Recent orders
Healthcare gatekeeping process
Healthcare gatekeeping process
Institution
Name
Gatekeeping in healthcare plays a significant role to both the institution staff and patients, but it could be attached to certain problems. In healthcare, gatekeeping could cause difficulties for researchers. The process involves the denial of access certain healthcare facilities, services, researches, medical practitioners, or patients. It is known to occur in various stages in research projects (Lee, 2005). On a similar aspect, there are gatekeeping processes at the patient’s level. A patient cannot get access to the GP without consulting the receptionist. A GP is a physician who is not a specialist but treats all illnesses. It is the work of the receptionist to check on the GP’s schedule. The denial of the patient’s access could come in when the GP is not on duty, or the appointment list is completely full (Lee, 2005). Patient may not certainly find gatekeeping beneficial but rather provoking from the associated restrictions. There could be minimal financial savings from gatekeeping per patient, but there are advantages associated with the process. It is therefore important as a patient to look at some of the advantages associated with gatekeeping in healthcare or the disadvantages associated with it.
Taking a scenario whereby the GP is busy on attending to a patient in his or her office, disruption may not be accommodated. There is no point of every new patient checking by himself or herself on the GP’s schedule and thereby intervening in his or her critical medical activities. The intervention could be harmful and could even result to mistakes in especially timed medical processes. It is therefore the obligation of the gatekeeping personnel, such the secretary to determine whether a patient could see the physician or not (Lee, 2005). The receptionist should try all the best to ensure that their medical practitioners are not presented with excess appointments.
During medical research activities, patients need to be protected. Gatekeeping in research is done deliberately to protect vulnerable subjects especially patients and sometimes their families. Their vulnerability makes is impossible to allow them participate in research. The idea behind patients’ denial to participate in research is their lack of experience and for the safety because of their health conditions. They could not be allowed to take part in research interviews given that medical practitioners are sometimes restricted through gatekeeping (Lee, 2005). Healthcare gatekeeping within healthcare research processes is therefore useful in patients’ protection.
In order to minimize the costs associated with heath care gatekeeping, some new technologies are being implemented. Sometimes physicians are recommended to assist in gatekeeping. In this case, it becomes possible for the primary physicians to function as gatekeepers for every member in their client groups (Weinstein, 2001).
Gatekeeping at the research level could have gatekeepers get enough information about any proposed research. It is through this information that the gatekeeper would be in a position to make informed decisions in granting permission to the researcher’s request or not. The gatekeeper may turn down the request following schedule problems or vulnerability of the researcher to risks. He may demand that the proposal go through the Local committee for research ethics or not. This would probably save the institution many possible losses that would have emanated from the research (Sommers & Wholey, 2003). A patient would consequently avoid higher medical charges placed to them in compensation for such losses. The medical institution would in addition evade the risk of blames from the public who could shun its reputation.
Positives benefits associated with gatekeeping could also include the help of refining a project by the key gatekeepers. A key gatekeeper may as well come up with suggestions of constructive restrictions (Lee, 2005). An instance is whenever they firmly decide that medical practitioners such as nurses cannot be called for interviews during their working time. If a nurse breaks for an interview, the patients could surfer by lacking the particular nurse’s attention at that juncture. A compensation for the time loss during an interview of a nurse by the researcher may be determined (Fullerton, 2008). The gatekeeper may not be in the position to make such decisions but he or she would have directed the researcher to the responsible committee. The researcher may be expected to compensate for the lost time during the interview session in monetary terms.
Some researchers could be inexperienced and could as a result have problems constructing their project timetables. Their impatience could push them to fail in waiting for a response from the key gatekeepers’ responses with respect to the letters posted these experience gatekeepers by the researchers. This impatience could however lead to the denial of their access and consequently a definite failure of a chance for their research (Sommers & Wholey, 2003). This may not directly benefit patients but to a great capacity, it does. It is also the responsibility of the gatekeeper make decisions based on researcher’s age, credibility, gender, or trustworthiness.
Physicians have an ethical role in gatekeeping. Physicians are expected to provide patients with the best medical care services possible hence; their role in gatekeeping could be a roadblock to their success in medical service delivery efficiency. A patient may gain the feeling that an institution dominated by such cases is not the best for them. A tradeoff between a medical service to a patient and gatekeeping after every patient encounter could be disastrous in terms of time and efficiency (Weinstein, 2001). If a physician compromises his or her patient in attendance in favor of another anonymous patient, the patient in office may feel intimidated as far as his or her health is concerned. Few people could be in a position to stand such a medical practitioner’s behavior.
Gatekeeping by key medical practitioners such as doctors and physicians could be destructive and harmful to patients’ patience and health. It is not cost effective either and the institution may be subjected to great time losses and inefficiencies in various medical operations. Physicians could best attain the limits of their healthcare resources if they act in the interest of their patients (Weinstein, 2001). Medical practitioners should incorporate the associated limitations they could stimulate with the fact that patients face compromises in order to achieve high quality healthcare. Health care services are never free but are centrally expensive. Any loss of time and associated with inefficiencies would be a cost to the affected patient and the institutions as a whole.
In solving problems associated with gatekeeping, the associate cost effectiveness has to be considered. Cost-benefit analysis may be based on the available resource and the population served by the health care institution. From a single patient perspective, gatekeeping could be costly. The marginal cost diminishes with increase in the number of patients just like in any other economically producing farm. A small healthcare that serves very few patients may demand some other medical practitioners to serve in gatekeeping in order to minimize the labor costs associated with a professional gatekeeper. Costs or benefits should not only be counted in monetary terms but also in social terms and net savings in the future healthcare services or facilities. Effective gatekeeping process can help decrease complications associated with future patients and practitioners alongside decreasing problems related with insurance while at the same time saving on time and money in the end (Grumbach & Bodenheimer, 2002).
References
Fullerton, M. (2008). Looking for solutions in healthcare for 2006 and beyond. Retrieved October 18, 2012, from Physicians as Gatekeepers-Journal: http://realist2.squarespace.com/journal/2008/1/4/physicians-as-gatekeepers.html
Grumbach, T.S. & Bodenheimer K. (2002). Understanding Health Policy: A Clinical Approach. 3rd Ed. New York, NY: The McGraw-Hill Companies.
Lee, P. (2005). The process of gatekeeping in health care research. Nursing Times VOL: 101, ISSUE: 32 , 36.
Sommers A.R. & Wholey D.R. (2003). The effect of HMO competition on gatekeeping, usual source of care, and evaluations of physician thoroughness. Managing Health Care. vol 9 issue 9 , 618-627.
Weinstein, M. C. (2001). Should physicians be gatekeepers of medical resources? Journal of Medical Ethics, vol 27, Issue 4 , 268-274.
The Government Should Raise The Federal Minimum Wage.
Subject
Students Name
Institution of Affiliation
Date
The Government Should Raise The Federal Minimum Wage.
The federal government first introduced the minimum wage in the year 1938 at a rate of 0.25 dollars per hour (Kim & Jang, 2019). Since then, the minimum wage in the United States has increased for 22 times. The minimum wage refers to the lowest possible rate to which the employers are required to pay their workforce. Most recent increment in the federal minimum wage was in the year 2009 whereby it was raised to 7.25 dollars per hour.
At present, there are 29 states have a higher minimum wage to that of the federal state. By July of the year 2017, around 27 cities had passed the laws that aimed at increasing the minimum wage, with some of the states requiring cities adhere to the minimum wage rates as stipulated by the laws of specific states. Whether the minimum wage rate of the various states varies with that of the federal government, the federal government should raise the minimum wage rate setting it at around 10 dollars per hour.
There are many reasons in support of the federal government raising the minimum wage. The minimum wage rate in the United States has not kept up with the inflation, and a majority of the minimum wage workers are impoverished. Increasing the minimum wage to 10 dollars per hour implies that a large number of people with have a higher salary and this has the consequent effects of raising the standards of living among the workers (Dabla-Norris et al. 2015). With a higher wage, the employees will have an increased purchasing ability, and therefore, they will be able to afford the essential and basic needs that are essential for their survival. There is no doubt that the poverty levels will reduce as most of the people live below the poverty line due to the lower salary rates. Increasing the minimum wage rate, therefore, imply that a large number of people who previously lived below the poverty level will have a chance to upgrade, crossing the bridge of poverty. With a large number of people earning a better salary, poverty is alleviated, and the consequent effect, therefore, will lead to an increase of the middle-class people in the country meaning that the country doesn’t have to spend much money on the welfare of the poor.
With an increased minimum wage rate, a large number of people will enter the middle class and therefore, the people will be able to afford the health insurance plans and as well be able to cater for other health plans (Mishel, Bernstein & Schmitt, 2016). Thus, the health of the people in the United States will be improved, having a healthy and energetic workforce that is available to contribute to the growth of the nation’s economy. With a higher minimum wage, the American citizens will be able to afford to buy medications that and as well take care of their relatives who are sick. A higher income means that the patients are able to afford better treatment and that their relatives are able to cater for their welfare without any strains and therefore there is a need for the federal government to increase the minimum wage rate.
Having an increased minimum wage rate to around 10 dollars per hour implies that the government will have increased revenue through taxation (Ehrenberg et al. 2016). An increased minimum wage rate will help more than 27 million workers have a better salary, and this implies that through taxation, the government will be able to pocket more than 35 billion dollars annually. It is therefore of a significant benefit for the government to raise the wage rate as they will the largest beneficially of the increment as a higher amount of revenue will be generated in accordance to the amount of salary. With the increased amount of revenue, the government will be able to increase its development in a country implying that the infrastructure of a country will increase and as well be improved thus raising and promoting business investments in the country.
An increased salary has the overall effect of promoting the purchasing power of a people, and therefore it implies that the demand and supply of essential commodities will be on the rise (Pigou, 2017). With increased demand and supply, the manufacturing and service industries will increase, and this means that the people will set up more business in the nation along with other investors. High investment in the country means that the country will produce more and import less into the country meaning that the gross domestic product of the country will increase. The rise in the gross domestic product will be as a result of the high exports compared to the imports.
An increase in the minimum wage in the United States by the federal government will help in the reduction of the employee turnover in the employment sector (Dube et al. 2016). The main contributor to the high rate of employee turnover is the low wages paid to the employees and therefore to curb such cases, raising the minimum wage will play a significant role in reducing the turnover. A culture of a better salary payment is known to keep employees as they are contented with better payment and therefore aim to give their best for the company increasing the production of the company and as well increasing the profit margins. It will, therefore, be of importance for the government to develop and put laws that will be aimed to increase the minimum wage in the attempt to protect the interests of the employees.
It is with no doubt that there is a need to increase the minimum wage by the federal government of the United States as this will be the basis of an improved economy in the country. With an increased rate in the minimum wage the employee will have in increased income, and this will raise their standards of living being able to purchase the essential commodities and as well living above the poverty line. Besides, the increase will raise the country’s gross domestic product due to higher investments in the country and as well aid the government to collect more revenues through taxes.
References
Dabla-Norris, M. E., Kochhar, M. K., Suphaphiphat, M. N., Ricka, M. F., & Tsounta, E. (2015). Causes and consequences of income inequality: a global perspective. International Monetary Fund.
Dube, A., Lester, T. W., & Reich, M. (2016). Minimum wage shocks, employment flows, and labor market frictions. Journal of Labor Economics, 34(3), 663-704.
Ehrenberg, R. G., & Smith, R. S. (2016). Modern labor economics: Theory and public policy. Routledge.
Kim, H. S., & Jang, S. S. (2019). Minimum wage increase and firm productivity: Evidence from the restaurant industry. Tourism Management, 71, 378-388.
Mishel, L., Bernstein, J., & Schmitt, J. (2016). The state of working America: 1992-93. Routledge.
Pigou, A. (2017). The economics of welfare. Routledge.
Healthcare Economics
Healthcare Economics
Question One
The government intervenes in the provision of healthcare, in an attempt to achieve efficiency and equity in the provision of health care. The interventions involve the following policies: expenditure, regulation and taxation. All these policies have economic effects on the provision of health care. In the expenditure policy, the government spends part of its revenues in the health industry either directly or indirectly. For example, the government may provide a subsidy in training physicians in order to increase the supply of physicians, who will provide health care services. Such a subsidy will create market imperfection in the provision of health care since there will be an increase in the supply side. This is likely to lower the quality of health care since there will be no incentive to work as the number of physicians will be overwhelming; physicians are likely to be paid less for their services since there will be more workers available to provide health care services (Lazar et al, 2004).
Regulation policy is also another form of government intervention that the government may use in the health care provision. The government may lower the cost of licensing physicians in order to lower the monopoly powers in the health sector. This will have an effect of lowering the cost of providing health care and at the same time lower the quality of health care provided because of increased competition. On the other hand, the government can raise the cost of licensing physicians in order to limit the number of practitioners in the health sector (Lazar et al, 2004). This increases the cost of providing health services and improves the quality of health care. The other form of intervention is taxation policy. The government may exempt individuals for employer paid health insurance, which increases demand for health insurance. This benefits individuals receiving higher incomes at the expense of low income earners. Hence, it is not efficient.
Question Two
Provision of subsidies by the government for the training of nurse midwives constitutes a supportive intervention by the government to the low income earners. The initiative is good since it is likely to increase the number of midwives that can offer the service. The number of individuals requiring the services of a midwife may be on the increase, but providing a subsidy for the training of midwives will help in matching the demand (Morris et al, 2007). On the other hand, offering of subsidy in the training of nurse midwives will help in the accessibility of the services since the trained midwives can be distributed to areas with scarcity of midwives.
A state mandate requiring all health insurers to include chiropractic services in their benefits is an expensive requirement since chiropractor services may be exceedingly expensive (Morris et al, 2007). However, lack of this mandate may increase the cost of health care and premiums of the health insurance. In case an individual having a medical problem seeks services without having the necessary health care, he may become sicker and require more expensive health services in the future. Hence, the mandate is expensive in the short run, but beneficial in the long run. Thus, it is a good intervention (Lazar et al, 2004).
An inclusion of psychologists as a covered provider under Medicare is not a good decision. This is because the decision is likely to increase the government expenditures while the service is not a necessity. Very few individuals will be in need of the service, which implies the government will be wasting resources in the provision of Medicare.
References
Lazar, H., St-Hilaire, F., Institute for Research on Public Policy., & Queen’s University (Kingston, Ont.). (2004). Money, politics and health care: Reconstructing the federal-provincial partnership. Montreal: Institute for Research on Public Policy.
Morris, S., Devlin, N., & Parkin, D. (2007). Economic analysis in health care. Chichester: Wiley.
Health Policy and the Legislative Marketplace. Delmar: Cengage Learning.
The Role of Government in Health and Medical care. Delmar: Cengage Learning.