Political Instability-Challenges and OpportunitiesNon-governmental Organizations (NGOs) are essential as they fulfill a purpose that is traditionally addressed by a government (Balteanu & Marcu, 2
Required Resources week 6
Required Text
Lovett-Scott, M., & Prather, F. (2014). Global health systems: Comparing strategies for delivering health services. Burlington, MA: Jones & Bartlett Learning.
Chapter 15: Prevalence and Management of Behavioral Health Care
Chapter 16: Comparative Health Systems
Chapter 17: Conclusions and Future Leadership
Articles
Baumol, W., & Blinder, A. (1999). Economics: Principles and policy (8th ed.). Fort Worth, TX: Dryden Press.
Collins, T. (2003). Globalization, global health, and access to healthcare. International Journal of Health Planning and Management, 18, 97–104.
Flesner, M. K. (2004). Care of the elderly as a global nursing issue. Nursing Administration Quarterly, 28(1), 67-72.
Getzen, T. E. (2004). Health care economics: Fundamentals and flow of funds (2nd ed.). New York, NY: Wiley.
Lee, R. (2003). The demographic transition: Three centuries of fundamental change. Journal of Economic Perspectives, 17(4), 167-190.
Medicare Rights Center. (2011). The history of Medicare and the current debate (Links to an external site.)Links to an external site.. Retrieved from http://www.medicarerights.org/
Strunk, B., Ginsburg, P., & Banker, M. (2006). The effect of population aging on future hospital demand. Health Affairs, 25(3), 141-149. doi: 10.1377/hlthaff.25.w141
World Health Organization. (2011). Globalization (Links to an external site.)Links to an external site.. Retrieved from http://www.who.int/trade/glossary/story043/en/index.html
Recommended Resources
Textbook PowerPoint Presentations
Lovett-Scott, M., & Prather, F. (2014). Chapter 15: Prevalence and Management of Behavioral Health Care
. Burlington, MA: Jones & Bartlett Learning.
Lovett-Scott, M., & Prather, F. (2014). Chapter 16: Comparative Health Systems. Burlington, MA: Jones & Bartlett Learning.
Lovett-Scott, M., & Prather, F. (2014). Chapter 17: Conclusions and Future Leadership. Burlington, MA: Jones & Bartlett Learning.
Week Six Standard Guidance
The globalization of health services has moved to the forefront of national political discussions. According to the World Health Organization (2011):
Increased interconnectedness and interdependence of people and countries, is generally understood to include two interrelated elements: the opening of borders to increasingly fast flows of goods, services, finance, people, and ideas across the international borders and the changes in institutional and policy regimes at the international and national levels that facilitate or promote such flows (para. 1).
Balancing the increasing cost of quality health care and access for a country’s population has given rise to economic measurement of inputs and outputs to determine actual cost of health delivery. An aging population in countries around the globe adds to the growing list of health trends that have taxed health systems around the world.
Global healthcare systems today are growing at an unsustainable rate, while consumers on a worldwide basis are demanding more and better healthcare services. Integration and access to information, innovation, and entrepreneurship will play a growing role in aligning escalating demand with discovery and delivery of affordable, quality healthcare.
Globalization is a trend that has significantly affected many societies over the past few decades. The ability of globalization to provide all kinds of goods and services efficiently and effectively has extended into the field of health care. The health care systems in most industrialized countries are being challenged due to global trends such as decreasing economic growth, escalating costs, aging populations, advances in medical knowledge and costly technology, heightened expectations, and an increasing dependence on medicine to solve human problems.
In public health, as in other areas of international policy, a key challenge remains as to how to raise the quality of health care while increasing access, containing costs, and balancing local and global priorities. It is interesting to note that while globalization has increased, poverty, living conditions, and inequity between countries has, in many cases, worsened, resulting in poorer health around the world. As a result of globalization over the past decade, in some countries aggregate improvements in the standards of living have been reversed. For example, Collins (2003) noted in many countries of West Asia and sub-Saharan Africa, per capita income levels have fallen below their 1970s levels. Cornia stated that the rise in inequality was universal in the countries of the former Soviet Union, and common in Latin America and member states of the Organization of Economic Cooperation and Development (OECD), and in South Asia, South-East Asia, and East Asia (as cited by Collins, 2003).
Cost, Quality, & Access versus Consumer Satisfaction & Safety
While some regions have declined, the health services industry (public and private) has continued to grow. Multinationals, western private equity funds, and large companies have earmarked billions of dollars to invest in global ventures to build financial services, biotech, healthcare, and technology industries around the world.
The concept of production function was developed to help economists select the combination of inputs to produce the desired output at the least cost given the technology available (Baumol & Blinder, 1999). It is a comprehensive theoretical model that expresses the total, average, and marginal costs of a commodity, in this case health services, under a set of assumptions about the relationship between the inputs and outputs, cost of inputs, and available technology. In healthcare the production function may summarize the technical and clinical information about the relationship between an organization’s output (e.g. services rendered or effect on health of patients) and its inputs (e.g. health professional salaries, overhead cost, cost of supplies). In a production function, the input and output can be physical commodities such as patient-physician communication, customer service, or patient safety, where price and costs cannot be easily attributed.
A production function can be represented graphically or in a simple table. In a quadratic production function graph, the points above the function are unobtainable with the current technology, all points below the function are technically obtainable with the current technology, and all points on the function illustrate the maximum quantity of output obtainable at various specified input levels.
There are three stages to a production function graph. In the first stage, the input is being used with increased efficiency, ultimately reaching its maximum efficiency. In the second stage, the output increases and the inputs begin to decrease. In the third and final stage, the efficiency of both the input and the output begins to decrease. Optimally, profit outcomes are achieved at the boundary between stage 2 and 3 when there is a fixed input being used efficiently and the output is maximized.
The Aging Population
The aging population has become an international health care concern. According to Flesner (2004), the growth of the elderly population is "A 21st century phenomenon shared by many nations. . . ." (p. 70). The World Health Organization (2011) estimates the number of elderly people worldwide will reach more than 1 billion with over 700 million in developing countries. Oeppen and Vaupel stated "Trending from current age demographics indicate it is possible the life-span of a female could very well reach age 97.5 by mid-century and reach a high of 109 years by 2100" (as cited by Lee, 2003, p. 171).
The elderly population will affect the economies of virtually every country around the world through increased utilization of all kinds of health services. Baby-boomers will increase the ranks of the elderly from "12.4 percent in 2005, 14.5 percent in 2015 and culminate in 18.2 percent in the year 2025" (Strunk, Ginsburg, & Banker, 2006, p. 145).
Health systems are beginning to experience an increase in costs due to the higher disability rate of an increasing elderly population. The rise in procedures for a population that is living longer will undoubtedly continue to strain the financial resources of various payers. Additionally, Lee (2003) states:
Dramatic population aging is the inevitable final stage of the global demographic transition, low fertility rates, and long life. It will bring serious economic and political challenges. Nonetheless, life in aging, capital-intensive, and culturally diverse high-income countries should be pleasant, provided our institutional structures are sufficiently flexible to allow us to adapt our life cycle plans to the changing circumstances and provided we are willing to pay for the health care and the extended retirement that we apparently want (p. 187). In the United States, the legislation that led to the development of Medicare was driven by the rapidly aging society, rising cost of health care, the decline of the nuclear family, and the annual increase in cost of living. Passed on to the consumer as higher premiums and copayments and/or benefit reductions, these costs make health insurance unaffordable for many Americans, specifically older adults on fixed incomes (Medicare Rights Center, 2011).
References
Lovett-Scott, M., & Prather, F. (2014). Global health systems: Comparing strategies for delivering health services. Burlington, MA: Jones & Bartlett Learning.
