Guest Author:
Riley, Michelle
http://medicalstudentblog.co.uk
Due to significant changes in the mechanisms of financing, the entire healthcare system now faces significant challenges. The three most significant challenges are: the ability to service and fund public programs such as Medicare and Medicaid, controlling costs through managed care programs, and addressing the significant amount of under- or non-insured citizens.
During the economic recession, as well as during a healthy economy, it is important to carefully control costs and spending with Medicare and Medicaid programs. Medicare and Medicaid account for 18 and 16 percent respectively of healthcare payment sources.
Currently, those totals are even more significant due to job loss following the economic hardships as well as an aging baby boomer population. Both situations will put more stress on the system to care for increasing amounts of people; at the same time, the dire economic situation will cause less available funds to be put towards these services.
Managed care offers options for bundling medical services; offering advantages over fee-for-service plans. Managed care is a form of provider and patient healthcare behavior that allows for higher efficiency and lower costs; these methods are backed with financial incentives and organizational arrangements. While managed care was first designed to tackle the escalating healthcare costs, so far it has only had a minimal effect on negating the growing economic drain caused by healthcare costs. More pressure will be put on managed care systems to balance costs, especially due to the profound necessity of healthcare reform and the need to curtail rising costs.
The last of the most significant challenges faced by the healthcare system is dealing with the tremendous percentage of Americans who are uninsured. According to Williams and Torrens, 84.8 million total people were uninsured during the 1996-1999 period. Accordingly, 21% of healthcare payment sources are from out-of-pocket and other private sources. With limited financial mechanisms, there will be a tremendous stretch and a very difficult reorganization necessary in order to meet the need of so many.
It is important during the current climate where one of the forefront issues is healthcare reorganization to address these significant challenges resulting from the mechanisms of financing.
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