Question

1. Hospitals and other health care institutions, whether voluntary or for-profit, need to be financially solvent to survive growing market pressures. In what ways is this “bottom line” focus changing the nature of the U.S. health care system?

2. The typical relationship of patient to physician used to be one of deference to a more knowledgeable authority. Why is it now critically important for patients take a more proactive role in their medical care?

3. Health care planners could be effective and efficient if they used the concept of the natural history of disease and the levels of prevention to design services that intervene at the weakest link in the chain of progression of specific diseases. Instead, most focus on high-technology solutions to preventable problems while experts know that high-technology solutions do not address health disparities, the major causes of diseases and disabilities. What characteristics of the medical care culture hinder the prevention focus?

4. Increasing costs and declining populations caused many rural hospitals to shift from in-patient to ambulatory care and, sometimes, long-term care services. Regulations regarding staffing and other service requirements are relaxed in rural settings. Is a two-tiered system of care being created that denies rural citizens access to the same quality of care available in urban areas?

5. The practice of medicine has undergone dramatic change. Physicians are now accountable for costs and patient care outcomes by organizations that pay for care and their performance track records are exposed to increasing public scrutiny. In your opinion, given these evolving developments, will the attractiveness of medicine as a career decline, stay the same or increase? Consider the rational points for your opinion.

Answer 1

1. Answer:- The establishment of health services now depends almost entirely on its profitability. -The predominant view of corporate-minded politicians at federal, state and municipal levels is that government does not belong in the health care business and should divest itself of its health care assets.
-To save themselves the hospitals must cut costs, merge in order to realize greater economies and capture markets and generally begin to function similar to other competitive business entities.
-The hospital, the final holdout in the total commodification of health care, must now drastically rewrite its traditional mission statement if it is to survive.
-If present tendencies continue, two developments are likely to occur. First, the hospital will become a thoroughgoing creature of the marketplace.
-The financial bottom line will displace the clinical base line, wherever it not already done so. Hospital mergers “downsizing” and “shrinkages” are likely to accelerate. Hospital staff will continue to be replaced by machines wherever it is economically and technically feasible.
-The ideal patient will be:-
(i) who got lots of insurance coverage, but isn’t particularly sick.
(ii) those without insurance coverage will receive less medical care.
- As private hospitals tighten admissions policies to maximize reimbursements, the poor and uninsured will be caught in a double bind. -The cash-strapped public system will close its clinics or restrict access, cut back on services, and be generally less capable of providing quality care.