Major reform is necessary if the current healthcare delivery is going to meet the needs of the population while controlling costs. This discussion looks into the processes of identifying elements of reforming the current health care delivery system. It discusses the objectives of the healthcare delivery system, the population served, services provided, financial base, provider mix and the broad implementation strategy.
Objectives of the Health delivery system
The aim of an ideal healthcare delivery system is to provide healthcare services to all citizens in the country by ensuring that everyone can afford healthcare services and receive personalised attention from the physicians. The other objective is for the physician to access the patients’ medical records easily and quickly through Electronic Health Records of patients making it easy to treat them according to their medical history. The restoration of buyer and seller kind of relationship between the physician and the patient is very important. In this kind of a relationship, the patient is able to buy services from the physicians or medical facilities of their choice (Reid, 2009).
The other objective of an ideal service delivery is to have instances where patients can spend their own money rather than institutions money. This will give the patients an opportunity to compare prices and services offered by different medical facilities. The other goal of an ideal healthcare service delivery system is to provide an opportunity for the health provision to be a competitive market.
The health care providers compete for patients by offering quality health services and lowering prices (Starr, 2007). The other objective of an ideal healthcare service delivery service system is that the government will serve as an insurer of the last resort where only people without income or unable to pay medical bills turn to the government for help. In an ideal healthcare delivery system, everybody is insured or has savings to enable them pay the medical bills (Reid, 2009).
The healthcare service in the United States serves more than three hundred million people. Seventy percent of them get services from the private medical facilities that have better personalised facilities. Thirty per cent of the population receive healthcare services from the government-sponsored facilities (National Centre for Health Statistics, 2011). The other population demographic is that most of the patients are elderly people who are between the ages of sixty five to eighty years old and they suffer from chronic illnesses such as diabetes, hepatitis, which imply that they have to visit the hospital regularly.
The older population need home care and nursing services. The other dominant population aspect is economy because there is no demographic which is not susceptible to illnesses but most of the patients are from middle class (National Centre for Health Statistics, 2011). Children are part of the population served by the medical facilities and they are also majority of the patients although the parents pay their bills. An ideal healthcare can serve all the population demographics within the country (Malhotra, 2010).
In an ideal healthcare delivery system, there are services available to the patients. The first one is the general practitioner services where the patients receive medical services on minor medical issues such as prescription and diagnosis of a disease. The second one is the surgical services for minor and specialised surgeries. Thirdly, an ideal healthcare service delivery should have accommodation facilities for patients who need immediate attention from the medics. The other service necessary is that of physiotherapists, radiotherapist, gynaecologist and obstetrics specialists. Other specialised services such as cardiologist and psychiatrist are also required in a healthcare facility (Reid, 2009).
Other than the medical services, the healthcare facility must incorporate support services to ensure efficient delivery of services. These services may include healthcare administration to deal with the financial management of the healthcare facility. The other service needed is an appropriate and efficient information management system to keep the patients medical records safe for quick access when needed. It should also have an online connection to other medical facilities such that the medical doctors can access online prescribing services and other networking forums for the doctors. Specialised services should be offered for vulnerable groups such as the elderly and children (Malhotra, 2010).
The financial aspect of healthcare service delivery is an imperative factor that influences service delivery. The financial aspect of healthcare service delivery looks for ways in which the healthcare facility can deliver services in a cost effective way to the patients without compromising quality of the health care services. To ensure universal accessibility to ideal health care services there must be a good financial base to cater for the patients (Starr, 2007). The patients’ savings will cater for affordable services such as general practitioner services and minor surgeries. The insurance in an ideal scenario will cater for major illnesses such as heart transplant whose cost may be above patient’s savings. In an ideal health service, the patient will have both medical savings fund and health insurance (Reid, 2009).
The current insurance policies need reform as the insurance agencies pay for the patient the amount that they feel is appropriate (Malhotra, 2010). They also restrict the kind of care that the patient will receive from the healthcare facility. The patient has to receive services from the medical facilities predetermined by the insurance (Malhotra, 2010). This limits the options that the patients have and restricts them to one medical facility. Therefore, the patient cannot compare the services offered by different medical facilities and make a rational choice of the appropriate medical facility that offers quality services at reasonable prices. Currently, the health industry is bound to the health insurance industry that acts as the buyer of the medical services (Reid, 2009).
To create an ideal healthcare service where patients can afford the services, it is imperative for the government to institute health funds or health schemes where patients can save money for their health care services. To cater for instances where the patients saving is inadequate to meet the current medical cost, the insurance will be the alternative where the insurance will pay for the patient’s medical costs at the facility of their choice. To cater for low income earners who may not afford medical savings and the insurance, the government will act as an insurer of the unemployed and low-income earners.
This will apply only for complicated medical conditions whose cost for treatment is unaffordable. This would be an alternative to the health insurance policies, as the patients will have autonomy on how the fund will be used. The patients will also have autonomy to choose the hospital or the medical facility that they feel is cost effective and offers quality health care services (Mahar, 2006).
The healthcare delivery system should provide variety of services. Most of the medical facilities offer general practitioner services but they do not offer other types of specialised medical facilities such as surgery, physiotherapy, nursing care, psychiatrist and counselling services (Reid, 2009). These services are offered by other specialised medical facilities. This complicates the process in which the patients receive the services and even payment methods as the patient may manage to pay for the general practitioner through the insurance but fail to pay another medical facility for specialised treatment. The providers on the other hand may be specialists in one field of health care and unable to provide other services that patients may require (Malhotra, 2010).
To offer variety of services, many of the providers have a network system where the medical service provider who specialises in one area of health care interconnects with specialists from other fields. In case there is patient in need of medical services that are not available, the patient can access the services of other specialist without having to pay extra money or using the current insurance. This means that if a medical facility deals with obstetrics and one of the children has a condition that needs the attention of a cardiologist, the child can access the services of a cardiologist without incurring extra cost. The medical facilities also host specialists through medical camps once in a month to take care of conditions, which are beyond the scope of the general practitioner (Starr, 2007).
Broad implementation strategy
To implement an ideal healthcare delivery system, it is important to first harness the financial base to ensure that everyone either is insured or has savings to cater for health needs. The financial base to support the ideal heath care delivery system will be from the patients’ savings, insurance policies as well as from the government. When everyone is insured, the health facilities will have finances to offer personalised healthcare to patients as well as quality services.
The ideal medical services will allow patients to decide on the appropriate health facility. It will also help the doctors to advice the patients accordingly on the health status due to easy accessibility of patients’ health history, through the electronic records. Implementing computerised systems in the healthcare facility is an important step in implementing the ideal health care delivery system. The other aspect of implementing a healthcare delivery system is incorporating other care services such as care for the elderly and mental health as part of the general health and ensuring that the medical facilities can handle these services.
Competent and well-trained staffs are necessary in the development of the ideal healthcare delivery system. The system should therefore provide the medical providers with opportunities to upgrade their skills. It should also train the medical practitioners in empathy, accountability and providing personalised attention.
As a part of the implementation strategy, the government must come up with mechanisms of subsidising the health costs for the aged who are ailing and they need personalised care. With the approval of the current health reform bill, creation of an ideal healthcare system may take five years to establish the financial base and another five years to bring the ideal services to the public.
It is possible to have the ideal healthcare services by ensuring that there are appropriate systems to take care of the patients. Training the health service providers will also help them to offer quality services. Taking care of the elderly and ensuring that they enjoy their old age in good health is imperative in creating an ideal healthcare service delivery system. Without the healthcare facilities offering variety of services to the patients, the service delivery will not meet the expectations. The ideal health care delivery system will cater for both the poor and the rich. It will be based on value of the services rather than HCAHPS measures.
Mahar, M. (2006). Money-driven medicine: The real reason health care costs so much. New York: Harper/Collins.
Malhotra, U. (2010). Solving the American healthcare crisis. Massachusetts: Harvard University Press.
Reid, T. (2009). The healing of America: A global quest for better, cheaper and fairer health care. London: Penguin Books.
Starr, P. (2007). The social transformation of American medicine. Cincinnati: Basic Books.