Health Policy
Key drivers that affect health care organizations and the health care delivery system in the United States
Population aging
Every day, health care organizations as well as the US health care delivery system experiences a growing, fatter, sicker, and older population. Emigration and immigration rates, mortality, and changing birth patterns play a cardinal role in this. Population aging refers to a population’s age structure shift. Similar to other industrialized nations, the US is experiencing a demographic shift. Irrespective of the fact that the biggest population concentration is in the 40s and 50s (middle age groups), the baby-boom cohort, the largest in US’s recent history, is starting to turn 65(Porter, 2009). The aging population comprises of a largely diverse group. The aging population spends a lot in health care services in both territorial and provincial government health spending. On average, the spending per individual is hugest for people aged eighty years and more. The last months of an elderly’s life involve huge health care spending and a majority of them suffer from chronic illnesses that necessitateintensive and comprehensive medical attention with increase age (Porter, 2009). There is a stronger correlation between higher health services’ utilization and multiple chronic diseases’ presence as opposed to between utilization and age.
Proximity to death as opposed to aging is considered the principal factor as far as health spending is concerned. People aged more than sixty five years account for no more than fourteen percent of the US population. However, they spend more than fifty percent of the assigned health care spending (Smith, 1997).There has been no major change on the aging population’s share. Hence, the aging population’s impacts have evolved slowly. Although the aging population is the costs’ modest contributor, the key concern is the pre-baby boom population’s aging.
Technology
Technology-related transformations in health care practice have resulted to 38-65% increased spending in US. Although technology results to increased short-term costs, it can be a key factor to reduced long- and medium-term costs. If there is introduction of new treatments that involve one-time costs, this can minimize spending if they are used instead of more costly treatments. Genetic treatments are likely to eliminate conditions such as heart disease and glaucoma, which will result to reduced costs (Smith, 1997).For example, coronary angiography improved heart disease diagnosis and lowered the average treatment cost. There are two aspects involved in technological change in the health care sector; introduction of novel techniques (bariatric surgery) and products (new cancer drugs) and transformations in patient demand and clinical practices as a result of novel techniques and products (Porter, 2009).
Future and current implications for health care administrators
Irrespective of the fact that the decision makers in health care systems and organizations have no control over the key drivers of health care, a growing population’s implications in regard to potential health care services’ demand, both presently and in future, should be considered. One of the consequences of an aging population is greater health care services’ demand as well as acceleration in health care spending’s growth. Health care administrators should, therefore, develop strategies through which health care spending can be standardized so as to accommodate the aging population. As a result of increased demand, there is a need to ensure adequate health care facilities, professionals, resources, and comprehensive services. Health care administrators should consider the fact that the baby boom generation’s needs and expectations are different once they reach 65 years, which might impact greatly on their future health care system use (Smith, 1997).Hence, health care administrators should consider their health care needs’ evolution across care continuum in the future.
As far as technological advancements are involved in health care, administrators should be able to separate technologies that cure or prevent particular diseases from those that only treat symptoms. This can greatly reduce health care costs since technologies that cure and prevent diseases have a greater potential of reducing costs (Porter, 2009). More particularly, administrators should consider chronic lifestyle diseases and the coronary angiography introduction. Administrators ought to implement technologies such as medical equipment and devices (imaging), communications and information technology (telehealth, electronic health records, and computers), prescription drugs, and surgical improvements (robotic devices). On the same note, administrators will be faced with pressure from manufacturers, providers, and patients due to the accelerated rate of new technologies’ evolution (Smith, 1997).Consequently, there will be a need to expand the use and public coverage of these technologies. Technological change is a principal underlying driver for costs in both private and public prescription drug plans. Therefore, there will be changes regarding the type and number of drugs that will be developed, which will influence drug spending. Administrators will be required to rely heavily on health technology assessments so as to offer guidance in regard to whether new technologies are necessary as well as offer public coverage for new prescription drugs.
Reforms
In order to ensure an effective health care system, there are numerous reforms that should be implemented. It is necessary to scale up sustainable human resources for the sake of health, governments to prioritize the health of the population though resource allocation and policies, and community-based education and problem-based learning for all professionals. More significantly, potable water and accessibility to vaccines are exceptionally crucial in preventing diseases (Batalden & Davidoff, 2007). Implementing reforms that are related to these proven approaches is crucial in improving health care. Additionally, there is a need for complementary strategies that include equitable access to medicine and care, integrating agencies and services that are committed to well-being and health, coordinated international cooperation, and more importantly, transforming health care from a privilege that only a few can access to a right that is exercised by all. The principal reforms that will be discussed in this paper are as follows;
Chronic diseases
Chronic diseases contribute sixty percent of the universal disease burden (Kovner & Jonas, 2002). The leading among them are cancer, stroke, diabetes, and heart disease, and tens of millions die annually from them. In this regard, there is a need to engage more in creating public awareness and educating people on the factors that contribute to chronic diseases, the risks they pose, and strategies that are useful in preventing and managing them (Kovner& Jonas, 2002).Majorities of the people suffering from chronic diseases are unaware about it and, therefore, there is a need for screening campaigns so as to enable early detection and effective management. It is also important to deconstruct the perception that ‘only the rich suffer from chronic disease.’ Eighty percent of the deaths are from middle- and low-income countries. Hence, more strategies are necessary in these countries (Epping-Jordan et al., 2004).
Use of Technology
Intensive infiltration of health care digital devices will transform how professionals communicate with their patients. Technologies and innovations will make detection and management of diseases easy. Some of the technologies include genome sequencing, wireless biosensors, and telemedicine.
90/10 Gap and access to treatments and medications
There are immense disparities in health care based on gender, race, economic status, and age. There aggravate health care outcomes. In this regard, health care stakeholders should begin defining their goals based on ‘healthy people’ and dedicate funds towards bolstering health systems and prevention (Kovner & Jonas, 2002). This will ensure sustainable and long-term changes in the world of the poor and discriminated.
Health care consumer
Consumers will possess more information about chronic disease and, thus, they will be able to prevent or manage them accordingly. Their practices will also influence the lifestyles of other family members and friends (Epping-Jordan et al., 2004). Digital innovations will enable consumers to utilize portable devices in accessing medical information, monitoring vital signs, and taking tests at home. This will ensure that they access health services early. Closing the disparities experienced in health care will ensure equal access to vaccines and essential drugs, which will improve overall heath (Bourne, Keck & Reed, 2006).
Health care administrator
Adequate knowledge about chronic diseases will make administrators implement strategies that will contain the burden of chronic disease and positive patient outcomes. With technologies and innovations, administrators will be able to detect diseases easily and manage them appropriately regardless of comprehensive processes (Epping-Jordan et al., 2004). By mending health care disparities, administrators will be held accountable and responsible of implementing the ethical standards required from them.
International comparison and the US health care delivery system and reform opportunities
International comparisons are vital in revealing many issues that are prevalent in health care systems globally. It clearly reveals the fact that there have been remarkable improvements in the health status globally within the last century. However, these improvements have not been equally shared owing to the fact that the gap between poor and rich nations has widened. This trend is similar for inequities within countries, between the old and young, women and men, and rural and urban (Batalden & Davidoff, 2007). People who are most vulnerable to evolving and existing heath crisis are mainly those under the influence of social determinants that impact on population health adversely including gender and racial discrimination, unsafe working and living conditions, and poverty. An analysis of these factors leads to the identification of gaps within the US health care system and consequent identification of reform opportunities.
If the health care systems and organizations in the US engage in international comparisons, this will lead to deconstruction of the interrelated and complex factors. Using international comparisons is beneficial in that determining these factors, which contribute greatly to a key concern in global health care, is recognized as a daunting task (Batalden & Davidoff, 2007).International comparisons help in detecting the factors that play a role in the unreliable health care systems. These include global imbalances and shortages in the workforce, weak health systems, vaccine development and vaccines for conditions that impact on high-income countries disproportionately, re-emerging and new diseases, and absence of political will. Following the detection of these factors, the US health care system can assess areas where it is lacking and, therefore, form a platform for implementing reforms (Palfreman, Neuburger & Reid, 2008)
While implementing its reforms, the US health care system should consider investing more in health infrastructures, economics of health, using health care dollars efficiently, as well as spending restrictions that have been placed on the government by universal funding mechanisms including the International Monetary Fund and World Bank (Batalden & Davidoff, 2007). Moreover, knowledge of the causes assists health care stakeholders to design appropriate solutions.
References
Batalden, P. B., & Davidoff, F. (2007). What is “quality improvement” and how can it transform healthcare?.Quality and Safety in Health Care, 16(1), 2-3.
Bourne, P. G., Keck, W., & Reed, G. (2006).Salud! What puts Cuba on the map in the quest for global health.Available from http://www.saludthefilm.net/ns/main.html
Epping-Jordan, J. E., Pruitt, S. D., Bengoa, R., & Wagner, E. H. (2004).Improving the quality of health care for chronic conditions.Quality and Safety in Health Care, 13(4), 299-305.
Kovner, A. R., & Jonas, S. (Eds.). (2002). Jonas and Kovner’s health care delivery in the United States. Springer Publishing Company.
Palfreman, J., Neuburger, J., & Reid, T. R. (2008).Sick around the world [Television series episode].In D. Fanning (Executive producer), FRONTLINE. Retrieved from http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/etc/synopsis.html
Porter, M. E. (2009). A strategy for health care reform—toward a value-based system.New England Journal of Medicine, 361(2), 109-112.
Smith, R. (1997). The future of healthcare systems.BMJ: British Medical Journal, 314(7093), 1495.
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