Insurance acts as intermediary between buyer and provider and has no incentive to provide a better price or higher quality. This is especially true in the movement from the medical model to the business model of health care. “The United States spends more on healthcare than any other country in the world, in 2008 US healthcare costs were 2.3 trillion or 7,000 per capita. The US per capita cost is 45% greater than our northern neighbor Canada, and 33% greater than Norway”. (Organization for Economic Co-operation and Development (OECD), 2011). The business model is profit based. Requiring a profit almost always includes streamlining of services and mandating cost controls. Both of which limit the insured’s access to services, drugs, and new technology.…
Young, K, (2009), Healthcare USA: Understanding its organization and delivery, Sudbury, MA: Jones and Bartlett, pp. 20-43.…
Greene, J. (2008, July). Members of Consumer-Driven Health Plans Choosing Less Care. Retrieved July 27, 2008, from Medical News Today Web site: http://www.medical.news.today.com…
Green, M. A., & Rowell, J. C. (2008). Understanding Health Insurance: A Guide to Billing and…
A searchable compendium of healthcare report cards, designed especially for consumers, and which includes comparative data on quality designed especially for healthcare organizations and providers by type of provider, is offered. This organization also provides access to different types of data primarily used for quality and utilization purposes. For instance, it sponsors the Healthcare Cost and Utilization Project (HCUP). This project provides access to a family of databases which contain public and private hospital care data, but accessing this data set requires an agreement in which limitations and provisions of data usage are summarized, and users (organizations) are required to cite AHRQ when using the data in reports. Finally, the AHRQ supports the Medical Expenditure Panel Survey in its provision of data on the cost and use of healthcare services and health insurance across the United States. This data’s main components are household data, which focuses on patients and their providers, and insurance data. Such data can be used for private planning, and to help policy makers have a better understanding of the nation’s healthcare needs and how best to meet them (Bronnert et al., 2010).…
Despite the fact that United States is the most affluent country in the world, a significant portion of its citizens have inadequate access to medical care. The barriers to obtaining health care are numerous; perhaps the most difficult hurdle to overcome is the lack of financial resources to pay for it. But the problem of lack of access to health cares for large segments of the population. The largest barrier to obtaining needed care is the lack of financial means to obtain it. The uninsured the underinsured cannot be stereotyped for they include many people who are employed, the elderly, children, minorities, person with handicaps, pregnant women, and other vulnerable populations. A lack of insurance does not translate in some cases to a lack of access to medical care, but it does have a clear impact upon access of health care.…
HS 546: Health Insurance and Managed Care Keller Graduate School of Management of DeVry University Professor: David Adu-Boateng February 19, 2012…
In contrast to most industrially developed countries, American private-public health care system is far from being universal. However, health care system makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy people are. Research has repeatedly shown that the lack of insurance ultimately compromises a persons’ health because they are less likely to receive preventive care, are less able to afford prescription drugs, are more likely to be hospitalized for avoidable health problems, are more likely to be diagnosed in the late-stages of disease and once diagnosed tend to receive less therapeutic care (1).…
I hold myself, and those around me to the strictly adherence of the seven Army Values: loyalty, duty, respect, selfless service, honor, integrity, and personal courage. These values are my guide when making decisions and recommending both reward and punishment. A positive command climate is critical in any organization’s ability to achieve their mission. I believe leaders must adhere to these in all aspects of their life. When leaders adhere to the values, a positive climate exists.…
While debate continues on both the success and the future of managed care, one cannot deny the increased emphasis on cost containment. The results of managed care and the continuing evolution of the American health care system are both quantitative and qualitative. They range from a reduction in hospital admissions and stays to an increase in ambulatory care, out-patient surgeries, and home care from an emphasis on prevention and better decisions by consumers about health-related behaviors to the sometimes limited choices by consumers in selecting practitioners and in utilizing benefits from increasing limitations in coverage with higher deductibles and co-pays to the reality of a still significant portion of the population among the disenfranchised or uninsured and from quality of care and treatment to issues and concerns around trust. Four of these areas will be addressed in greater detail below. The Institute for the Future in Health and Health Care 2010 described three tiers of coverage in todays evolving health care system and projected how individuals and families may experience this changing system based on which tier of health coverage describes their particular situation (2000). Their observations are summarized below Tier 1 The securely enfranchised. The first group represents 38 percent of the population. It consists of empowered consumers with considerable discretionary income, who are well educated and use technology, including the Internet,, to get information about their health. Usually they are able to make choices in their plans and coverages. They are able to educate themselves about health behaviors as well as health care issues and concerns. They are likely to engage in shared decision making with physicians and other allied health professionals. Because access and benefit/ coverage security are not issues for them, and because they are more likely to be politically active, their tier will be the most likely to influence changes in legislation…
Providing health care service for uninsured and underinsured individuals in the United States is an ongoing concern. A report released by the U.S. Census Bureau reveals the number of uninsured Americans under age 65 rose from 45.7 million in 2008 to 50.0 million in 2009 and an estimated 25 million American’s were reported to be underinsured in 2007 (Gould, 2010). Uninsured are individuals not covered by any type of health insurance. Underinsured are individuals who have health coverage that does not adequately protect them from additional costs of care. From an economic perspective, the weight of this concern falls heavily on the leaders and citizens of the nation.…
Today, the United States is facing a shortage of about 16,000 primary care physicians and this number will continue to grow by 2025 (Amirault, 2014). Primary care physicians (PCPs) are the doctors who focus on overall health and offer the treatments and preventive screenings that save lives. A physician shortage is a situation in which there are not enough providers to treat all patients in need of medical care. The Association of American Medical Colleges (AAMC) has long pointed out that the shortage of primary care physicians will be a major setback for the American healthcare system advancing (Amirault, 2014). The shortage of primary care providers presents a serious problem for many healthcare organizations, and one that cannot be easily fixed. Throughout this paper, the contemporary health care issue of the shortage of primary care physicians will be further discussed, as well as its challenges and its impact on health care organizations from a business perspective.…
With the growing number of the insured and those that are underinsured many more clinics, and community based healthcare organizations are opening the doors for those individuals that are in need of health care or an acute basis. In an article published by Market Watch, it showed," There has been a 21 percent jump in the number of patients served nationally at health centers between midyear 2008 and midyear 2009.…
The Patient Protection and Affordable Health Care, also known by its nickname “Obamacare”, is federal healthcare legislation that was passed through congress and signed by President Barack Obama on March 23, 2010. The Affordable Care Act (ACA) was designed to provide affordable health insurance for everyone in the country. The ACA faced many legal challenges after President Obama signed it into law, and the legal proceedings ended with the Supreme Court ruling that the legislation was constitutional. The ACA is an intricate law with numerous provisions. The focus of this research paper is not to weigh the benefits and negative impacts of the ACA, but to examine the healthcare systems in place in countries around the world. The countries that will be considered are England, Canada, Australia, Switzerland, and Ecuador. The ACA will have a few similarities to the healthcare laws in these countries; however, there are many differences.…
The Cleveland Clinic succeeded because of one simple word: cooperation. Its founders believed that cooperation between everyone administrating care would lead to more efficient better quality care. In addition to cooperation, the Clinic used other business practices which are similar to practices used by other successful companies. The variety of ideas, and the strength of the Clinic’s cooperation idea, helped it recover from early setbacks to become one of the top two medical centers in the United States.…