The Complexities Of The Health Care Delivery System

2119 Words 9 Pages
This book discusses the complexities of the health care delivery system in the United States and the current evolving reform. The preface begins with a brief introduction on how the United States Government has passed an Affordable Care Act (ACA) and a somewhat shady “Health Care Reform Bill.” The ACA is not favored by most of the American people, but the Obama Administration is pushing for the bill to pass so it can ensure their political dominance. Apart from the political aspect of this bill, it is inevitable that some major reform is underway. Many concerns remain, which have been addressed long before these bills. Some of these issues include dealing with chronic conditions, ensuring adequate staffing, and financing long term care and …show more content…
Our healthcare system differs from other developed countries– in fact, it is hardly even a system. Our country delivers care in different ways – private insurance, Medicare and Medicaid. Some people do not even have health care. The four essential components of the system which make up the ‘quad-function model’ are finance, insurance, delivery and payment. Financing health insurance is usually fulfilled through employers who purchase it from an insurance company. Small companies may often not be able to afford health insurance coverage. Insurance specifies how and where health care services can be received and determines what type of services the individual can receive. Delivery refers to how services are received through the providers, which can be a physician, dentist or therapist. Finally, the payment function provides reimbursement to the providers for services rendered. The amount paid to the provider is determined by the insurance, which earns its funds from the employer. The patient will usually pay a small fee of 25-30$, and their employer will cover the rest. These sectors are mainly in private hands, unlike the sectors controlled by the government. These sectors usually only help …show more content…
Dissimilar to the Healthcare Industry, the American Automobile Industry has improved because they figured out a better way to make a car by learning how to be a true “Lean Organization.” In Healthcare, guidelines and feedback on performance data have shown significant improvement, but these tactics are not enough. The first principle discussed is the Reduction of Waste. We have not scratched the surface of this principle yet since very few organizations have built their foundations on the broad idea of reducing waste. As much as 95% of healthcare effort is wastes. For example, $120,000 a year is spent gowning babies in hospitals with NICU’s. In 12/14 studies, it was proven that this method did was not beneficial. It is if “we lack a deep sense of the nature of waste.” The second principle is Continuous Flow, which is essentially the idea of viewing production similar to water in a river. For example, if both an elevator and escalator can complete the same job with the same throughput, the escalator allows for continuous flow. Continuous flow will reduce inventory by 2 or more orders of magnitude, but we are currently forced to “surrender to waste.” The third principle is Reduced Demand. There are not alternative ways to let patients seek out their own

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