Last Updated 15 Feb 2023

Decision-Making In The Field Of Health Care

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Mr. Alan Weil pointed out that there are three countries at the beginning of his lecture where Great Britain, France, and Japan all agree that the nation will take care of the health/insurance system so that all can participate. Means that the healthcare/insurance system meets the needs of everyone, free to patient delivery, and the clinical need, not the ability to pay. It is regulated by the government but stakeholders such as the providers, the insurance companies, and the people have a say in the regulations. This of which the U.S. does not have a leg to stand on. The U.S. focus is of Medicare and the Medicaid health system. This only matters to those individuals enrolled in those systems and it does not protect the privately insured. This does not meet the meaning of economic efficiency as per.

This is where health policy decision-making requires consideration of both health benefits and resource costs. Saying this only include the Medicare and Medicaid insured not the privately insured. So, this only effect a portion of the economy, but effects everyone when it comes to the Quality of Adjusted Life Year. Prescription cost have also been a problem for the insured as well. In the United States healthcare spending is very high, and its team continues to surge as the spending for prescription drugs. It has been stated by the American Academy of Actuaries, that in 2016 the United States spent$ 3,337 billion or 17.9% of the gross domestic product (GDP) on national health expenditures, of which $329 billion was used on prescription medications.

The problem with Medicare Part D, which has to do with prescription drugs, predominantly lies with the failure to avoid private insurance plans from receiving the incentives enjoy from pushing enrollees into the catastrophic range, which makes them careless to negotiate for lower drug prices for certain types of prescription drugs. The insurance company has self-assurance that the government reinsurance program would cover the excess. Medicare’s spending on prescription pharmaceuticals additionally has risen: between 2004 and 2014, the program’s portion of US drug expenditures incremented from 2% of $193 billion to 29% percent of $298 billion. Prices for many specialty drugs are higher in the merging states than other developed countries, and about 1 in 4 people in all the states who take prescription drugs report arduousness affording them.

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Most of the public favors for policy actions to hold drug prices in check: requiring pharmaceutical companies to publicly release information on how they set prices; sanctioning Medicare to negotiate medication prices; constraining charges for high-cost drugs; and sanctioning people in the adjoining states to buy drugs imported from Canada. With the increased utilization of prescriptions, it has resulted into an approved guidance for healthcare providers to write for additional indications or new categories for certain medications, transformations in disease occurrence, amendments in a therapeutic plan, and more effective disease identification, this is due to the result of improved access to precautionary screenings.

When mentioning a revision to medication therapy plans for patients’ it is also important that patients adhere to their regiments as prescribed by their physician. If patient do not adhere to their maintenance medications plan this can cause devastating effects. Nonadherence or noncompliance to medication treatment plans occur when patients do not follow appropriate drug treatment protocol. It is very imperative to patient with chronic health conditions, such as those that treat diabetes “sugar” and/or hypertension “high blood pressure”.

In lieu of the nonadherence treatment plan, this causes patient’s conditions to get worse and causes an extreme shift to the left with their health worsening. With their health worsening, the will also drive up the unit costs of prescription medications. Cost per unit usually rises over time. However, certain peripheral issues may cause the cost per unit to surge substantially. Name brand e.g. “Motrin”, instead of “ibuprofen” typically experience higher price increases as their exclusivity period ends. New name brand drugs are frequently introduced at prices greater than the existing drugs they are targeting to replace.

In discussing the demand of use of medication, the increase of cost, and the use of brand or generic use of prescriptions; the United States health care system is immensely complex. One way or another the people to the United States are affected the most health care. The effect is caused by the health care premiums, taxes, fees, out of pocket expenses, access to care, and the insureds family budget. Universal care models if you look at health care from public health perspective would be a great idea, but the problem is that it would cause a great rift in pharmaceutical company's bottom line in their potential financial gains.

Physicians already speak of the US government picking up 2/3 of health care cost now with a more stream line universal health care system the government will pick up all the cost and there will be a produce and administrative in spending cost. This also would affect the physician bottom line into charging for more test and fees for services. Even though this would be an advantage to those that medical care and that have chronic health care issues. Physicians are worried about their financial position with health care being given to all instead of those that who can only afford. This would bring conflict of what the World Health Organization (WHO) exhibits as good health measures. This would also bring an increase in morbidity and mortality rates.

An organization is an organized body of people with a purpose, especially a business, society, association, and or corporation. This is also a system of consciously coordinated activities that are carried out by people to achieve a specific goal. However, when decisions are made to achieve that goal the organization must maintain the internal system as well as the external environment to coordinate the human aspect. The Organizational Theory provides a focus on, the effect of social organizations on the behavior and attitudes of individuals within them, the properties of individual characteristics and action on organization, the performance, accomplishments, and endurance of organizations, and the reciprocated effects of environments, including resource and task, political, and cultural environments on organizations and vice versa.

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