefits through employment, which can be used as a source of funding for government healthcare systems through income taxation.

Works Cited

“USA Vs UK Healthcare,” us-vs-uk.com, 2005. Web. HYPERLINK “http://www.usa-vs-uk.com/healthcare.html” http://www.usa-vs-uk.com/healthcare.html (Accessed 3 September 2011)

Chantrill, Christopher. “US Healthcare Spending,” usgovernmentspending.com, 2011. Web. HYPERLINK “http://www.usgovernmentspending.com/us_health_care_spending_10.html” http://www.usgovernmentspending.com/us_health_care_spending_10.html (Accessed 3 September 2011)

Heslop, Katy. “How Does US Healthcare Compare to the Rest of the World?” guardian.co.uk, 2010. Web. HYPERLINK “http://www.guardian.co.uk/news/datablog/2010/mar/22/us-healthcare-bill-rest-of-world-obama” http://www.guardian.co.uk/news/datablog/2010/mar/22/us-healthcare-bill-rest-of-world-obama (Accessed 3 September 2011)

Johnson, Toni. “Healthcare Costs and US Competitiveness,” 2010. Web. HYPERLINK “http://www.cfr.org/health-science-and-technology/healthcare-costs-us-competitiveness/p13325” http://www.cfr.org/health-science-and-technology/healthcare-costs-us-competitiveness/p13325 (Accessed 3 September 2011)