This paper examines the historical and current policies of health care in the U.S. and introduces a new model of collaboration utilizing a systems approach.
Written in 2004; 7,090 words; 12 sources; APA; $ 158.95
Paper Summary:
This paper stress that health care is the largest single industry in the country and that health policy making in the United States involves a complex web of decisions made by various institutions and political actors across a broad spectrum of the public and private sectors. The author reports that the Health Maintenance Organization is a system in which enrollees pay a fixed fee (capitation) in advance and, in return, receive a comprehensive set of health services. This paper concludes that the goal of the integrative health care model is to advance the current health care system to a new level cooperation, mutual partnerships, and dedication that will keep intact the true values of accessible, efficient and affordable quality health care, which does not discriminate against individuals.
Table of Contents
Introduction
Historical Examination of Health Care Politics and Policies
Medicare Politics and Policy
Medicaid Politics and Policies
Managed Care Politics and Policy
Types of Managed Care Organizations
Preferred Provider Organizations (PPOs)
Exclusive Provider Organizations (EPOs)
Point of Service Plans (POSs)
A New Integrative Systems Model of Health Care
Primary Level
Secondary Level
Third Level
Conclusions
From the Paper:
"During this period, doctors and specialists had unquestioned authority within the hospital and retained nearly total control over medical decision-making. They merely had to ask, and they would gain access to the hospital's complete arsenal of medical personnel and equipment. Individual roles were well respected. Hospital administrators stayed out of medical decision-making. The administrators staffed the hospitals, procured supplies, and handled fiscal matters and deferred to the medical staff in all clinical matters. Health insurers also had there role and did not intervene. They sold indemnity insurance, which permitted patients to receive care from any licensed provider, and paid for all services rendered, except possibly for a nominal co-payment. With administrators and insurers playing passive roles, physicians clearly stood atop the hierarchy of the health care economy."
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