Analyze how each has changed healthcare delivery on both the macro and micro levels. Provide specific examples of how both macro and micro impacts/changes: (a) Managed care and (b) Total quality improvement.
On a micro level, although many Americans say they're satisfied with healthcare and healthcare plans, they still worry about the future. Teixeira (2005) states that they are worried "about treatment that could be denied them, about costs that could ruin them, and about loss of coverage." Healthcare reform is important for both patients and healthcare facilities.
Mainly, as a result of managed care in the 1990's, the healthcare system is perceived to be on the decline, i.e. increased cost, poor quality care, increased number of uninsured, mistrust of the providers and insurers, unethical behavior by both insurers and providers, etc (Fottler & Malvey, 2004). On the macro level, insurers shaped these perceptions by high insurance premiums and those that are out of reach for many Americans (who remain uninsured). Unethical behavior by insurers hasn't helped the matter either. Healthcare executives should develop better leadership and public relations savvy. Many institutions have incurred a world of trouble when they were perceived as violating fundamental values. The introduction of managed care resulted in the eroding of public trust and perceptions of a steady decline (due to medical errors, increased workload, eroding physician-patient relationship, less people insured, etc.) in the healthcare system (Teixeira, 2005). Low levels of trust amongst providers and insurers also lead to mistrust, low level care, etc. The level of trust in the industry has dipped to a critical level. Nurses distrust doctors. Doctors hate insurers andmanaged