Consumer Driven Healthcare – Health System Example

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"Consumer-Driven Healthcare" is a great example of a paper on the health system. The Healthcare system has seen several changes over the years.   These changes range from services offered, mode of operation, technology, and even insurance. Like any other sector, healthcare systems have to adapt to new ways to improve service delivery. Financial accountability is one such area that has improved over time. Insurance companies have been on the rise since the civilization of the world. Public and private insurance companies have sought to bridge the gap between the rich and the poor by providing medical covers for various people.   This paper reflects on financial accountability in the health care system and how it has impacted it. History of Private Health Insurance   The idea of private health insurance has been with us for an extended period; however, it was put into practice in the first half of the 20th century.   The first insurance company was established in 1850 by Franklin in the United States.

This provided cover for injuries against steamboats and railroads. A small group of teachers joined in paying a fee, which they agreed with a hospital (the Dallas hospital) for their future treatments.

In the 1930s, a group of employers from mining and lumber industries sought to provide physician services to their employees. The blue cross and blue insurance companies, which currently serve in the United States are. As a result, the arrangement.   As the years passed, people felt the need to have insurance covers, especially workers in various sectors. Employers, especially in the mid 20th century, started paying medical fees for their employees. This was translated into the medical scheme. The private health scheme was, however, expensive for many people to afford especially the poor, unemployed, and the elderly.

The private health schemes grew as a result of a section feeling the need to provide for health cover. Employers also, through their intuition sought to provide health care for employees that worked in their companies. Moreover, private health insurance is greatly involved in the healthcare industry. Almost half of the United States population has acquired private health insurance. Private health insurance pays for medication, in-patient services, and out-patient services. For those who have insurance, it provides cover and pays bills for any hospital emergencies. Key Federal Laws The federal law in the United States does not entirely dictate the operations of the private insurance company, but it provides for provisions that ensure the protection of individuals who use the private insurance.

First, the federal law provides that private health schemes should provide for essential services. The essential services include covering individuals for their medication, in-patient services, and out-patient services among others. Such a law ensures that people who opt to have a private health scheme are given the required services as the law protects them. Furthermore, the federal law provides that no discrimination shall be allowed whatsoever in private health schemes.

It further states that people would not be discriminated against in salary, age, race, and gender. It simply ensures that anyone who has a private insurance cover gets the same cover and services in whatever hospital they choose to attend as much as it is stipulated in their cover. This law protects individuals from being exploited by private insurance firms. It ensures that people are treated fairly without taking into consideration the class and social status of individuals. Consumer-Driven Healthcare Consumer-driven healthcare is a new model that the world is adapting to.

This model is instrumental in allowing the patient to be more in charge of the medical costs decision. This model provides for preventive care, change in behavior, and short and long-term incentives. The patient and the physician are majorly involved in making viable decisions that are within the patient’ s limits and better health-wise. Also, this model is either funded by the employer or the employee and employer-funded.

The savings are deposited for the employee to use when they are feeling sick. Moreover, this system ensures the patient-doctor relationship, the efficacy of the health care systems, and offers better opportunities for patients. The patient and the doctor would be involved in making decisions to determine the best way to provide healthcare, hence they will hold consultations before taking a decision. The health system would also be effective in a manner that the funds would be readily available for treatment to be approved faster. This will reduce a tedious process whereby the one has to apply to the insurance to provide for funds.

Also, the patients from whatever social class are able to get better health care services since they can afford the funds (from their savings) and avoid insurance companies’ discrimination. This model empowers the healthcare consumer in the sense that, the patient is given a chance to decide the kind of hospital to be admitted to. Unlike the insurance companies that restrict one to some particular hospitals, this model allows that one can go to any hospital.

The consumer-driven model gives the consumer a choice on the kind of treatment they would want. A patient in consultation with the doctor is able to decide the best medication they would want since they directly pay for it. Emerging Opportunities for Nurses within Private Insurance Market There are many opportunities for nurses within the private insurance market. The private insurance market provides for a platform in which nurses would market and get opportunities to provide for services elsewhere. For instance, private insurance would provide a platform whereby, they can connect nurses with patients who need nurses for home care.

Private insurance offers nurses job opportunities that enable them to get an income. Furthermore, the private insurance market guarantees the nurses their pay after work in case of emergencies. A nurse would take up private insurance against job loss, and other emergencies that would cover in case such a scenario happens. This is an opportunity for a nurse to have the security of their job when an uncontrollable emergency happens. This opportunity will reduce further damages for nurses given that issues such as pandemics and other unforeseen issues would lead to a job loss.   Conclusion In conclusion, the healthcare sector has undergone a complete metamorphosis; which is necessary given a continuous change of human nature.

This can be evidenced by the introduction of private insurance. Private insurance covers were after helping workers that worked in particular industries. There is also an emergence of a new model: consumer-driven which has given the patient more freedom to determine the quality of healthcare services offered to them.   The federal government has as well provided for regulations to shield individuals from exploitation by private health schemes.

References

Fronstin, P. (2018). Consumer Engagement in Health Care Among Millennials, Baby Boomers, and Generation X: Findings from the 2017 Consumer Engagement in Health Care Survey. EBRI Issue Brief, (444).

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12.

Duckett, S., & Nemet, K. (2019). The history and purposes of private health insurance.

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