Development of a system of health care

What is health care system. Purpose, scope and methods. Health care industry. Health economics and politics. The healthcare industry consists of the following segments. Micro-economic evaluation at treatment level. What is health and what is its value.

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Язык английский
Дата добавления 07.12.2014
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Contents

1. Purpose, scope and methods

2. What is health care system

3. Health care industry

4. Health economics and politics

References

1. Purpose, scope and methods

The delivery of modern health care depends on an expanding group of trained professionals coming together as an interdisciplinary team. The health-care industry incorporates several sectors that are dedicated to providing health care services and products. According to industry and market classifications, such as the Global Industry Classification Standard and the Industry Classification Benchmark, the health-care industry includes health care equipment and services as well as pharmaceuticals, biotechnology and life sciences. The particular sectors associated with these groups are: biotechnology, diagnostic substances, drug delivery, drug manufacturers, hospitals, medical equipment and instruments, diagnostic laboratories, nursing homes, providers of health care plans and home health care. According to government industry classifications, which are mostly based on the United Nations system, the International Standard Industrial Classification, health care generally consists of hospital activities, medical and dental practice activities, and other human health activities. The last class consists of all activities for human health not performed by hospitals, physicians or dentists. This involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, home, or other Para-medical practitioners in the field of optometry, hydrotherapy, medical massage, yoga therapy, music therapy, occupational therapy, speech therapy, chiropody, homeopathy, chiropractic's, acupuncture, etc.

Scope of study in this work is the health care and need for innovations in this sphere.

The purpose of my work is to figure out what influence upon innovations in health care are influenced by.

As a student civil service academy I should know the modern condition of health care, as it'll be this is useful for my future job. I have a little experience in this sphere since I passed practical person in management on work with referencing the people.

I will use online research to answer my research questions:

1. http://www.ft.com/indepth/us-healthcare-reform

2. http://www.bls.gov/oco/cg/cgs035.htm

3. health-nn.com

4. http://www.gfk.ru/Go/Page?id=247

2. What is health care system

Health (or health care) is the treatment and prevention of illness. Health care is delivered by professionals in medicine, dentistry, nursing, pharmacy and allied health. The social and political issues surrounding access to health care in the US have led to vigorous public debate and the almost colloquial use of terms such as health care (medical management of illness), health insurance (reimbursement of health care costs), and public health (the collective state and range of health in a population). Health care systems are composed of individuals and organizations that aim to meet the health care needs of target populations. There are a wide variety of health care systems around the world. In some countries, the health care system planning is distributed among market participants, whereas in others planning is made more centrally among governments, trade unions, charities, religious, or other coordinated bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has often been evolutionary rather than revolutionary.

Health care system includes:

1. Health care industry (Philosophy)

2. Research (World Health Organization)

3. Economics

4. Politics

The main role in Health care system plays World Health Organization. This organization contributes changes and innovations in all part Health care system. The World Health Organization (WHO) is a specialized United Nations agency which acts as a coordinator and researcher for public health around the world. Established on 7 April 1948, and headquartered in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which had been an agency of the League of Nations. The WHO's constitution states that its mission "is the attainment by all peoples of the highest possible level of health." Its major task is to combat disease, especially key infectious diseases, and to promote the general health of the peoples of the world. Examples of its work include years of fighting smallpox. In 1979 the WHO declared that the disease had been eradicated - the first disease in history to be completely eliminated by deliberate human design. The WHO is nearing success in developing vaccines against malaria and schistosomiasis and aims to eradicate polio within the next few years. The organization has already endorsed the world's first official HIV/AIDS Toolkit for Zimbabwe from October 3, 2006, making it an international standard. The WHO is financed by contributions from member states and from donors. In recent years the WHO's work has involved more collaboration, currently around 80 such partnerships, with NGOs and the pharmaceutical industry, as well as with foundations such as the Bill and Melinda Gates Foundation and the Rockefeller Foundation. Voluntary contributions to the WHO from national and local governments, foundations and NGOs, other UN organizations, and the private sector (including pharmaceutical companies), now exceed that of assessed contributions (dues) from its 193 member nations.

Social health insurance is where a nation's entire population is eligible for health care coverage, and this coverage and the services provided are regulated. In almost every country, state or municipality with a government health care system a parallel private, and usually for-profit, system is allowed to operate. This is sometimes referred to as two-tier health care. The scale, extent, and funding of these private systems is variable. A traditional view is that improvements in health result from advancements in medical science. The medical model of health focuses on the eradication of illness through diagnosis and effective treatment. In contrast, the social model of health places emphasis on changes that can be made in society and in people's own lifestyles to make the population healthier. It defines illness from the point of view of the individual's functioning within their society rather than by monitoring for changes in biological or physiological signs. The United States currently operates under a mixed market health care system. Government sources (federal, state, and local) account for 45% of U.S. health care expenditures. Private sources account for the remainder of costs, with 38% of people receiving health coverage through their employers and 17% arising from other private payment such as private insurance and out-of-pocket co-pays.

Opponents of government intervention into the market generally believe that such intervention distorts pricing as government agents would be operating outside of the corporate model and the principles of market discipline; they have less short and medium-term incentives than private agents to make purchases that can generate revenues and avoid bankruptcy. Health system reform in the United States usually focuses around three suggested systems, with proposals currently underway to integrate these systems in various ways to provide a number of health care options. First is single-payer, a term meant to describe a single agency managing a single system, as found in most modernized countries as well as some states and municipalities within the United States. Second are employer or individual insurance mandates, with which the state of Massachusetts has experimented. Finally, there is consumer-driven health, in which systems, consumers, and patients have more control of how they access care. This is argued[by whom?] to provide a greater incentive to find cost-saving health care approaches. health economic politic treatment

Critics of consumer-driven health say that it would benefit the healthy but be insufficient for the chronically sick, much as the current system operates. Over the past thirty years, most of the nation's health care has moved from the second model operating with not-for-profit institutions to the third model operating with for-profit institutions; the greater problems with this approach have been the gradual deregulation of HMOs resulting in fewer of the promised choices for consumers, and the steady increase in consumer costs that have marginalized consumers and burdened states with excessive urgent health care costs that are avoided when consumers actually have adequate access to preventive health care. A few states have taken serious steps toward universal health care coverage, most notably Minnesota, Massachusetts and Connecticut, with recent examples being the Massachusetts 2006 Health Reform Statute and Connecticut's SustiNet plan to provide quality, affordable health care to state residents.

We can see that system Health care touches one of the most important spheres our life. It system mast be changed all time for best result in treatment and diagnostics of the different diseases.

3. Health care industry

The delivery of modern health care depends on an expanding group of trained professionals coming together as an interdisciplinary team. The health-care industry incorporates several sectors that are dedicated to providing health care services and products. According to industry and market classifications, such as the Global Industry Classification Standard and the Industry Classification Benchmark, the health-care industry includes health care equipment and services as well as pharmaceuticals, biotechnology and life sciences. The particular sectors associated with these groups are: biotechnology, diagnostic substances, drug delivery, drug manufacturers, hospitals, medical equipment and instruments, diagnostic laboratories, nursing homes, providers of health care plans and home health care. According to government industry classifications, which are mostly based on the United Nations system, the International Standard Industrial Classification, health care generally consists of hospital activities, medical and dental practice activities, and other human health activities. The last class consists of all activities for human health not performed by hospitals, physicians or dentists. This involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, home, or other Para-medical practitioners in the field of optometry, hydrotherapy, medical massage, yoga therapy, music therapy, occupational therapy, speech therapy, chiropody, homeopathy, chiropractic's, acupuncture, etc.

Combining medical technology and the human touch, the healthcare industry diagnoses, treats, and administers care around the clock, responding to the needs of millions of people--from newborns to the terminally ill. Industry organization. About 595,800 establishments make up the healthcare industry; they vary greatly in terms of size, staffing patterns, and organizational structures. About 76 percent of healthcare establishments are offices of physicians, dentists, or other health practitioners. Although hospitals constitute only 1 percent of all healthcare establishments, they employ 35 percent of all workers. The healthcare industry includes establishments ranging from small-town private practices of physicians who employ only one medical assistant to busy inner-city hospitals that provide thousands of diverse jobs. In 2008, around 48 percent of non-hospital healthcare establishments employed fewer than five workers. In contrast, 72 percent of hospital employees were in establishments with more than 1,000 workers.

The healthcare industry consists of the following segments:

Hospitals. Hospitals provide complete medical care, ranging from diagnostic services, to surgery, to continuous nursing care. Some hospitals specialize in treatment of the mentally ill, cancer patients, or children. Hospital-based care may be on an inpatient (overnight) or outpatient basis. The mix of workers needed varies, depending on the size, geographic location, goals, philosophy, funding, organization, and management style of the institution. As hospitals work to improve efficiency, care continues to shift from an inpatient to outpatient basis whenever possible. Hospitals employ workers with all levels of education and training, thereby providing a wider variety of opportunities than is offered by other segments of the healthcare industry. About 28 percent of hospital workers are registered nurses. Hospitals also employ many physicians and surgeons, therapists, and social workers. About 21 percent of hospital jobs are in a service occupation, such as nursing, psychiatric, and home health aides, or building cleaning workers. Hospitals also employ large numbers of office and administrative support workers.

Nursing and residential care facilities. Nursing care facilities provide inpatient nursing, rehabilitation, and health-related personal care to those who need continuous nursing care, but do not require hospital services. Nursing aides provide the vast majority of direct care. Other facilities, such as convalescent homes, help patients who need less assistance. Residential care facilities provide around-the-clock social and personal care to children, the elderly, and others who have limited ability to care for themselves. Workers care for residents of assisted-living facilities, alcohol and drug rehabilitation centers, group homes, and halfway houses. Nursing and medical care, however, are not the main functions of establishments providing residential care, as they are in nursing care facilities. About 63 percent of nursing and residential care facility jobs are in service occupations, primarily nursing, psychiatric, and home health aides. Professional and administrative support occupations make up a much smaller percentage of employment in this segment, compared with other parts of the healthcare industry. Federal law requires nursing facilities to have licensed personnel on hand 24 hours a day and to maintain an appropriate level of care.

Offices of physicians. About 36 percent of all healthcare establishments fall into this industry segment. Physicians and surgeons practice privately or in groups of practitioners who have the same or different specialties. Many physicians and surgeons prefer to join group practices because they afford backup coverage, reduce overhead expenses, and facilitate consultation with peers. Physicians and surgeons are increasingly working as salaried employees of group medical practices, clinics, or integrated health systems. Many of the jobs in offices of physicians are in professional and related occupations, primarily physicians, surgeons, and registered nurses. About 37 percent of all jobs, however, are in office and administrative support occupations, such as receptionists and information clerks.

Offices of dentists. About 20 percent of healthcare establishments are dentist's offices. Most employ only a few workers, who provide preventative, cosmetic, or emergency care. Some offices specialize in a single field of dentistry, such as orthodontics or periodontics. Roughly 35 percent of all jobs in this segment are in service occupations, mostly dental assistants. The typical staffing pattern in dentists' offices consists of one dentist with a support staff of dental hygienists and dental assistants. Larger practices are more likely to employ office managers and administrative support workers.

Home healthcare services. Skilled nursing or medical care is sometimes provided in the home, under a physician's supervision. Home healthcare services are provided mainly to the elderly. The development of in-home medical technologies, substantial cost savings, and patients' preference for care in the home have helped change this once-small segment of the industry into one of the fastest growing healthcare services. About 59 percent of jobs in this segment are in service occupations, mostly home health aides and personal and home care aides. Nursing and therapist jobs also account for substantial shares of employment in this segment.

Offices of other health practitioners. This segment of the industry includes the offices of chiropractors, optometrists, podiatrists, occupational and physical therapists, psychologists, audiologists, speech-language pathologists, dietitians, and other health practitioners. Demand for the services of this segment is related to the ability of patients to pay, either directly or through health insurance. Hospitals and nursing facilities may contract out for these services. This segment also includes the offices of practitioners of alternative medicine, such as acupuncturists, homeopaths, hypnotherapists, and naturopaths. About 42 percent of jobs in this industry segment are professional and related occupations, including physical therapists, occupational therapists, dispensing opticians, and chiropractors. Healthcare practitioners and technical occupations and office and administrative support occupations also accounted for a significant portion of all jobs--35 percent and 31 percent, respectively.

Ambulatory healthcare services. This segment includes outpatient care center and medical and diagnostic laboratories. These establishments are diverse including kidney dialysis centers, outpatient mental health and substance abuse centers, blood and organ banks, and medical labs that analyze blood, do diagnostic imaging, and perform other clinical tests.

Recent developments. In the rapidly changing healthcare industry, technological advances have made many new procedures and methods of diagnosis and treatment possible. Clinical developments, such as infection control, less invasive surgical techniques, advances in reproductive technology, and gene therapy for cancer treatment, continue to increase the longevity and improve the quality of life of many Americans. Advances in medical technology also have improved the survival rates of trauma victims and the severely ill, who need extensive care from therapists and social workers as well as other support personnel.

In addition, advances in information technology have a perceived improvement on patient care and worker efficiency. Devices such as hand-held computers are used record a patient's medical history. Information on vital signs and orders for tests are transferred electronically to a main database; this process eliminates the need for paper and reduces recordkeeping errors. Adoption of electronic health records is, however, relatively low presently. Cost containment also is shaping the healthcare industry, as shown by the growing emphasis on providing services on an outpatient, ambulatory basis; limiting unnecessary or low-priority services; and stressing preventive care, which reduces the potential cost of undiagnosed, untreated medical conditions. Enrollment in managed care programs--predominantly preferred provider organizations, health maintenance organizations, and hybrid plans such as point-of-service programs--continues to grow. These prepaid plans provide comprehensive coverage to members and control health insurance costs by emphasizing preventive care. Cost effectiveness also is improved with the increased use of integrated delivery systems, which combine two or more segments of the industry to increase efficiency through the streamlining of functions, primarily financial and managerial. These changes will continue to reshape not only the nature of the healthcare workforce, but also the manner in which healthcare is provided. Various healthcare reforms are presently under consideration. These reforms may affect the number of people covered by some form of health insurance, the number of people being treated by healthcare providers, and the number and type of healthcare procedures that will be performed.

Recent developments. Average weekly hours of nonsupervisory workers in private healthcare varied among the different segments of the industry. Workers in offices of dentists averaged only 27.4 hours per week in 2008, while those in psychiatric and substance abuse hospitals averaged 35 hours, compared with 33.6 hours for all private industry. Many workers in the healthcare industry are on part-time schedules. Part-time workers made up about 20 percent of the healthcare workforce as a whole in 2008, but accounted for 37 percent of workers in offices of dentists and 32 percent of those in offices of other health practitioners. Many healthcare establishments operate around the clock and need staff at all hours. Shift work is common in some occupations, such as registered nurses. It is not uncommon for healthcare workers hold more than one part-time job.

A wide variety of people with various educational backgrounds are necessary for the healthcare industry to function. The healthcare industry employs some highly educated occupations that often require many years of training beyond graduate school. However, most of the occupations in the healthcare industry require less than four years of college. A variety of postsecondary programs provide specialized training for jobs in healthcare. People interested in a career as a health diagnosing and treating practitioner--such as physicians and surgeons, optometrists, physical therapists, or audiologists--should be prepared to complete graduate school coupled with many years of education and training beyond college. A few healthcare workers need bachelor's degrees like social workers, health service managers, and some RNs. A majority of the technologist and technician occupations require a certificate or an associate degree; these programs usually have both classroom and clinical instruction and last about 2 years. The healthcare industry also provides many job opportunities for people without specialized training beyond high school. In fact, 47 percent of workers in nursing and residential care facilities have a high school diploma or less, as do 20 percent of workers in hospitals. Some healthcare establishments provide on-the-job or classroom training, as well as continuing education. Most healthcare workers that do not have postsecondary healthcare training and work directly with patients will receive some on-the-job training.

These occupations include nursing aides, orderlies, and attendants; psychiatric aides; home health aides; physical therapist aides; and EKG technicians. Hospitals are more likely than other facilities to have the resources and incentive to provide training programs and advancement opportunities to their employees. In other segments of healthcare, the variety of positions and advancement opportunities are more limited. Larger establishments usually offer a broader range of opportunities. Some hospitals provide training or tuition assistance in return for a promise to work at their facility for a particular length of time after graduation. Nursing facilities may have similar programs. Some hospitals have cross-training programs that train their workers--through formal college programs, continuing education, or in-house training--to perform functions outside their specialties. Persons considering careers in healthcare should have a strong desire to help others, genuine concern for the welfare of patients and clients, and an ability to deal with people of diverse backgrounds in stressful situations. Many of the healthcare jobs that are regulated by State licensure require healthcare professionals to complete continuing education at regular intervals to maintain valid licensure. Opportunities for advancement will vary depending on the occupation itself. Healthcare service assistants and aides may advance to positions with more responsibility with years of experience or additional education or training. Health technologists and technicians often advance by becoming credentialed in a specialty within their field or with additional education or training. Health professionals may advance to managerial or administrative positions.

Outlook this section Healthcare will generate 3.2 million new wage and salary jobs between 2008 and 2018, more than any other industry, largely in response to rapid growth in the elderly population. Ten of the twenty fastest growing occupations are related to healthcare. Many job openings should arise in all healthcare employment settings as a result of employment growth and the need to replace workers who retire or leave their jobs for other reasons.

Employment change. Wage and salary employment in the healthcare industry is projected to increase 22 percent through 2018, compared with 11 percent for all industries combined. Employment growth is expected to account for about 22 percent of all wage and salary jobs added to the economy over the 2008-18 periods. Projected rates of employment growth for the various segments of the industry range from 10 percent in hospitals, the largest and slowest growing industry segment, to 46 percent in the much smaller home healthcare services. Employment in healthcare will continue to grow due to many contributing factors. The proportion of the population in older age groups will grow faster than the total population between 2008 and 2018. In addition, older persons have a higher incidence of injury and illness and often take longer to heal from maladies. As a result, demand for healthcare will increase, especially in employment settings specializing in gerontology care for the elderly. Employment in home healthcare and nursing and residential care should increase rapidly as life expectancies rise, and families are less able to care for their elder family members and rely more on long-term care facilities. Advances in medical technology will continue to improve the survival rate of severely ill and injured patients, who will then need extensive therapy and care.

New technologies will continue to enable earlier diagnoses of many diseases which often increase the ability to treat conditions that were previously not treatable. Industry growth also will occur as a result of the shift from inpatient to less expensive outpatient and home healthcare because of improvements in diagnostic tests and surgical procedures, along with patients' desires to be treated at home. Many of the occupations projected to grow the fastest in the economy are concentrated in the healthcare industry. For example, over the 2008-18 periods, total employment of home health aides is projected to increase by 50 percent, medical assistants by 34 percent, physical therapist assistants by 33 percent, and physician assistants by 39 percent. Rapid growth is expected for workers in occupations concentrated outside the inpatient hospital sector, such as pharmacy technicians and personal and home care aides. Because of cost pressures, many healthcare facilities will adjust their staffing patterns to reduce labor costs. Where patient care demands and regulations allow, healthcare facilities will substitute lower paid providers and will cross-train their workforces. Many facilities have cut the number of middle managers, while simultaneously creating new managerial positions as the facilities diversify. Traditional inpatient hospital positions are no longer the only option for many future healthcare workers; persons seeking a career in the field must be willing to work in various employment settings. Hospitals will be the slowest growing segment within the healthcare industry because of efforts to control hospital costs and the increasing use of outpatient clinics and other alternative care sites.

Demand for dental care will rise due to greater retention of natural teeth by middle-aged and older persons, greater awareness of the importance of dental care, and an increased ability to pay for services. Dentists will use support personnel such as dental hygienists and assistants to help meet their increased workloads. Many job openings should arise in all employment settings as a result of employment growth and the need to replace workers who retire or leave their jobs for other reasons. Tougher immigration rules that are slowing the numbers of foreign healthcare workers entering the United States should make it easier to get a job in this industry. Occupations with the most replacement openings are usually large, with high turnover stemming from low pay and status, poor benefits, low training requirements, and a high proportion of young and part-time workers. Nursing aides, orderlies and attendants, and home health aides are among the occupations adding the most new jobs in this industry between 2008 and 2018, about 592,200 combined. In contrast, occupations with relatively few replacement openings--such as physicians and surgeons--are characterized by high pay and status, lengthy training requirements, and a high proportion of full-time workers. Another occupation that is expected to have many openings is registered nurses. The median age of registered nurses is increasing, and not enough younger workers are replacing them. As a result, employers in some parts of the country are reporting difficulties in attracting and retaining nurses. Healthcare workers at all levels of education and training will continue to be in demand. In many cases, it may be easier for jobseekers with health-specific training to obtain jobs and advance in their careers. Specialized clinical training is a requirement for many jobs in healthcare and is an asset even for many administrative jobs that do not specifically require it.

Earnings About this section Industry earnings. Average earnings of nonsupervisory workers in most healthcare segments are higher than the average for all private industry, with hospital workers earning considerably more than the average and those employed in nursing and residential care facilities and home healthcare services earning less. Average earnings often are higher in hospitals because the percentage of jobs requiring higher levels of education and training is greater than in other segments. Those segments of the industry with lower earnings employ large numbers of part-time service workers. As in most industries, professionals and managers working in healthcare typically earn more than other workers in the industry. Wages in individual healthcare occupations vary as widely as the duties, level of education and training, and amount of responsibility required by the occupation. Some establishments offer tuition reimbursement, paid training, child day care services, and flexible work hours. Healthcare establishments that must be staffed around the clock to care for patients and handle emergencies often pay premiums for overtime and weekend work, holidays, late shifts, and time spent on call. Earnings vary not only by type of establishment and occupation, but also by size; salaries tend to be higher in larger hospitals and group practices. Geographic location also can affect earnings.

Benefits and union membership. Healthcare workers generally receive standard benefits, such as health insurance, paid vacation and sick leave, and pension plans. However, benefits can vary greatly by occupation and by employer. Although some hospitals have unions, the healthcare industry is not heavily unionized. In 2008, 17 percent of workers in hospitals were members of unions or covered by union contracts, while all other healthcare sectors had rates below the 14 percent average for all industries

Work environment. In 2008, the incidence of occupational injury and illness in hospitals was higher than the average for private industry overall. Nursing care facilities had an even higher rate. Healthcare workers involved in direct patient care must take precautions to prevent back strain from lifting patients and equipment; to minimize exposure to radiation and caustic chemicals; and to guard against infectious diseases. Home care personnel and other healthcare workers who travel as part of their job are exposed to the possibility of being injured in highway accidents. As one of the largest industries in 2008, healthcare provided 14.3 million jobs for wage and salary workers. About 40 percent were in hospitals; another 21 percent were in nursing and residential care facilities; and 16 percent were in offices of physicians. Healthcare jobs are found throughout the country, but they are concentrated in metropolitan areas. Healthcare firms employ large numbers of workers in professional and service occupations. Together, these two occupational groups account for 76 percent of jobs in the industry. The next largest share of jobs, 18 percent, is in office and administrative support. Management, business, and financial operations occupations account for only 4 percent of employment.

Other occupations in healthcare made up only 2 percent of the total. Professional occupations, such as physicians and surgeons, dentists, registered nurses, social workers, and physical therapists, usually require at least a bachelor's degree in a specialized field or higher education in a specific health field, although registered nurses also may enter through associate degree or diploma programs. Professional workers often have high levels of responsibility and complex duties. In addition to providing services, these workers may supervise other workers or conduct research. Some professional occupations, such as medical and health services managers, have little to no contact with patients. Health technologists and technicians work in many fast-growing occupations, such as medical records and health information technicians, diagnostic medical sonographers, radiologic technologists and technicians, and dental hygienists. These workers may operate medical equipment and assist health diagnosing and treating practitioners. These technologists and technicians are typically graduates of 1-year or 2-year postsecondary training programs. Service occupations attract many workers with little or no specialized education or training. For instance, some of these workers are nursing aides, home health aides, building cleaning workers, dental assistants, medical assistants, and personal and home care aides. Nursing or home health aides provide health-related services for ill, injured, disabled, elderly, or infirm individuals either in institutions or in their homes. By providing routine personal care services, personal and home care aides help elderly, disabled, and ill persons live in their own homes instead of in an institution. With experience and, in some cases, further education and training, service workers may advance to higher-level positions or transfer to new occupations.

4. Health economics and politics

Health economics is a branch of economics concerned with issues related to scarcity in the allocation of health and health care. Broadly, health economists study the functioning of the health care system and the private and social causes of health-affecting behaviors such as smoking. The USA health economics as a discipline, drew conceptual distinctions between health and other goals. Factors that distinguish health economics from other areas include extensive government intervention, intractable uncertainty in several dimensions, asymmetric information, and externalities. Governments tend to regulate the health care industry heavily and also tend to be the largest payer within the market. Uncertainty is intrinsic to health, both in patient outcomes and financial concerns. The knowledge gap that exists between a physician and a patient can prevent the patient from accurately describing his symptoms or enable the physician to prescribe unnecessary but profitable services; these imbalances lead to market failures resulting from asymmetric information. Externalities arise frequently when considering health and health care, notably in the context of infectious disease. For example, making an effort to avoid catching a cold, or practicing safer sex, affects people other than the decision maker. The scope of health economics is neatly encapsulated by Alan William's “plumbing diagram”. Dividing the discipline into eight distinct topics:

* What influences health? (Other than health care)

* What is health and what is its value

* The demand for health care

* The supply of health care

* Micro-economic evaluation at treatment level

* Market equilibrium

* Evaluation at whole system level; and,

* Planning, budgeting and monitoring mechanisms.

Consuming just fewer than 10 percent of gross domestic product of most developed nations, health care can form an enormous part of a country's economy. In 2008, health care consumed an average of 9.0 percent of GDP across the OECD countries with the United States (16.0%), France (11.2%), and Switzerland (10.7%) being the top three spenders. The United States and Canada account for 48% of world pharmaceutical sales, while Europe, Japan, and all other nations account for 30%, 9%, and 13%, respectively. United States accounts for the three quarters of the world's biotechnology revenues.

The politics of health care depend largely on which country one is in. Current concerns in England, for instance, revolve around the use of private finance initiatives to build hospitals which it is argued costs taxpayers more in the long run. In Germany and France, concerns are more based on the rising cost of drugs to the governments. In Brazil, an important political issue is the breach of intellectual property rights, or patents, for the domestic manufacture of antiretroviral drugs used in the treatment of HIV/AIDS. The South African government, whose population sets the record for HIV infections, came under pressure for its refusal to admit there is any connection with AIDS because of the cost it would have involved. In the United States 12% to 16% of the citizens do not have health insurance. State boards and the Department of Health regulate inpatient care to reduce the national health care deficit. To tackle the problems of the perpetually increasing number of uninsured, and costs associated with the US health care system, President Barack Obama says he favors the creation of a universal health care system. However, New York Times opinion columnist Paul Krugman said that Obama's plan would not actually provide universal coverage, and Factcheck.org alleges that Obama's predicted savings were exaggerated. In contrast, the state of Oregon and the city of San Francisco are both examples of governments that adopted universal healthcare systems for strictly fiscal reasons.

System health care it'll be notice that everywhere this system unique. For instance that in each country its try to change and create something new for greater efficiency system. Matter of experience foreign countries we must keep a check on that level of the health care in our country was high. For this it is necessary constantly to change and reform system health care. Necessary to search for the new ways of the diagnostics, treatments, new sources of the financing, prepare the more skilled personnel and introduce them in already existing system. The development of the system health care will raise the level of living as a whole.

References

1. http://www.bls.gov/oco/cg/cgs035.htm

2. http//:www.health-nn.com

3. http://www.gfk.ru/Go/Page?id=247

4. http://www.ft.com/indepth/us-healthcare-reform

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