The issue of health care has been a subject of discussion in many fora all over globe. This is as a result of the realization that the present changing times present serious challenges to the health care system especially because of the advent of many serious diseases and strains that have been a challenge to the medics.
More importantly, the role of the individual and governments in ensuring good health care has been at the centre of these debates. This is because of the need for personal responsibility in ensuring self health, as well as the constitutional rights to health care that individuals are conferred by their national constitutions.
The essence of this paper is to attempt to explore the situation of the global health care system with emphasis on the issue of inequality, economics and preexisting conditions in health care today. The various interventions that have been put in place to ensure equal access to health care services will also be discussed. The vision for health care in the 21st century will be discussed too, with particular emphasis on to what health care systems and specialists will be expected to do, so as to realize sustainability in the global health care system, one of the global millennium goals.
Health is wealth, so they say. This saying has been proven to be true in a number of arenas. Health care is an expensive affair, and even the wealthiest will spend up to the last dime, just to stay healthy. This means that a healthy person is wealthy since he is able to find means of survival and even create wealth as long as they are in good health.
Health care is a very important aspect of any government or community. This is because; a healthy nation is very productive. Many governments have always used the issue of health care as a core concept of their campaigns because of the importance of this issue in the society. If you look at any political manifesto, of any political party or even individuals aspiring for elective positions, health care will be first on the agenda. This is because healthcare is itself very expensive and any opportunity to have a government or leadership that effectively provides quality healthcare will endear it to the electorate and is likely to see the light of the day in terms of assuming power.
The Obama administration for instance fought for the introduction of the Obamacare. This was a policy that involved the use of taxpayers’ money for the provision of healthcare for all Americans. The proposal was of course opposed by a few elements but it managed to sail through and today, the average American is able to enjoy quality health care. The impact of this policy was also evidenced by the recent re election of the president for another four year term in tightly contested elections in November 2012.
The access to healthcare for other people across the globe is however not an easy thing. This is because as earlier stated, quality healthcare is very expensive and almost out of reach of the average citizen. The issues that have led to the inaccessibility of health care are known and the governments of the day have made attempts to intervene through different measures that shall be discussed later, but these issues have still persisted and effectively denied the poor and middle class, access to quality healthcare services.
Healthcare, just like any other commodity is affected by the forces of economics, which are demand and supply. Governments have to do a tradeoff between healthcare funds allocation and alternative uses of funds.
Healthcare is something that touches on everyone’s right, and at one point in time, all of us must have visited a doctor or even a dentist. The future of the healthcare insurance services of any nation seems to be one of the most important issues in the healthcare industry today yet healthcare is probably the most permanent crisis that humans have. There are always lesser beds in the hospitals and patient are sometimes forced to lie in corridors as they await treatment while politicians are busy arguing in parliament whether the government is doing enough to allocate resources in the medical services.
This is only explainable in the economics of healthcare or simply the concept of healthcare economics. This is a concept that tries to reason out why governments allocate a given amount of resources for the health care system.
Many countries and especially developing countries always live on a debt economy,. this means that a big chunk of their spending is financed by government borrowings either locally or abroad. The management of the country has an enormous responsibility to ensure the provision of basic essential services such as education, security, electricity, healthcare etc. this means that the government has to allocate the available scarce resources in the provision of diverse services to the citizens and this may effectively means that the healthcare system of the country gets grossly underfunded.
Developed nations such as the US, the UK, Japan and the recent entrant, China, have always attempted to improve the healthcare services of these nations but the issue of corruption crops in. the money never finds its intended use but is pocketed by a few individuals. The people in these areas are of course not able to afford expensive heath care services offered abroad.
This means that the people with a small amount of income will not be able to attain the quality healthcare that is a constitutional right under the first amendment of the US constitution.
The second issue that deserves mention and attention is inequality that abides in the health care system. Inequality has been a very serious issue that has had profound impact on the healthcare system in the world. The magnitude of inequality in the world is insurmountable.
The three richest people in the world control more wealth than over 600million who live in the world poorest nations combined. This appears farfetched but a closer look at the Forbes list of the richest in the globe and also the availability of global statistics shows the magnitude of the inequality that abides in our society today. This unprecedented inequality is one of the many factors that are pushing global health to the forefront of medicine today (Arrow.1963).
This rapid growth of economic inequality has been the culprit in fueling the extremely contrasting health conditions throughout the world. Simply put, the poorest of the poor have worst heath. In Africa for instance, quality heath is a preserve of the few rich people who are able to access the few available hospitals or even find alternative medication elsewhere. Africa for instance holds 12% of the world population, and by contrast, 25% of the world’s diseases according to the health economics website, healtheconomics.com. In a more serious context, Africa holds less than 3% of the global healthcare professionals, despite the many illnesses that are reported in the continent.
This issue has led to a more widened gap in the access of health care by the populations of different countries’ .This, according to researchers is evidenced by the high mortality rates in Africa compared to any other part of the world.
This social inequality is also rumored to lead to the growth of urbanization like never before. Its estimated that 22 cities in Africa will be expected to reach a population of more than 10 million people by 2020, 16 of which will be from developing nations (World Health Organization,2005). While some scholars believe that such growth in population would lead to concentration near health facilities, others believe that the most likely scenario would be the overcrowding and substandard housing and poverty. This is because of the likely growth of slums in this expanded population
Even at personal and or family levels, inequality is a major issue when it comes to healthcare. In most traditional societies, women are naturally homemakers, meaning that they stay at homes. This means that they do not bring in any income. This has made their spouses to take advantage of this and become abusive. The healthcare of the women is therefore put at great risk as a result of the domestic inequalities that are experienced, for instance, it would be pointless for a woman to go home and insist of protected sex with an abusive husband.
Their health is therefore out at risk as a result of the economic inequalities that abide between men and women and especially where the woman has been prevailed upon to stay at home. Such inequalities have actually led to the poor health of women, who mostly have to rely on their husbands for money to obtain health care services.
Lastly, we analyze the problem of preexisting conditions in the health care industry today and the reforms that are taking place to reverse the impact of problem of the preexisting conditions in the heath sector.
As an extension of the issue of inequality in the health sector, is the element of preexisting conditions in the healthcare industry. Healthcare givers and insurance industries are in the business of making profit. This means that they have to charge very high premiums while at the same time assuming very little risk.
The recent years have witnesses the ballooning of many ailments that take long to cure. Most of these are degerative diseases or what medics call lifestyle diseases. So serious is this issue of degenerative diseases that many nations are now beginning to take cognizance of the issue and invest adequately in the provision of healthcare and maintenance.
Some of the most serious pre existing conditions that medical insures consider in their premiums on admission, most of which are discriminative include, disabilities of many forms, people with cancer of HIV, Diabetes and other ailments.
In fact, when HIVAIDS Became a public issue, not a single insurer would cover anyone with such a disease as such a plan was bound to the bad for business. In fact, most insures will still screen you for any serious health issues before accepting a policy proposal by the client. This is because; such business may not be productive as it was believed that there was a very high probability that such a person would not live for long.
The present healthcare reforms in many countries have however attempted to bring out some element of a government intervention and reforms that is responsive to the plight of its citizens. For instance, the Obama administration has issued a number of proposals to help implement key provisions of the Patient Protection and Affordable Care Act going forward and this includes a provision that prohibits an insurance company from denying coverage based on preexisting conditions, even though these proposals is meant to take place in 2014
One of the goals of these reforms was to ensure that healthcare and insurance is fair to all patients and also physicians. The administration of Obama has issued three proposals to implement various provisions of affordable and unbiased healthcare to take effect in the year 2014. These rules and regulations that would help in addressing the issue of preexisting conditions in healthcare include
- A proposed rule that would prohibit insurance companies from denying coverage based on existing or even chronic ailments will effect from 2014. This effectively means that insurance companies will be forced by the law to admit and cover any individual, regardless of the preexisting conditions that persist.
This proposal also expanded to deny the insurance companies the opportunity to charge higher premiums to people because of their past medical history, present or past medical problems, gender, race, occupation, employer size or even industry.
The rules also propose an amendment that outlines the standards for coverage of essential health benefits so as to give consumers a way of comparison of the health plans in the markets. This proposed rule also confers the rights to ambulatory patient services, primary care services and also essential health benefits
The last rule proposes the implementation and expansion of employment based wellness programs that promote the heath of the staff and therefore have control over the healthcare costs.
Once implemented in 2014, these proposed rules will have an immediate impact in that primary care will be effective. For instance, the proposed rule that bars insurers from denying coverage based on preexisting conditions means that patients that live with these preexisting conditions will have it easier in the access of healthcare services, similarly, patients will be able to change jobs much comfortably without the fear of losing insurance coverage (Edwards,2001).
The rules that ensure that primary care as an essential health benefit are loudly applauded in the healthcare industry as patients are able to enjoy these services under the new proposals.
The third proposal that supports and expands the work place wellness programs and outlines the standards for nondiscriminatory wellness programs are helpful to all. For instance, the proposal says that the organization should for instance reward workers for not smoking or even attaining a certain weight target. These proposals will therefore ensure that family physicians have more resources to help patients to live a healthier lifestyle
A number of scholars have written widely about the issue of equal healthcare for all. Most of the studies have however been focused on the technical aspects of the current crop of diseases and the available Medicare but ignored other contagious issues.
Matthias Graf von der Schulenburg, an author and editor with the European journal of health economics appreciates that while there have been a lot of literature on the healthcare system, little has been done to address the issues that bedevil the global health system such as inequality, economics and the issue of preexisting conditions (Kaiser Family Foundation,2005).
Even the authors who attempt to research on this topic usually fail to appreciate the diverse nature of the countries and especially in relation to their legislative issues, economic factors and the like. This has resulted to rather shallow literature that fails to capture the existing context of these nations and the relationship of their healthcare systems and legislations as well as economic constrictions (Grossman,2004).
These pieces of work have also failed to realize that poor countries have complex intricacies that prevent the efficient administration of healthcare as a result of deliberate bureaucracies instituted by the ruling class to protect their selfish interests (Edwards, 2001)
Rich nations such as the US have always allocated a big chunk of their national budget to foreign assistance and mostly health related support but those funds never manage to reach the intended purposes and thus the weak healthcare system in the country.
Claudia Cardoso, in his famous article, health economics or healthcare economics?, attempts to explain the role of the economic system in healthcare. His findings led him to believe that the issue of economics in healthcare is one that is mostly understood. He goes on to demonstrate that health, just like any other commodity experienced demand and supply force of economics
Conclusion and recommendation
Healthcare is one of the most important aspects of any economy. This is because it affects the most important factors of production, the people. Governments and even organizations are working hard to enact laws and regulations that enforce the right to health for all people globally.
Amendments of the present legal and regulatory framework to allow for the adoption of the healthcare proposals of the Obama administration should be replicated in all countries so that all individuals are able to access free and non discriminatory health care system.
The realization of an efficient healthcare system will not however see its full potential unless the medical professionals are trained on the 21st century skills that are a great shift from the conventional technical knowledge of the 70’s and 80’s.
The role of the citizen and the government in attaining a world class healthcare system must also be underscored. This is because each and everyone has a duty to play in ensuring an affordable and efficient healthcare system
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