“Managed Care Organizations”
Clearly, I feel that a person under a managed healthcare system will have the opportunity to be able to have their insurance policies managed and looked over so they can so they can make sure that they stay on the right track. I feel that this is a major issue with most Americans today who are using insurance money when not needed. For example, many people go to the emergency room when it's not needed for minor illnesses that can be resolved by taking over the counter medication and or call the ambulance when they could have drove in a car for their emergency. This is why I say Americans must have a Managed Care System in place to limit their spending and save themselves time and money.
Managed Care System
Managed Care was introduced in the 1960's to control the rapidly spiraling cost of providing health care services. In today's world, Managed Care Systems became a dominant health care delivery tool which controls the insurance, financing, payment and delivery of health care services. Through the introduction of utilization analysis efficiencies of management and aggressive negotiation of contracts with the providers, manage care systems try to control costs. Managed Care Systems are responsible for costs of treatment and the profit relies on how they control their costs. Managed Care Systems has had a major impact on the practice of medicine. It has focused on introduced outcome measurement, preventive health care, incorporated cost accountability evidence based medicine and control in healthcare delivery.
Managed Care Systems have came along way from what they were in the past due to multiple factors such as employers could negotiate rates, their organizations increased size and their lower premiums rates which brought them more enrollees. Managed Care Systems have become the focus point of the US Health Care System. With soaring increases in health care costs in the first decade of 21st century, many people have started to question the effectiveness of the managed care model. I believe that we might see the emergence of new Managed Care Systems that will benefit employers in order to help eliminate a middle man. This change will result in better compensated providers, employers paying little money to health providers and clients will receive better care.
The supply side and demand side of health management
For many years, employers and many other people have tried to reduce health costs as it relates to the demand side of things for a quick fix. I believe that our health care system should be looked at on the supply side of things rather than the demand side of things which can help to eliminate the many problems that exists in today's society. Some strategies can be taken to eliminate problems and or issues that exist in our health care system. The first thing that can be done is to reduce medical procedure over usage. There have been many problems in today's world with physicians overprescribing medicine to patients as well as not paying as much attention to the problem at hand. For example, most physicians are quick to jump to a conclusion to get a patient to have surgery rather than view other alternatives in order to not have to do a high risk procedure. I feel that physicians should take the time out to get to know the patient and further look into a situation rather than try to jump to a conclusion on a high risk procedure that can potentially do more harm than good.
Another approach is to cut costs for medical errors. Some hospitals usually don't tend to care a lot about making too many errors because they now that Medicare would cover them in order to help cover the costs on their mistakes. They would pay for the hospitals mistakes on patients due to a wrong site surgery, falls, hospital infections and medication errors. All of these errors can be easily avoided by hospitals if they were deeply penalized for their careless mistakes because the money wasted on trying to cover up hospitals careless mistakes can be used for many things such as extra money for patient care services, hospital materials, prescription drugs, and or medicine research. I feel that physicians in hospitals must take cautious measures in order to ensure the safety of their patients and also make sure that they limit their mistakes as when dealing with patients to ensure that their patients are receiving the right dosage of medicines and that they are receiving the best possible care with no mistakes.
Another approach that can be taken is to develop and put into effect modern information technology procedures. I feel that a lot of money will be saved if health-care providers used updated information-technology systems. The reason why is because it will lead to reduce medical errors, make it easier to retrieve test results and review medications and will be able to lower administrative costs. This will also give physicians access to a complete listing o a patient's medical histories which will help to avert hospitalization. On the demand side of things, since the demand for health care has risen, the country must be able to fund money to develop a plan of action to try to insure that many Americans will be able to have the opportunity to get health care. Without taking a look at the supply side of things and taking the necessary steps to help cut costs to save money and eliminate mistakes that can easily be avoided at hospitals, there will be more and more spending of money that can be easily used to help assist with healthcare that will be just thrown away on other things.
I believe that the demand side of things always will affect the supply because when a customer demands something, it is always crucial for a company to satisfy the customer's needs and wants with innovative products or services that stand out from competitors. I believe that demand leads to supply, but in the health care world, supply leads to demand because you must take all the necessary measures to save money everywhere possible in order to meet the demands of Americans that lack health insurance.
Ways to Manage Healthcare
As a health care manager, I feel that I would have to take my time out to analyze the situation that I am in first and make a decision from there on how I would actually handle a certain situation. Since the economy is in a bad state right now and many Americans are losing their jobs, I feel that I would have to do everything in my power to try to ensure that I will be able to help as many as I can be able to get health insurance. I would have to ask for all of the help that I can get and try to get all of the funding that I can get, try to push for a slight push in taxes to help with funding, and also cut costs and hospitals for unnecessary procedures, and save all the money that we can in order to help as many Americans as possible.
“To battle established leaders, you need the right product and strategy, and a big dose of savvy. Here's how to show up after the starting gun and still come out on top” (Birger, pg301). I will consider all options that I know will be beneficial to making sure that everyone will have healthcare coverage. I feel that as a healthcare manager, I feel that my job is very important because I have to be able to manage and deal with issues and concerns from the American people concerning healthcare coverage and help to plan and develop strategies to help assist with any plan brought forth and enforce those plans. I will enforce them through meetings, research, and planning because I believe that no one should be denied care so if I had to conduct meetings, research options, and plan ahead to accomplish those goals, then I would have to because I want to be prepared so that I can help anyone who needs assistance.
In closing, I believe that a Managed Care System is very important and that every American must have one. With the recession that is taking place, it is very vital for people to save money and make sure that they have health insurance in a time of need since so many people are losing their jobs. It is also important that people should have a Managed Care System in place due to the fact that most people may tend to get procedures that they really don't need and waste insurance money that they could have been used for something else. “The real lessons in life come from the failures,” she reflected. “The things you really learned and that stay with you are the things that you tried and didn't work out, and you said, ‘I wish I would have said that; I wish I would have done that” (Pomerleau, pg 1). It is just important that people manage themselves accordingly and make sure that they have insurance just in case something may happens to them so that they will not have to worry about the possibility of being denied service because of lack of insurance.
1. Shi, L., & Singh, D. A. (2008) Delivering health care in America: A systems approach (4th ed.). Boston: Jones and Bartlett.
2. Birger, Jon (2006, Mar 13).Second-Mover Advantage. Retrieved March 20, 2009,from http://money.cnn.com/magazines/fortune/fortune_archive/2006/03/20/8371782/index.htm
3. Pomerleau, Patricia (2005, Dec). 75th Anniversary Grants. Retrieved December 2005, fromfhttp://ww2.wkkf.org/default.aspx?tabid=119&CID=297&ItemID=21&NID=183&LanguageID=0