Question

Much of what is happening in the health care sector is based upon and driven by ‘competition.’ Should competition among health care organizations (e.g. hospitals, physicians, integrated health systems, and managed care plans) be restrained and regulated by government policy? Use concepts, principles, and material about policy and economics to argue in favor of and then in opposition to that type of policy.

Answer 1

ansss...
competitin
In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients. In other words, competition ensures the provision of better products and services to satisfy the needs of customers This paper aims to develop a model that can be used to empirically investigate a number of complex issues and relationships associated with competition in the health care industry.
Within the health care industry, competition impacts several relational perspectives; with numerous studies reporting the impact of increased competition. For example, several studies have examined the relationships between competition and quality of health care (Zwanziger and Melnick, 1996; Enthoven, 1993; Kassirer, 1995; Chassin, 1997); between competition and health care system costs (Robinson and Luft, 1985; Robinson and Luft, 1987; Robinson and Luft, 1988; Zwanziger and Melnick, 1996; Zwanziger and Melnick, 1988; Robinson, 1991); and between competition and patient satisfaction (Miller, 1996; Brook and Kosecoff, 1988). These studies show that competition is capable of increasing value for customers over time. Quality and process improvements lead to decreased costs, which in turn results in increased customer satisfaction. This paper reviews relevant literature and develops a model that can be used to empirically investigate a number of complex issues and relationships associated with competition in the health care industry. Specific consideration is given to the impact of competition, in the context of a volatile external environment, on the health care organization’s strategic mission and goals and its internal environment in terms of health care quality and health care system costs, and how these relate to customer satisfaction. While there are different types of customers within a health care system, we limit discussion of customers to patients.
This research attempts to provide direction for the advancement of knowledge and practice in the field based on a number of considerations: first, it is possible to provide a more consistent definition of competition in health care in relation to patient satisfaction; second, it is important to identify and understand the mechanism of competition in the health care industry if premium services and products are to be offered to patients; third, it is possible to apply theories, concepts, and principles from other disciplines to gain insight concerning competition in health care; and fourth, there is a need for greater comprehension in delineating the impact of increased competition via the use of a more precise definition as well as the knowledge from other disciplines.
This paper also reviews relevant literature on the impact of competition, particularly in regards to system costs, quality of care, and patient satisfaction; presents and discusses a research model of competition and patient satisfaction in health care with propositions for empirical research; and suggests directions for future research and practice. The theoretical basis for this model takes a system approach to understanding the relationship between competition and patient satisfaction that recognizes the external environment as the catalyst for increased competition in the health care industry. Governmental regulations, political dynamics, changing social and demographic characteristics and ever-advancing technology are driving a major shift in the health care industry resulting in the disintegration of health care networks and intensified competition and cost pressures.
no, there should be compitation in health care organizations because based on compitation the organization provide best quality to the patients ,regulations should be on the organizations which are not providing proper fecility
Traditional competition in health care involves one or more elements (e.g. price, quality, convenience, and superior products or services); however, competition can also be based on new technology and innovation. A key role of competition in health care is the potential to provide a mechanism for reducing health care costs. Competition generally eliminates inefficiencies that would otherwise yield high production costs, which are ultimately transferred to patients via high health service and delivery costs.
The first component is comprised of individuals who provide health care (e.g. physicians and other practitioners) The second component is comprised of the organizations that provide health care services (e.g. hospitals, hospital systems, or other health services organizations) The third component comprises organizations that provide health care financing and insurance and health care plans (e.g. health management organizations (HMO), preferred provider organizations (PPO), and various insurance companies).
Measurement of health care competition
Baker (2001) discusses five important conceptual issues in measuring competition in health care markets including the identification of products offered, market areas, selecting a basic measure, considering forces that modify competitive dynamics, and accounting for managed care. There is a concomitant increase in competition as the number of firms increase. Competition is measured by carefully identifying the products and/or services as well as firms which offer these products and/or services, identifying the relevant geographical market area (e.g. metropolitan statistical areas (MSAs)), and selecting a basic measure of competition.
Concepts of service quality and patient satisfaction
Experts have struggled for decades to formulate a concise, meaningful, and generally applicable definition of the quality of health care. For example, Palmer et al. (1991) defined quality of health care as “the production of improved health and satisfaction of a population within the constraints of existing technology, resources, and consumer circumstances.” For physicians, quality of health generally involves a technical and a physician-patient interaction.
Measuring quality and satisfaction
The primary means of assessing how patients feel about the care they receive in a health care setting is measurement of patient satisfaction. Measuring satisfaction also serves as an important tool for quality audit and improvement in all types of health care organizations. Patients sometimes (or always) have different views from the health professionals when judging the quality of care and services. It is essential to realize the needs of the patients and collect information on services delivery and operations from a patient’s perspective. The results of a patient satisfaction survey can be used to further improve care management and promote the quality of patient outcomes.
Competition and patient satisfaction: research model and propositions
This section proposes a research model of competition and customer satisfaction in health care with implications for empirical research. The model depicts customer satisfaction as an outcome measure directly dependent on competition, and indirectly through quality of care and health care systems costs, which themselves are directly dependent on the organization’s strategic mission and goals. The organization’s strategic mission is viewed as mediating the relationship between competition and customer satisfaction and the patient’s perceived performance and expectations are viewed as moderating the relationship between quality of care and health care systems costs and patient satisfaction.
competition among hospitals tends to increase differentiation, whereas higher financial PPS pressure is associated with increased specialization;
hospitals tend to adopt some high visibility services offered by their competitors while filling market niches selectively overall; and
the cost savings expected for specialization may prevail only for narrowly defined services.
some regulations by government policy
Current regulatory policy concerning health care professionals is based on the assumption that the market for health care services fails because consumers do not have full information about the quality of services these professionals provide. As a result, some professionals may exploit consumers by providing lower-quality services. Economic theory suggests that in the absence of regulation, some health care professionals may provide low-quality services at high-quality prices to uninformed consumers.
The current policy trends in the market for nonphysician professionals' services leave existing regulations in place for better or for worse, attempt to correct the basic market failure due to asymmetric information by collecting and publishing comparative quality information, and stimulate competition by increasing the number of nonphysician professionals eligible for direct insurance reimbursement.